兒少不當對待對自我傷害之影響：負向認知與情緒調節困難的多重中介模型

本研究結合憂鬱認知理論（Beck, 1967）、發展心理病理模式（Yates, 2004）、自我傷害整合模式（Nock, 2009）及認知情緒模式（Hasking, Whitlock, Voon & Rose, 2017）的觀點，探討兒少不當對待、負向認知、情緒調節困難及自我傷害等四者間的關係，並建立整體模型。綜觀近年的研究，認知因素被認為與自傷有關，認知情緒模式主張自傷的個體會先進行認知考量，進而選取不同的因應方式，上述其餘理論則補充負向認知的形成因素（如：兒少不當對待），以及自傷的維持因素（如：情緒調節困難）。因此，本研究檢驗兒少不當對待對自我傷害的影響，假設兒少不當對待透過負向認知、情緒調節進而影響自我傷害。本研究參與者為654位高中職生，自傷比率為20.4%，採用問卷調查法，量表包括兒時創傷量表、認知三元素量表、情緒調節量表及自我傷害行為量表，對背景變項與研究變項進行描述性統計、卡方檢定、獨立樣本t檢定、相關分析及結構方程式模型以驗證研究假設。主要研究結果顯示：(一)兒少不當對待、負向認知、情緒調節困難為自我傷害的風險因子；(二)負向認知透過情緒調節困難預測自傷頻率與自傷方式數；(三)情緒不當對待直接預測負向認知、情緒調節困難及自傷頻率與方式數；(四)僅情緒不當對待透過情緒調節困難影響自我傷害；(五)情緒不當對待與情緒忽視先透過負向認知，進而讓情緒調節困難影響自我傷害。(六)在各自的兒少不當對待模型中，情緒不當對待、身體不當對待能直接影響自我傷害。(七)在各自的兒少不當對待模型中，各種不當對待皆會先透過負向認知，進而讓情緒調節困難影響自我傷害。根據研究結果，針對不當對待與自傷防治提出未來研究及實務工作上的建議。

關鍵字

兒少不當對待；認知三元素；情緒調節；非自殺自傷；高中職生

並列摘要

This study combines the points of view of depression cognitive theory (Beck, 1967), developmental psychopathology model (Yates, 2004), integrated theoretical model of self-injury(Nock, 2009) as well as cognitive-emotional model of non-suicidal self-injury(Hasking, Whitlock, Voon & Rose, 2017) to discuss the relationships among childhood maltreatment, negative cognition, emotion regulation difficulties and self-harm, and to establish an integrated model. Making a comprehensive survey of the research for the past few years, cognitive factors are deemed to be related to non-suicidal self-injury (NSSI). The cognitive-emotional model claims that the individual of self-injury will first carry out cognitive consideration, and then select varying coping styles. The rest theories mentioned above supplement the formative factors of negative cognition (for instance: childhood maltreatment), as well as the sustentive factors of self-injury (for instance: emotion regulation difficulties). As a result, this study examines the influence of childhood maltreatment on self-harm, and hypothesizes that childhood maltreatment further influences self-harm through negative cognition and emotion regulation. The participants of this study are 654 senior high school students, with a self-injury ratio of 20.4 percent. This research adopts questionnaire survey, consisting of childhood trauma questionnaire, cognitive triad inventory, difficulties in emotion regulation scale as well as self-injurious behavior scale, and carries out descriptive statistics, Chi-square test, Independent-Samples t-test, correlation analysis as well as Structural Equation Modeling (SEM) on background variables and research variables, so as to verify the research hypothesis. The primary study results show that: (I) childhood maltreatment, negative cognition and emotion regulation difficulties are the risk factors of self-harm; (II) Negative cognition predicts the frequency of self-injury and the number of self-injury ways through emotion regulation difficulties; (III) Emotional maltreatment directly predicts negative cognition, emotion regulation difficulties, as well as the frequency and number of ways of self-injury; (IV) Emotional maltreatment alone influences self-harm through emotion regulation difficulties; (V) Emotional maltreatment and emotional neglect will first through negative cognition, and then let emotion regulation difficulties influence self-harm; (VI) In their respective childhood maltreatment models, emotional maltreatment and physical maltreatment can directly influence self-harm. (VII) In their respective childhood maltreatment models, various kinds of childhood maltreatment will first through negative cognition, and then let emotion regulation difficulties influence self-harm. In accordance with study results, in allusion to childhood maltreatment and prevention and treatment of self-injury, this article comes up with some suggestions for future studies as well as practical work.