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Detecting Intimate Partner Violence

a woman talks to a psychologist

Dr. Katherine Iverson, a clinical research psychologist with VA’s National Center for PTSD in Boston, discusses Intimate Partner Violence with a patient.

by Tom Cramer, VA staff writer
Thursday, December 12, 2013

Researchers at the VA Boston Healthcare System, the VA National Center for PTSD and Boston University School of Medicine teamed up recently to study a quick and easy screening tool that detects if a female patient has recently experienced Intimate Partner Violence (IPV).

Their study appears in the October 2013 issue of the Journal of General Internal Medicine.

Intimate Partner Violence is a major public health issue, particularly for women Veterans,” said Dr. Katherine Iverson, a clinical research psychologist with VA’s National Center for PTSD in Boston. She is the study’s lead author. “Available data suggests that women Veterans may be more likely to experience IPV than non-Veteran women, so there’s a critical need for screening tools that are quick and accurate.”

The screening tool studied by Iverson’s team is called the ‘HITS,’ which stands for Hurt, Insult, Threaten, Scream. It can be used in under four minutes.

“The HITS test is simpler and faster than other IPV measures, which makes it more practical to use in a busy clinical setting,” Iverson explained. “It’s unique because it also assesses psychological IPV in addition to physical aggression.”

The study involved 160 women Veterans who reported involvement in an intimate relationship within the prior year. The women — all of them VA patients — were asked to complete the HITS screening test, as well as a more time-consuming test called the Conflict Tactics Scale, considered the gold-standard for measuring IPV.

Both tests were completed at home and mailed in to researchers.

“We found that nearly 30 percent of these women reported physical, sexual or severe psychological IPV in the past year,” Iverson reported. “The HITS screening tool demonstrated good sensitivity and specificity in detecting IPV in these patients. Women who experienced past-year IPV reported higher PTSD and depression symptoms, as well as lower levels of perceived health.

“The use of tools like HITS is critical,” she added, “because women tend not to spontaneously disclose IPV to their health care providers. But they’re often willing to talk about it when we use non-judgmental, behaviorally-specific questions to inquire about IPV, that’s precisely what HITS does.”

The psychologist said her study reinforces the critical importance of detecting IPV sooner rather than later.

“Detection gives us an opportunity to begin treating associated health problems,” Iverson said, “and to offer the woman appropriate services — such as safety planning, housing, and mental health — that increase her safety as well as her sense of well-being.”

For more information on PTSD, visit the VA National Center for PTSD at