Moberg Tomas, Stenbacka Marlene, Jönsson Erik G, Nordström Peter, Asberg Marie, Jokinen Jussi
The Department of Clinical Neuroscience/Psychiatry, Karolinska Institutet, Karolinska University Hospital, Solna, SE-171 76 Stockholm, Sweden.
BMC Psychiatry. 2014 Jul 7;14:195. doi: 10.1186/1471-244X-14-195.
Suicidal and violent behaviours are interlinked and share common biological underpinnings. In the present study we analysed the association between violent behaviour as a child, childhood trauma, adult psychiatric illness, and substance abuse in relation to interpersonal violence as an adult in suicide attempters with mood disorders.
A total of 161 suicide attempters were diagnosed with Structured Clinical Interviews and assessed with the Karolinska Interpersonal Violence Scale (KIVS) measuring exposure to violence and expressed violent behaviour in childhood (between 6-14 years of age) and during adult life (15 years or older). Ninety five healthy volunteers were used as a comparison group. A logistic regression analysis was conducted with the two KIVS subscales, expressed violent behaviour as a child and exposure to violence in childhood together with substance abuse, personality disorder diagnoses and age as possible predictors of adult interpersonal violence in suicide attempters.
Violent behaviour as a child, age and substance abuse were significant predictors of adult interpersonal violence. ROC analysis for the prediction model for adult violence with the KIVS subscale expressed violence as a child gave an AUC of 0.79. Using two predictors: violent behaviour as a child and substance abuse diagnosis gave an AUC of 0.84. The optimal cut-off for the KIVS subscale expressed violence as a child was higher for male suicide attempters.
Violent behaviour in childhood and substance abuse are important risk factors for adult interpersonal violent behaviour in suicide attempters.
自杀行为和暴力行为相互关联且有着共同的生物学基础。在本研究中，我们分析了情绪障碍自杀未遂者儿童期暴力行为、童年创伤、成人精神疾病以及药物滥用与成人期人际暴力之间的关联。
共有161名自杀未遂者接受了结构化临床访谈诊断，并使用卡罗林斯卡人际暴力量表（KIVS）进行评估，该量表用于测量童年期（6至14岁）和成年期（15岁及以上）遭受暴力的情况以及表现出的暴力行为。95名健康志愿者作为对照组。采用逻辑回归分析，将KIVS的两个子量表（儿童期表现出的暴力行为和童年期遭受的暴力）与药物滥用、人格障碍诊断及年龄作为自杀未遂者成人期人际暴力的可能预测因素。
儿童期暴力行为、年龄和药物滥用是成人期人际暴力的显著预测因素。使用KIVS子量表儿童期表现出的暴力行为对成人暴力预测模型进行ROC分析，曲线下面积（AUC）为0.79。使用两个预测因素：儿童期暴力行为和药物滥用诊断，AUC为0.84。男性自杀未遂者中，KIVS子量表儿童期表现出的暴力行为的最佳临界值更高。
童年期暴力行为和药物滥用是自杀未遂者成人期人际暴力行为的重要危险因素。
