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为何自杀?自我伤害动机分析。

Why Suicide? The Analysis of Motives for Self-Harm.

作者信息

Abbas Mohammed J, Mohanna Mostafa A, Diab Tarig A, Chikoore Millicent, Wang Michael

机构信息

Leicestershire Partnership NHS Trust.

Lincolnshire Partnership NHS Foundation Trust.

出版信息

Behav Cogn Psychother. 2018 Mar;46(2):209-225. doi: 10.1017/S135246581700042X. Epub 2017 Jun 19.

DOI:10.1017/S135246581700042X
PMID:28625205
Abstract

BACKGROUND

There is a gap in understanding the meaning and motives behind suicidal behaviour. Using the Ideal Type methodology, Jean Baechler systematically examined the internal logic of suicidal and self-harming behaviours. He developed a typology of eleven typical meanings/motives: Flight, Grief, Self-punishment, Vengeance, Crime, Blackmail, Appeal, Sacrifice, Transfiguration, Ordeal and Game.

AIMS

To develop and validate a standardized instrument to measure the motives/meanings of suicidal and self-harming behaviours, using Baechler's typology.

METHOD

We developed a self-fill Likert questionnaire (Ideal Typical Meaning Questionnaire, ITMQ) covering ten of Baechler's eleven types. The questionnaire was completed by 147 patients within four weeks of attempting suicide or self-harm. The Death Attitude Profile-Revised (DAP-R) questionnaire was used to examine the concurrent validity of the Flight and the Transfiguration types and to explore the association between suicidal/self-harming motives and views about death.

RESULTS

The final 25-item ITMQ has an eight-factor structure (Appeal/Blackmail, Ordeal/Game, Vengeance, Self-punishment, Sacrifice, Flight, Grief and Transfiguration) supporting Baechler's theory. The types have adequate reliability. Correlations with the DAP-R gave some support for the concurrent validity of the Flight and Transfiguration types.

CONCLUSIONS

The ITMQ is a measure of suicidal and self-harming motives/meanings based on a sound conceptual framework and could significantly contribute to the understanding of suicidal and self-harming behaviour in research and clinical settings.

摘要

背景

在理解自杀行为背后的意义和动机方面存在差距。让·贝希勒运用理想类型方法系统地研究了自杀和自我伤害行为的内在逻辑。他构建了一个包含十一种典型意义/动机的类型学:逃避、悲痛、自我惩罚、复仇、犯罪、敲诈、呼吁、牺牲、变形、考验和游戏。

目的

利用贝希勒的类型学开发并验证一种标准化工具,以测量自杀和自我伤害行为的动机/意义。

方法

我们编制了一份自填式李克特问卷(理想类型意义问卷,ITMQ),涵盖贝希勒十一种类型中的十种。147名有自杀或自我伤害未遂经历的患者在四周内完成了该问卷。使用修订后的死亡态度剖面图(DAP-R)问卷来检验逃避和变形类型的同时效度,并探讨自杀/自我伤害动机与对死亡看法之间的关联。

结果

最终的25项ITMQ具有八因素结构(呼吁/敲诈、考验/游戏、复仇、自我惩罚、牺牲、逃避、悲痛和变形),支持了贝希勒的理论。这些类型具有足够的信度。与DAP-R的相关性为逃避和变形类型的同时效度提供了一定支持。

结论

ITMQ是一种基于合理概念框架的自杀和自我伤害动机/意义测量工具,能够在研究和临床环境中显著促进对自杀和自我伤害行为的理解。

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