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

Abstract

IntroductionViolence refers to any act that results in physical, sexual, or psychological harm or individual's suffering and it includes threats, coercion, and deprivation of freedom whether occurring in public or in private life.About 1/3 of women experience physical or sexual violence by an intimate partner (1).Domestic violence exists in all societies with varied prevalence rates.In a national survey conducted in 28 provinces of Iran, the reported prevalence of violence against women was 66% (2).However, we found no study on the prevalence of violence in women with psychiatric diseases in Iran.Adverse effects of domestic violence on health are the same around the world but may vary from short-term to long-term physical and mental effects, including anxiety, depression, post-traumatic stress, substance abuse to suicide, and violence-induced death (3,4) There is an association between intimate partner violence (IPV) against women and mental disorders.A systematic review indicates a greater likelihood of IPV victimization in women across all mental disorders (5).In addition, women with mental illnesses are more vulnerable to violence.It increases duration and recurrence of the disease (6,7), as well as the likelihood of suicide attempts, substance abuse, noncompliance with treatment, and disruption of family and social relations (8,9).On the other hand, another systematic review showed that IPV victimization significantly increases the occurrence of most mental disorders like perinatal depression and anxiety (10).For example, a study in Turkey indicated significant relationships between violence against infertile women and mental health sequels including depression, anxiety, psychosomatic symptoms, homicide, and suicide (11).Although the routine assessment of domestic violence by psychiatric services has been emphasized in international AbstractObjectives: 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.

Cite this work

No public copy is stored for this record, so only the metadata is cited.

Stored only when both papers are in the corpus — 12 citations exist upstream.

Papers that cite the same references — the relational fallback while embeddings are still backfilling.