Case studies from Manchester, UK.
White C, Martin G, Schofield AM, Majeed-Ariss R. 'I thought he was going to kill me': Analysis of 204 case files of adults reporting non-fatal strangulation as part of a sexual assault over a 3 year period. J Forensic Leg Med. 2021 Apr;79:102128. doi: 10.1016/j.jflm.2021.102128. Epub 2021 Feb 16. PMID: 33618205.
The study shows that NFS in sexual assault is a gendered crime, with most victims female and most assailants male. NFS is prevalent and this prevalence increases where the alleged perpetrator is a partner or ex-partner. Many are assaulted in their own homes, homes frequently shared with children. Visible NFS injuries are not the norm yet fear of death is not uncommon. Over 1 in 6 (15.7%) reported loss of consciousness suggesting that they were victims of a near lethal assault. That 27% had previously been a victim of NFS by the same alleged perpetrator indicates that there are considerable numbers potentially living in fear and at risk. Awareness of the risk of NFS, and an enhanced response to it, is required by those looking after victims and all those in the criminal justice system
pubmed.ncbi.nlm.nih.gov/33618205/
Bichard H, Byrne C, Saville CWN, Coetzer R. The neuropsychological outcomes of non-fatal strangulation in domestic and sexual violence: A systematic review. Neuropsychol Rehabil. 2021 Jan 12:1-29. doi: 10.1080/09602011.2020.1868537. Epub ahead of print. PMID: 33432860.
Pathological changes included arterial dissection and stroke. Neurological consequences included loss of consciousness, indicating at least mild acquired brain injury, seizures, motor and speech disorders, and paralysis. Psychological outcomes included PTSD, depression, suicidality, and dissociation. Cognitive and behavioural sequelae were described less frequently, but included memory loss, increased aggression, compliance, and lack of help-seeking. However, no studies used formal neuropsychological assessment: the majority were medical case studies or based on self-report. Furthermore, few authors were able to control for possible confounds, including other physical violence and existing psychosocial difficulties. There is therefore a need for further neuropsychological research, focusing on cognitive and behavioural outcomes, using standardized tools, and control groups where possible. This is urgent, given societal normalization of strangulation, and legal systems which often do not reflect the act's severity and its consequences.
pubmed.ncbi.nlm.nih.gov/33432860/
Full paper
St Ivany A, Schminkey DL, Munro-Kramer ML. Acquired Brain Injuries and Intimate Partner Violence: A Situational Analysis of Help Seeking Barriers in Rural Northern New England. Glob Qual Nurs Res. 2021 Apr 13;8:23333936211008163. doi: 10.1177/23333936211008163. PMID: 33912624; PMCID: PMC8047928.
Findings included the concepts of paying social consequences and the normalization of violence. Non-fatal strangulation was described as increasingly related to violence and other areas. Repetitive acquired brain injuries can impair functioning needed to address violence and healthcare providers and advocates are generally unaware of the impact of acquired brain injuries.
www.ncbi.nlm.nih.gov/pmc/articles/PMC8047928/
Full paper
Patch M, Anderson JC, Campbell JC. Injuries of Women Surviving Intimate Partner Strangulation and Subsequent Emergency Health Care Seeking: An Integrative Evidence Review. J Emerg Nurs. 2018;44(4):384-393. doi:10.1016/j.jen.2017.12.001
www.ncbi.nlm.nih.gov/pmc/articles/PMC6026083/