【研究背景】
學齡兒童自傷行為有其高盛行率與嚴重性，近期研究進一步將自傷行為細分為有無自殺意圖之自傷，因無自殺意圖之自傷與有自殺意圖之自傷兩者可能在特性與成因上有所不同；而過去研究多呈現有自殺意圖之自傷與無自殺意圖之自傷在負向經驗上、負向情緒的變項之差異，而無針對情緒調節歷程上的差異做研究，也未能作出統整性的解釋，且少有研究聚焦在有自殺意圖之自傷、無自殺意圖之自傷與無自傷的差異三組比較，目前仍缺乏加入對照組作比較，以及少有研究將社區學齡兒童作為研究樣本。
給予不同自傷行為有效的衡鑑與介入方式，釐清不同自傷行為的差異，以及了解不同自傷行為的心理歷程有其重要性，目前台灣鮮少有研究提出情緒調節歷程說明學齡兒童自傷行為的心理歷程，本研究以國小四、五年級學齡兒童為研究對象，對有自殺意圖之自傷、無自殺意圖之自傷與無自傷在情緒調節歷程上之差異與負向生活事件內容之差異進行探討，以及建構出心理社會壓力、憂鬱、情緒調控與自殺意圖至自傷頻率之路徑的假設歷程模式。
過去研究顯示兒童與青少年自傷行為和憂鬱症狀有關，而壓力會影響兒童的憂鬱症狀，當採用不適應的壓力因應策略來因應壓力時，會增加其憂鬱症狀，故本研究將探討壓力因應策略與自傷行為之間的關係；而自傷者被認為缺乏適應良好之情緒調節策略，因此當產生負向情緒時，自傷者傾向使用不適應之情緒調節策略，導致最後產生自傷行為以緩解情緒，在不適應的情緒策略中，壓抑情緒表達及衝動情緒表達已被證實與憂鬱症狀與自傷行為相關，故本研究以上述相關變項探討有自殺意圖之自傷、無自殺意圖之自傷與無自傷在情緒調節歷程上之差異與負向生活事件內容之差異，並建立一心理社會壓力、憂鬱、情緒調控與自殺意圖至自傷頻率之路徑，檢視有無自殺意圖之自傷者在路徑上的差異。
【研究目的】
1.探討有自殺意圖之自傷、無自殺意圖之自傷與無自傷組在情緒調節歷程上之差異。
2.探討有自殺意圖之自傷、無自殺意圖之自傷與無自傷組在負向生活事件內容上之差異。
3.建構心理社會壓力、憂鬱、情緒調控與自殺意圖至自傷頻率之路徑。
A.探討逃避因應策略與負向生活事件及兒童憂鬱症狀間的關係。
B.探討衝動情緒表達及自殺意圖在憂鬱症狀至自傷頻率間所扮演的角色。
【研究方法】
1.參與者：以台南市三所國小四、五年級學生為樣本，在排除資料未填寫完全之參與者後，共475位學生納入研究分析。
2.研究工具：「基本資料問卷」、「兒童自傷行為問卷（Children’s Self-injury Questionnaire, CSIQ）」、「兒童生活事件量表（Children’s Life Events Scale, CLES）」、「兒童因應策略量表（Children’s Coping Strategies Scale，CCSS）」、「兒童情緒行為檢核表（Child Behavioral and Emotional Checklist for Ages 4-16, CBECL/4-16）」、以及「兒童情緒調節量表（Children’s Emotion Regulation Scale，CERS）」。
3.研究程序：在取得人體試驗委員會同意後，取得家長及學童的同意書，以標準化施測程序於各校提供之場地分別進行團體施測，並於施測後進行資料的輸入及分析。
4.統計分析：針對研究問題，研究者將使用描述統計、相關分析、結構方程式模型來進行資料的分析。
【研究結果】
1.有自殺意圖之自傷組比無自殺意圖之自傷組經歷較多負向生活事件，且較常使用逃避因應策略，並經驗較高的憂鬱症狀；而有自殺意圖之自傷組較無自傷組較常使用壓抑情緒表達與衝動情緒表達；無自殺意圖之自傷組較無自傷組較常使用分心策略，以及較常使用壓抑情緒表達與衝動情緒表達。
2.有自殺意圖之自傷組有較高的比例經歷較嚴重的家庭負向事件；無自殺意圖之自傷組有較高的比例經歷典型的負向事件。
3.心理社會壓力、憂鬱、情緒調控與自殺意圖至自傷頻率之路徑：負向生活事件可透過逃避因應策略的調節作用，預測兒童憂鬱症狀；而憂鬱症狀會透過衝動情緒表達作為中介變項，預測兒童自傷頻率，憂鬱症狀亦會透過自殺意圖作為中介變項，預測兒童自傷頻率。
【討論與建議】
本研究結果顯示有自殺意圖之自傷者較常使用逃避因應當面對壓力時，較可能發展出憂鬱症狀而產生有自殺意圖之自傷；而無自殺意圖之自傷者當有憂鬱症狀時會從事衝動情緒表達而進行無自殺意圖之自傷。此外，建議應提早篩檢出高壓力與憂鬱症狀程度高的兒童，將其視為高危險群提早介入，並增加自傷兒童的適應性的壓力因應策略與情緒調節策略，以減少有無自殺意圖之自傷的產生。

This study aimed to examine the differences between stress, coping strategies, depression, emotional impulse, and emotional inhibition among school-aged children with non-suicidal self-injury (NSSI), suicidal self-injury (SSI), and non-self- injury (NSI). The negative life events, coping strategies, depression, emotional impulse, emotional inhibition and self-injury were collected by self-report questionnaires. Results illustrated that children with SSI were more likely to have higher negative life events, avoidant coping, and depressive symptoms compared to those with NSSI. Children with SSI were likely to have more emotional inhibition and emotional impulse than those with NSI, and those with NSSI had increased emotional inhibition, emotional impulse and distraction than those with NSI. Results also illustrated that children with SSI were more likely to have higher negative life events, avoidant coping, and depressive symptoms compared to those with NSSI. Avoidant coping moderated the effect between negative life events and depressive symptoms. Furthermore, depressive symptoms predicted the frequency of self-injury meditated through emotional impulse or suicidal intent.

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