Both childhood trauma and violent behaviour are important risk factors for suicidal behaviour. The aim of the present study was to construct and to 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 to predict ultimate suicide in suicide attempters.

161 suicide attempters and 95 healthy volunteers were 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). 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 fours years from entering in the study.

Patients who committed suicide had significantly higher scores in exposure to violence as a child, in expressed violent behaviour as an adult and in KIV total score compared to survivors. Suicide attempters scored significantly higher compared to healthy volunteers in three of the four KIV scales. There were significant correlations between the KIVS subscales, BDHI, Urge to act out hostility and EEQ.

Exposure to violence in childhood and violent behaviour in adulthood are risk factors for suicide in suicide attempters. The KIVS is a valuable new tool in suicide risk assessment.