A brief two-item screener for detecting a history of physical or sexual abuse in childhood

Abstract

Background A number of medical practice guidelines and recommendations call for screening adult patients for a history of physical or sexual abuse in childhood, but no brief screening tools exist. The objective of this study was to assess the accuracy of a two-item screener for physical or sexual abuse in childhood. Methods This is a cross-sectional study of randomly selected women (aged 18–65 years) from a large health maintenance organization. One thousand two hundred twenty-five patients were administered a questionnaire, which included two items in a brief screener: (a) “When I was growing up, people in my family hit me so hard that it left me with bruises or marks” and (b) “When I was growing up, someone tried to touch me in a sexual way or tried to make me touch them.” A subset of 216 patients completed a semistructured interview for a history of physical or sexual abuse in childhood. Results The two-item screener was sensitive (84.8%) and specific (88.1%) for detecting a history of physical or sexual abuse in childhood, as determined by the semistructured interview. Conclusions The two-item screener provides an accurate tool, which is easily integrated into a comprehensive health questionnaire or administered verbally by a clinician, to assess for history of abuse.