Ascertainment of intimate partner violence in women seeking legal protection

Background: Brief questions are necessary for identification of women seeking emergency professional services for intimate partner violence (IPV), and for initiating dialogue with women presenting for care who have previously reported abuse. We compare three questions that inquire about physical and psychological abuse to the Conflict Tactics Scale, version 2 (CTS-2) in a cohort of women seeking legal protection for IPV. Methods: A total of 448 urban women reporting IPV to police or the court system completed surveys at 8 weeks (baseline), and 5 and 10 months after the incident to assess IPV. Sensitivity and specificity of brief questions on physical assault/abuse (one question) and psychological abuse (two questions) were assessed at baseline and in the periods between baseline and follow-up, using items from the CTS-2 reflecting minor and severe physical and psychological IPV as reference standards. Results: Compared to the CTS-2 severe items, the physical abuse question at baseline detected 93% of abused women, and the two psychological abuse questions 94%. Sensitivity varied at follow-up (74% to 95% for physical, and 89% to 90% psychological), but remained higher when the severe versus minor CTS-2 items were reference standards. Specificity was reasonable for the physical question compared to the severe CTS-2 section (77% to 95%), but was more varied for the psychological questions (29% to 74%). Conclusions: Three brief questions reasonably identified women who experienced severe IPV and sought legal protection. The low specificity of the psychological questions suggests that women's abuse experience may not fit within the CTS-2 framework. The three questions should be considered for further testing in real-world settings as a tool for initiating conversation with women about abuse. (C) 2005 American Journal of Preventive Medicine.