Cognitive Functioning and Mental and Behavioral Health in Women Survivors with and without Traumatic Brain Injury Due to Intimate Partner Violence

Women survivors of intimate partner violence (IPV) experience increased risk for traumatic brain injury (TBI) due to partner abuse, but few studies have examined cognition and mental and behavioral health outcomes among women with IPV-related TBIs. This pilot study examined differences in cognition, neurobehavioral symptoms, mental health symptoms, chronic pain, alcohol use, and social functioning between women survivors with and without repetitive IPV-related TBIs. Women with 2 or more IPV-related TBIs (n = 33; M = 36.5 years old, SD = 9.4; 63.6% White) were compared to women survivors without IPV-related TBI history (n = 22; M = 34.4 years old, SD = 10.3; 77.3% White) on the Rey Auditory Verbal Learning Test, NIH Toolbox Cognition Battery, and mental and behavioral health questionnaires. Women with repetitive IPV-related TBIs had greater cognitive concerns (one-tailed p = .006, d = 0.71), lower verbal learning (p = .045, d = 0.47) and delayed memory test scores (p = .034, d = 0.51), and reduced fluid cognition compared to estimated premorbid functioning (p = .035, d = −0.51), particularly executive functions (p < .001, d = −1.01). Women with IPV-related TBIs also had greater neurobehavioral (p = .003, d = −0.78), post-traumatic (p = .003, d = −0.75), depressive (p = .038, d = −0.50), and anxiety-related symptom severity (p = .047, d = −0.44). Women with IPV-related TBIs had worse pain intensity (p = .003, d = −0.79) and interference (p = .001, d = −0.87), greater social isolation (p = .002, d = −0.84), and less emotional support (p = .002, d = 0.80). Per adjusted analyses, group differences in delayed memory (p = .025, ηp2 = 0.08) and reduced fluid cognition (p = .012, ηp2 = 0.10) remained significant after controlling for comorbid mental and behavioral health conditions. Repetitive IPV-related TBIs were associated with worse objective cognitive performances and worse mental, behavioral, and social health. These pilot results require replication but indicate that women with IPV-related TBIs experience multidimensional health needs. In practice, women with IPV-related TBIs may benefit from psychological or neuropsychological assessments evaluating cognition, mental health, pain, substance use, and social support to characterize the health needs of survivors and inform treatment planning.