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To See or Not to See: Concussions Behind Closed Doors  

Author:  Eve Valera, Ph.D..

Source: Volume 25, Number 03, February/March 2020 , pp.47-50(4)

Domestic Violence Report

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Concussions that occur behind closed doors, and possibly in such a way that no marks are left behind, may go completely unrecognized. As a result, post-concussive symptoms and behaviors may be misinterpreted and left untreated. It is my belief that this may be the case for many women sustaining concussions or mTBIs from IPV. Because IPV usually occurs “behind closed doors,” the hit or force to the head is typically not observed by any outsiders (in contrast to what occurs in athletics where many people observe it). Also, as brain injuries can occur with no visible external injuries, there may be no evidence (unlike my case above) that a brain injury has occurred. What is ultimately observable are a range of post-concussive symptoms1 that could easily be misinterpreted as intoxication, untruthful, unreliable and/or uncooperative behavior, non-compliance, and laziness (among others). For women who have sustained IPV-related mTBIs, misinterpreting behaviors as such can have serious implications for recovery as well as shelter assistance and legal decisions. This article examines ways in which relevant stakeholders—including legal, judicial, law enforcement and social work personnel—should and can consider the possibility of IPV-related TBI in every woman who has experienced IPV.

Keywords: Mild Traumatic Brain Injuries (mTBI); Assessing Alteration in Consciousness (AIC)

Affiliations:  1: Harvard Medical School and Massachusetts General Hospital.

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