Traumatic brain injury (TBI) is a serious consequence of intimate partner violence (IPV) that is often overlooked. In the case of Indigenous women in Canada the challenges are broad, multidimensional, and left almost entirely unexplored. Given the elevated rates of violence and injury experienced by women exposed to IPV and the increased levels of physical assault among Indigenous women in Canada, it is important to understand the unique experiences and service needs of these women. This study sought to identify barriers and facilitating factors for TBI-sensitive service provision for Indigenous women experiencing IPV.

As part of a larger national stakeholder consultation process to develop a TBI educational toolkit for IPV service providers, input from Indigenous stakeholders was specifically sought to allow for insights into unique challenges and strengths related to this population. Interviews and focus groups were conducted with IPV direct-service providers, support professionals, and advocates working with Canadian First Nations and Inuit women.

Findings suggest that multiple intersections of marginalization, shame and stigma, and colonization, coupled with significant barriers to service provision in remote communities are such that solutions generated for urban-based settler populations are ineffective.

Recommendations include a widespread educational campaign to raise awareness of the seriousness of TBI among Indigenous women exposed to IPV. Education is particularly important among healthcare and direct service providers, survivors and their families and communities, legal professionals and child protection agencies, and Indigenous and settler government bodies. Future research should focus on expanding our understanding of this complex issue and developing culturally sensitive, community-based supports.

Adverse childhood experiences (ACE) exhibit long-lasting consequences on later life and are considered as a major public health problem. ACEs can be divided into household dysfunctions, which affect the child indirectly, and direct maltreatment. As a high correlation between ACEs in general is known, we assessed the risk for child maltreatment associated with the occurrence of household dysfunctions. To provide a better understanding for the mechanisms leading to the deleterious sequelae of ACEs, we furthermore assessed whether the long-term consequences of household dysfunction are mediated by child maltreatment and thereby might be targeted by effective child protection programs.

A representative sample of the German population above the age of 14 (N = 2531) was assessed in a cross-sectional observational population-based survey.

The data reveal that mental illness of a household member was associated with significantly increased risks for all child maltreatment subtypes (ORs 4.95–5.55), just as household substance abuse (ORs 5.32–6.98), violence against the mother (ORs 4.43–10.26), incarceration of a household member (ORs 6.11–14.93) and parental separation (OR 3.37–4.87). Child maltreatment partially mediated the association of household mental illness, substance abuse and parental separation with later depression, anxiety, life satisfaction and subjective general health status and completely mediated the associations of intimate partner violence (IPV) and incarceration of a household member with anxiety, depression and subjective health status in adulthood.

ACEs linked to household dysfunction are associated with an increased risk for all subtypes of child maltreatment. The assessed widespread consequences of household dysfunction are mediated by child maltreatment. This underlines the role of prevention of child maltreatment in families with household dysfunction and implies child protection as a priority in any interventions.

Women living in war-affected contexts face high levels of gender-based violence, including intimate partner violence (Stark & Ager, 2011). Despite well-documented negative consequences, including posttraumatic stress disorder (PTSD) (Garcia-Moreno et al. 2006; Steel et al. 2009), evidence remains thin regarding intervention effectiveness to mitigate consequences in these settings.

This study used a two-armed parallel pilot randomized controlled trial to compare the impact of a group savings only (control) to gender dialogue groups added to group savings (treatment) on women's symptoms of PTSD in northwestern Côte d'Ivoire. Eligible Ivorian women (18+ years, no prior experience with group savings) were invited to participate and 1198 were randomized into treatment groups.

In the ITT analyses, women in the treatment arm had significantly fewer PTSD symptoms relative to the control arm (β: −0.12; 95% CI: −0.20 to −0.03; p = 0.005). Partnered women in the treatment arm who had not experienced intimate partner violence (IPV) at baseline had significantly fewer PTSD symptoms than the control arm (β = −0.12; 95% CI: −0.21 to −0.03; p = 0.008), while those who had experienced IPV did not show significant differences between treatment and control arms (β = −0.09; 95% CI: −0.29 to 0.11; p = 0.40).

Adding a couples gender discussion group to a women's savings group significantly reduced women's PTSD symptoms overall. Different patterns emerge for women who experienced IPV at baseline v. those who did not. More research is needed on interventions to improve mental health symptoms for women with and without IPV experiences in settings affected by conflict.