Women who have sustained brain injuries from muggings, rapes, and other physical assaults suffer from neuropsychological sequelae and experience difficulties in coping with ordinary life activities after injury. Psychodynamically-based interpretations of some women's inability to quickly return to a fully functioning status have interfered with comprehensive diagnosis and prevented women from receiving available rehabilitation. Many health professionals have been trained to perceive women as having "emotional" problems whereas men have "physical" problems. As a result, women's physical concerns, outside of a limited set of reproductive problems, are overlooked and misdiagnosed as "hysteria", "borderline personality disorders", or "psychosomatic" disorders.

Some diagnoses that are correlated with neuropsychological impairment are postconcussive syndrome, post traumatic stress disorder, chronic pain syndrome, pseudoseizures, and fibromyalgia. In clinical cases involving rape and physical assault, women were previously told by medical and nursing personnel in emergency rooms that they had no injuries other than lacerations and broken bones, which would heal eventually. Frequent problems include symptoms of frontal lobe syndrome, such as poor judgment, flat affect, severe depression with suicidal tendencies, difficulty in learning new material, problems making generalizations, and inability to manage employment and homemaking tasks previously handled with ease. Other difficulties involve partial paralysis of limbs which limit ability to walk and manual dexterity, and increased risk of falling, which can lead to additional peripheral and cerebral damage. Chronic stress, depression, and organic anxiety complicate the lifestyles of women and girls as they adjust to their changed lifestyles after head injury. Often personality changes occur with consequent need for multiple caregivers to provide several aspects of ordinary living activities. Social isolation complicates family and support network dynamics. Violence and hostility, ease of anger, poor judgment, and assaults against others become frequent with brain injuries.

Neuropsychological implications are illustrated with neuropsychological data on two rape victims. In the absence of appropriate diagnosis and rehabilitation treatment of the brain injuries, there is a downward spiral in overall functioning which is exemplified in the Rape Sample 1 profile after three years of no treatment. The Rape Sample 2 profile illustrates the subtleties of head injury which might be overlooked or misdiagnosed. Participants were tested with the Ackerman-Banks Neuropsychological Rehabilitation Battery, a 43-scale comprehensive screen.
 

This paper was presented at the April 1996 convention Traumatic Brain Injury: Models and Systems of Care in Washington, DC. The abstract was published in the proceedings of that conference. 

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Last Updated: 12/26/00