影響自殺企圖者的自殺危險性發生路徑之檢驗

Testing the Path of Influencing Suicidal Attempter s Suicidal Risk

自殺企圖者的自殺危險性之提高是因對未來的正向期待少，或是對未來的負向期待多，或者二者均會造成影響，乃過去探討無望感與自殺間的一項重要議題。本研究依循Williams與Pollock（2000，2002）之觀點推導出影響自殺企圖者發生自殺危險性的可能路徑，以探討此議題。Williams與Pollock認為自殺是由挫敗、脫困、及拯救三個因素交織而成。本研究以資源流失、控制及無望來表徵這三個因素。在研究理念上，本研究認為當自殺企圖者遇及資源流失時，如採用不同的因應策略，會對自殺危險性有不同的影響性。本研究的受試來自中部某社區心理衛生中心，該中心自921地震後成立自殺通報系統，本研究選取半年內通報的個案，經同意後納入樣本群，共收集到146位自殺企圖者。測量工具包含資源流失調查問卷，控制調節策略問卷，無望感量表，及自殺危險程度量表等四份量表。首次因徑分析先刪除路徑係數不顯著者，再進行因徑分析，其結果指出，直接影響自殺企圖者的自殺危險性之路徑有二：一為對未來的正向期待，而非對未來的負向期待，另一為逃避。本研究於討論中說明這些結果的意涵及預防自殺企圖者自殺危險性發生的可能介入方法。

An important issue in the studies of the relationship between the sense of hopelessness and suicide is whether suicide is encouraged by a diminished positive anticipation about the future, by an increased negative anticipation about the future, or by both. Williams and Pollock (2000, 2002) claimed that suicide was the result of the interaction of three factors, namely, defeat, no escape, and no rescue. In the present study, we translated the three factors into loss of resource, control, and hopelessness to evaluate Williams and Pollock s claim. We hypothesized that when suicide attempters experienced a loss of resource, the different coping strategies they adopted would have different consequences on their risk of committing suicide. One hundred and forty six suicide attempters, referred through the suicide prevention report system established for the survivors of the 921 Chi-Chi major earthquake, were administered the Loss of Resources Scale, the Control Regulation Questionnaire, the Hopelessness Scale, and the Degree of Suicide Scale. Path analysis of the data revealed two paths showing direct influence on suicide attempter s risk of committing suicide. One of them was positive anticipation, rather than negative anticipation, about the future. The other was escape. The implication of these findings for suicide interventions is discussed.