Brain Injuries and Chronic Stress May Drive Memory Loss in Abuse Survivors

Women who survive intimate partner violence show measurable impairments in verbal and visual memory compared with women who have not experienced such abuse, according to a new study published in BMC Psychology. The research, led by Cristina Villasclaras-García and colleagues at the Mind, Brain and Behavior Research Center (CIMCYC) of the University of Granada in Spain, goes a step further than most previous work by testing several candidate mechanisms at once: post-traumatic stress disorder, traumatic brain injury, non-fatal strangulation, and the stress hormone cortisol. The findings point to physical head trauma and chronic stress biology as the strongest correlates of the memory deficits observed, offering one of the most integrated pictures to date of how abuse leaves traces in the brain.

The study recruited 194 women in total, divided into a control group and four separate groups of survivors corresponding to different types of intimate partner violence against women, abbreviated IPVAW in the scientific literature. This design mattered because prior research had often lumped survivors together, obscuring whether particular forms of abuse carry particular cognitive consequences. Each participant completed a battery of neuropsychological assessments covering working memory, verbal memory, and visual memory, the three domains most consistently implicated in earlier studies of trauma exposure. Alongside the cognitive testing, the researchers gathered clinical data on post-traumatic stress symptoms, documented histories of traumatic brain injury, experiences of non-fatal strangulation, and measurements of cortisol, the body’s principal stress hormone.

The headline result was clear: women survivors underperformed the control group on both verbal and visual memory tasks. Verbal memory, the ability to encode, retain, and recall word-based information, and visual memory, the parallel capacity for remembering images, faces, and spatial layouts, both showed deficits relative to women without abuse histories. Working memory, the short-term buffer that holds information in mind for immediate manipulation, did not show the same group-level differences, a pattern that helps localize the impairment to longer-term memory systems rather than to attentional or immediate-holding processes. This distinction is neurologically meaningful, because long-term memory depends heavily on structures such as the hippocampus and surrounding medial temporal lobe regions, which are known to be vulnerable to both mechanical injury and chronic stress exposure.

When the team examined which mechanisms best explained the memory problems, two candidates stood out. Traumatic brain injury and cortisol were both associated with poorer performance on delayed visual memory, the measure of how well visual material is retained after a delay rather than immediately encoded. Traumatic brain injury in the context of intimate partner violence typically results from blows to the head, being shaken, or impacts against objects during assaults, and it is strikingly common yet frequently unrecognized, since many survivors never receive medical evaluation for head injuries sustained at home. Non-fatal strangulation, another signature violence type examined in the study, involves compression of the neck that can cause hypoxic damage to the brain even without external marks, making it a plausible but harder-to-document route to cognitive harm.

The cortisol finding connects the study to a large body of research on the neurobiology of chronic stress. Cortisol is released by the adrenal glands under the control of the hypothalamic-pituitary-adrenal axis, the hormonal cascade that mobilizes the body’s response to threat. In situations of ongoing danger, such as living with an abusive partner, this system can remain chronically activated, and prolonged elevation of glucocorticoids is known from animal and human research to affect the hippocampus, a region densely populated with cortisol receptors and central to forming new long-term memories. The association between cortisol and delayed visual memory in this study is consistent with the idea that sustained stress biology contributes to the consolidation and retrieval difficulties seen in survivors, although the cross-sectional design of the research means causality cannot be definitively established.

Equally informative were the mechanisms that did not emerge as significant predictors. Post-traumatic stress disorder, long considered the dominant psychological explanation for cognitive complaints in trauma survivors, did not account for the memory deficits once other variables were considered, and the regression analyses for several memory outcomes returned non-significant results, which the authors report transparently in their supplementary materials. This does not mean PTSD is irrelevant to the cognitive lives of survivors, but it does suggest that the memory alterations associated with intimate partner violence cannot be reduced to a PTSD diagnosis alone. Physical injury to the brain and the endocrine consequences of chronic threat appear to carry explanatory weight that psychological symptoms alone do not capture, a conclusion with direct implications for how clinicians evaluate survivors who report forgetfulness, concentration problems, or difficulty retaining new information.

The study’s structure deserves attention because it reflects a methodological shift in the field. By splitting survivors into four groups based on the type of violence experienced, the researchers could ask whether physical violence, sexual violence, or other abuse patterns differentially affect memory. The authors also employed Bayesian linear regression for the visual memory analysis, a statistical approach that quantifies evidence for and against effects rather than simply rejecting or failing to reject a null hypothesis, providing a more nuanced picture of which mechanisms merit continued investigation. Supplementary tables detail performance across working, verbal, and visual memory for survivors and controls, as well as the non-significant regressions, giving other researchers the raw material to build on these findings.

The research was conducted with careful ethical oversight, approved by the Provincial Research Ethics Committee of Granada under approval code SICEIA-2024-000912 and carried out in accordance with the Declaration of Helsinki, with written informed consent from all participants. The authors acknowledge the Andalusian Institute for Women and the professionals at Women’s Care Centers for their collaboration, and above all the 194 women who shared their time and experiences. The work was funded by Spain’s Ministry of Science, Innovation and Universities and the European Union’s NextGenerationEU program, and it forms part of the broader BELIEVE research project on the consequences of gender-based violence.

For clinicians, the practical message is that memory complaints among survivors of intimate partner violence should prompt consideration of head injury history and stress physiology, not only psychological trauma. The authors argue that their findings support trauma-informed care, an approach that recognizes the widespread impact of trauma and integrates that understanding into assessment and treatment. Screening for traumatic brain injury in domestic violence services, which is already recommended by several professional bodies, gains empirical support from these results, as does attention to the biological embedding of chronic stress. Because many survivors interact first with social services, shelters, or primary care rather than neurology clinics, embedding brief cognitive screening into those settings could identify impairments that would otherwise be misattributed to inattention, depression, or lack of effort.

Scientifically, the study opens several avenues for future work. Longitudinal designs could track whether memory performance recovers after survivors leave violent relationships, and whether cortisol normalization accompanies cognitive improvement, which would strengthen the causal case for stress-mediated damage. Neuroimaging could test whether delayed visual memory deficits correspond to structural or functional changes in medial temporal lobe circuits. And because the study was published as an open-access article, initially shared early as a citable peer-reviewed version of record in progress, its data and methods are available for scrutiny and replication by research groups worldwide. What the Granada team has established is that the cognitive footprint of intimate partner violence is real, measurable, and more physical than the field once assumed, a finding that reframes memory problems in survivors not as psychological fragility but as the traceable consequence of injury and chronic stress on the brain.

Subject of Research: Memory impairment and its mechanisms in women survivors of intimate partner violence

Article Title: Memory performance and tentative mechanisms of its alteration in women survivors of intimate partner violence

Article References: Villasclaras-García, C., Hidalgo-Ruzzante, N., Pérez-Cámara, N., Pérez-García, M., Pérez-González, M., & Álvarez, E. I. T. (2026). Memory performance and tentative mechanisms of its alteration in women survivors of intimate partner violence. BMC Psychology. https://doi.org/10.1186/s40359-026-05378-5

Image Credits: AI Generated

DOI: 10.1186/s40359-026-05378-5

Keywords: intimate partner violence, memory, traumatic brain injury, cortisol, PTSD, non-fatal strangulation, neuropsychology, trauma psychology, hippocampus, chronic stress, BMC Psychology, women's health