Derivation and validation of a short emergency department screening tool for perpetrators of intimate partner violence: the PErpetrator RaPid Scale (PERPS).

BACKGROUND: There is no short screening tool for perpetrators of intimate partner violence (IPV), although one is needed. OBJECTIVE: To retrospectively derive and prospectively validate a brief screening tool for perpetrators of IPV: the PErpetration RaPid Scale (PERPS). METHODS: In the derivation phase of the study, we developed the PERPS based on historical data. The PERPS consists of three Yes/No questions about physical abuse of a partner. In the validation phase, we prospectively screened subjects during randomized 4-h shifts in a busy emergency department (ED). Subjects were asked to complete the newly derived three-question PERPS as well as the Physical Abuse of Partner Scale (PAPS), a 25-question Likert scale that is the gold standard for detection of physical abuse of a partner. The main outcome measures were sensitivity, specificity, predictive values, accuracy, and Cronbach alpha of the PERPS for internal consistency. RESULTS: The PERP Scale derivation was based on a 207-subject historical database, and resulted in a three-question PERPS. Validation was completed on a new set of 214 patients presenting to the ED during 52 randomized 4-h shifts. The prevalence of IPV perpetration using the PERPS was 47/207 (22.7%; 95% confidence interval [CI] 16-27). For the PAPS, prevalence was 56/207 (27%; 95% CI 20-32). Compared with the PAPS, the sensitivity of the PERPS was 66%, specificity 93%, negative predictive value 87%, positive predictive value 78%, with an accuracy of 85%. Cronbach alpha of the PERPS was 0.68. Age, gender, and race were not predictive of positive results on either scale. CONCLUSION: We successfully derived and validated a three-question perpetrator of IPV scale that can be used in a busy ED or office setting.

Witnessing intimate partner violence as a child does not increase the likelihood of becoming an adult intimate partner violence victim.

OBJECTIVES: To determine whether adults who witnessed intimate partner violence (IPV) as children would have an increased rate of being victims of ongoing IPV, as measured by the Ongoing Violence Assessment Tool (OVAT), compared with adult controls who did not witness IPV as children. The authors also sought to determine whether there were differences in demographics in these two groups. METHODS: This was a cross sectional cohort study of patients presenting to a high-volume academic emergency department. Emergency department patients presenting from November 16, 2005, to January 5, 2006, during 46 randomized four-hour shifts were included. A confidential computer touch-screen data entry program was used for collecting demographic data, including witnessing IPV as a child and the OVAT. Main outcome measures were witnessing IPV as a child, ongoing IPV, and associated demographics. Assuming a prevalence of IPV of 20% and a clinically significant difference of 20% between adults who witnessed IPV as children and adult controls who did not witness IPV as children, the study was powered at 80%, with 215 subjects included. RESULTS: A total of 280 subjects were entered; 256 had complete data sets. Forty-nine percent of subjects were male, 45% were Hispanic, 72 (28%) were adults who witnessed IPV as children, and 184 (72%) were adult controls who did not witness IPV as children. Sixty-three (23.5%) were positive for ongoing IPV. There was no correlation of adults who witnessed IPV as children with the presence of ongoing IPV, as determined by univariate and bivariate analysis. Twenty-three of 72 (32%) of the adults who witnessed IPV as children, and 39 of 184 (21%) of the adult controls who did not witness IPV as children, were positive for IPV (difference, 11%; 95% confidence interval [CI] = -2% to 23%). Significant correlations with having witnessed IPV as a child included age younger than 40 years (odds ratio [OR], 4.2; 95% CI = 1.7 to 9.1), income less than $20,000/year (OR, 5.1; 95% CI = 1.6 to 12.5), and abuse as a child (OR, 9.1; 95% CI = 4.2 to 19.6). Other demographics were not significantly correlated with having witnessed IPV as a child. CONCLUSIONS: Adults who witnessed IPV as children were more likely to have a lower income, be younger, and have been abused as a child, but not more likely to be positive for ongoing IPV, when compared with patients who had not witnessed IPV.