This study explores the validity of a two-question questionnaire, HCE-2, which surveys the perception of harassment and control by electronic tools, as a screening tool for the detection of cases of IPV in young women. In the analysis, good validity indices were obtained, and these indices were better in the group of women aged 18–24 years, in which an overall test efficiency of 95.1% and a PPV of 95.2% were observed.
Cyberbullying within relationships has been described as a type of digital practice in which the aggressor exercises domination over the victim through harassing strategies that affect her privacy and intimacy12. This work addresses cyberbullying from a gender perspective. Most of the studies reviewed analyze cyberbullying in the context of violence in general, aimed at the detecting both victims and perpetrators of both genders. This fact might make it difficult to compare our results with others.
The use of electronic tools to perpetrate different acts of violence is relatively new. Whether electronic media incite violence or are a mere new avenue for it has been discussed in previous publications, but there are still discrepancies. Electronic media have certain characteristics that differentiate them from other forms of violence: their immediacy, their lack of geographical boundaries, and the possibility of communicating online7. Electronic media are also heterogeneously distributed, with the young population using them the most5. INE data from 2012 (the latest before this study) indicate that 95.3% of young women are frequent users of electronic media17.
Discrepancies are also observed in terms of terminology and classification. Some authors consider harassment and control by electronic tools an independent type of IPV, while others consider it a subtype of psychological violence18. Although there is no agreement on this matter, there appears to be an association between harassment and control by electronic tools in the couple and IPV towards women, called offline IPV. A study conducted in the United States in university students between 18 and 25 years of age observed a significant correlation between cases of cyberbullying within the couple and psychological, physical, and sexual violence6. Specifically, 95% of the participants who suffered psychological violence from their partner also suffered it by electronic tools, and conversely, those who suffered harassment by electronic tools were 28 times as likely to report psychological violence from a partner as those who did not suffer harassment. These figures support the results obtained in our study, where 95.2% of women aged 18 to 24 years who suffered cyberbullying also met the criteria of IPV. In other studies, our results are in line with others 8,19−21 showing a strong association between harassment and control by electronic tools and psychological partner violence.
Violence by electronic media could hinder self-perception of violence, since among young people, control and harassment are often confused with attention and caring. This perception is fostered by the idea of romantic love5, and in turn, the normalization of these behaviors favors the onset of violence19. However, other studies have shown that the negative consequences of IPV are present even when women are not perceived as victims of IPV22.
The questions developed for our study have obtained good validity indices for the detection of IPV, especially in the age group of 18–24 years. Regarding scoring for the two questions, the response “rarely” was initially considered a positive score, but after observing a decrease in the overall efficiency of the questionnaire, it was given the same scoring as “never”. Recently, the short version of the Woman Abuse Screening Tool (WAST) has been validated as an IPV screening tool, in which, despite obtaining very good results, the need for improvement in detection in young populations is expressed 11. The screening test validated in this study presents better validity indices (overall test efficiency, specificity, PPV, and POR) than WAST when applied to women aged 18 to 29 years. On the other hand, this test presents slightly lower sensitivity and NPV, although both values are considerably better in the group of younger women (18–24 years). The brevity of this test gives it an advantage over other tests geared towards young people4,19.
Among the limitations of this study is the nonresponse bias because it could be expected that the prevalence of IPV among women who did not want to participate in the interview would differ from the prevalence in the women who did respond. There may also be selection bias, as we included only women with an individual health card, though this would be minimal, since it is issued to almost 100% of the population. Added to these limitations is that we took as the gold standard a definition based on self-reported information, instead of a specialized clinical interview, and we collected information only on the most recent partner of each woman in the case that there was more than one partner in the year before the interview. The biggest strengths of the test are its brevity and simplicity, which facilitate its rapid implementation and positive acceptance by women (response rate of 100% in our sample). Since 2017, the two questions analyzed have been included in the Noncommunicable Disease Risk-Factor Surveillance System that annually monitors behavior in young people (SIVFRENT-J) in the Community of Madrid.
In conclusion, due to the need to improve the detection of IPV in young women and the good results of this exploratory study, it is recommended to consider cyberbullying to screen for other forms of violence in women between 18 and 24 years of age. It will be necessary to carry out more studies to ensure that the results obtained here are reliable.