by Betsy Serrano & Anne DePrince
Intimate partner violence (IPV) impacts about 1 in every 3 women worldwide. Following IPV, psychological distress is common – ranging from depression, post-traumatic stress disorder (PTSD), and anxiety to sleep difficulties, substance-/alcohol-use disorders and even suicidality. Survivors also face a host of service needs and challenges, such as housing instability.
IPV-related distress and challenges can be magnified when the violence includes blows to the head or strangulation, both of which can cause brain injuries. Indeed, as awareness of partner-inflicted brain injuries has grown, so have calls for research to inform policy and practice.
Calls for research on partner-inflicted brain injury will have to be met with approaches that balance the relative costs and benefits of participating in research.
To be sure, weighing costs and benefits is an ethical obligation in all research, regardless of topic. Of course, providers who refer clients to research studies, survivors, ethics committees (called Institutional Review Boards or IRBs), and funders are all likely to have particular interest in the ethics of research at the intersection of IPV and brain injury.
For instance, they may wonder:
- Is research overwhelming for survivors who are already navigating different systems?
- Does discussing traumatic events, reporting current challenges, and reflecting on criminal justice interactions lead to negative emotions?
- Is there anything to be gained by telling their stories one more time to a researcher?
Our team has long cared about these questions – for every study with trauma survivors, including at the intersection of IPV and brain injury.
That’s why we ask participants at the end of studies to tell us about the benefits and costs of participating. We do this with a survey that participants fill out in private, so that they can give their honest take on the study.
The survey starts by asking what motivated them to take part in the study – for example, because they were curious, wanted to help, or needed the money.
Next, the survey asks participants to rate possible costs and benefits. Costs include things like unexpected negative emotions or the amount time the study took. Benefits include things like feeling respected, feeling in control of their choices in the study, and feeling that they learned something or found the study personally meaningful.
We used this cost-benefit measure in a recent study on partner-inflicted brain injuries. We interviewed more than 30 women after IPV incidents that were reported to law enforcement. The interview included questions about the IPV incident, possible brain injuries, common forms of psychological distress, experiences in the criminal legal system, and more.
After the interview, we asked participants to fill out the survey on participants costs and benefits. Their responses showed that they found the benefits of participating to outweigh costs.
For instance, they strongly agreed that the study was personally meaningful, that they had autonomy in decision-making in the study, and that they were treated with respect and dignity. In contrast, they rated items about emotional reactions as neutral and disagreed with common costs of research, such as the time that study procedures took.
Take-Aways
So can research with a focus on IPV and brain-injury be done in a way that the benefits outweigh costs for participants?
Yes, according to our findings.
Of course, we took many steps in the design of our protocol to maximize benefits and minimize costs. For instance, our team’s interviewers were trained in trauma- and brain injury-informed practices. We developed a thorough consent process to explain the study to participants – and checked that our descriptions were clear and thorough.
We hope this means the future is bright for designing studies that can ethically address IPV and brain injury at a time when research is urgently needed in this area.
***
Note: Thank you to our study team, especially Leah Waltrip, Dr. Julia Dmitrieva, Dr. Kim Gorgens, Dr. Becky Suzuki, Amber Fredrick, and Courtney McCrimmon. This project was supported by Award No. 15PNIJ-22-GG-01619-MUMU from the National Institute of Justice, Office of Justice Programs, U.S. Department of Justice. The opinions, findings, and conclusions or recommendations expressed in this publication are those of the authors and do not necessarily reflect those of the Department of Justice.
