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題名 以自殺歷程觀探索不同自殺危險組別之危險因子： 以台北市生命線安心專線紀錄為依據
Exploration of suicidal risk factors of different suicidal risk groups through the lens of Suicidal Process: an analysis of suicidal callers of Taipei lifeline association
作者 林怡彤
貢獻者 許文耀
林怡彤
關鍵詞 自殺歷程觀
自殺危險程度
自殺危險因子
Suicidal process
Suicidal risk
Suicidal risk factors
日期 2016
上傳時間 31-七月-2017 11:12:13 (UTC+8)
摘要 本研究參考自殺的歷程觀，認為長期累積的不利因素將造成個體的自殺危險，且不利因子越多，個體的自殺危險性越高（吳英璋、金樹人、許文耀，民84）。為了在短時間內收集較多的自殺危險個體資料，本研究採用台北市生命線協會協辦的安心專線之電話紀錄為數據進行二次分析，驗證是否高自殺危險個體具有較多的不利因子，並探討不利因素為何？以及具不同自殺危險指標的族群在哪些因子上會有差異。本研究樣本為1182筆於2011至2013年間，在台北市生命線安心專線之資料庫（台灣eSOS自殺危機個案處理系統）留下個案紀錄的資料。去除可辨識個人的資料（姓名、住址等），進行非記名、非互動且非介入性之研究。將資料以過去有無自殺企圖、現在有無自殺意念，區分成四個自殺危險組別。其中本研究依過去理論，推論過去無自殺企圖現在也無自殺意念組（組0）為自殺危險性最低組，具有現在的自殺意念或過去的自殺企圖其中之一者（組1、組2）自殺危險次之，而過去有自殺企圖現在有自殺意念組（組3）為自殺危險性最高組。並以多項式邏輯斯回歸進行分析，探討對於這四個組別具預測力的因子為何。結果顯示女性、有伴侶、獨居、無工作、有精神疾病、有物質濫用皆是會累積造成自殺危險的不利因素，且自殺危險最高的組3的確具有最多的不利因素，組1和組2次之。處在不良或匱乏的人際關係者（有伴侶者、獨居者）較可能具有自殺意念，女性、有心理病理因素者（有精神疾病、有物質濫用者）較可能有過自殺企圖。
According to suicidal process, the suicidal risk factors can cumulatively cause an individual’s suicidal risk. Furthermore, the more suicidal risk factors are, the higher suicidal risk is (Wu, Jin, & Hsu, 1995). Using台灣eSOS自殺危機個案處理系統 as the database, this study undertook a secondary analysis to examine whether the highest suicidal risk group had the most suicidal risk factors and to understand what these risk factors were. Moreover, this study also aimed to find out if there were any differences between different suicidal risk groups. To understand the questions mentioned before, this study analyzed the data of the Taipei Lifeline callers from 2011 to 2013, dividing data into four groups according to previous suicidal attempt record and current suicidal ideation record: group 0 (the lowest suicidal risk group) had no previous suicidal attempt and no current suicidal ideation; group 1 had no previous suicidal attempt but had current suicidal ideation; group 2 had previous suicidal attempt without current suicidal ideation; group 3 (the highest suicidal risk group) had both previous suicidal attempt and current suicidal ideation. This study conducted a multinominal logistic regression to find out which suicidal risk factors could significantly predict the four suicidal risk groups. The results showed that female, having a romantic partner, living alone, unemployment, psychiatric disorders, and substance abuse could all cumulatively cause an individual’s suicidal risk. Furthermore, the group 3 did have the highest suicidal risk factors and was followed by group 2 and 1. The results also showed that having a problematic or lack of interpersonal relationship could lead to higher risk of having current suicidal ideation, while female and people with psychiatric disorder had greater risk of having a previous suicidal attempt.
參考文獻 內政部統計處（民106年）。內政部統計年報。取自：http://sowf.moi.gov.tw/stat /year /list.htm。
行政院主計總處（民99年）。99年人口及住宅普查總報告提要分析。取自：http://www.stat.gov.tw/ct.asp?xItem=31969&ctNode=548&mp=4
吳英璋、金樹人、許文耀。（1995）。校園自我傷害防治處理手冊.台北市:教育部.
周怡芳、沈中柱。（2014）。統計應用分析報告，台北市自殺統計概述。台北市政府衛生局統計室。
許文耀、鍾瑞玫。（1997）。[自殺危險程度量表] 的編製及其信、效度考驗. 中華心理衛生學刊, 1997, 10.2: 1-17.
Beck, A. T. (1996). Beyond belief: A theory of modes, personality, and psychopathology. In P Salkovskis, (Ed), Frontiers of cognitive therapy (pp. 1-25). New York, NY: Guilford Press
Berman, A. L., Silverman, M. M., & Bongar, B. M. (2000). Comprehensive textbook of suicidology. Guilford Press.
Blakely, T. A., Collings, S. C., & Atkinson, J. (2003). Unemployment and suicide. Evidence for a causal association?. Journal of Epidemiology and Community Health, 57(8), 594-600.
Bongar, B., & Sullivan, G. (2013). The suicidal patient: Clinical and legal standards of care. American Psychological Association.
Borges, G., Angst, J., Nock, M. K., Ruscio, A. M., & Kessler, R. C. (2008). Risk factors for the incidence and persistence of suicide-related outcomes: a 10-year follow-up study using the National Comorbidity Surveys. Journal of Affective Disorders, 105(1), 25-33.
Cavanagh, J. T., Carson, A. J., Sharpe, M., & Lawrie, S. M. (2003). Psychological autopsy studies of suicide: a systematic review. Psychological medicine, 33(03), 395-405.
Cheng, A. T., & Lee, C. S. (2000). Suicide in Asia and the far East. The international handbook of suicide and attempted suicide, 29-48.
Durkheim, E. (1951). Suicide: a Stuidy in Sociology.
Fremouw, W. J., De Perczel, M., & Ellis, T. E. (1990). Suicide risk: Assessment and response guidelines. Pergamon Press.
Goldney, R. D., Dal Grande, E., Fisher, L. J., & Wilson, D. (2003). Population attributable risk of major depression for suicidal ideation in a random and representative community sample. Journal of affective disorders, 74(3), 267-272.
Goldsmith, S. K., Pellmar, T. C., Kleinman, A. M., & Bunney, W. E. (2002).Reducing suicide: a national imperative. National Academies Press.
Harris, E. C., & Barraclough, B. (1997). Suicide as an outcome for mental disorders. A meta-analysis. The British Journal of Psychiatry, 170(3), 205-228
Hatton, C. L., & Valente, S. M. (1984). Suicide, assessment and intervention. Appleton & Lange.
Hawton, K. (2000). Sex and suicide gender differences in suicidal behaviour. The British Journal of Psychiatry, 177(6), 484-485.
Joiner, T. (2005). Why people die by suicide. Harvard University Press.
Inskip, H. M., Harris, E. C., & Barraclough, B. (1998). Lifetime risk of suicide for affective disorder, alcoholism and schizophrenia. The British Journal of Psychiatry, 172(1), 35-37.
Kring, A. M., Johnson, S. L., Davison, G. C., & Neale, J. M. (2012). Abnormal psychology. John Wiley & Sons.
Kposowa, A. J. (2001). Unemployment and suicide: a cohort analysis of social factors predicting suicide in the US National Longitudinal Mortality Study.Psychological medicine, 31(01), 127-138.
Lewinsohn, P. M., Rohde, P., Seeley, J. R., & Baldwin, C. L. (2001). Gender differences in suicide attempts from adolescence to young adulthood. Journal of the American Academy of Child & Adolescent Psychiatry, 40(4), 427-434.
Links P, Nisenbaum R, Ambreen M, Balderson K, Bergmans Y, Eynan R, Harder H, Cutcliffe J (2012). Prospective study of risk factors for increased suicide ideation and behavior following recent discharge. General Hospital Psychiatry 34, 88–97.
Mäkinen, I. H. (1999). Effect on suicide rate of having reduced unemployment is uncertain. BMJ: British Medical Journal, 318(7188), 941.
Maltsberger, J. T. (1988). Suicide danger: clinical estimation and decision.Suicide and Life-Threatening Behavior, 18(1), 47-54.
Miranda R, Gallagher M, Bauchner B, Vaysman R, Marroquín B (2012). Cognitive inflexibility as a prospective predictor of suicidal ideation among young adults with a suicide attempt history. Depression and Anxiety 29, 180–186.
Mishara, B. L. Chagnon, F., Daigle, M., Balan, B., Raymond, S., Marcoux, I., Bardon, C., Campbell, J. K., & Berman, A. (2007b). Which helper behaviors and intervention styles are related to better　short-term outcomes in telephone crisis intervention? Results from a silent monitoring study of calls to the U.S. 1–800-SUICIDE Network. Suicide and Life-Threatening Behavior, 37 (3), 310–323.
Murphy, G. (2013). The National Suicide Prevention Lifeline and New Technologies in Suicide Prevention: Crisis Chat and Social Media Initiatives. InSuicide Prevention and New Technologies (pp. 111-122). Palgrave Macmillan UK.
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描述 碩士
國立政治大學
心理學系
103752018
資料來源 http://thesis.lib.nccu.edu.tw/record/#G0103752018
資料類型 thesis
dc.contributor.advisor 許文耀zh_TW
dc.contributor.author (作者) 林怡彤zh_TW
dc.creator (作者) 林怡彤zh_TW
dc.date (日期) 2016en_US
dc.date.accessioned 31-七月-2017 11:12:13 (UTC+8)-
dc.date.available 31-七月-2017 11:12:13 (UTC+8)-
dc.date.issued (上傳時間) 31-七月-2017 11:12:13 (UTC+8)-
dc.identifier (其他 識別碼) G0103752018en_US
dc.identifier.uri (URI) http://nccur.lib.nccu.edu.tw/handle/140.119/111501-
dc.description (描述) 碩士zh_TW
dc.description (描述) 國立政治大學zh_TW
dc.description (描述) 心理學系zh_TW
dc.description (描述) 103752018zh_TW
dc.description.abstract (摘要) 本研究參考自殺的歷程觀，認為長期累積的不利因素將造成個體的自殺危險，且不利因子越多，個體的自殺危險性越高（吳英璋、金樹人、許文耀，民84）。為了在短時間內收集較多的自殺危險個體資料，本研究採用台北市生命線協會協辦的安心專線之電話紀錄為數據進行二次分析，驗證是否高自殺危險個體具有較多的不利因子，並探討不利因素為何？以及具不同自殺危險指標的族群在哪些因子上會有差異。本研究樣本為1182筆於2011至2013年間，在台北市生命線安心專線之資料庫（台灣eSOS自殺危機個案處理系統）留下個案紀錄的資料。去除可辨識個人的資料（姓名、住址等），進行非記名、非互動且非介入性之研究。將資料以過去有無自殺企圖、現在有無自殺意念，區分成四個自殺危險組別。其中本研究依過去理論，推論過去無自殺企圖現在也無自殺意念組（組0）為自殺危險性最低組，具有現在的自殺意念或過去的自殺企圖其中之一者（組1、組2）自殺危險次之，而過去有自殺企圖現在有自殺意念組（組3）為自殺危險性最高組。並以多項式邏輯斯回歸進行分析，探討對於這四個組別具預測力的因子為何。結果顯示女性、有伴侶、獨居、無工作、有精神疾病、有物質濫用皆是會累積造成自殺危險的不利因素，且自殺危險最高的組3的確具有最多的不利因素，組1和組2次之。處在不良或匱乏的人際關係者（有伴侶者、獨居者）較可能具有自殺意念，女性、有心理病理因素者（有精神疾病、有物質濫用者）較可能有過自殺企圖。zh_TW
dc.description.abstract (摘要) According to suicidal process, the suicidal risk factors can cumulatively cause an individual’s suicidal risk. Furthermore, the more suicidal risk factors are, the higher suicidal risk is (Wu, Jin, & Hsu, 1995). Using台灣eSOS自殺危機個案處理系統 as the database, this study undertook a secondary analysis to examine whether the highest suicidal risk group had the most suicidal risk factors and to understand what these risk factors were. Moreover, this study also aimed to find out if there were any differences between different suicidal risk groups. To understand the questions mentioned before, this study analyzed the data of the Taipei Lifeline callers from 2011 to 2013, dividing data into four groups according to previous suicidal attempt record and current suicidal ideation record: group 0 (the lowest suicidal risk group) had no previous suicidal attempt and no current suicidal ideation; group 1 had no previous suicidal attempt but had current suicidal ideation; group 2 had previous suicidal attempt without current suicidal ideation; group 3 (the highest suicidal risk group) had both previous suicidal attempt and current suicidal ideation. This study conducted a multinominal logistic regression to find out which suicidal risk factors could significantly predict the four suicidal risk groups. The results showed that female, having a romantic partner, living alone, unemployment, psychiatric disorders, and substance abuse could all cumulatively cause an individual’s suicidal risk. Furthermore, the group 3 did have the highest suicidal risk factors and was followed by group 2 and 1. The results also showed that having a problematic or lack of interpersonal relationship could lead to higher risk of having current suicidal ideation, while female and people with psychiatric disorder had greater risk of having a previous suicidal attempt.en_US
dc.description.tableofcontents 第一章 緒論 1
第二章 文獻回顧 2
第一節 自殺相關理論 2
第二節 自殺危險因子 5
第三節 研究問題與假設 8
第三章 研究方法 11
第一節 研究資料 11
第二節 研究工具 11
第三節 編碼方式 12
第四節 統計方法 14
第四章 研究結果 15
第一節 樣本特性檢定 15
第二節 主要研究結果 20
第五章 討論 24
第一節 主要研究發現 24
第二節 研究貢獻、限制與展望 29
第六章 參考文獻 32
附錄一 36
附錄二 37		zh_TW
dc.format.extent 1354963 bytes-
dc.format.mimetype application/pdf-
dc.source.uri (資料來源) http://thesis.lib.nccu.edu.tw/record/#G0103752018en_US
dc.subject (關鍵詞) 自殺歷程觀zh_TW
dc.subject (關鍵詞) 自殺危險程度zh_TW
dc.subject (關鍵詞) 自殺危險因子zh_TW
dc.subject (關鍵詞) Suicidal processen_US
dc.subject (關鍵詞) Suicidal risken_US
dc.subject (關鍵詞) Suicidal risk factorsen_US
dc.title (題名) 以自殺歷程觀探索不同自殺危險組別之危險因子： 以台北市生命線安心專線紀錄為依據zh_TW
dc.title (題名) Exploration of suicidal risk factors of different suicidal risk groups through the lens of Suicidal Process: an analysis of suicidal callers of Taipei lifeline associationen_US
dc.type (資料類型) thesisen_US
dc.relation.reference (參考文獻) 內政部統計處（民106年）。內政部統計年報。取自：http://sowf.moi.gov.tw/stat /year /list.htm。
行政院主計總處（民99年）。99年人口及住宅普查總報告提要分析。取自：http://www.stat.gov.tw/ct.asp?xItem=31969&ctNode=548&mp=4
吳英璋、金樹人、許文耀。（1995）。校園自我傷害防治處理手冊.台北市:教育部.
周怡芳、沈中柱。（2014）。統計應用分析報告，台北市自殺統計概述。台北市政府衛生局統計室。
許文耀、鍾瑞玫。（1997）。[自殺危險程度量表] 的編製及其信、效度考驗. 中華心理衛生學刊, 1997, 10.2: 1-17.
Beck, A. T. (1996). Beyond belief: A theory of modes, personality, and psychopathology. In P Salkovskis, (Ed), Frontiers of cognitive therapy (pp. 1-25). New York, NY: Guilford Press
Berman, A. L., Silverman, M. M., & Bongar, B. M. (2000). Comprehensive textbook of suicidology. Guilford Press.
Blakely, T. A., Collings, S. C., & Atkinson, J. (2003). Unemployment and suicide. Evidence for a causal association?. Journal of Epidemiology and Community Health, 57(8), 594-600.
Bongar, B., & Sullivan, G. (2013). The suicidal patient: Clinical and legal standards of care. American Psychological Association.
Borges, G., Angst, J., Nock, M. K., Ruscio, A. M., & Kessler, R. C. (2008). Risk factors for the incidence and persistence of suicide-related outcomes: a 10-year follow-up study using the National Comorbidity Surveys. Journal of Affective Disorders, 105(1), 25-33.
Cavanagh, J. T., Carson, A. J., Sharpe, M., & Lawrie, S. M. (2003). Psychological autopsy studies of suicide: a systematic review. Psychological medicine, 33(03), 395-405.
Cheng, A. T., & Lee, C. S. (2000). Suicide in Asia and the far East. The international handbook of suicide and attempted suicide, 29-48.
Durkheim, E. (1951). Suicide: a Stuidy in Sociology.
Fremouw, W. J., De Perczel, M., & Ellis, T. E. (1990). Suicide risk: Assessment and response guidelines. Pergamon Press.
Goldney, R. D., Dal Grande, E., Fisher, L. J., & Wilson, D. (2003). Population attributable risk of major depression for suicidal ideation in a random and representative community sample. Journal of affective disorders, 74(3), 267-272.
Goldsmith, S. K., Pellmar, T. C., Kleinman, A. M., & Bunney, W. E. (2002).Reducing suicide: a national imperative. National Academies Press.
Harris, E. C., & Barraclough, B. (1997). Suicide as an outcome for mental disorders. A meta-analysis. The British Journal of Psychiatry, 170(3), 205-228
Hatton, C. L., & Valente, S. M. (1984). Suicide, assessment and intervention. Appleton & Lange.
Hawton, K. (2000). Sex and suicide gender differences in suicidal behaviour. The British Journal of Psychiatry, 177(6), 484-485.
Joiner, T. (2005). Why people die by suicide. Harvard University Press.
Inskip, H. M., Harris, E. C., & Barraclough, B. (1998). Lifetime risk of suicide for affective disorder, alcoholism and schizophrenia. The British Journal of Psychiatry, 172(1), 35-37.
Kring, A. M., Johnson, S. L., Davison, G. C., & Neale, J. M. (2012). Abnormal psychology. John Wiley & Sons.
Kposowa, A. J. (2001). Unemployment and suicide: a cohort analysis of social factors predicting suicide in the US National Longitudinal Mortality Study.Psychological medicine, 31(01), 127-138.
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