Psychosocial Outcomes of IPV Interventions in Women With and Without Probable IPV-Related Brain Injury

Background: Between 33% and 75% of women who experience intimate partner violence (IPV) sustain an IPV-related traumatic brain injury (TBI). Although IPV-related TBI is associated with adverse psychosocial outcomes, its impact on response to healthcare-based IPV interventions remains unclear. Methods: Using data from a randomized clinical trial within the Veterans Health Administration, we examined psychosocial outcomes among 60 woman veterans with past-year IPV experiences participating in two brief IPV interventions: Enhanced Care As Usual (ECAU) and Recovering from IPV through Strengths and Empowerment (RISE). Results: At pretreatment, 21 women (35%) reported a history of probable IPV-related TBI. Multilevel modeling revealed no significant main or interaction effects of TBI history for self-efficacy, empowerment, patient activation, depression, physical health symptoms, or resilience. However, there was a significant interaction of time and probable IPV-related TBI history for valued living, such that women with probable IPV-related TBI history demonstrated greater initial gains followed by slight posttreatment decline; F(2, 76.55) = 2.96, p = 0.049. There was also a significant interaction between probable IPV-related TBI history, treatment condition, and pretreatment anxiety symptoms for anxiety symptoms as an outcome, such that women with probable IPV-related TBI history in the RISE condition, who had more severe anxiety symptoms at pretreatment, reported higher anxiety symptoms on average across the study period than women without probable IPV-related TBI history in RISE; F(1, 48) = 5.04, p = 0.029. Furthermore, there was a significant interaction of probable IPV-related TBI history and pretreatment physical health symptoms for physical health symptoms as an outcome, such that women with probable IPV-related TBI histories maintained higher physical symptoms from pretreatment to the last follow-up assessment; F(1, 134) = 8.99, p = 0.004. Conclusions: No evidence of differential treatment response was detected for women with and without probable IPV-related TBI history. Findings related to valued living and anxiety suggest areas where additional support may improve implementation of brief healthcare-based IPV interventions.