Violence-related mild traumatic brain injury in women: identifying a triad of postinjury disorders.

Violence against women whether from domestic partner abuse, sex trafficking injuries, or sexual assault is a pervasive health problem without racial or social boundaries. Regardless of cause, violence results in a complex triad of physical, emotional, and psychological injuries. There is clear evidence that female victims of violence or "battered women" experience brain injury. What is less certain is whether the constellations of events surrounding brain injury including postconcussion syndrome, depression, and posttraumatic stress disorder are acute symptoms after the brain injury, premorbid as a result of persistent abuse, or a synergistic triad of combined disorders as a result of the injuries. The purpose of this article is to examine the relationship between physical violence-associated mild traumatic brain injury (MTBI) and postinjury cognitive, emotional, and psychological disorders. The review of the literature addresses epidemiological factors associated with domestic partners and sexual violence, abuse and health outcomes in women, physical injury, and its consequences. Along with MTBI, a triad of disorders is hypothesized that includes postconcussion syndrome, depression, and posttraumatic stress disorder. Screening for MTBI and the triad of disorders is advocated, and assessment methods are offered.