國中生自傷行為之盛行率與心理因素之相關研究

Abstract

本研究的目的在了解國中生青少年「自我傷害行為」（self-harming behaviour） 之三種次行為類別的盛行率，分別為「刻意自傷」 （deliberate self-harm） 、 「非外顯性自傷」 （non-over self-harm）、 與「衝動性自傷」 （impulsively self-harm）行為，以及其與人口統計學和心理因素的相關性。本研究為橫斷式研究，採用問卷的方式進行資料收集，邀請基隆、台北、桃園、與雲林各一所國中參與。透過學校導師將邀請函連同同意書轉交給學生及其父母，共有1489位家長簽名同意，1489位學生填答問卷，最後得到1271份有效問卷進行分析。分析結果顯示： 1) 「自我傷害行為」之終生盛行率為30.84%，與各次分類下之性別差異；2) 三種次行為類別之盛行率如下：「刻意自傷」為18.57%，「非外顯性自傷」為3.54%，「衝動性自傷」為19.04%；3) 青少年學業表現，與4) 出現「刻意自傷」行為的青少年在家庭因素上與無「刻意自傷」者有顯著差異；5) 「刻意自傷」與部分心理因素呈顯著相關，分別是：壓力源、家人支持、親子溝通、無望感、及憂鬱；6) 壓力源多寡與憂鬱於「刻意自傷」次類別有顯著之可能性比率 （odds ratio）。本研究將針對上述結果作深入的討論，並與過去的文獻進行比較。根據本研究的結果推斷，家人的支持與良性的親子溝通為青少年「刻意自傷」行為之重要保護因子，而壓力源與憂鬱則為預測因子。後續研究方向與臨床意涵亦於本文中提出。

The objectives of the research were to study the prevalence rates of 3 types, Deliberate self-harm (DSH), Non-overt self-harm (NoSH), and Impulsively self-harm (ISH), of the self-harming behaviour (SHB) in junior-high school adolescents, and its relation with some demographic and psychological factors. This is a cross-sectional questionnaire study. One junior-high school from Keelung, Tapei, Tao-Yuan, and Yun-Lin were invited to participate in the study. An invitation letter with consent form were delivered to parents of the adolescent through teachers. A total of 1489 students’ parents signed the consent. Among them, 1489 students returned the questionnaires, but only 1271 were valid for analyses. The analyses reveals: 1) the life-time SHB rate of 30.84% and gender differences; 2) the prevalence of SHB sub-types were 18.57% for DSH, 3.54% for NoSH, and 19.04% for ISH; 3) grade, 4) and familial correlates between adolescents with/out DSH; 5) DSH significantly correlated with psychological factors of stressors, family support, communication, hopelessness, and depression; then 6) significant odds ratios of stressors and depression for DSH. The above findings were discussed and compared with previous reports. It is concluded that supportive family and good communication with the parents are important protective factors, and stressors and depression predictive factors for DSH in adolescents. Directions for future studies and clinical implications are suggested.