Intimate Partner Violence

IPV-related complex trauma produces distinct neurobiological patterns identifiable on functional neuroimaging: persistent amygdala hyperactivation with threat-related stimuli, hippocampal atrophy (8-15% volume reduction in chronic PTSD), medial prefrontal cortex hypoactivation (impaired fear extinction), and anterior cingulate cortex dysfunction (impaired emotional regulation). Chronic sympathetic nervous system activation produces elevated norepinephrine levels, contributing to hypervigilance, exaggerated startle response, and insomnia. Repeated traumatic brain injury from physical assaults creates cumulative neurological damage similar to chronic traumatic encephalopathy (CTE). The clinician must conduct comprehensive trauma-informed assessments, prescribe pharmacotherapy for PTSD, depression, and anxiety, manage TBI-related sequelae, coordinate forensic examinations, fulfill complex medico-legal reporting obligations, order and interpret diagnostic studies, and develop comprehensive treatment plans addressing physical, psychological, and social determinants of health.