Pridmore Saxby, Jamil Mohammed Yaacob
Professor of Mental Health, Centre for Remote Health, A joint centre of Flinders University and Charles Darwin University, Alice Springs, NT, Australia.
Australas Psychiatry. 2009 Dec;17(6):466-471. doi: 10.1080/10398560903281824.
Objective: The aim of this paper is to present two models of separate but related aspects of suicide, developed with a view to improving understanding and management of this behaviour. Conclusions: First, the predicament model of suicide posits that all suicide represents an escape from a predicament and associated distress. Predicaments are composed of either external (environmental) or internal (mental disorders) factors, or both. Suicide occurs when a threshold is exceeded on a suicide risk ladder, and the degree of movement toward the threshold in response to a particular stressor depends on a range of factors. Second, the suicide pathways model integrates medical and sociological concepts, with distress as the central component, and three run-offs: mental disorder, medicalized and a non-mental disorder (egoistic/anomic; reaction) suicide.
本文旨在呈现自杀行为两个相互独立但又相关方面的模型，以期增进对这种行为的理解与管理。结论：其一，自杀困境模型假定，所有自杀行为都代表着从一种困境及相关痛苦中解脱出来。困境由外部（环境）因素、内部（精神障碍）因素或两者共同构成。当在自杀风险阶梯上超过某个阈值时，自杀就会发生，而针对特定应激源向该阈值移动的程度取决于一系列因素。其二，自杀路径模型整合了医学和社会学概念，以痛苦为核心组成部分，并包含三种结果：精神障碍型、医学化型和非精神障碍型（利己主义/失范型；反应型）自杀。
