男同志自殺企圖：性少數壓力源與自殺人際理論的角色

Suicidal Attempts among Sexual Minority Males in Taiwan: The Roles of Sexual Minority Stressors and the Interpersonal Theory of Suicide

林逸祥(Yi-Shiang Lin)

指導教授 ： 孫旻暐

中山醫學大學/醫學科技學院/心理學系暨臨床心理學碩士班/碩士(2017年)

摘要

背景：台灣社會中，仍存在對同志的偏見與歧視，因而造成同志的心理健康問題。過去研究一致顯示，同志的自殺行為盛行率較異性戀者高，尤其是男同志。同志的自殺行為危險因子研究主要以Meyer（2003）的少數壓力模型為研究典範，連結性少數壓力源與自殺行為之間的關係。然而，性少數壓力源影響自殺行為的機制少有研究探討且未有清楚的結論。自殺的心理學研究中的自殺人際理論（Van Orden et al., 2010）為獲得實證支持的理論，且有研究證實相較於異性戀者，此理論在同志族群中預測力更強。因此，本研究的目的為探討性少數壓力源、自殺人際理論、自殺行為之間的關係，以提出男同志自殺行為的心理機制。
方法：採用橫斷性研究，以便利取樣針對277名13歲以上，且性傾向（性吸引、性行為、性認同）為男同志者進行問卷調查，探討的變項包含性少數壓力源、自殺人際構念、自殺相關行為、人口學變項。
結果：在便利取樣下，男同志過去一年自殺意念、自殺計畫、自殺企圖盛行率分別為21.66%、12.27%、11.55%。控制年齡、教育程度及收入後，性少數壓力源（性別表現、歧視/騷擾、替代創傷、原生家庭、HIV/愛滋、傷害、孤立）與自殺意念之間的關係可透過知覺負擔來中介，但受挫歸屬感則否。習得自殺的能力在非自殺之自我傷害與自殺企圖之間的中介角色則未獲得支持。
結論：本研究證實台灣男同志的自殺行為問題甚為嚴重，且多項性少數壓力源皆可顯著預測自殺意念，而這之間的機制為同志認為自己是他人的負擔的心理狀態。針對性少數壓力源與心理機制的發現，可提供性別政策擬定與臨床實務重要建議。

關鍵字

性少數壓力源 ； 自殺人際理論 ； 男同志 ； 自殺行為

並列摘要

Background: Prejudice and discrimination toward sexual minority males (SMM) still exists in Taiwan, and therefore puts them at higher risk for developing mental disorders. Previous studies have consistently shown that the prevalence of suicidality in sexual minorities is higher than heterosexuals, especially in sexual minority males. The research of risk factors for suicides in SMM frequently use the Minority Stress Model (Meyer, 2003) as a paradigm: exploring the relationship between sexual minority stressors (SMS) and suicidal behaviors (SB). However, little is known about the underlying mechanisms. The psychological model of suicide, Interpersonal Theory of Suicide (IPT; Van Orden et al., 2010), has been supported by recent research, as well as presented more significant predictive effects that were greater for sexual minorities than heterosexuals. The study aims to propose a working mechanism of suicidal behavior in SMM, through examining the relationship among SMS, IPT, and SB.
Methods: In this cross-sectional study, 277 SMM aged 13 or above were recruited by convenience sampling. The participants were expected to complete an anonymous questionnaire assessing SMS, the constructs of IPT, suicide-related behaviors, and demographic variables.
Results: The 12-month prevalence of suicidal ideations, suicidal plans, and suicide attempts were 21.66%, 12.27%, and 11.55%. After controlling for age, education, and income, the association of SMS and suicidal ideation was mediated by perceived burdensomeness, but not thwarted belongingness. The role of acquired capability of suicide in suicide attempt was not supported.
Conclusions: The results suggest that suicidal behaviors in SMM in Taiwan are significant. Many SMS can significantly predict the suicide ideation, and the mechanism is perceived burdensomeness. The results of SMS, and psychological mechanisms have implications for policy and clinical practice.

並列關鍵字

sexual minority stressor ； interpersonal theory of suicide ； sexual minority male ； suicidal behavior

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