压力不协调与自杀:从155个案例看扭力体验

Strain and Suicide:an Analysis of 155 Suicide Cases

目的:探索自杀死亡者生前扭力(不协调压力)体验,验证自杀的"压力不协调理论"。方法:对155个(91个男性,64个女性)年龄15～34岁之间的自杀案例进行深入调查,访谈对象为自杀者的亲人和朋友,将收集的背景材料及自杀事件写成故事,并由独立审阅人依据4种扭力类型对每一故事进行分析(各项目赋值:0=无,1=微弱,2=较强,3=强烈)。结果:全部的自杀死亡者在实施自杀前均体验过至少一种扭力。4种扭力体验由强到弱依次为应对扭力(100%)、愿望扭力(81%)、相对剥夺扭力(72%)和价值观扭力(45%)。男性的应对扭力得分及失去金钱或投资失败因素得分高于女性[(8.85±3.64)vs.(7.72±3.77),(0.35±0.92)vs.(0.09±0.52);均P<0.05],而传统与现代妇女地位、宗教信仰与无神论因素得分低于女性[(0.08±0.37)vs.(0.53±0.97),(0.00±0.00)vs.(0.06±0.30);P<0.001或0.05]。价值观扭力与年龄呈正相关(r=0.16,P=0.048),而愿望扭力与年龄呈负相关(r=-0.30,P<0.001)。结论:不协调压力普遍存在于自杀者中,危机干预和自杀预防工作应从降低扭力的心理咨询、辅导和治疗开始。

Objective： To explore the strain experiences by suicides and to test the strain theory of suicide. Methods： A consecutive sample of 155 suicides （91 males and 64 females） aged from 15 to 34 years was studied with the psychological autopsy method. Informants consisted of family members and close friends of the suicides. Suicide stories were composed based on the background information of the suicides and what happened at the suicide site and then content-analyzed and rated by independent judges. Results： All of the victims had experienced at least one type of strain before suicide took place. The sequence of the 4 types of strains beginning with the most frequent one was coping strain, 100% ; aspiration strain, 81%, deprivation strain, 72% and value strain, 45%. Generally, males experienced more coping strains, especially loss of money or investment than females [ （ 8.85 ± 3.64 ） vs.（ 7.72 ±3.77 ）, （ 0. 35± 0. 92 ） vs. （ 0. 09± 0. 52 ） ; Ps 〈 0. 05 ], except for the traditionalism and modernity for status of women, religion and atheism [ （0.08 ±0.37） vs. （0.53±0.97）, （0.00±0.00） vs.（ 0. 06± 0. 30 ） ; Ps 〈 0. 05 ] . As age increased, value strain tended to increase （r = 0. 16, P = 0. 048 ） , whereas aspiration strain tended to decrease （ r = - 0. 30, P 〈 0. 001 ） . Conclusion： With the prevalence of dissonant stresses among suicide victims, it is suggested that crisis intervention and suicide prevention should begin with strain reduction through psychological counseling and therapy.