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研究生: 鄭聖樺
Jeng, Sheng-hua
論文名稱: 性別對於台灣大學生性傾向與自殺關連性之調節分析
Gender moderated the relationship between sexual orientation and suicidality among college students in Taiwan
指導教授: 柯慧貞
Ko, Huei-Chen
學位類別: 碩士
Master
系所名稱: 醫學院 - 行為醫學研究所
Institute of Behavioral Medicine
論文出版年: 2007
畢業學年度: 95
語文別: 中文
論文頁數: 89
中文關鍵詞: 性傾向性別差異自殺意念自殺企圖自殺危險因子
外文關鍵詞: gender, suicidality, sexual orientation
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  • 研究背景與目的 
      性傾向與大學生自殺的關係在國內缺乏以具代表性樣本所進行的調查分析。過去研究指出,少數性傾向者的自殺意念與企圖均較高,但有的研究指出只有男性少數性傾向才有較高的自殺企圖,故性別對於自殺與性傾向間關係的調節作用仍須驗證與解釋。同性性傾向者的高自殺危險性並不能由一般自殺危險因子(憂鬱、非法藥物使用、以及親人及朋友的自殺企圖)所完全解釋;而同性性傾向者可能經驗許多性傾向特有的壓力源;但過去的對於性傾向與自殺間關係的研究多半缺乏性傾向相關因子的討論,或是使用的樣本缺乏代表性,因此本研究將(一)比較不同性別性傾向的自殺意念與自殺企圖(二)探討在控制一般自殺危險因子後,性傾向相關的自殺危險因子(性傾向的接受度、因性傾向而遭受的暴力行為)是否預測台灣男性大學生少數性傾向與自殺意念與企圖。
        
    研究方法 
      本研究採橫斷式設計,在2004-2005年間使用自陳式問卷收集全國大專院校透過分層叢集抽樣法收得有效樣本2,613名大學生的過去一個月的自殺意念、過去一年的自殺企圖、性傾向以及自殺危險因子(包含:憂鬱症狀、非法藥物使用、過去一年親友自殺企圖、父母或朋友對性傾向的接受度、因性傾向而遭受的暴力)資料。
        
    研究結果 
      台灣大學生中少數性傾向組(同性戀、雙性戀或對性傾向不確定者)一共118名(4.5%),在過去一個月的自殺意念以及過去一年的自殺企圖顯著的高於異性戀組(t=3.73, p<.001; χ2=9.03, p<.01)。以多元階層迴歸(multiple hierarchical regression)以及羅吉斯階層迴歸(logistic hierarchical regression)進行分析,性別對性傾向與自殺企圖/自殺意念間關係的調節效果達到顯著(=-.10, p<.001; OR=.24, 95% CI=.06, .99)。進一步進行單純主要效果分析,只有在男性中,少數性傾向組在過去一個月的自殺意念及過去一年的自殺企圖上顯著高於異性戀組(t=3.31, p<.001; χ2=17.37, p<.01)。以多元階層迴歸以及羅吉斯階層迴歸進行分析,發現男性性傾向與自殺意念之間的關係可以透過憂鬱、朋友的自殺企圖、父母對於性傾向的接受度以及朋友對於性傾向的接受度所中介。而男性性傾向與自殺企圖之間的關係則可被憂鬱症狀、過去一年親人自殺企圖部分中介,由父母或朋友對性傾向的接受度完全中介。進一步分析在控制了憂鬱、親友的自殺企圖之後,發現父母以及朋友對於性傾向的接受度仍可顯著預測自殺意念,而朋友接受度仍可顯著預測自殺企圖。
        
    研究結論 
      本研究發現少數性傾向台灣大學生中,男性少數性傾向之自殺意念與企圖較高。對男性而言,在控制憂鬱症狀、過去一年親友的自殺企圖後,父母與朋友對其性傾向的接受度可預測自殺意念,而朋友對於性傾向的接受度可進一步預測自殺企圖。但是,本研究的限制是本研究為橫斷性研究,變項在時間上發生的先後順序無法確切得知,因此無法得到明確的因果關係,往後研究應朝向縱貫性設計努力。而本研究建議對少數性傾向大學生應鼓勵其培養獨立判斷與堅毅的性格,不輕易因為他人的不贊同與不喜歡而否定自我價值,在有憂鬱困擾時,能夠主動尋求專業協助。

    Objectives:
      This study examined the moderating effects of gender on the relationship of sexual orientation to suicidality among college students and the mediating factors between sexual orientation and suicidality.
      
    Methods:
      A representative sample, consisting of 1,288 females and 1,325 males completed the self-administered questionnaires.
      
    Results: 
      Results found that individuals who were gay, lesbian, bisexual and not sure (GLBN) had more severe suicide ideations, and a higher suicide attempt rate compared to their heterosexual peers.  The hierarchical regression analyses showed that an interaction between gender and sexual orientation reached significance in predicting suicide ideation or suicide attempt.  Further analyses revealed only GLBN males were more likely to be at risk for suicidality.  Depressive symptoms and suicide attempts among relatives partially mediated, but the perceived acceptance from parents or friends completely mediated the relationship between sexual orientation and suicide attempt.
      
    Conclusions:
      GLBN male college students in Taiwan were at a higher risk for suicide ideation and suicide attempt compared to their peers, and such risk was explainable through their depressive symptoms, suicide attempts among relatives, and perceived acceptance from parents or friends.

    摘要…I Abstracts…III 致謝…IV 內文目錄…V 附錄目錄…VII 表目錄…VII 圖目錄…VIII 第一章 研究背景 第一節 研究性傾向與大學生自殺問題的重要性…1  壹、自殺行為的定義…1  貳、性傾向的定義與測量…2  參、性傾向與自殺之關係…4  肆、小結…6 第二節 性別對性傾向與自殺的影響…7  壹、性別對於性傾向與自殺間關係的影響…7  貳、小結…9 第三節 透過自殺危險因子探討性傾向與自殺之間的關係…10  壹、一般自殺危險因子…10  貳、與性傾向相關的壓力源…11  參、與性傾向相關的自殺危險因子…13 一、父母及朋友接受度…13 二、因性傾向而受到的暴力14  肆、小結…15 第四節 研究目的與假設…16  壹、研究目的…16  貳、研究問題與假設…16 第二章 研究方法 第一節 研究樣本…18 第二節 研究工具…20 1.人口學變項…20   2.自殺意念…20   3.自殺企圖…20   4.性傾向…20   5.憂鬱症狀…21   6.非法藥物使用…22   7.親人與朋友的自殺企圖…22   8.父母以及朋友對性傾向的接受度…23   9.因性傾向而遭受的暴力…23 第三節 研究程序…25 第四節 統計方法與資料處理…26 第三章 研究結果 第一節 人口統計變項與描述統計…29 壹、樣本特性…29 貳、主要變項之描述統計與差異檢定…30 第二節 各研究變項之相關…37 第三節 少數性傾向組與異性戀組在自殺意念和自殺企圖之比較…40 第四節 性別對性傾向與自殺間關係之調節分析…40   壹、性別調節性傾向與自殺意念之間的關係…41   貳、性別調節性傾向與自殺企圖之間的關係…42   參、少數性傾向組中自殺危險因子的性別差異…43 第五節 自殺危險因子對性傾向與自殺關係之中介分析…44   壹、性傾向、自殺危險因子與自殺意念…44   貳、性傾向、自殺危險因子與自殺企圖…47 第六節 控制一般自殺危險因子後性傾向相關危險因子對自殺之解釋力…49   壹、父母與朋友對性傾向的接受度預測自殺意念…49   貳、朋友對性傾向的接受度預測自殺企圖…50 第四章 討論 第一節 本研究之主要發現與解釋…53   壹、 性傾向的盛行率…53   貳、 性傾向與自殺行為…54   參、 性別調節性傾向與自殺行為間的關係…54   肆、 男性中性傾向與自殺關連性之顯著危險因子…55    一、 憂鬱…56    二、親人自殺…56    三、父母與朋友對於性傾向的接受度…57 第二節 研究限制與未來研究之建議…61 第三節 研究貢獻與臨床應用之建議…63  壹、本研究之理論貢獻…63  貳、本研究之應用價值…63 中文參考文獻…65 英文參考文獻…66 附錄目錄 附錄I 個人資料表…77 附錄II 自殺意念量表…82 附錄III 瞭解你的生命經驗量表…83 附錄IV 性傾向問卷…84 附錄V 柯氏憂鬱量表…85 附錄VI 非法藥物使用…88 附錄VII 同意書…89 表目錄 表一、中華民國教育統計之高等教育類別…18 表二、性傾向盛行率…30 表三、自殺意念得分…30 表四、自殺企圖盛行率…31 表五、憂鬱症狀得分……31 表六、非法藥物使用盛行率…32 表七、朋友曾有過自殺企圖盛行率…32 表八、親人曾有過自殺企圖盛行率…33 表九、朋友對於性傾向接受度得分…33 表十、親人對於性傾向接受度得分…34 表十一、因性傾向而遭受的暴力或言語侮辱…34 表十二、研究主要變項之描述統計…36 表十三、男性樣本中研究變項間的相關表…38 表十四、女性樣本中研究變項間的相關表…39 表十五、異性戀組與少數性傾向組在過去一個月的自殺意念之比較…40 表十六、異性戀組與少數性傾向組在過去一年的自殺企圖之比較…40 表十七、性別調節性傾向與自殺意念之迴歸分析…41 表十八、性別調節性傾向與自殺意念關係之簡單主要效果分析…42 表十九、性別調節性傾向與自殺企圖之迴歸分析…42 表二十、性別調節性傾向與自殺企圖關係之簡單主要效果分析…43 表二十一、男性樣本中性傾向預測自殺意念之迴歸分析…44 表二十二、男性樣本中性傾向預測憂鬱症狀之迴歸分析…44 表二十三、男性樣本中性傾向預測過去一年親人的自殺企圖之迴歸分析…45 表二十四、男性樣本中性傾向預測過去一年朋友的自殺企圖之迴歸分析…45 表二十五、男性樣本中性傾向預測父母對於性傾向之接受度之迴歸分析…45 表二十六、男性樣本中性傾向預測朋友對於性傾向的接受度之迴歸分析…45 表二十七、男性樣本中性傾向預測因性傾向而遭受的暴力或侮辱之迴歸分析…45 表二十八、多元階層迴歸預測過去一個月的自殺意念:檢視自殺危險因子對於性傾向與自殺意念間的中介效果…46 表二十九:羅吉斯階層迴歸預測過去一年的自殺企圖:檢視自殺危險因子對於性傾向與自殺企圖間的中介效果…48 表三十:多元階層迴歸預測過去一個月的自殺意念:檢驗朋友對性傾向的接受度在控制一般自殺危險因子後對自殺意念之解釋力…49 表三十一:多元階層迴歸預測過去一個月的自殺意念:檢驗父母對性傾向的接受度在控制一般自殺危險因子後對自殺意念之解釋力…50 表三十二:多元階層迴歸預測過去一年的自殺企圖:檢驗朋友對性傾向的接受度在控制一般自殺危險因子後對自殺企圖之解釋力…51 表三十三:多元階層迴歸預測過去一年的自殺企圖:檢驗父母對性傾向的接受度在控制一般自殺危險因子後對自殺企圖之解釋力…52 圖目錄 圖一、性別調節性傾向與自殺意念及自殺企圖之關係意示圖…16 圖二、性傾向、自殺危險因子與自殺意念自殺企圖之路徑圖-中介模式…17

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