Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
J Clin Psychiatry. 2010 Aug;71(8):1025-32. doi: 10.4088/JCP.09m05944blu.
Both childhood trauma and violent behavior are important risk factors for suicidal behavior. The aim of the present study was to construct and validate a clinical rating scale that could measure both the exposure to and the expression of violence in childhood and during adult life and to study the ability of the Karolinska Interpersonal Violence Scale (KIVS) to predict ultimate suicide in suicide attempters.
A total of 161 suicide attempters and 95 healthy volunteers were assessed with the KIVS measuring exposure to violence and expressed violent behavior in childhood (between 6-14 years of age) and during adult life (15 years or older). The Buss-Durkee Hostility Inventory (BDHI), "Urge to act out hostility" subscale from the Hostility and Direction of Hostility Questionnaire (HDHQ), and the Early Experience Questionnaire (EEQ) were used for validation. All patients were followed up for cause of death and a minimum of 4 years from entering in the study.
Five patients who committed suicide within 4 years had significantly higher scores in exposure to violence as a child, in expressed violent behavior as an adult, and in KIVS total score compared to survivors. Suicide attempters scored significantly higher compared to healthy volunteers in 3 of the 4 KIVS subscales. There were significant correlations between the subscales measuring exposure to and expression of violent behavior during the life cycle. BDHI, Urge to act out hostility, and EEQ validated the KIVS.
Exposure to violence in childhood and violent behavior in adulthood are risk factors for completed suicide in suicide attempters. Behavioral dysregulation of aggression is important to assess in clinical work. The KIVS is a valuable new tool for case detection and long-term clinical suicide prevention.
儿童创伤和暴力行为都是自杀行为的重要危险因素。本研究旨在构建和验证一种临床评分量表，既能测量儿童期和成年期的暴力暴露程度，又能测量暴力表达程度，并研究 Karolinska 人际暴力量表（KIVS）对自杀未遂者最终自杀的预测能力。
对 161 名自杀未遂者和 95 名健康志愿者进行评估，使用 KIVS 测量儿童期（6-14 岁）和成年期（15 岁及以上）的暴力暴露程度和表达的暴力行为。采用 Buss-Durkee 敌意量表（BDHI）、敌意和敌意方向问卷（HDHQ）的“表现敌意的冲动”分量表和早期经验问卷（EEQ）进行验证。所有患者均进行死因随访，至少随访 4 年。
5 例在 4 年内自杀的患者，其儿童期暴力暴露程度、成年期暴力行为表达程度和 KIVS 总分显著高于幸存者。自杀未遂者在 KIVS 的 4 个分量表中的 3 个分量表上的得分显著高于健康志愿者。测量生命周期中暴力暴露程度和表达程度的分量表之间存在显著相关性。BDHI、表现敌意的冲动和 EEQ 验证了 KIVS。
儿童期的暴力暴露和成年期的暴力行为是自杀未遂者自杀的危险因素。攻击性的行为失调在临床工作中很重要，需要进行评估。KIVS 是一种用于发现病例和长期临床预防自杀的有价值的新工具。
