New study explores extent of brain injuries in victims of domestic violence in Canada

Original Article: Melanie Green  |  The Star Vancouver  |  April 18, 2018  |

VANCOUVER— Though in recent years medical science has been uncovering the damaging effects of traumatic brain injury for professional athletes and the military, a UBC researcher is now gathering data on head trauma in a much-less-highlighted group: survivors of domestic violence in Canada.

The goal of the study is to gather statistics that will eventually lead to protocols to help treat and support women who have suffered concussions and other brain injuries at the hands of their partners, said the study’s author, neuroscientist and health professor Paul van Donkelaar.

“That work has changed the way we approach sports concussion,” he said. “Coaches, athletes, parents are way more aware, and we’ve had huge changes in that conversation and way we approach that at the early stages.”

Van Donkelaar said there are some 400,000 concussions a year in Canada from contact sports — and roughly 100,000 women a year in Canada who suffer traumatic head injuries.

“This is a hugely under-served and understudied population,” he said,

The study collected information from 40 participants: a questionnaire looking at emotional challenges then sensorimotor and cerebrovascular assessments with blood draws to measure various markers of brain injury. Plans are to submit completed research for publication by the end of summer.

The idea for the study came from an early dating conversation with now-life-partner Karen Mason.

Van Donkelaar had been conducting research on sports concussions for years. Mason was the director of Kelowna Women’s Shelter.

“The focus is so strong in sports and yet we have women who make up half the population,” Mason told the Star, estimating that at least one in three women will be subject of some form of intimate partner violence. “It just made sense to look into it.”

At the Kelowna shelter, Mason and her staff found women could not accomplish tasks such as finding housing, employment or chores, she said. Day after day, they just didn’t have the capacity to move forward.

“We expect women to parent their children effectively,” she said. “We expect them to remove themselves from abusive relationships and hold down jobs. And yet there aren’t dedicated services in place.”

Mason wondered if TBI was part of the problem, especially since frontline services are not trained in assessment, symptoms or treatment of brain injuries.

But there is little data in Canada linking the two, Van Donkelaar said, and the topic has gone largely unexplored. “It’s not surprising survivors of intimate partner violence just can’t do tasks,” he said. “TBI isn’t taken into account.”

The impacts of TBI’s range from headaches, double vision, memory loss, deficits in learning and difficulty completing tasks.

The stigma associated often leads survivors to return to their abuser over and over again, which van Donkelaar said increases the likelihood of multiple head injuries.

“Researching this population can be challenging,” he said.

And unlike athletes, survivors of intimate partner violence experience emotional difficulties such as PTSD, depression or anxiety. Also unlike athletes, there are typically no witnesses with domestic violence, meaning diagnoses aren’t made.

Collaborating with the shelter was a huge advantage because survivors there “are committed to the reality that their partner has been abusive to them,” he explained.

There is no doubt that brain injuries are associated with intimate partner violence, said Michelle McDonald, the executive director of Brain Injury Canada. “Many times they go for the head area because it makes the most impact,” she told the Star. “It’s becoming an increased area of interest.”

McDonald said the numbers aren’t there because incidents go unreported or the correlation isn’t made between the act and the brain injury.

When left untreated, symptoms can lead to depression, anxiety, financial stress, unemployment or even a family breakdown when other parties can’t understand why the survivor won’t get better, she added.

But the research is only as important as the next steps, said Angela Marie MacDougall, executive director of Battered Women’s Support Services.

Every week a woman in Canada is killed by her partner, according to BWSS statistics. More than 86,000 victims of violence by a spouse or family member was reported in 2017, according to Statistics Canada.

“We’ve talked to women who have had neck and face injuries. That includes detached retinas, broken bones in the face, loose and missing teeth,” MacDougall said.

Looking at the overlapping health outcomes still does not address prevention. But the research gives a deeper understanding of the social and cultural pressures that are barriers to women dealing with abuse, she added.

Really preventing violence takes a community-based response, not just putting resources into policing.

And organizations do a lot with little resources, she added. Dispelling the idea that intimate partner violence is a private issue would make it harder for abusers to continue their behaviour. She said it’s about community accountability.

“These are social problems and the only way we will solve them is through our relationships with our community,” MacDougall said. “We should continue to build more of a helping culture for women while also holding those that impose violence accountable for their behaviours. That matters.”

The research, which began in June last year, comes on the heels of the national Prevention of Violence Against Women Week running from April 15-21.