網路使用與社會支持來源對於青少年不同自傷類型的影響

Internet use and sources of social support in association with self-injury types among adolescents

曾芳儀(Fang-Yi Tseng)

指導教授 ： 楊浩然

中山醫學大學/健康管理學院/公共衛生學系碩士班/碩士(2011年)

https://doi.org/10.6834/CSMU.2011.00043

摘要

研究目的：近年來青少年族群常使用網路來進行交流及獲取支持，但很少有研究探討網路使用與社會支持對於青少年不同自傷類型的影響，因此本研究欲推估青少年不同自傷類型的盛行率；以及探討其相關之社會支持與網路使用因素。
研究方法：本研究以二階段隨機抽樣方式(two-phase sampling)，從中部三縣市國高中公立學校中抽取學生進行研究。第一階段總計納入2494位學生進行分析，並填寫網路使用、社會支持(Multidimensional Scale of Perceived Social Support, MSPSS)及憂鬱量表(Center for Epidemiological Study-Depression scale, CES-D)等相關問卷。第二階段根據CES-D分數高低抽出部份樣本，共391人，並使用自傷量表(Self-Injurious Thought and Behaviors Interview, SITBI)進行診斷面訪。自傷的診斷類別有自殺意念、自殺計畫、作態性自殺、自殺未遂、非自殺的自我傷害想法及非自殺的自我傷害，終生及現行診斷均加以評估。加權盛行率及加權邏輯斯迴歸分析均以SAS統計軟體加以分析。
研究結果：青少年不同自傷類型以終生自殺意念最盛行(39.65%) ，其次為終生非自殺的自我傷害想法(28.50%)。終生及現行的自殺未遂則相當少(0.43-1.11%)。在控制其他變項之後，每天上網時間越久對於現行所有自傷類型(OR=1.93, 95% CI=1.01-3.71)及自殺計畫(OR=3.40, 95% CI=1.09-10.58)有較高的危險性；而尋求幫助朋友數對於終生自殺計畫(OR=0.20, 95% CI=0.08-0.55)有保護作用；在社會支持方面，家人支持越高普遍地對於所有及不同自傷類型皆呈現保護作用(OR=0.90-0.94, 95% CI=0.82-0.99)；重要他人支持越高，對於現行所有自殺類型(OR=1.11, 95% CI=1.02-1.21)、終生/現行自殺計畫(OR=1.17-1.18, 95% CI=1.02-1.36)及終生非自殺的自我傷害(OR=1.14, 95% CI=1.02-1.28)均有較高的危險性。
結論：在青少年發展階段，雖然自傷行為不多，但意念已經相當盛行。家人支持能夠普遍預防不同自傷類型的發生；但越少上網時間以及適當尋求朋友幫助，也能夠降低特定自傷類型的危險性。

關鍵字

青少年 ； 自傷類型 ； 自殺 ； 網路使用 ； 社會支持

並列摘要

Objective: In recent years, adolescent groups usually used the internet to communicated and obtained support. However, yet little was known about whether there were specific relationships between used the internet and sources of social support with types of self-injury effect among adolescents. The aim of this study is examining the prevalence rates of different types of self-injury as well as internet use and sources of social support among adolescents. Methods: A two-phase sampling study was conducted in central Taiwan. Participants were randomly selected from five public junior and four public senior high schools through a multi-stage sampling strategy. The first stage, there were 2494 subjects invited to complete the self-administered Internet Use, Multidimensional Scale of Perceived Social Support (MSPSS), and Center for Epidemiological Study-Depression scale (CES-D) questionnaire. The second stage, survey from the first stage subjects according to the CES-D scores group random sampling, a total of 391 subjects, and they underwent an in-person interview by well-trained interviewers to obtained information about self-injury by using the Self-Injurious Thought and Behaviors Interview (SITBI). The five types of self-injury (suicidal ideation, suicidal plans, suicide gesture, suicide attempt, thoughts of non-suicidal self-injury, non-suicidal self-injury), lifetime and current diagnosis were evaluated. Weighted prevalence and weighted logistic regression analyses were used SAS statistics. Results: Among self-injury types among adolescents, the most prevalent was lifetime suicidal ideation (39.65%), secondly was lifetime thoughts of non-suicidal injury (28.50%). Lifetime and current suicide attempt were relatively little. After controlling for other variables, the longer time spent online each day were associated with higher risks of current all types of self-injury (OR=1.93, 95% CI=1.01-3.71) and suicide plan (OR=3.40, 95% CI=1.09-10.58). The number of friends for seeking help were associated with protection of lifetime suicide plan (OR=0.20, 95% CI=0.08-0.55). In social support, among adolescents, family support was comprehensively associated with protection of all and any self-injury types (OR=0.90-0.94, 95% CI=0.82-0.99). Support from significant other were associated with higher risks of current all types of self-injury (OR=1.11, 95% CI=1.02-1.21), lifetime and current suicide plan (OR=1.17-1.18, 95% CI=1.02-1.36), lifetime non-suicidal self-injury (OR=1.14, 95% CI=1.02-1.28). Conclusions: During adolescence, although non-suicidal self-injurious behavior not many, but the ideation has been quite prevalent. Family's support is an important preventive factor for all types of self-injury. The less time spent online each day and appropriate seeking help of friends also can decrease risks of specific types of self-injury.

並列關鍵字

social support ； suicide ； self-injury ； internet use ； adolescent

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