Intimate Partner Violence | ISSUES | The Ohio State University

New Publication: Profiles of Stressful Life Experiences in Pregnancy

Wed, 02 Sep 2026 00:00:00 +0000

We are excited to announce a new publication from the ISSUES Lab!

Profiles of stressful life experiences in pregnancy: a latent class approach linking early childhood adversity, intimate partner coercive control, and material hardship to adverse birth outcomes

Gia Elise Barboza-Salerno & Taylor Harrington

Published August 31, 2026 in BMC Pregnancy and Childbirth (Open Access)

Abstract

Acute antenatal stressful life events (SLEs) during pregnancy are well-established risk factors for adverse birth outcomes. However, little is known about how distinct constellations of antenatal SLEs, shaped by early adversity, material hardship, and intimate partner coercive control, combine to influence perinatal health.

Data were drawn from 5,280 participants in the Kansas Pregnancy Risk Assessment Monitoring System. Using latent class analysis, five distinct stress profiles were identified:

Family Member Illness and Death (16.3%)
Multiple Overlapping Stressors (5.2%)
Financial Insecurity (11.2%)
Residential Instability and Family Conflict (8.7%)
Low Stress (58.6%)

Compared with the Low Stress class, individuals in all high-risk classes had significantly higher odds of reporting ACEs, IPV, material hardship, and cigarette use before pregnancy. The Multiple Overlapping Stressors class showed the greatest risk of low birth weight, small for gestational age, and preterm birth.

Key Takeaway

Tailoring perinatal interventions to specific SLE profiles, particularly for individuals with histories of ACEs and IPV, may reduce poor birth outcomes.

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Profiles of stressful life experiences in pregnancy: a latent class approach linking early childhood adversity, intimate partner coercive control, and material hardship to adverse birth outcomes

Mon, 31 Aug 2026 00:00:00 +0000

Detecting Intimate Partner Violence Injury Mechanisms Using LLMs and LDA

Wed, 29 Apr 2026 15:45:00 -0500

Dr. Gia Barboza-Salerno, Olivia McLucas, and Dr. Karla Shockley will present their research at the 2026 Symposium on Data Science & Statistics (SDSS) in Milwaukee, Wisconsin.

Presentation Details

Title: Automated Detection of Intimate Partner Violence Injury Mechanisms from Emergency Department Narratives Using Large Language Models and Latent Dirichlet Allocation

Session: AI and LLM Applications I
Date: Tuesday, April 29, 2026
Time: 3:45 - 5:15 PM CT
Format: 25-minute refereed presentation
Location: Milwaukee, Wisconsin

Registration: Register for SDSS 2026
Registration Deadline: March 25, 2026

Abstract

We developed an AI pipeline designed to overcome limitations in existing surveillance systems by distinguishing the underlying mechanisms of Traumatic Brain Injury (TBI) in intimate partner violence (IPV). The primary goal was to apply a Large Language Model (LLM) to extract and classify behavioral and contextual information from unstructured free-text narratives within the National Electronic Injury Surveillance System (NEISS).

The pipeline first cleans the narratives and uses the LLM to convert the text into six targeted structured semantic representations (e.g., action, cause, diagnosis), which are then quantified using Latent Dirichlet Allocation (LDA) topic modeling. Our results can be used to enhance injury surveillance to identify IPV in emergency department settings.

Introduction

Head, face, and neck injuries are common IPV-related injuries and frequently involve TBI, yet NEISS diagnostic codes lack the behavioral detail needed to differentiate mechanisms of harm. Although NEISS narratives contain brief descriptions of arguments, aggression, object use, and environmental context, they have been underutilized in surveillance research and rarely analyzed at scale.

As a result, diagnostic codes collapse distinct injury pathways—including accidental falls, object impacts, impulsive actions during conflict, and direct assaults—into the same categories, obscuring meaningful variation in risk and limiting clinical screening and prevention efforts.

Our method fills this gap by applying AI-based extraction and topic modeling to detect behavioral and situational information embedded in NEISS narratives, producing a more nuanced understanding of IPV-related injury mechanisms.

Methods

Analytical Framework

We developed an AI pipeline to extract and classify behavioral and contextual information from unstructured NEISS narratives related to IPV:

Text Preprocessing: Used regular expressions to flag domestic-violence–related incidents, expand abbreviations, clean shorthand, and isolate IPV cases
Custom Prompting: Generated prompts by merging cleaned narratives with structured NEISS variables
LLM Extraction: Transformed narratives into six semantic fields (action, cause, diagnosis, mechanism, object, location)
Topic Modeling: Applied LDA to identify latent themes within each semantic field
Typology Classification: Integrated regex-based typology and LDA clusters to produce quantitative injury pathways

Text Processing and Prompting

We used vectorized regular expressions to:

Flag violence-related narratives
Expand abbreviations and clean shorthand
Isolate IPV cases by identifying relationship and conflict terms
Exclude clearly non-IPV incidents

After preprocessing, we generated custom prompts by merging each cleaned narrative with structured NEISS variables to produce context-rich descriptions of the event.

LLM Extraction and Topic Modeling

The LLM transformed cleaned narratives into six structured semantic representations:

Action: What happened (e.g., verbal disputes, punching, striking objects)
Cause: Why it happened (e.g., intoxication, falls, collisions)
Diagnosis: Medical outcome (e.g., fractures, contusions, lacerations)
How: Mechanism of injury (e.g., physical struggle, impulsive acts)
What: Objects involved (e.g., walls, windows, doors, fists)
Where: Location (e.g., home, public place, bathroom)

LDA topic modeling systematically discovered and quantified overarching themes across all responses, resulting in quantifiable dimensions like interpersonal conflict or blunt impact injuries.

Data & Results

Quantification of Contextual Dimensions (LDA Topics)

Topic modeling produced interpretable themes across all semantic dimensions:

Action: verbal disputes, play fighting, punching, striking objects
Cause: intoxication, falls, collisions with walls, windows, or furniture
Diagnosis: fractures, contusions, lacerations, closed head injury
How: physical struggle, impulsive acts, heated altercations
What: walls, windows, doors, bricks, glass, fists
Where: home, public place, outside environment, bathrooms

Identified Head/Neck Injury Typologies

Narrative- and topic-derived clusters aligned with six major typologies:

Typology	%	Representative Narrative
Accidental fall or slip	38.6%	“Slipped and fell hitting head on carpet.”
Self-inflicted harm	19.9%	“Banging head against wall during argument.”
Physical assault	25.1%	“Stabbed in neck with kitchen knife.”
Blunt object impact	9.9%	“Head-butted wall; forehead hematoma.”
Environmental	2.3%	“Pepper spray during fight.”
Vehicle-related impact	1.7%	“Swerved and crashed; head/neck pain.”

Word Cloud Visualization

The figure above shows word-cloud representations of dominant latent topics extracted from LLM-generated semantic dimensions (Cause, Diagnosis, How). Each cloud visualizes high-frequency terms within a topic cluster, highlighting recurrent mechanisms of injury across IPV-related emergency department visits.

Key patterns identified:

Heavy concentration of head trauma in incidents involving walls, floors, or doors
High rates of head contact in intoxication-related falls
Frequent head or neck injury during impulsive self-directed actions

Discussion & Conclusions

Combining regex-based classification with LLM extraction and LDA provides a detailed mapping of how, where, and why brain injuries occur during IPV-related incidents.

Key Findings

Blurred Boundaries: Many injuries categorized as “accidental” or “environmental” occur in the context of relationship conflict, revealing blurred boundaries between unintentional and interpersonal harm
Enhanced Surveillance: These methods improve surveillance and detection of IPV-related injuries in emergency departments by recovering behavioral information that structured diagnostic codes cannot capture
Mechanism Identification: The narrative-based approach identifies specific mechanisms that contribute to injury, whereas structured codes often make it difficult to distinguish between distinct behavioral pathways

Future Work

Expanding prompts to capture richer contextual cues
Validating typologies with larger datasets
Examining variation across sociodemographic and clinical subgroups

About SDSS

The Symposium on Data Science & Statistics is a premier conference bringing together researchers, practitioners, and students working at the intersection of statistics, data science, and computational methods. The 2026 symposium takes place April 28 - May 1 in Milwaukee, Wisconsin.

Keywords: Traumatic brain injury, intimate partner violence, surveillance, Natural Language Processing, topic modeling, emergency medicine, LLM, LDA

Emotional and Physical Symptoms Following Intimate Partner Violence Victimization in the United States: Implications for Law and Public Health Policy

Mon, 01 Dec 2025 00:00:00 +0000

Craniofacial Injuries in IPV-Related Physical Abuse

Wed, 27 Aug 2025 00:00:00 +0000

Overview

Intimate Partner Violence (IPV) is a widespread public health crisis, and craniofacial injuries—including trauma to the head, face, and neck—are among the most common physical consequences. Many of these injuries involve brain trauma such as concussion, traumatic brain injury (TBI), or hypoxic-ischemic brain injury (HIBI).

National emergency department data indicate that nearly 900,000 IPV-related visits occurred during the study period, with almost three in five involving craniofacial trauma. Female survivors experienced injury rates nearly five times higher than males, with the starkest disparities in early adulthood (ages 20–34).

Policy Relevance

Legal Context: Recognition of IPV-related craniofacial injury in statutes and clinical guidelines can improve survivor protections and treatment access.
Health Systems: Emergency medicine protocols should include screening for IPV in patients with head, face, and neck injuries.
Civil Rights: Survivors face barriers in healthcare and justice systems; data-driven policy is needed to reduce disparities in detection, treatment, and support.

Recommendations

Mandate IPV screening protocols in emergency departments, especially for craniofacial injuries.
Expand Medicaid and social safety net coverage for long-term treatment of IPV-related traumatic brain injuries.
Increase funding for prevention and survivor support programs that integrate health and legal services.

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Intimate Partner Violence & Brain Injury in U.S. Adults: Findings from the Medical Expenditure Panel Survey, 2021

Wed, 27 Aug 2025 00:00:00 +0000

Overview

National survey data show that adults who screen positive for intimate partner violence (IPV) experience more injuries and face greater medical costs than those who do not. Nine million screened IPV-positive using the HITS screening tool, and survivors were significantly more likely to utilize emergency rooms and hospitals for treating their injuries. Head and brain injuries were much more frequent among IPV survivors, and the average cost of treating these injuries was nearly twice as high compared to adults who did not screen positive for IPV.

Key Messages

Approximately 9 million adults screened positive for IPV in 2021.
IPV-positive adults had 3–4× higher ER and inpatient injury rates than IPV-negative adults.
Adults who screened positive for IPV experienced more than twice the rate of brain-injury healthcare events compared to those who screened negative.
Average per-capita spending on brain-injury care was about twice as high among IPV-positive adults.
Inpatient TBI events are less common than ER events but far more costly; counts and spending are higher among IPV-positive adults.
Poverty, social stressors, depression, and chronic conditions are significantly associated with IPV screen positivity.

Policy Relevance & Recommendations

Standardized protocols: Implement routine protocols so that IPV-positive patients with head injury are screened for brain injury, and patients with head injury are also screened for IPV.
Integrated referral pathways: Establish clear referral systems across emergency, primary, and specialty care so that when screening protocols are triggered, patients are automatically connected to appropriate follow-up services.
Follow-up for delayed symptoms: Incorporate temporal follow-up in care plans, recognizing that brain injury symptoms may appear or worsen over time.
Accessibility and appropriateness: Ensure screening and follow-up services are accessible, widely available, and tailored to the needs of IPV survivors.
Holistic screening: Extend screening beyond identifying head injury to include social and health needs that may magnify injury effects and increase vulnerability to future IPV.
Care coordination: Utilize medical social workers and interdisciplinary teams to integrate medical, psychosocial, and safety needs into a comprehensive care response.

Methodology

This brief analyzes nationally representative data from the Medical Expenditure Panel Survey—Household Component (MEPS-HC) 2021. Adults (age ≥18) were classified as IPV screen-positive if they scored ≥10 on the Hurt, Insult, Threaten, Scream (HITS) scale, a validated four-item screening tool for intimate partner violence.

Injury outcomes were identified using ICD-10-CM codes and Clinical Classifications Software Refined (CCSR) groupings from the MEPS Conditions file, with condition–event linkages used to assign emergency department (ER), inpatient, outpatient, office-based, home health, and prescription care to specific injuries. Brain injuries were defined as traumatic brain injury (ICD-10 S06) and other head injuries (S00–S09).

We estimated:

Injury and brain-injury events per 100 adults,
Per-capita spending (in 2021 USD), and
Weighted counts of injury-linked encounters.

Analyses applied MEPS survey weights (PERWT21F) and accounted for the complex design (VARSTR, VARPSU). We used survey-weighted generalized linear models (svyglm) to generate adjusted comparisons standardized over age, sex, and race/ethnicity. Risk ratios were estimated for sociodemographic factors, health-related social needs, and chronic health conditions associated with IPV screen positivity.

Suggested Citation

Barboza-Salerno, G. E., Shockley McCarthy, K., Watson-Grace, A., Harrington, T., McCarthy, M. A., Peremen, N., & McLucas, O. (2025). Intimate Partner Violence & Brain Injury in U.S. Adults: Findings from the Medical Expenditure Panel Survey, 2021. Policy brief. The Ohio State University, ISSUE Lab (Investigating Spatial Structures in Urban Environments).

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Download the full brief for more information