压力不协调与自杀：从155个案例看扭力体验(1)
【摘 要】 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。
, 百拇医药
【关键词】 自杀;扭力;不协调压力;危机应对;冲突
中图分类号:C913.9 文献标识码:A 文章编号:1000-6729(2009)011-0784-06
doi:10.3969/j.issn.1000-6729.2009.11.007
Strain and Suicide:an Analysis of 155 Suicide Cases
ZHANG Jie1,2@,TANG Yong3,4
1School of Social Development,Central University of Finance and Economics,Beijing 100081,China
, 百拇医药
2Department of Sociology,State University of New York College at Buffalo,1300 Elmwood Avenue,Buffalo,NY 14222-1095,USA
3School of Public Health,Central South University,Changsha 410078,China
4Department of Psychiatry,Brain Hospital Affiliated to Nanjing Medical University,Nanjing 210029,China
@ Corresponding author,Email:zhangj@buffalostate.edu
【Abstract】 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.
, http://www.100md.com
【Key words】 suicide;strain;dissonant stress;crisis coping;conflict
与世界各国相比,我国的自杀率处于中等偏上[1]。中国自杀率的特点是农村发生率为城市的3~4倍,男女性别比接近于1,且15~34岁年龄组呈现一个高峰[2-3]。尽管在过去20年中我国的自杀率逐步下降[3-4],但是中国农村15~34年龄组的自杀仍然是一个重大的公共卫生课题。研究这一群体的自杀危险因素有助于发展有效的干预措施以提高全民的生活质量和公共卫生水平。
在研究自杀的危险因素过程中,曾引入“不协调压力”或“扭力”(strain)概念,用以描述个体在面临两个冲突因素却无法放弃其中任何一个时,所体验到的心理痛苦[5]。不协调压力有别于简单压力,并非日常生活中的单变量现象。不协调压力至少包含两种压力或两个变量,且相互冲突。其主要来源有:(1)不同价值观冲突。当两种相抵触的社会价值观或信念在个人日常生活中不断冲突时,个人会体验到价值观方面的压力。(2)现实与愿望间冲突。在个人愿望或高目标期待与其必须面对的现实之间有较大差距时,个人会体验到愿望压力。(3)相对剥夺。如处于极度贫困下的人发现和自己背景相同或相似的人却过着优越生活时,就会体验到相对剥夺(贫困)的压力。(4)应对危机技能缺乏。面对人生中的危机,一些人缺乏应对手段,于是体验到危机和应对手段缺乏所带来的压力。“不协调压力”或“扭力”形成后,在其导致自杀行为的路径中受到社会、心理因素的调节,以及精神病理学因素的干预或强化 [5-6]。, 百拇医药
, 百拇医药
【关键词】 自杀;扭力;不协调压力;危机应对;冲突
中图分类号:C913.9 文献标识码:A 文章编号:1000-6729(2009)011-0784-06
doi:10.3969/j.issn.1000-6729.2009.11.007
Strain and Suicide:an Analysis of 155 Suicide Cases
ZHANG Jie1,2@,TANG Yong3,4
1School of Social Development,Central University of Finance and Economics,Beijing 100081,China
, 百拇医药
2Department of Sociology,State University of New York College at Buffalo,1300 Elmwood Avenue,Buffalo,NY 14222-1095,USA
3School of Public Health,Central South University,Changsha 410078,China
4Department of Psychiatry,Brain Hospital Affiliated to Nanjing Medical University,Nanjing 210029,China
@ Corresponding author,Email:zhangj@buffalostate.edu
【Abstract】 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.
, http://www.100md.com
【Key words】 suicide;strain;dissonant stress;crisis coping;conflict
与世界各国相比,我国的自杀率处于中等偏上[1]。中国自杀率的特点是农村发生率为城市的3~4倍,男女性别比接近于1,且15~34岁年龄组呈现一个高峰[2-3]。尽管在过去20年中我国的自杀率逐步下降[3-4],但是中国农村15~34年龄组的自杀仍然是一个重大的公共卫生课题。研究这一群体的自杀危险因素有助于发展有效的干预措施以提高全民的生活质量和公共卫生水平。
在研究自杀的危险因素过程中,曾引入“不协调压力”或“扭力”(strain)概念,用以描述个体在面临两个冲突因素却无法放弃其中任何一个时,所体验到的心理痛苦[5]。不协调压力有别于简单压力,并非日常生活中的单变量现象。不协调压力至少包含两种压力或两个变量,且相互冲突。其主要来源有:(1)不同价值观冲突。当两种相抵触的社会价值观或信念在个人日常生活中不断冲突时,个人会体验到价值观方面的压力。(2)现实与愿望间冲突。在个人愿望或高目标期待与其必须面对的现实之间有较大差距时,个人会体验到愿望压力。(3)相对剥夺。如处于极度贫困下的人发现和自己背景相同或相似的人却过着优越生活时,就会体验到相对剥夺(贫困)的压力。(4)应对危机技能缺乏。面对人生中的危机,一些人缺乏应对手段,于是体验到危机和应对手段缺乏所带来的压力。“不协调压力”或“扭力”形成后,在其导致自杀行为的路径中受到社会、心理因素的调节,以及精神病理学因素的干预或强化 [5-6]。, 百拇医药