The HITS (Hurt, Insulted, Threatened, Screamed) tool is a brief interview instrument that can be used to screen for domestic violence in a primary care setting.
The instrument consists of 4 questions related to partner behavior.
(1) physical
(2) insults
(3) threaten
(4) scream or curse
Responses
Points
never
1
rarely
2
sometimes
3
fairly often
4
frequently
5
HITS score =
= SUM(points for the 4 questions)
Interpretation:
• minimum score: 4
• maximum score: 20
• A score >= 11 identified someone as a victimized respondent (in the article, a score > 10.5).
• This would seem to be a level that would be sensitive rather than specific (answering "sometimes" to 3 questions and "rarely" to 1 would be considered positive).
Performance of the HITS tool:
• good internal consistency, with Cronbach alpha of 0.80
• good concurrent validity with comparison instrument (Conflict Tactics Scale, CTS), with correlation of 0.85
• good construct validity: able to differentiate non-abused from abused persons
Limitations:
• Patients probably will vary in their interpretation of the frequency terms (sometimes might be once a day or once a year).
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