Strangulation as an Acquired Brain Injury in Intimate-Partner Violence and Its Relationship to Cognitive and Psychological Functioning: A Preliminary Study.
Eve M Valera, Julia C Daugherty, Olivia C Scott and 1 others
PMID 34985030WHAT IT FOUND
Women with a history of strangulation-related loss of consciousness performed worse on memory tests and reported higher PTSD and depression than those without such history.
These differences persisted even after accounting for other brain injuries, suggesting specific cognitive and psychological consequences of strangulation.
Key findings
01Women who had experienced strangulation-related alteration in consciousness performed more poorly on long-delay free recall and showed a trend for poorer digit span performance compared to controls.
02After controlling for confounds including mild TBIs and childhood abuse, the difference in long-delay free recall and PTSD symptomatology remained significant, and the difference in digit span became significant.
03Women who experienced strangulation had higher ratings of anhedonic depression and PTSD symptomatology relative to women who had not experienced strangulation.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study was a secondary analysis not originally designed to test these specific hypotheses. The sample size was very small (52 total, 15 in the strangulation group), limiting statistical power and the ability to detect smaller effects. The Brain Injury Severity Assessment (BISA) used to identify strangulation-related AICs lacks established psychometric properties. Data on strangulation and brain injury history relied on self-report, which is subject to recall bias. The same researcher collected both interview and cognitive data for most participants, which could introduce bias. The study could not control for abuse severity directly because strangulation is an extreme form of abuse and is included in abuse severity measures; thus, it is unclear if outcomes are due to strangulation specifically or the overall severity of violence. The study did not examine whether effects were moderated by race or ethnicity, despite known disparities in strangulation risk.
Declared interests
The research was supported by the National Institute of Justice (grant 96-IJ-CX-0048) and the National Institute of Mental Health (grants MH57343, MH59206, and MH01733). The authors declared no conflicts of interest.
The easy way to misread this
Do not assume that all cognitive or psychological difficulties in IPV survivors are due to strangulation alone. This study found associations, not causation, and could not separate the effects of strangulation from the overall severity of abuse. Additionally, the small sample size and lack of psychometric validation for the assessment tool mean these findings are preliminary and require replication in larger studies.