Validation of the Spanish Version of the Index of Spouse Abuse Juncal Plazaola-Castan ˜ o, Ph.D., 1,2 Isabel Ruiz-Pe ´ rez, M.D., Ph.D., 1,2 Vicenta Escriba ` -Agu ¨ ir, M.D., Ph.D., 2,3 Juan Manuel Jime ´ nez-Martı ´n, B.Sc., 1 and Elisa Herna ´ ndez-Torres, Ph.D. 4 Abstract Background: Partner violence against women is a major public health problem. Although there are currently a number of validated screening and diagnostic tools that can be used to evaluate this type of violence, such tools are not available in Spain. The aim of this study is to analyze the validity and reliability of the Spanish version of the Index of Spouse Abuse (ISA). Methods: A cross-sectional study was carried out in 2005 in two health centers in Granada, Spain, in 390 women between 18 and 70 years old. Analyses of the factorial structure, internal consistency, test-retest reliability, and construct validity were conducted. Cutoff points for each subscale were also defined. For the construct validity analysis, the SF-36 perceived general health dimension, the Rosenberg Self-Esteem Scale and the Goldberg 12-item General Health Questionnaire were included. Results: The psychometric analysis shows that the instrument has good internal consistency, reproducibility, and construct validity. Conclusions: The scale is useful for the analysis of partner violence against women in both a research setting and a healthcare setting. Introduction P artner violence against women is a recognized public health problem. Its prevalence is high, 1,2 incidence and mortality rates are increasingly reported, 3 and it has serious consequences for both the mental and physical health of women. 4–6 Health repercussions range from immediate visi- ble problems, such as physical injuries, to chronic health conditions, such as headaches, sexually transmitted diseases (STDs), and psychiatric problems. 7,8 In recent years, many studies have tried to determine the magnitude of the problem in Spain in the population as a whole 9–11 and in healthcare settings. 12–14 Because there is no consensus regarding the definition of the problem and the use of different methodologies and tools to study it, however, it is difficult to compare the different sets of data obtained with the results of other international research work. The healthcare setting is considered to be one of the most suitable contexts in which to address partner violence against women, both in terms of helping the women involved and for the purpose of research. This observation is based on the fact that abused women use healthcare services more often than do those who are not abused. 15 There are a number of validated tools that have been used to screen for and evaluate partner violence against women in cross-sectional 16 and longitudinal studies. 17 However, this trend has not extended to Spain, where the lack of screening and diagnostic tools for partner violence is a major obstacle to increasing knowledge of the problem. One of the most widely used diagnostic tools in the United States is the Index of Spouse Abuse (ISA), which was designed in 1981 for use in a clinical environment 18 in order to evaluate progress made in interventions with abused women. The ISA measures the severity of partner violence against women over the past year. In addition to measuring physical, sexual, and emotional violence, it also measures behavior that aims to control and isolate women. It includes 30 items, which make up two independent scales: one relating to nonphysical violence (19 items) and another relating to physical violence (11 items). Items receive different weights, given that some of 1 Andalusian School of Public Health, Granada, Spain. 2 Ciber Epidemiologı ´a y Salud Pu ´ blica (CIBERESP), Spain. 3 General Directorate of Public Health, Valencia, Spain. 4 Hospital Virgen de las Nieves, Granada, Spain. JOURNAL OF WOMEN’S HEALTH Volume 18, Number 4, 2009 ª Mary Ann Liebert, Inc. DOI: 10.1089=jwh.2008.0944 499