| Jackson, H., Philp, E., Nuttall, R.L. and Diller, L. (2002).
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| "Traumatic brain injury: A hidden consequence for battered women.
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| Professional Psychology: Research and Practice, 33, 39-45.
There is much overlap between the psychological symptoms created by
battering and those caused by mild traumatic brain injury (MTBI). For
example, some symptoms that may be the result of either condition
include problems with concentration, confusion, poor judgment,
difficulty with attention, problems with decision making, headache,
memory problems, depression and pervasive feelings of being
overwhelmed. The purpose of this study is to determine just how many
battered women who suffer from MTBI are mis-diagnosed with
psychological disorders.
The authors study 53 women, 36 who are living in shelters and 17 who
are attending a community outreach program. Their average age is 30
years old. Forty five percent are married, 26% are single and 21% are
separated or divorced. Sixty percent are African Americans, and 28%
are Hispanic. One third have less than a high school education, 21%
have attended college and 86% are unemployed.
The authors interview the women and evaluate them using a well
researched check list of thirteen symptoms for MTBI. They make sure to
include only those women who are most likely to have suffered a head
injury.
Of the 53 women they interview, 49 have a history of being hit in the
head or face during partner violence from 2-5 times. Thirteen of the
women have been hit more than 20 times in the past 5 years. (See our
next Digest for an article on why battered women return to abusive
relationships.)
"In summary, roughly half of the women reported about half of the
thirteen symptoms one or more times a day" (p.42). In addition, "They
may not recognize their symptoms to be a result of their injuries and
consequently are unlikely to seek treatment for head trauma immediate
to an assault" (p.41).
CRITICAL ANALYSIS
It is hard to know whether the authors have a representative sample of
battered women. It may be that only the most severely battered women
go to shelters. In this case, their estimates of MTBI may be too
high. On the other hand, it may be that only those who are less
severely injured are able to extricate themselves and seek assistance.
If this is true, their estimates might be too low. Because we cannot
know the answer, it hard to generalize from this one study to the
population as a whole.
Another problem is that the authors are unable to separate the women
who only have a psychological disorder from those who have MTBI,
because the percentage of women in their sample who suffer head injury
is so high. Therefore, the study does not give us any guidance as to
how to distinguish between the two groups.
RECOMMENDATIONS
This is an important study because it is the first we are aware of
that examines the problem of MTBI in a sample of battered women. At a
minimum it alerts the family law community to the existence of a
serious problem that has received very little attention in the past.
If the findings of this study are supported by future research, it
will force us to conclude that the percentage of battered women who
suffer from MTBI is far higher than we had previously assumed.
Finally, one should never make definitive conclusions based on one
study. Nevertheless, these findings are sufficiently compelling that
evaluators should routinely investigate MTBI in those cases where
women complain of prior abuse due to the relevance it may have on
decisions regarding custody.
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