Boston University School of Medicine (BUSM) researchers have identified a promising screening tool to detect intimate partner violence (IPV) in females in the VA Boston Healthcare System. The findings, which appear in the current issue of Journal of General Internal Medicine, accurately detected 78 percent of women identified as abused within the past year by a more comprehensive and behaviorally specific scale.
IPV is a major public health issue, particularly among women receiving medical care at VA facilities. The researchers cite “lifetime reports of IPV as high as 74 percent among this population,” reinforcing the critical need for both brief and accurate screening tools. The four-item screening tool studied is named HITS (Hurt/Insult/Threaten/Scream) and can be used in under four minutes. HITS is unique in that it assesses psychological IPV in addition to physical aggression.
The study used a sample of 700 women with data extracted from the Veterans Health Administration electronic health records, with 63.5 percent of those contacted participating. The subjects completed two surveys by mail: the HITS screening test, as well as the Conflict Tactics Scale (CTS-2), considered the gold-standard for measuring IPV. The final study sample included 160 women who reported involvement in an intimate relationship within the prior year.
The study found that nearly 29 percent of women who had been involved in a recent intimate relationship reported physical, sexual and/or severe psychological IPV in the past year. The tool demonstrated good sensitivity and specificity in detecting IPV in this sample. Report of IPV in the past year was associated with higher scores for depression and PTSD. The use of the HITS screening tool was also found to assess sexual IPV with a sensitivity of 87 percent, signifying that very few cases of sexual IPV go undetected.
“Further research is needed to validate questionnaire answers by mail with in-person clinical assessment, however HITS has the potential to effectively and efficiently identify a high proportion of female VHA patients who have experienced past-year IPV,” explained lead author Katherine Iverson, PhD, assistant professor of psychiatry at BUSM and clinical research psychologist at the VA Boston Healthcare System and VA’s National Center for PTSD.
According to Iverson the screening tool has the benefit to quickly identify high-risk patients, and coordinate referrals to more comprehensive support services.
This research was supported by the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development (HSR&D) Services as part of Dr. Katherine Iverson’s HSR&D Career Development Award (CDA10-029).