| 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 |
| 相關次數: | 點閱:218 下載:40 |
| 分享至: |
| 查詢本校圖書館目錄 查詢臺灣博碩士論文知識加值系統 勘誤回報 |
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.
中華民國教育統計指標(2002)。高等教育-九十學年度大專院校學生數分析。台北市:教育部。
中華民國行政院衛生署(2004a)。歷年死亡柱狀圖。 http://www.doh.gov.tw/statistic/data/死因摘要/92年/歷年自殺死亡柱狀圖.xls
中華民國行政院衛生署(2004b)。台灣地區青年主要死亡原因。http://www.doh.gov.tw/statistic/data/死因摘要/92年/表6.xls。
柯慧貞(民78)。內因性與非內因性憂鬱症在腎上線皮質素抑制反應、認知偏差及生活壓力上之比較。國立台灣大學心理學研究所博士論文。
柯慧貞,廖聆岑,林美芳,蘇鈴茱,丁建谷,林依靜,蔡均棠,劉秀霞,陳孟莉,傅木龍,何進財。(民92)。南區大專校院學生憂鬱與自殺之現況與其成因分析。南區大專院校學務長諮詢會議-憂鬱與自殺研討會。
American Psychiatric Association (1974). Position statement on homosexuality and civil rights. American Journal of Psychiatry, 131, 497.
American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders. 3rd ed. Text Revision. Washington DC: American Psychiatric Association.
Bagley, C., & Tremblay, P. (2000).Elevated rates of suicidal behavior in gay, lesbian, and bisexual youth.Crisis, 21, 111-117.
Balsam, K. F, Beauchaine, T. P., Mickey, R. M., & Rothblum, E. D. (2005). Mental health of lesbian, gay, bisexual, and heterosexual siblings: effects of gender, sexual orientation, and family. Journal of Abnormal Psychology, 114, 471-476.
Bar-Joseph, H., & Tzuriel, D. (2002). Suicidal tendencies and ego identity in adolescence . Adolescence, 25, 215-223.
Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic and statistical considerations. Journal of Personality & Social Psychology, 51, 1173-1182.
Barrios, L. C., Everett, S. A., Simon, T. R., & Brener, N. D. (2000).Suicide ideation among US college students associations with other injury risk behaviors. Journal of American College Health, 48, 229-33.
Bearman, P.S., & Moody, J. (2004). Suicide and friendship among American adolescents. American Journal of Public Health, 94(1), 89-95.
Beck, A.T. (1974). Beamsderfer A. Assessment of depression: the depression inventory. Pharmacopsychiatry,7, 151-69.
Borowsky, I. W., Ireland, M., & Resnick, M. D. (2001). Adolescent suicide attempts: risks and protectors. Pediatrics, 107, 485-493.
Botnick, M. R., Heath, K. V., Cornelisse, P. G.A., Strathdee, S. A., Martindale, S. L., & Hogg, R. S. (2002). Correlates of suicide attempts in an open cohort of young men who have sex with men. Canadian Journal of Public Health, 93, 59-64.
Brener, N. D., Hassan, S. S., & Barrios, L.C. (1999). Suicidal ideation among college students in the United States. Journal of Consulting and Clinical Psychology, 67, 1004-1008.
Brent, D. A., & Perper, J. A. (1995). Research on adolescent suicide: implications for training service delivery, and public policy. Suicide Life Threatening Behaviour, 25, 222-240.
Cain, R. (1991). Stigma management and gay identity development. Social Work, 36, 67-73.
Cass, V.C. (1984). Homosexual identity formation: Testing a theoretical model. The Journal of Sex Research, 20, 143-167.
Chan, C.S. (1989). Issues of identity development among Asian-American lesbians and gay men. Journal of Counseling and Development, 68, 16-20.
Chien, L. L., Ko, H. C., & Wu, Y. W. (2007). The five-factor model of personality and depressive symptoms: One-year follow-up. Personality and individual differences, in press.
Chiu, S. H., Ko, H. C., & Wu Y. W. (2007) Depression moderated the effect of exposure to suicide news on suicidality among college students in Taiwan. Suicide & Life – Threatening Behavior, in press.
Cochran S. & Mayo V. (2000). Lifetine prevalence of suicide symptoms and affective disorders among en reporting same sex sexual parteners: results from the NHANES III. American Journal of Public Health, 90, 573-578.
D’Augelli, A.R., Hershberger, S.L. (1993). Lesbian, gay, and bisexual youth in community settings: Personal challenges and mental health problems. American Journal of Community Psychology, 21, 421-449.
D’Augelli, A.R., Hershberger, S.L., & Pilkington, N.W. (1998). Lesbian, gay, and bisexual youth and their families: Disclosure of sexual orientation and its consequences. American Journal of Orthopsychiatry, 68, 361-371.
D’Augelli, A. R., Grossman, A. H., Salter, N. P., Vasey, J. J., Starks, M. T., Sinclair, K. O. (2005). Predicting the suicide attempts of lesbian, gay, and bisexual youth. Suicide & Life – Threatening Behavior, 35, 646-660.
D’Augelli, A. R., Hershberger, S. T., & Pilkington, N. W. (2001). Suicidality patterns and sexual orientation relatd factors among lesbian, gay, and bisexual youths. Suicide & Life – Threatening Behavior, 31, 250-262.
Dempsey, C.L. (1994). Health and social issues of gay, lesian, and bisexual adolescents. Families in Society, 75,160-.
Diamond, L. M. (2003). New paradigms for research on heterosexual and sexual-minority development. Journal of Clinical Child and Adolescent Psychology, 32, 490-498.
Elizur Y., & Mintzer A. (2001). A framework for the formation of gay male identity: Processes association with adult attachment style and support from family and friends. Archives of Sexual Behavior, 30, 143-167.
Erikson, E. (1963). Childhood and society (2nd ed.). New York: W. W. Norton.
Erikson, E. (1968). Identity: Youth, and crisis. New York: W. W. Norton.
Eskin, M., Kaynak-Demir, H., & Demir, S. (2005). Same-sex sexual orientation, childhood sexual abuse, and suicidal behavior in university students in Turkey. Archives of sexual behavior, 34,185-95.
Fassinger, R.E., & Miller, B.A. (1996). Validation of an inclusive model of sexual minority identity formation on a sample of gay men. Journal of Homosexuality, 32, 53-78.
Faulkner, A. H., Cranston, K. (1998). Correlates of same-sex sexual behavior in a random sample of Massachusetts high school students. American Journal of Public Health, 88, 262-266.
Felts, W. M., Chehier, T., & Barnes, R. (1992). Drug use and suicide ideation and behavior among North Carolina public school students. American Journal of Public Health, 82, 870-872.
Fergusson, D. M., Horwood, L. J., & Beautrais, A. L. (1999). Is sexual orientation related to mental health problems and suicidality in young people? Archives of General Psychiatry, 56(10), 876-880.
Fikar, C. R. (1992). Gay teens and suicide. Pediatrics, 89, 519-520.
Fitzpatrick, K. K., Euton, S. J., Jones, J. N., & Schmidt, N. B. (2005). Gender role, secual orientation and suicide risk. Journal of Affective Disroders, 87, 35-42.
Ford, J. A., & Jasinski, J. L. (2006). Sexual orientation and substance use among college students. Addictive behaviors, 31(3):404-13.
Fortuna, L. R., Perez, D. J., Canino, G., Sribney, W., & Alegria, M. (2007). Prevalence and correlates of lifetime suicidal ideation and suicide attempts among Latino subgroups in the United States. The Journal of clinical psychiatry, 68, 572-81.
Frable, D.E.S., Wortman, W., & Joseph J. (1997). Predicting self-esteem, well-being, and distress in a cohort of gay men: The importance of cultural stigma, personal visibility, community network, and positive identity. Journal of Personality, 65(3), 599-624.
Garofalo, R., Cameron, W., Wissow, L. S., Woods, E. R., & Goodman E. (1999). Sexual orientation and risk of suicide attempts among a representatice sample of youth. Archives Pediatrics & Adolescent Medicine, 91, 903-906.
Garofalo, R., Wolf, R.C., Kessal, S., Palfrey, J. & DuRamt, R.H. (1998). The association between health risk behaviours and sexual orientation among a school-based sample of adolescents. Pediatrics, 101, 895-902.
Goffman, E. (1963). Stigma: notes on the management of spoiled identity. New York: Simon & Schuster, Inc.
Gonsiorek, J. (1988). Mental health issues of gay and lesbian adolescents. Journal of Adolescent Health Care, 2, 114-122.
Gonsiorek, J. C., Sell, R. L., & Weinrich, J. D. (1995). Definition and measurement of sexual orientation. Suicide & Life - Threatening Behavior, 25, 40
de Graaf, R., sandfort, G. M., & ten Have, M. (2006). Suicidality and sexual orientation: differences between men and women in a general population-based sample from the Nteherlands. Archives of sexual Behavior, 35, 253-262.
Griensven, F.V., Kilmarx, P.H., Jeeyapant, S., Manopaibmoom, C., Korattana, S., Jenkins, R.A., Uthaivoravit, W., Limpakarnjanarat, K., & Mastro, T.D. (2004). The prevalence of bisexual and homosexual orientation and related health risks among adolescents in northern Thailand. Archives of sexual Behavior, 33(2), 137-147.
Harrison, T. W. (2003). Adolescent homosexuality and concerns regarding disclosure. Journal of School Health, 73, 107-112.
Harry, J.(1983) Parasuicide, gender and gender deviance. Journal of Health and Social Behaviour, 24, 305-361
Herek, G. M., Gillis, J. R., & Cogan, J. C. (1999). Psychological sequelate of hate crime victimizartion among lesbian, gay, and bisexual adults. Journal of Consulting and Clinical Psychology, 67, 945-951.
Hershberger, S. L., & D’Augelli, A. R. (1995). The impact of victimization on the mental helth and suicidality of lesbuan, gay, and bisexual youths. Developmental Psychology, 31, 65-74.
Herrell, R., Goldberg, J., True, W. R., Ramakeishnan, V., Lyons, M., Eisen, S., and Tsuang, M. D. (1999). Sexual orientation and suicidality: a co-twin control stud in adult men. Archives of general Psychiatry, 56, 867-874.
Hidaka, Y., & Operario, D. (2005). Attempted suicide, psychological health and exposure to harassment among Japanese homosexual, bisexual, or other men questioning their sexual orientation recruited via the internet. Journal of Epidemiology Community Health, 60, 962-967.
Janssen, I., Hanssen, M., Bak, M., Biji, R. V., de Graaf, R., Vollebergh, W., wr al. (2003). Discrimination and delusion ideation. British Journal of Psychiatry, 182, 71-76.
Joiner Jr., T. E. (2003). Contagion of suicide symptoms as a function of assortative relating and shared relationship stress in college roommates. Journal of Adolescents, 26, 495-504.
Jorm, A. F., Korten, A. E., Rodgers, B., Jacomb, P. A., & Christensen, H. (2002). Sexual orientation and mental health: results from a community survey of young and middle-aged adults. British Journal of Psychiatry, 180, 423-7.
Judd, C. M., Kenny, D. A. (1981). Process analysis: Estimating mediation in treatment evaluations. Evaluation Review, 5, 602-619.
Kadushin, G. (1996). Gay men with AIDS and their families of origin: An Analysis of social support. Health and Social Work, 21, 141-149.
Kinsey, A. C., Pomeroy, W.B., & Martin, C.E. (1948). Sexual behavior in the human male. Philadelphia: W. B. Saunders, p.659.
Kisch, J., Leino, V., & Silverman, M. M. (2005). Aspects of suicide behavior, depression, and treatment in college students: results from the spring 2000 National College Health Assessment Survey. Suicide and Life-Threatening Behavior, 35, 3-13.
Kumar, G., & Steer, R. A. (1995). Psychosocial correlates of suicidal ideation in adolescent psychiatric inpatients. Suicide Life Threatening Behaviour, 25, 339-346.
LaSala, M.C.(2000). Lesbians, gay men, and their parents: Family therapy for the coming out crisis. Family process, 39, 67-81.
Lebson, M. (2002).Suicide among homosexual youth. Journal of Homosexuality, 42, 107-17.
Lewissohn, P.M., Rohde, P., & Seeley, J. R. (1996) Adolescent suicide ideation and attempts: risk factors and clinical implications. Clinical Psychology Science Practice, 3, 25-46.
Link, B.G., Struening, E.L., Rahav, M., Phelan, J.C. & Nuttbrock, L. (1997). On stigma and its consequences: Evidence from a longitudinal study of men with dual diagnoses of mental illness and substance abuse. Journal of Health and Social Behavior, 38, 177-190.
Liu, J. X., & Choi, K. (2006). Experiences of social discrimination among men who have sex with men in ShangHai, China. AIDS & Behavior, 10, 25-33.
Mathy, R. M. (2002). Suicidality and sexual orientation in five continents: Asia, Australia, Europe, North America, and South America. International Journal of Sexuality and Gender Studies, 7, 215-225.
McAndrew, S. & Warne, T. (2004). Ignoring the evidence dictating the practice: sexual orientation, suicidality and the dichotomy of the mental health nurse Journal of Psychiatric and Mental Health Nursing, 11, 428-434.
McQuillan, C.T., & Rodriguez J. (2000). Adolescent suicide: a review of the literature. Boletin de la Association Medica de Puerto Rico, 92, 30-38.
Meyer, H. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychological Bulletin, 129, 674-697.
Muehrer, P. (1995). Suicide and sexual orientation: a critical summary of recent research and direction for future research. Suicide Life Threatening Behaviour, 25, 72-81.
Paul, J. P., Catania, J., Pollack, L., Moskowitz, J., Canchola J., Mills, T., Binson, D., & Stall, R. (2002). Suicide attempts among gay and bisexual men: lifetime prevalence and antecedents. American Journal of public Health, 92, 1338-1345.
Poters, P. R., Sandhu, D. S., & Longwell-Grice, R. (2002). Understanding adolescent suicide: A psychosocial interpretation of developmental and contextual factors. Adolescence, 37, 805-814.
Pinhey, T. K., Millman, S. R. (2004). Asian/pacific islander adolescent sexual orientation and suicide risk in Guam. American Journal of Public Health, 94, 1204-1206.
Polderl, M., & Fartacek, R. (2005). Sucidiality and associated risk factors among lesbian, gay, bisexual compared to heterosexual Austrian adults. Suicide & Life – Threatening Behavior, 35, 661-670.
Remafedi, G., Farrow, J.A. & Deister, R.W. (1991). Risk factors for attempted suicide in gay men and bisexual youths. Pediatrics, 87, 869-875.
Remafedi, G., French, S., Story, M., Resnick, M. D., & Blum, R. (1998). The relationship between suicide risk and sexual orientation: results of a population-based study. American Journal of Public Health, 88, 57-60.
Reynolds, W. M. (1991). Psychometric characteristics of the Adult Suicidal Ideation Questionnaire in college students. Journal of personality assessment, 56, 289-307.
Rich, C.L., Fowler, R.C., Young, D. & Blenkush, M. (1986). SanDiego suicide study: a comparison of gay to straight males. Suicide and Life Threatening Behaviour, 16, 448-457.
Robin, L., Brener, N. D., Donahue, S. F., Hack, T., Hale, K., & Goodenow, C. (2002). Associations between health risk behaviors and opposite, same, and both-sex sexual partners in representative samples of Vermont and Massachusetts high school students. Archives of Pediatric Adolescent Medicine, 156, 349-355.
Ross, M. W. (1985). Actual and anticipated societal reaction to homosexuality and adjustment in two societies.Journal of Sex Research, 21, 40-55.
Rotheram-Borus, M. J., Hunter, J., & Rosario, M. (1994). Suicidal behavior and gay-related stress among gay and bisexual male adolescents. Journal of Adolescent Research, 9(4):498-508.
Rudd, M.D. (1989). The prevalence of suicidal ideation among college students. Suicide and Life Threatening Behaviour, 19, 173-83.
Russell, S. T., Franz, B. T., & Driscoll A. K. (2001). Same-sex romantic attraction and experiences of violence in adolescence. American Journal of Public Health, 91, 903-906
Russell, S. T., Joyner, K. (2001). Adolescent sexual orientation and suicide risk: evidence from a national study. American Journal of Public Health, 91, 1276-1281.
Rutter, P.A., & Soucar, E. (2002). Youth suicide risk and sexual orientation. Adolescence, 37(146) , 289-299.
Saewyc, E. M., Bauer, G. R., Skay, C. L., Bearinger, L. H., Resnick, M. D., Reis, E., & Murphy, A. (2004). Measuring sexual orientation in adolsecent health surveys: evaluation of eight school-based surveys. Journal of Adolescent Health, 35, 345-358.
Safren, S. A., & Heimberg, R. G. (1999). Depression, hopelessness, suicidality, and related factors in sexual minority and heterosexual adolescents. Journal of Consulting and Clinical Psychology, 67, 859-566.
Savin-Williams, R. C. (1989). Parental influences on the self-esteem of gay and lesbian youths: A reflected appraisals model. Journal of Homosexuality, 17, 93-109.
Savin-Williams, R.C. (1998). The disclosure to families of same-sex attraction by lesbian, gay, and bisexual youth. Journal of Research on Adolescences, 8, 49-68.
Sell, R. L., Wells, J. A., & Wypij, D. (1995). The prevalence of homosexual behavior and attraction in the United States, the United Kingdom and France: Results of national population-based samples. Archives of Sexual Behavior, 24(3), 235-248.
Shaffer, D., Fisher, P., Hicks, R.H., Parides, M. & Gould, M. (1995). Sexual orientation in adolescents who commit suicide. Suicide and Life Threatening Behaviour, 25, 64-71.
Shively, M. G., & De Cecco, J. P. (1977). Components of sexual identity. Journal of Homosexuality, 2, 41-48.
Savin-Williams, R.C. (1998). The disclosure to families of same-sex attraction by lesbian, gay, and bisexual youth. Journal of Research on Adolescences, 8, 49-68.
Skegg, K., Nada-Raja, S., Dickson, N., Paul, C., & Williams, S. (2003).Sexual orientation and self-harm in men and women. American Journal of Psychiatry, 160, 541-6.
Soremson, S. B., & Rutter, C. M. (1991). Transgenerational patterns of suicide attempt. Journal of Consulting and Clinical Psychology, 59, 861-866.
Strang, S., & Orlofsky, J. D. (1990). Factors underlying suicidal ideation among college students: A test of Teicher and Jacob’s model. Journal of Adolescence, 13, 39-52.
Stronski-Huwiler, S.M., & Remafedi, G. (1998). Adolescent homosexuality . Advance in Pediatrics, 45, 107-44.
The Durex Global Survey(2005) <Availablehttp://www.durex.com/cm/gss2005result.pdf >
Troiden, R.R. (1989). The formation of homosexual identities. Journal of Homosexuality, 17, 43-73.
Wagner, B. M., Cole, R. E., & Schwartzman, P. (1995). Psychosocial correlates of suicide attempts aming junior and senior high school youth. Suicide Life Threatening Behaviour, 25, 358-372.
Weinberg, M. S., & Williams, C. J. (1974). Male homosexuals: Their problems and adaptations. New York: Oxford University Press.
Weston, K. (1991). Families we choose: Lesbians, gays, kinship. New York: Columbia University Press.
Willis, D. G. (2004). Hate crimes against gay males: an overview. Issues in Mental Health Nursing, 25, 115-132.
Yu, R. L., & Ko, H. C. (2006). Cognitive determinants of MDMA use among college students in Sothern Taiwan. Addictive Behaviors, 31, 2199-2211.