INS NYC 2024 Program

Poster	Poster Session 03 Program Schedule 02/15/2024 09:30 am - 10:40 am Room: Shubert Complex (Posters 1-60) Poster Session 03: Neurotrauma \| Neurovascular Final Abstract #11 Interpersonal Violence Among Individuals with and Without TBI During the COVID-19 Pandemic: A Nationwide Survey Study Emily Blunt, Icahn School of Medicine at Mount Sinai, New York, United States Brittany Engelman, Icahn School of Medicine at Mount Sinai, New York, United States Annell Ovalles, Icahn School of Medicine at Mount Sinai, New York, United States Lisa Spielman, Icahn School of Medicine at Mount Sinai, New York, United States Nancy Chiaravalloti, Rutgers New Jersey Medical School, Newark, United States Candace Robledo, University of Texas Rio Grande Valley, Edinburg, United States Anthony Lequerica, Rutgers New Jersey Medical School, Newark, United States Jay Morrow, UT Southwestern Medical Center, Dallas, United States Michael Machiorlatti, University of Texas Rio Grande Valley, Edinburg, United States Kristen Dams-O’Connor, Icahn School of Medicine at Mount Sinai, New York, United States Category: Acquired Brain Injury (TBI/Cerebrovascular Injury and Disease - Adult) Keyword 1: traumatic brain injury Keyword 2: brain injury Keyword 3: self-report Objective: Individuals living with traumatic brain injury (TBI) are at elevated risk of violence and may be more susceptible to abuse. Social isolation measures during the COVID-19 pandemic may have increased the risk of interpersonal violence, particularly among vulnerable populations. We aimed to compare the prevalence of self-reported abuse in individuals with TBI and a community-based sample (CS) during the COVID-19 pandemic and investigate the implications of gender and financial strain. Participants and Methods: Adults with TBI were recruited from NIDILRR-funded TBI Model System centers from August 2020 to May 2021. The University of Texas Rio Grande Valley recruited non-institutionalized community-based adults from April 2020 to May 2021. Participants completed an online survey to investigate the impact of the pandemic on health, care access, and well-being. An adapted four-item Hurt Insult Threat Scream (HITS) tool assessed the frequency of physical and verbal abuse perpetrated by anyone, including family. Items are scored on a 5-point Likert scale (1=Never; 5=Frequently) with total sum scores ranging from 4-20. A self-report survey asked participants to describe their current financial situation, and we dichotomized responses to create financial strain and low/no financial strain groups. We used t-tests for continuous measures and Chi-squared tests for categorical measures. We fit linear regression models to assess the association between TBI and abuse adjusting for age, sex, and household financial strain. Results: In this nationwide sample of individuals with mild-severe TBI (n=1,596; mild[46.4%], moderate[21.2%], severe[32.4%]) and CS (n=2,986), those with TBI were younger (39.8±13.9 vs. 44.0±12.3 years) and predominantly male (TBI 62.1% vs. CS 9.8%). On average, individuals with TBI reported a greater frequency and range of abuse (mean sum score 7.4±3.3) than CS (5.0±1.6) during the pandemic (t(1733.8)=24.8, p<.0001). Mean group differences in reported abuse remained after adjusting for age and sex (R²=0.21, F(3,3606)=316.8, p<.0001, ß=2.1, 95% CI: 1.93-2.33). Individuals with TBI reported higher rates of physical and verbal abuse compared to the CS. Most notably, only 45.8% of the TBI sample endorsed “Never” when queried about frequency of physical abuse compared to 97.2% of the CS (X²=1328.8, p<.0001). There were no differences in overall frequency of abuse between males and females in either group. A greater proportion of individuals with TBI (30%) compared to CS (13.9%) reported household financial strain (X²=141.1, p<.0001). The frequency of abuse was greater among those who indicated financial strain regardless of TBI (t(1002.8)=-6.60, p<.0001). A significant difference in mean level of abuse remained after adjusting for age, sex, and financial strain (R²=0.21, F(4,3587)=240.0, ß=2.1, p<.0001, 95% CI: 1.91-2.32). Conclusions: This study elucidated alarming rates of abuse that raise great concern. Rates dwarfed those reported in individuals without TBI; in both samples, abuse was associated with financial strain. The pandemic altered household dynamics worldwide, but perhaps the change was less apparent for individuals with disability-related mobility restrictions and underemployment. The rates of abuse found herein may extend beyond the pandemic, emphasizing the need for trauma-informed care to address lasting consequences of abuse. Care providers should routinely query abuse, and ensure available resources are adapted to serve this vulnerable population.

Poster

02/15/2024
09:30 am - 10:40 am
Room: Shubert Complex (Posters 1-60)

Poster Session 03: Neurotrauma | Neurovascular

Final Abstract #11

Interpersonal Violence Among Individuals with and Without TBI During the COVID-19 Pandemic: A Nationwide Survey Study

Emily Blunt, Icahn School of Medicine at Mount Sinai, New York, United States
Brittany Engelman, Icahn School of Medicine at Mount Sinai, New York, United States
Annell Ovalles, Icahn School of Medicine at Mount Sinai, New York, United States
Lisa Spielman, Icahn School of Medicine at Mount Sinai, New York, United States
Nancy Chiaravalloti, Rutgers New Jersey Medical School, Newark, United States
Candace Robledo, University of Texas Rio Grande Valley, Edinburg, United States
Anthony Lequerica, Rutgers New Jersey Medical School, Newark, United States
Jay Morrow, UT Southwestern Medical Center, Dallas, United States
Michael Machiorlatti, University of Texas Rio Grande Valley, Edinburg, United States
Kristen Dams-O’Connor, Icahn School of Medicine at Mount Sinai, New York, United States

Category: Acquired Brain Injury (TBI/Cerebrovascular Injury and Disease - Adult)

Keyword 1: traumatic brain injury
Keyword 2: brain injury
Keyword 3: self-report

Objective:

Individuals living with traumatic brain injury (TBI) are at elevated risk of violence and may be more susceptible to abuse. Social isolation measures during the COVID-19 pandemic may have increased the risk of interpersonal violence, particularly among vulnerable populations. We aimed to compare the prevalence of self-reported abuse in individuals with TBI and a community-based sample (CS) during the COVID-19 pandemic and investigate the implications of gender and financial strain.

Participants and Methods:

Adults with TBI were recruited from NIDILRR-funded TBI Model System centers from August 2020 to May 2021. The University of Texas Rio Grande Valley recruited non-institutionalized community-based adults from April 2020 to May 2021. Participants completed an online survey to investigate the impact of the pandemic on health, care access, and well-being. An adapted four-item Hurt Insult Threat Scream (HITS) tool assessed the frequency of physical and verbal abuse perpetrated by anyone, including family. Items are scored on a 5-point Likert scale (1=Never; 5=Frequently) with total sum scores ranging from 4-20. A self-report survey asked participants to describe their current financial situation, and we dichotomized responses to create financial strain and low/no financial strain groups. We used t-tests for continuous measures and Chi-squared tests for categorical measures. We fit linear regression models to assess the association between TBI and abuse adjusting for age, sex, and household financial strain.

Results:

In this nationwide sample of individuals with mild-severe TBI (n=1,596; mild[46.4%], moderate[21.2%], severe[32.4%]) and CS (n=2,986), those with TBI were younger (39.8±13.9 vs. 44.0±12.3 years) and predominantly male (TBI 62.1% vs. CS 9.8%). On average, individuals with TBI reported a greater frequency and range of abuse (mean sum score 7.4±3.3) than CS (5.0±1.6) during the pandemic (t(1733.8)=24.8, p<.0001). Mean group differences in reported abuse remained after adjusting for age and sex (R²=0.21, F(3,3606)=316.8, p<.0001, ß=2.1, 95% CI: 1.93-2.33). Individuals with TBI reported higher rates of physical and verbal abuse compared to the CS. Most notably, only 45.8% of the TBI sample endorsed “Never” when queried about frequency of physical abuse compared to 97.2% of the CS (X²=1328.8, p<.0001). There were no differences in overall frequency of abuse between males and females in either group. A greater proportion of individuals with TBI (30%) compared to CS (13.9%) reported household financial strain (X²=141.1, p<.0001). The frequency of abuse was greater among those who indicated financial strain regardless of TBI (t(1002.8)=-6.60, p<.0001). A significant difference in mean level of abuse remained after adjusting for age, sex, and financial strain (R²=0.21, F(4,3587)=240.0, ß=2.1, p<.0001, 95% CI: 1.91-2.32).

Conclusions:

This study elucidated alarming rates of abuse that raise great concern. Rates dwarfed those reported in individuals without TBI; in both samples, abuse was associated with financial strain. The pandemic altered household dynamics worldwide, but perhaps the change was less apparent for individuals with disability-related mobility restrictions and underemployment. The rates of abuse found herein may extend beyond the pandemic, emphasizing the need for trauma-informed care to address lasting consequences of abuse. Care providers should routinely query abuse, and ensure available resources are adapted to serve this vulnerable population.