Psychometric Characteristics of an Intimate Partner Violence Screening Tool in Women With Mental Disorders

Abstract

Objectives: Quick recognition of intimate partner violence (IPV) victimization is important in women with mental disorders. Therefore, we assessed the accuracy of the brief and comprehensive 8-item woman abuse screening tool (WAST) and its 2-item short form (WAST-SF) by comparison to the reference standard for past year IPV with the 39-item revised conflict tactics scale (CTS-2) at this population. Materials and Methods: In this cross-sectional study, 400 women with mental disorders within the age range of 19-49 years were interviewed using the WAST and CTS-2 at a psychiatric hospital in Tabriz, Iran. Receiver operating characteristic (ROC) was used to determine characteristics of the screening tools. Results: All types of IPV were very common in the past year; 90% overall, 86% psychological aggression, 62% physical assault, 53% sexual coercion and 53% injury. The highest diagnostic accuracy of WAST was at the cutoff score of 12 (area under the curve [AUC] 0.90, 95% CI 0.83 to 0.96) with 96% (93% to 98%) sensitivity and 84% (67% to 93%) specificity. Predictive values of the optimal score were 99% (97% to 99.4%) for victims and 64% (48% to77%) for non-victims. Its agreement with CTS2 was good (r = 0.69). The highest diagnostic accuracy of WAST-SF was at the cutoff score of 3 (AUC 84%, 95% CI 0.77 to 0.91) with sensitivity 93%, specificity 71%, positive predictive value 97.5%, and negative predictive value 47%. Conclusions: The WAST at cutoff score of 12 and WAST-SF at cutoff score of 3 have good accuracy in diagnosis of the past year IPV among women with mental disorders. Healthcare providers at psychiatric facilities should use these tools for IPV screening.