素因，精神病理學，適應力及自殺

Diathesis, Psychopathology, Resilience, and Suicidality

自殺在全球中是其中一項嚴重危害公眾健康之問題。而，自殺意念似為嘗試或完成自殺的一項危險因子。許多不同的近端和遠端危險因子與增加自殺率有關，包含遺傳背景、個人特質、雙親教養、與心理健康問題。從遺傳因子到心理健康問題及自殺行為之路徑是複雜及不可預測的。本綜說主要提供從遺傳、素因、精神病理學及適應力的概圖。我將從相關之研究中，經由結構方程模式中，從遺傳背景、個人特質、心理健康至自殺（意念、計畫、嘗試與完成）去尋找直接和決定因子。並將總和所有的數據，利用結構方程模式探討每一項影響因子在路徑上及對現況之影響以及回歸。首先，我將介紹自殺壓力與素因之概念；然後，將討論遺傳，基因與環境之交互關係，雙親教養，人格特質，適應力與自殺之關係。在遺傳背景，雙親教養，人格特質與適應力之議題中，雖自殺中先天與後生之交互作用尚未釐清。然而，這些研究結果提升了解其關鍵因素，以及各種因素之影響，並提供未來有效的預防與介入。

Suicide is one of the serious public health problems worldwide. Moreover, suicidal ideation seems as a risk factor for attempted and completed suicidal behaviors. It seems that number of different proximal precipitating and distal predisposing risk factors, which include genetic backgrounds, personal characteristics, parental attachment and mental health problems, are associated with increased rates of suicide. The pathway from genes to mental health problems and suicidal behavior are complex and probabilistic. The aim of this overview is to provide a clear protocol for genetics, diathesis, psychopathology, and resilience in suicidal behavior. In this review article, I will assess relevant research articles dealing with direct and deterministic ways from genetic backgrounds, personal characteristics, mental health to suicidality (ideation, plans, attempts and completions) in struc-tural equation modeling. Combining with my own data, I also explored the natural course of the path effect, current effect, and the regression in each contributing factor, using structural equation modeling. I first introduce the concept of stress-diathesis of suicide; then, discuss the relationship between genetics, gene-environ-ment interactions, parental bonding, personality characteristics, and resilience in suicidality. Issues associated with the relationship between genetic backgrounds, parental bonding, personality characteristics and resilience, and its interaction between nature and nurture in suicidality, have not yet settled. But these research findings should improve understanding of the critical ingredients and their differential impact on various at-risk subgroups, and help with effective prevention and intervention in the future.