Is this domestic violence?

Reading through another painful recounting of abuse, I let out a sigh as the message ended with the same question I had seen so many times before: “Is this domestic violence?” I spent the summer of 2021 working at a domestic violence shelter to review non-emergent online messages. Some writers came asking for resources, other for advice, some concerned for a friend. But what surprised me most was how many people were simply trying to understand what they had lived through—asking, in one way or another, if what happened to them was truly abuse. And the answer was almost always yes.
All of us are familiar with the term domestic violence and likely have a picture in mind when asked what it means. But what about the partner who has loved you for years? The one who cuts you off from your friends and finances so slowly you don’t even notice? The one who twists your words so subtly that you start to doubt your own memories? One day you are making a romantic dinner together and the next, they pushed you into a wall. But it was an accident, or it was a bad day, and they love you. Or one time they shook you so hard that you see stars and you can’t remember what happened after that—maybe it was a concussion or maybe you’re just forgetful, like your partner keeps telling you.
There are so many forms abuse can take and when it’s happening to a friend, or even to ourselves, it can be hard to recognize. The more we speak out, the more we share, the easier it becomes for others to recognize abuse for what it is. And often, the simple act of naming something can be the first step toward making a change.
Author: Dr. Rachel Plouse, M.D.

mental health march: Barriers to brain injury care

This past March, SLS hosted our annual 5K - Your Way Fundraiser, with the theme being mental health in brain trauma. I personally had an amazing time running with the UChicago Neuro Club to Lake Michigan, all the while raising awareness of this vital and often overlooked issue.
Brain injury and mental health are deeply tied to one another, with even mild brain injuries associated with a range of psychiatric disorders and symptoms including suicidality, posttraumatic stress disorder (PTSD), and major depressive disorder (Howlett et al., 2022). The combination of psychological trauma along with physical
brain dysfunction makes these symptoms difficult to identify and comprehensively treat.
This is especially true for our most vulnerable populations, such as domestic and intimate partner violence survivors. Studies have shown that survivors with TBI are consistently associated with greater mental health burden, particularly when it comes to PTSD (Cimino et al., 2019). Despite this, our understanding of how TBI affects mental health in survivor populations is severely lacking (Toccalino et al., 2023). Indeed, findings from SLS’s needs assessment, a survey which sought to understand the gaps in knowledge and support for professionals who work with survivors, found that many providers—including psychologists, domestic violence advocates, and social workers—are uncomfortable in identifying signs and symptoms of brain injury. This is despite the high prevalence of brain injury in the survivor populations they work with, suggesting areas for improvement and potential for collaboration (Poon et al., 2024).
It is imperative for Safe Living Space as we move forward to continue pursuing holistic solutions, addressing the complex needs of survivors impacted by social, psychological, and physiological factors all at once. As we push for change, we hope you will join us and our community of advocates to create a better, safer, and more caring world for all individuals.
Author: Jack Poon

current research projects

• Homelessness as a Risk Factor For Repetitive Head Injury 

• Implications of Brain Injury Secondary to Intimate Partner Violence

• Traumatic Brain Stem Injury

• Differences in TBI-associated PTSD vs. non-TBI PTSD

• Axon Death vs. Neurofibrillary Tangle Following Repetitive Brain Trauma

• Repetitive Head Trauma as a Risk Factor for Incarceration in the Military Population

• Strangulation as a Physiological Risk Factor for Multiple Sclerosis

• Implementing Brain Injury Screening Tools in Domestic Violence and Homeless Shelters

• Establishing Case Law for Civil Cases and Personal Injury

Recognizing the prevalence of domestic violence and teen dating violence among high school students and how strangulation plays a role in TBI

Teen dating violence (TDV), which includes physical, emotional, and sexual or psychological abuse (Centers for Disease Control and Prevention [CDC], 2023) is an often overlooked cause of trauma and brain injury.  According to the 2021 Youth Risk Behavior Survey, which estimates the prevalence of interpersonal violence reported by U.S. high school students, 8.5% of students reported experiencing physical TDV and 9.7% reported sexual TDV. 11.0% of students reported experiencing sexual violence by anyone, with more than half of these cases being sexual teen dating violence. (Clayton et al.). One particularly dangerous yet often overlooked form of physical abuse is strangulation, which may leave few visible signs but carries serious consequences, including brain injury. (Foshee et al., 2011).
Strangulation is a deadly form of abuse that poses serious risks for traumatic brain injury (TBI), especially in teens whose brains are still developing. Among teens aged 12 to 18, the National Survey on Teen Relationships and Intimate Violence reported 63% intimate partner violence (IPV) perpetration and 69% victimization rates, with 10% of those individuals having experienced serious threats and physical violence, including choking  (Bush, 2020). Pressure to the neck, even for only a short moment, can compress blood vessels and/or the airway, obstructing circulation of oxygen and blood. Limiting the supply of oxygen and essential nutrients to the brain can lead to problems like strokes and injury to the brain, such as poor short-term memory, difficulty learning new things, struggling to get organized or motivated, and problems with focus and attention. The symptoms of the brain injury and cumulative brain injuries can often look like mental health issues, including anxiety, PTSD, depression, and substance abuse. It takes only a few seconds of strangulation to do irreversible damage, both physically and psychologically. (Dunn, RJ. et al, 2025). As for survivors of strangulation, research shows that it is one of the strongest predictors of future homicide, and victims who experience strangulation are seven times more likely to be killed by their abuser (Glass, N. et al, 2008).
It is important to recognize dating violence in teenagers early on in order to prevent life-altering risks of TBI or other physical and mental effects, and to stop ongoing harmful relationships from escalating to something fatal. Some warning signs that a teen may be experiencing DV include changes in mood or social habits, frequent headaches, dizziness and/or light sensitivity, changes in school performance, unexplained injuries or “accidents,” and fear or anxiety when talking about their relationship. It is imperative to identify the causes and contributing factors that increase the risk of violence among teens, such as exposure to violence in their homes, a lack of education about healthy relationships, violence in the media, and limited adult involvement or awareness. (Foshee et al., 2011) 

Educating teens and young adults on what an abusive relationship might look like can help victims understand and speak out about their personal experiences.  Incorporating safety screens and TBI assessments into medical visits for injuries is an important way to identify young people at risk for further violence. Raising awareness about teen dating violence red flags, such as signs of strangulation or symptoms of traumatic brain injury, often overlooked in young victims of abuse, will prevent further injuries to the brain and save lives.    
Author: Elah Case