Department of Family Medicine and Community Health, University of Massachusetts Chan Medical School, Worcester, MA.
Department of Family and Community Medicine, UT Southwestern Medical Center, Dallas, TX.
Fam Med. 2023 Jan;55(1):12-19. doi: 10.22454/FamMed.55.203565.
The purpose of this study is to establish the psychometric properties and diagnostic accuracy of the Teen Hurt-Insult-Threaten-Scream-Sex (TeenHITSS), a 5-item measure used to screen adolescents for family violence in clinical settings.
Study participants included 251 adolescent participants (n=197 not at-risk subsample; n=56 at-risk subsample), recruited from ambulatory care clinics, a medical center at-risk referral clinic, and area shelters. Participants completed a cross-sectional survey, including the TeenHITSS and Parent-Child Conflict Tactics Scales (CTSPC) questionnaires. We calculated internal reliability, validity, and sensitivity and specificity for the full sample and both subsamples for each screening instrument.
Concurrent validity between the TeenHITSS and CTSPC was strong (r=.71, P<.000). We determined an optimal cutpoint based on sensitivity and specificity for correctly identifying abuse victims as a score of one or greater on the TeenHITSS. The TeenHITSS also proved slightly superior to the CTSPC in differentiating between victims and nonvictims of adolescent abuse (AUC=.79 vs .73, respectively).
The TeenHITSS screening tool performed as well as the CTSPC in correctly classifying at-risk and not-at-risk teenagers and offers much greater utility to providers by supplying an actionable cut score. The findings of this study suggest that TeenHITSS is a valid and reliable tool to screen for physical and sexual abuse in children ages 13 years and older in clinical settings and can help health care providers detect adolescent abuse and initiate intervention and prevention of future abuse.
本研究旨在确立青少年伤害-侮辱-威胁-尖叫-性（TeenHITSS）的心理测量学特性和诊断准确性，这是一种用于在临床环境中筛查青少年家庭暴力的 5 项测量工具。
研究参与者包括 251 名青少年参与者（n=197 无风险亚组；n=56 风险亚组），他们来自门诊诊所、医疗中心风险转介诊所和地区避难所。参与者完成了一项横断面调查，包括 TeenHITSS 和父母-子女冲突策略量表（CTSPC）问卷。我们计算了全样本和两个亚组的每个筛查工具的内部可靠性、有效性、敏感性和特异性。
TeenHITSS 和 CTSPC 之间的同时效度很强（r=.71，P<.000）。我们根据 TeenHITSS 上得分大于等于 1 的正确识别受虐受害者的敏感性和特异性确定了最佳截断点。与 CTSPC 相比，TeenHITSS 在区分青少年受虐受害者和非受害者方面也略有优势（AUC=.79 与.73 相比，分别）。
TeenHITSS 筛查工具在正确分类高危和非高危青少年方面与 CTSPC 一样有效，并通过提供可操作的截断分数，为提供者提供了更大的实用性。本研究的结果表明，在临床环境中，TeenHITSS 是一种有效且可靠的工具，可以筛查 13 岁及以上儿童的身体和性虐待，并可以帮助医疗保健提供者发现青少年虐待，并启动干预和预防未来的虐待。
