Effectiveness of the Abuse Assessment Screen for Identifying Psychological, Physical and Sexual Abuse among Newly Mothering Women

Background: Intimate partner violence (IPV) is a major public health problem (Coker et al., 2002). Though the Abuse Assessment Screen (AAS; McFarlane et al., 1992) is widely used, only a handful of studies have examined its psychometric properties (Rabin et al., 2009). This study examined the effectiveness of the AAS for identifying psychological, physical and sexual IPV.

Methods: We used the AAS to screen 100 women (M=2.01 months postpartum, SD=1.32) recruited from an adult tertiary care hospital for lifetime psychological or physical IPV (item 1), physical IPV in the past year (item 2) and during pregnancy (item 3), sexual IPV during the past year (item 4), and current fear (item 5). The Conflict Tactics Scale-Revised (CTS2; Straus et al., 1996) was the criterion measure.

Results: The AAS significantly underdetected IPV. According to the CTS2, 84% of women experienced psychological or physical IPV during their lifetime, whereas 46% screened positive on the AAS (sensitivity=48.8%, specificity=68.8%). Seventeen women reported physical IPV in the past year on the CTS2, but the AAS identified just four cases (sensitivity=23.5%, specificity=100%). Thirteen women reported sexual abuse in the past year on the CTS2, compared to two who screened positive on the AAS (sensitivity=15.4%, specificity=100%). Finally, whereas 12 women disclosed physical IPV during pregnancy on the CTS2, only one screened positive on the AAS (sensitivity=8.3%, specificity=95.6%).

Conclusions: The AAS failed to identify many women who experienced IPV. Consistent with prior research, these findings question the appropriateness of the AAS as a standalone screening tool for IPV.