Screening for History of Traumatic Brain Injury Among Women Exposed to Intimate Partner Violence

Traumatic brain injury (TBI) is a common chronically debilitating consequence of intimate-partner violence (IPV). Diagnosis and effective treatment are precluded by poor detection and lack of uniform practice guidelines for TBI screening in IPV. Although there are several TBI-screening tools commonly used in clinical and research practices, their applicability to this unique and vulnerable population is unclear. In this review paper, we propose a theoretically based framework for screening for history of TBI in women exposed to IPV and apply it to investigate the applicability of TBI-screening instruments. The framework was developed by examining existing guidelines for working with IPV survivors and applied to evaluate the content of nine currently available TBI screening instruments to determine the extent to which each offers (1) events that can lead to TBI in an IPV situation; (2) safe (without increasing the risk of retaliation) endorsement of an event; and (3) ease of administration. Our evaluation of the currently available TBI-screening tools determined that no instrument met the proposed framework standards and only 2 (Brain Injury Screening Questionnaire and Ohio State University TBI Identification Method) came close, requiring only minor adjustments to meet the postulated criteria. We make specific content and interview-based recommendations for revising TBI screening instruments to minimize the weaknesses of currently available screening tools among women exposed to IPV and the knowledge gaps about TBI in this context. The proposed framework and recommendations are intended to guide future work in this area to enhance the capacity of TBI screening tools to safely detect TBI in this population.