ABSTRACT

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 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.

摘要

这篇系统评价汇集了文献中关于家庭暴力和性暴力中非致命勒死的病理、神经、认知、心理和行为结果的证据。对 PubMed、PsycINFO、CINHAL、Proquest、ASSIA、Web of Science、WestLaw、Open Grey 和 Ethos 进行了系统搜索，没有设置日期限制，以确定符合条件的研究。发现了 30 项符合纳入标准的经同行评议的实证研究。病理变化包括动脉夹层和中风。神经系统后果包括意识丧失，表明至少轻度获得性脑损伤、癫痫发作、运动和语言障碍以及瘫痪。心理结果包括创伤后应激障碍、抑郁、自杀和分离。认知和行为后遗症的描述较少，但包括记忆力减退、攻击性增加、顺从性和缺乏寻求帮助。然而，没有研究使用正式的神经心理学评估：大多数是医学案例研究或基于自我报告。此外，很少有作者能够控制可能的混淆，包括其他身体暴力和现有的心理社会困难。因此，需要进一步的神经心理学研究，重点关注认知和行为结果，尽可能使用标准化工具和对照组。鉴于扼杀的社会正常化以及通常无法反映该行为的严重性及其后果的法律制度，这是紧迫的。大多数是医学案例研究或基于自我报告。此外，很少有作者能够控制可能的混淆，包括其他身体暴力和现有的心理社会困难。因此，需要进一步的神经心理学研究，重点关注认知和行为结果，尽可能使用标准化工具和对照组。鉴于扼杀的社会正常化以及通常无法反映该行为的严重性及其后果的法律制度，这是紧迫的。大多数是医学案例研究或基于自我报告。此外，很少有作者能够控制可能的混淆，包括其他身体暴力和现有的心理社会困难。因此，需要进一步的神经心理学研究，重点关注认知和行为结果，尽可能使用标准化工具和对照组。鉴于扼杀的社会正常化以及通常无法反映该行为的严重性及其后果的法律制度，这是紧迫的。尽可能控制组。鉴于扼杀的社会正常化以及通常无法反映该行为的严重性及其后果的法律制度，这是紧迫的。尽可能控制组。鉴于扼杀的社会正常化以及通常无法反映该行为的严重性及其后果的法律制度，这是紧迫的。