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

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.

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.

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%.

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.