Chronic Intimate Partner Violence, Autonomic Dysregulation, and Intergenerational Impact: A Case Study with HRV Analysis

Intimate Partner Violence (IPV) represents one of the most persistent and devastating psychosocial stressors, with implications that extend beyond the psychological to measurable physiological dysregulation. This article presents a detailed clinical case of a 38-year-old woman subjected to 20 years of systematic physical and sexual violence, alongside caregiving for two children with neurodevelopmental and behavioral disorders. Using heart rate variability (HRV) as an objective biomarker, the study demonstrates converging reductions in RMSSD and HF with elevated LF/HF, consistent with reduced vagal modulation and heightened arousal linked to trauma-related dysregulation. Drawing on contemporary trauma theory and psychophysiological research, we conceptualize IPV as a pathological dyadic homeostasis in which the perpetrator’s aggression operates as a behavioral addiction while the victim’s identity becomes entrenched in a controlled victimhood. The intergenerational consequences are highlighted through the two children: a preschool‑age boy with ASD and severe screen addiction, and a mid-teen boy with screen addiction, ADHD and social withdrawal. The findings emphasize HRV not only as a biomarker of autonomic compromise in IPV survivors but also as a potential tool for clinical monitoring of trauma interventions. The case underscores the necessity of integrating physiological measures into trauma-informed care, and the urgency of addressing safety, intergenerational risk, and systemic barriers to protection.