Traumatic Brain Injury and Domestic Violence

Quick guide logo

What is the connection between domestic violence and brain injury?

A cause of brain injury that has been under-reported and under-researched is domestic violence. Domestic violence, also known as intimate partner violence, is a pattern of abusive behavior in any relationship that is used by one partner to gain or maintain power and control over another intimate partner. Domestic violence can be physical, sexual, emotional, economic, or psychological actions or threats of actions that influence another person. Domestic violence can happen to anyone – it affects people of all ages, genders, races, and socioeconomic classes.

How big is the problem?

Current data on the intersection between domestic violence and TBI is limited in part because little research has been done on this population and because many instances of abuse go unreported by victims. The research we do have consistently indicates widespread problems:

Why is the connection to TBI and domestic violence often overlooked?

Because domestic violence is a pattern of abuse, victims are typically exposed to repeated instances of violence, which includes traumatic brain injuries. The effects of repeated brain injury are cumulative and not unlike those experienced by athletes who have had multiple concussions.

In domestic violence situations, due to emotional and physical trauma, survivors often experience depression, anxiety, tension and/or inability to adapt to changing situations. Survivors may also appear to have behavioral issues, including problems with keeping appointments, following through, or completing tasks that require multiple steps. Sometimes these problems are the direct result of a brain injury. Determining whether these symptoms and behaviors are due to a TBI or the result of emotional trauma, or BOTH, can be difficult.

The intersection of TBI and domestic violence is also complicated by the fact that violence is not only a cause, but a consequence of TBI. Specifically, TBI-related cognitive and behavioral problems can also result in aggressive behavior that leads to perpetration of violence, or a lack of insight and judgment, and resulting vulnerability, that can lead to victimization. While a TBI can be a contributing factor to aggressive behavior, it does not cause or excuse patterns of abuse.

To treat the whole person and not just one symptom or behavior, service providers across health and social services need more education, training, and resources to recognize that the pattern of symptoms following abuse may include a brain injury.

What are some noticeable signs of (mild/moderate) TBI and domestic violence?

Remember, sometimes there are no visible or obvious signs of TBI or domestic violence. Signs of TBI and domestic violence can include:

  • Loss of consciousness for a few seconds to a few minutes More frequently, there is no loss of consciousness, but a state of being dazed, confused or disoriented
  • Headache
  • Nausea or vomiting
  • Fatigue or drowsiness
  • Problems with speech
  • Difficulty sleeping or sleeping more than usual
  • Dizziness or loss of balance
  • Memory or concentration problems
  • Mood changes or mood swings
  • Feeling depressed or anxious
  • Withdrawn
  • Bruising
  • Substance abuse
  • Suicide attempts

Service providers should keep in mind that brain injury can make it harder for a victim of domestic violence to:

  • Assess danger and defend against assaults.
  • Make and remember safety plans.
  • Go to school or hold a job (increasing financial dependency on the abuser).
  • Leave an abusive partner
  • Access services
  • Adapt to living in a shelter/residential program for victims of violence. The person may become stressed, anxious and confused or disruptive, or have trouble understanding or remembering shelter procedures.
  • The signs and behaviors associated with TBI and domestic violence can look very similar – the impact of physical and emotional violence on the body and mind is complex. That’s why practicing trauma-informed care when interacting with survivors is key.

Brain injuries can be life-threatening. If you have been injured, call 911 and seek medical help immediately.

If you need help creating a safety plan in order to seek medical care, call the Statewide Hotline for Family Violence and Sexual Assault, or use their chat feature. 1.800.828.8238 


Download Acrobat Reader here for free to read PDF Files

Accessibility Project e-learning modules for domestic violence and sexual assault service providers.

Directory of Brain Injury Community Resources and Supports in Virginia

Virginia Sexual and Domestic Violence Action Alliance- Phone Number 800.838.8238

 Statewide Hotline for Family Violence and Sexual Assault or Chat 

Directory of Sexual & Domestic Violence Service Providers in Virginia

Virginia Department for Aging and Rehabilitative Services Brain Injury Services Coordination Unit

Centers for Disease Control and Prevention

Understanding Protective Orders in Richmond, VA

Printable version of Traumatic Brain Injury and Domestic Violence Quick Guide

Read More Quick Guides

Content Resources:

U.S. Department of Justice

2017 Annual Report Domestic and Sexual Violence in Virginia, Virginia Office of Attorney General.  

Assessment and Treatment of Brain Injury in Women Impacted by Intimate Partner Violence and Post-Traumatic Stress Disorder, The Professional Counselor. Trish J. Smith, Courtney M. Holmes. 2018.

Breaking the Silence: Violence as a Cause and a Consequence of Traumatic Brain Injury. Brain Injury Professional Magazine. Jean Langlois, ScD, MPH

Domestic violence often leads to traumatic brain injury. Dr. Ann Marie Warren.  

National Coalition Against Domestic Violence

Breaking the Silence: Violence as a Cause and a Consequence of Traumatic Brain Injury. Jean Langlois, ScD, MPH, Brain Injury Professional Magazine

 Mayo Clinic. 

[1] New York State Office for the Prevention of Domestic Violence. Domestic Abuse and Traumatic Brain Injury Information Guide