{
  "abstract": "Objectives To investigate the prevalence of probable traumatic brain injury (TBI) in a UK-wide female cohort of survivors of domestic abuse (DA). Further, to investigate the specific relative contribution of TBI to neurobehavioural outcomes, accounting for co-occurring psychosocial factors.Design Cross-sectional observational study.Setting Specialist DA services across the UK.Participants 60 adult female survivors of DA (mean age 35.6 years; median lifetime DA exposure 84 months), all of whom had experienced multiple forms of abuse.Main outcome measures TBI exposure assessed using the Brain Injury Screening Index (BISI). Neurobehavioural symptoms were evaluated alongside measures of depression and functional outcomes (eg education, employment or training status).Results 80% of participants reported at least one blow to the head and 73% reported both head impacts and non-fatal strangulation. 60% met criteria for a positive BISI classification, indicating a high likelihood of TBI. Neurobehavioural symptoms were highly prevalent across the cohort (82% of participants scored >12 on the Rivermead Post-Concussion Scale). Presence of physical abuse was associated with increased TBI severity ( t=25.4, p<0.001). Positive BISI classification (z=2.32, p=0.02) and self-reported loss of consciousness following head impacts (z=2.23, p=0.03) were independently associated with the presence of neurobehavioural symptoms. Additionally, repeated head impacts were associated with poorer functional outcomes, including not being in education, employment or training (OR=9.72, z=2.34, p=0.02) and with more severe depressive symptoms (OR=21.27, z=2.90, p=0.006).Conclusions This first UK-wide study of TBI in survivors of DA demonstrates a high prevalence of head impacts and probable TBI. Findings suggest that TBI contributes, at least in part, to adverse neurobehavioural outcomes in this population. Further research incorporating objective measures such as biomarkers and neuroimaging is needed to clarify the extent and mechanisms of TBI-related impairment within this complex and vulnerable group.",
  "authors": [
    {
      "affiliations": [
        "Brain Sciences, Imperial College London, London, UK",
        "UKDRI CR&T at Imperial College London and University of Sussex, UK"
      ],
      "name": "Lucia M Li"
    },
    {
      "affiliations": [
        "Brainkind, Burgess Hill, UK"
      ],
      "name": "Stephanie Bechelet"
    },
    {
      "affiliations": [
        "Brainkind, Burgess Hill, UK"
      ],
      "name": "Annmarie Burns"
    },
    {
      "affiliations": [
        "Brainkind, Burgess Hill, UK"
      ],
      "name": "Sara da Silva Ramos"
    }
  ],
  "title": "Cross-sectional study of traumatic brain injury in women who have experienced domestic abuse",
  "uid": "ea982b72-13a6-5256-9d9e-16ce95eca515"
}