自殺危險性發生模式驗證

MODEL TESTING ON THE DEVELOPMENT OF SUICIDAL RISK

本研究認為自殺危險性行為的發生主要是經由慢性歷程和急性歷程互動而成的。慢性歷程是長期累積不良的內在成長與外在影響之過程，而急性歷程則是由於某些生活上的變化，使個人感受到壓力與情緒的波動，或是感受到無法解決的困境之歷程。本研究認為生活困境、因應及死亡概念三個變項是影響青少年於日常生活中是否累積其不利自己身心狀態的重要因素，如果累積愈多，亦即面臨的生活困境愈多，因應能力與資源愈少，以及具較多的扭曲死亡看法時，學生愈會產生較多的自我傷害行為。如果此種不利身心狀態的自我傷害行為累積愈多，導致學生感受到無法解決的困境，亦即感受到無望時，易有較高的自殺危險性。本研究以結構方程模式考驗自殺危險性發生模式的適切性，結果發現原先模式需修正。重要的結果為自我傷害行為比無望感更能預測自殺危險性，生活困境影響自我傷害行為發生的解釋量高達73.3%。本研究最後討論修正模式如何運用至校園自殺防治工作，與修正模式可再修補之處。

Suicidal behavior is reflection of an interaction between a chronic process and an acute process. The chronic process is an accumulating process of internal and external factors which have a negative effect on individual's well-being. The acute process refers to impacts of current life situations which entail stresses, emotional turmoil or predicaments. This study hypothesizes that an adolescent's hassles, ability to cope, concept of death are three predominant variables to affect his or her well-being. An adolescent with more hassels, less coping resources or a distorted concept of death, tends to be more self-destructive. When one becomes more self-destructive, inevitably, one's predicaments contribute to a higher sense of hopelessness, and the risk of committing suicide increases. This tudy applies the structural equation model to test its fitness. The results showed that this model needs further modification. In terms of suicidal risk, self-destructive behavior is more predictive than the sense of hopelessness. Current hassles account for 73.3% of the variance of self-destructive behavior. Finally, this study discussed how such a modified model can be applied to suicide prevention on campus.