臺灣博碩士論文加值系統

研究背景：自殺企圖與無死亡意圖自我傷害是自殺身亡的危險因子，也是國中生嚴重的偏差行為問題。為給予不同自我傷害行為有效的衡鑑與相對應的介入方式，釐清不同自我傷害行為的差異，以及了解自我傷害行為的心理歷程是重要的，但目前鮮少有研究提出整合性的心理模型說明自我傷害行為的心理歷程，並比較其中差異。
研究目的：本研究將以逃避理論作為基本架構，比較過去一年有自殺企圖、無死亡意圖自我傷害與無自我傷害行為（即未有自殺企圖與無死亡意圖自我傷害）的國中生在負向完美主義、苦惱自責與憂鬱上的差異，同時檢驗這些變項所組成的模式是否可用以解釋自我傷害行為。
研究方法：研究參與者為台南市某國中國一國二之學生，共計542名（男：261人，48.2%；女：281人，51.8%）。測驗工具包括了個人基本資料、青少年憂鬱反芻問卷、柯氏憂鬱量表、中文版多向度完美主義量表、自我傷害行為問卷。統計方法利用SPSS 17.0進行描述行統計與ANOVA，且透過Amos 18.0進行徑路分析。
研究結果：以變異數分析比較，自殺企圖組117人（22%），無死亡企圖自我傷害組84人(15%)，無自我傷害行為控制組341人（63%）。結果顯示，三組在負向完美主義、苦惱自責與憂鬱間的平均數達顯著差異。自殺企圖組在三項指標上的得分最高、無死亡意圖自我傷害組次之，無自我傷害行為控制組最低。另外，徑路分析顯示負向完美主義無法直接預測自我傷害行為，而須透過苦惱自責或憂鬱的完全中介。苦惱自責部分中介負向完美主義與憂鬱的關係；憂鬱則部分中介苦惱自責與自我傷害行為的關係。
結論與建議：本研究結果指出國中生自殺企圖與無死亡意圖均與負向完美主義、苦惱自責及憂鬱程度有關，但在嚴重度上有所不同，自殺企圖高於無死亡意圖自我傷害，故兩者可能非質的不同，而是量的差異。

Self-harm behaviors are serious maladaptive behaviors among adolescents. The aims of the current study were to evaluate the differences among non-suicidal self-injury (NSSI), suicide attempts (SA), and No self-harm behaviors over the past twelve months in levels of maladaptive perfectionism, brooding, and depression, as well as to test a psychological model of self-harm behaviors. Data were obtained from 542 junior high school students in Taiwan. Results illustrated significant differences on maladaptive perfectionism, maladaptive rumination and levels of depression among adolescents with NSSI and adolescents with SA over the past twelve months. The results of post hoc analyses showed that the NSSI group reported significantly higher levels of maladaptive perfectionism, maladaptive rumination, and depressive symptoms compared to the no self-harm group; moreover, the SA group revealed significantly increased levels of maladaptive perfectionism, maladaptive rumination, and depressive symptoms compared to the NSSI group. Furthermore, the model of psychological self-harm behaviors was validated.

第一章 研究背景 1
第一節 自我傷害行為的嚴重性 1
壹、自我傷害行為的定義與盛行率 1
貳、自殺企圖的定義與盛行率 2
參、無死亡意圖自我傷害的定義與盛行率 3
肆、小結 3
第二節 自殺企圖與無死亡意圖自我傷害之差異 4
壹、異質論 4
貳、連續論 6
參、小結 8
第三節 逃避理論與自我傷害行為 9
壹、自我傷害行為的逃避理論 9
貳、完美主義與自我傷害行為 11
一、完美主義的定義與理論 11
二、完美主義的測量 13
（一）Frost多向度完美主義量表 13
（二）Hewitt多向度完美主義量表 15
三、完美主義與自我傷害行為的實徵研究回顧 15
參、憂鬱反芻與自我傷害行為 16
一、憂鬱反芻的定義與理論 16
二、憂鬱反芻的測量 17
三、憂鬱反芻與自我傷害行為的實徵研究回顧 19
肆、憂鬱與自我傷害行為 20
一、憂鬱的定義與理論 20
二、憂鬱的測量 20
（一）柯氏憂鬱量表 20
（二）貝克憂鬱量表第二版 21
三、憂鬱與自我傷害行為的實徵研究回顧 22
伍、完美主義、憂鬱反芻、憂鬱及自我傷害行為 24
一、完美主義、憂鬱反芻與憂鬱 24
二、完美主義、憂鬱反芻與自我傷害行為 25
三、完美主義、憂鬱與自我傷害行為 26
四、憂鬱反芻、憂鬱與自我傷害行為 27
五、完美主義、憂鬱反芻、憂鬱與自我傷害行為 27
陸、小結 29
第四節 研究目的與假設 30
第二章 研究方法 32
第一節 研究參與者與研究流程 32
第二節 測量工具 33
壹、個人資料表 33
貳、青少年憂鬱反芻問卷 33
參、柯氏憂鬱量表 35
肆、中文版多向度完美主義量表 35
伍、自我傷害行為問卷 36
第三節 統計方法 37
第三章 研究結果 38
第一節 樣本特性 38
第二節 變項間的相關 39
第三節 三組在負向完美主義、苦惱自責、憂鬱程度上的組間差異 40
第四節 模式驗證 41
壹、模式適配度分析 41
貳、模式變相間中介分析 41
參、模式變項間的效果 43
一、模式變項間直接效果 43
二、模式變項間間接效果 43
三、模式變項間全體效果 43
第四章 討論 45
第一節 本研究之重要研究結果 45
第二節 自我傷害行為盛行率 46
第三節 三組在負向完美主義、苦惱自責與憂鬱程度間之差異 47
第四節 自我傷害行為模式檢驗 48
壹、負向完美主義、苦惱自責與憂鬱 48
貳、苦惱自責、憂鬱與自我傷害行為 48
參、負向完美主義與自我傷害行為 49
第五節 研究限制 50
壹、抽樣方式 50
貳、行為測量 50
參、研究設計 50
第六節 研究貢獻 51
壹、理論貢獻 51
貳、臨床貢獻 51
參考文獻 52

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