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This systematic review draws together evidence from the literature for the pathological, neurological, cognitive, psychological, and behavioural outcomes of non-fatal strangulation in domestic and sexual violence. A systematic search of PubMed, PsycINFO, CINHAL, Proquest, ASSIA, Web of Science, WestLaw, Open Grey, and Ethos was conducted, with no date limits set, to identify eligible studies. Thirty empirical, peer-reviewed studies were found which met the inclusion criteria. 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 standardised tools, and control groups where possible. This is urgent, given societal normalisation of strangulation, and legal systems which often do not reflect the act’s severity and its consequences.

Keywords

  • Choking, Hypoxic-ischaemic, Intimate partner violence, Sexual assault, Systematic review
Original languageEnglish
Pages (from-to)1164-1192
Number of pages29
JournalNeuropsychological Rehabilitation
Volume32
Issue number6
Early online date12 Jan 2021
DOIs
Publication statusPublished - 3 Jul 2022

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