近幾年國人的自殺事件發生率不斷地向上攀升，正反映著處在大環境下的我們必須正視自身的「生存議題」。本研究的目的主要是針對自殺死因排名於前的四個年齡族群，青年初期（15-17歲）、青年後期（18-24歲）、壯年期（25-40歲）及中年期（41-64歲），探討其在生活困擾上與在避免採取自殺行動的保護性信念上的差異性。本研究的研究樣本主要來自新竹以北地區的高中職、大專院校的學生，以及25~64歲從事各類行業的社會成人，總計有效樣本數為1,024位。研究工具為「活下來理由量表」、「自殺危險程度量表」與「生活困擾問卷」，並以卡方考驗、二因子變異數分析、Pearson積差相關等統計分析方法來進行顯著性考驗。本研究結果顯示：
一、受試者背景為女性、越年輕者、未婚者、無子女者及教育程度在大學以下者的族群佔有較高的自殺危險人口比率。
二、青年期族群最大的困擾問題主要是課業壓力；壯年期族群最大的困擾問題是經濟問題；而中年期族群最大的困擾問題則是身體健康。
三、男性對生存及因應信念的重要性反應顯著大於女性，女性對恐懼自殺的重要性反應顯著大於男性。
四、年齡越大者對生存及因應信念、家庭責任、孩童關心及道德爭議的重要性反應顯著越高，年齡越小者對自殺恐懼、對社會不贊同的恐懼其重要性反應顯著越高。
五、已婚者對生存及因應信念、家庭責任、孩童關心及道德爭議的重要性反應顯著較高，未婚者則對自殺恐懼、對社會不贊同的恐懼的重要性反應顯著較高。
六、有宗教信仰者對生存及因應信念、家庭責任、孩童關心及道德爭議的重要性反應顯著大於無宗教信仰者。
七、有子女者對生存及因應信念、家庭責任、孩童關心及道德爭議的重要性反應顯著大於無子女者，無子女者對自殺恐懼的重要性反應則顯著大於有子女者。
八、自殺意念愈低者對生存及因應信念、家庭責任及孩童關心的重要性反應顯著愈高，自殺意念愈高者對自殺恐懼的重要性反應顯著愈高。
九、低自殺企圖者對自殺恐懼的重要性反應顯著高於無自殺企圖者。
十、當自殺動機愈與他人有關時，個體對生存及因應信念、家庭責任、孩童關心的重要性反應顯著愈低。
最後，本研究建議「活下來理由量表」可作為重要的自殺危險評估工具，除了可發揮自殺危險性的篩選功能外，正向信念的強化也可一併進行。對於高自殺危險族群，儘管對於活下來理由的重視程度有限，但若有專業心理人員適切地協助當事人重視內在僅有的保護信念，與自殺危險處境抗衡，將有可能避免當事人走上自殺一途。

Suicide rate has increased dramatically in Taiwan over the past few years. The importance of the “issue of existence” has emerged under this context. The purpose of the study was to examine the differences on negative life events and protective living beliefs among four age groups that ranked top four of suicide mortality: early adolescence (15-17 years old), later adolescence (18-24 years old), early adulthood (25-40 years old), and middle adulthood (41-64 years old). A total of 1,024 valid subjects were sampled from senior high school students, college students, and adult population from various occupation backgrounds in the north of Hsinchu. The instruments of “The Reasons for Living Inventory (RFL)”, “Scale of Suicidal Risk,” and “Life Disturbance Questionnaire” were used.
The significant findings of the study were as follows:
(1) Subjects who have higher suicidal risk were female, younger, unmarried, no child, and below the education level of college (equivalent to 16 years of education).
(2) The main disturbances of life were academic stresses for early adolescence and later adolescence, were economic problems for early adulthood, and were physical health problems for middle adulthood.
(3) Males had higher ratings of importance on the “survival and coping beliefs” subscale than females did; whereas females had higher ratings of importance on the “fear of suicide” subscale than males did.
(4) The older subjects had higher ratings of importance on the “survival and coping beliefs,” “responsibility to family,” “child-related concerns,” and “moral objection” subscales than the younger ones did; whereas the younger subjects had higher ratings of importance on the “fear of suicide” and “fear of social disapproval” subscales than the older ones did.
(5) The married subjects had higher ratings of importance on the “survival and coping beliefs,” “responsibility to family,” “child-related concerns,” and “moral objection,” subscales than the unmarried ones did; whereas the unmarried subjects had higher ratings of importance on the “fear of suicide” and “fear of social disapproval” subscales than the married ones did.
(6) Those with religious beliefs had higher ratings of importance on the “survival and coping beliefs,” “responsibility to family,” “child-related concerns,” and “moral objection” subscales than those without religious beliefs did.
(7) Subjects with children had higher ratings of importance on the “survival and coping beliefs,” “responsibility to family,” “child-related concerns,” and “moral objection” subscales than those without children did; whereas those without children had higher ratings of importance on the “fear of suicide” subscale than those with children did.
(8) Subjects with less suicide ideation had higher ratings of importance on the “survival and coping beliefs,” “responsibility to family,” and “child-related concerns” subscales than those with severer suicide ideation; whereas those with severer suicide ideation had higher ratings of importance on the “fear of suicide” subscale than those with less suicide ideation did.
(9) Those with low suicide attempt had higher ratings of importance on the “fear of suicide” subscale than those with non-suicide attempt did.
(10) The more suicidal motivation was related with others, the lower ratings of importance were rated on the “survival and coping beliefs,” “responsibility to family,” and “child-related concerns” subscales.
Finally, it is suggested that “The Reasons for Living Inventory (RFL)” could be a useful instrument for suicide risk assessment. Besides distinguishing individuals with different suicidal risk, it may enhance one’s positive life-oriented beliefs at the same time. Although reasons for living were deemed less significant for people with higher suicide risk in this study, the use of the RFL as a screening tool by psychologists may lead the high risk people to value their inner protective beliefs and thus may protect them from committing suicide, after given adequate evaluation and careful guidance.

一、中文
Bille-Brahe, U. (2007)。自殺歷程與社會因素。在K. van Heeringen編著，瞭解自殺行為：自殺歷程的研究、處理與預防（Understanding suicidal behavior: The suicidal process approach to research, treatment and prevention）（吳羿諠、吳慧敏、陳牧君、陳湘華編譯）。台北：合記。（原作2001年出版）
Corey, G. (2003）。諮商與心理治療：理論與實務（Theory and practice of counseling and psychotherapy,6/E）（鄭玄藏等合譯）。台北：雙葉。（原作2001年出版）
Erikson, E. H., Erikson, J. M., & Kivnick, H. Q. (2000）。Erikson老年研究報告：人生八大階段（Vital involvement in old age：The experience of old age in our time）（周怜利譯）。台北：張老師文化。（原作1997年出版）
Kerkhof, Ad J. F. M. & Arensman, E. (2007)。自殺途徑：自殺歷程的流行病學研究。在K. van Heeringen編著，瞭解自殺行為：自殺歷程的研究、處理與預防（Understanding suicidal behavior：The suicidal process approach to research, treatment and prevention）（吳羿諠、吳慧敏、陳牧君、陳湘華編譯）。台北：合記。（原作2001年出版）
Newman, B. M., & Newman, P. R. (1994)。發展心理學：心理社會理論與實務（Development Through Life: A Psychosocial Approach,5/E)（郭靜晃、吳幸玲譯）。台北：揚智文化。（原作1991年出版）
van Heeringen, K. (2007a)。自殺歷程及其相關概念。在K. van Heeringen編著，瞭解自殺行為：自殺歷程的研究、處理與預防（Understanding suicidal behavior：The suicidal process approach to research, treatment and prevention）（吳羿諠、吳慧敏、陳牧君、陳湘華編譯）。台北：合記。（原作2001年出版）
van Heeringen, K. (2007b)。自殺歷程的心理生物模式。在K. van Heeringen編著，瞭解自殺行為：自殺歷程的研究、處理與預防（Understanding suicidal behavior：The suicidal process approach to research, treatment and prevention）（吳羿諠、吳慧敏、陳牧君、陳湘華編譯）。台北：合記。（原作2001年出版）
王彩鳳、張素鳳（1999）。大學生自殺意念的多層面預測模式。台灣大學心理研究所碩士論文，未出版。
王智璿（2000）。家庭因素、負向特值與自殺危險性關係之研究—國中生為例。國立政治大學心理學研究所碩士論文，未出版。
江慧珠（1996）。尋找末期腎病患者生命的意義。護理雜誌，43，92-96。
吳秋燕（2006）。青少年憂鬱症自殺行為與家庭結構相關之研究-以三位憂鬱症青少年的敘事分析為例。南華大學生死學系研究所碩士論文，未出版。
吳美玲（2003）。大專生自我知覺的親子關係與人格特質對自殺意念的影響。中原大學心理研究所碩士論文，未出版。
吳純儀（2006）。青少年自殺危險因子之檢視：整合分析。高雄醫學大學行為科學研究所碩士論文，未出版。
吳惠慈（2004）。一個多次自殺生還者的自殺經驗敘說。南華大學生死學系研究所碩士論文，未出版。
法蘭克（Frankl, V. E.）（1995）。活出意義來：從集中營說到存在主義（Man’s search for meaning: an introduction to logotherapy）（趙可式、沈錦惠譯）。臺北：光啟。（原作1967年出版）
法蘭克（Frankl, V. E.）（2001）。意義的呼喚（Was nicht in meinen büchern steht. Lebenserinnerungen）（鄭納無譯）。臺北，心靈工坊。（原作1995年出版）
林昆輝（2005）。自殺防治的理論與技術。 台北：天馬。
洪福源（2005）。強化個人生活的力量與自信-復原力的觀點。輔導季刊，41，37-45。
高之梅（1998）。保護大學生免於採取自殺行動的信念。中原大學心理研究所碩士論文，未出版。
高橋祥友（1999）。自殺心理學：以具體的例症來說明預防的方法。台北：智慧大學。
張如杏（1991）。臺北地區高職五專在學青少年之內外控歸因、社會關係及心理健康狀況關係之探討。台灣大學社會工作研究所碩士論文，未出版。
許文燿、林宜旻（1999）。「自殺危險性發生模式驗證」。中華心理學刊，41，87-108。
許文耀、鍾瑞玫（1997）。「自殺危險程度量表」的編製及其信、效度考驗。中華心理衛生學刊，10，1-17。
許淑瑛、張素凰（2005）。大學生自殺歷程模式之驗證：生死態度與無望感為仲介。國立政治大學教育與心理研究，28，721-744。
陳珍德（1995）。癌症病人生命意義之研究。國立彰化師範大學輔導研究所碩士論文，未出版。
陳毓文、鄭麗珍（2001）。青少年自傷行為分析及其因應對策。臺北：行政院青少年輔導委員會。
單延愷（1994）。青少年自殺行為危險因子與危險警訊之探討。私立中原大學心理學系研究所碩士論文，未出版。
曾文志（2005）。戰勝逆境的秘訣：兒童發展的保護因子與機制。師友，459，33-39。
湯瑪斯．薩斯（Thomas Szasz）（2001）。自殺的權利（Fatal freedom-The ethics and politics of suicide）（吳書榆譯）。臺北：商周。（原作1999年出版）
劉安彥、陳英豪（1994）。青年心理學。台北，三民。
劉安真（1992）。大學生生活事件、寂寞感與自殺意念之相關研究。彰化師範大學輔導研究所碩士論文，未出版。
劉修全（2000）。對自殺個案的輔導。諮商與輔導，175，5-7。
劉德威（1997）。青少年生死態度與自殺危險程度關係之研究。私立中原大學心理學系研究所碩士論文，未出版。
蔣秀容（2003）。轉換受苦經驗：成年自殺企圖者之歷程分析。國立成功大學醫學院護理學系碩士班碩士論文，未出版。
蔡宜玲（2002）。自殺意念青少年復原行為之探討：復原力之研究。彰化師範大學輔導與諮商系研究所碩士論文，未出版。
衛生署（2007）。衛生統計：公務統計。2007年9月30日，取自http://www.doh.gov.tw/statistic/index.htm
二、英文
Asarnow, J., Carlson, G., & Guthrie, D. (1987). Coping strategies, self-perceptions, hopelessness, and perceived family environments in depressed and suicidal children. Journal of Consulting and Clinical Psychology, 55, 361-366.
Batigun, D., & Ayegul, D. B. (2005). Suicide probability: an assessment terms of reasons for living, hopelessness and loneliness. Turk Psikiyatri Dergisi, 16, 29-39.
Beck, A. T., Brown, G., Berchick, R. J. Stewart, B. L., & Steer, R. A. (1990). Relationship between hopelessness and ultimate suicide: A replication with psychiatric outpatients. American Journal of Psychiatry, 147, 190-195.
Beck, A. T., Kovacs, M., & Weissman, A. (1979). Assessment of suicidal intention: The scale for suicidal ideation. Journal of Consulting and Clinical Psychology, 47, 343-352.
Beck, A. T., Weissman, A., Lester, D., & Trexler, L. (1974). Measurement of pessimism, the Beck Hopelessness Scale. Journal of Consulting and Clinical Psychology, 42, 861-865.
Bedrosian, R. C., & Beck, A. T. (1979). Cognitive aspects of suicidal behavior. Suicide and Life Threatening Behavior, 9, 87-96.
Berman, W. H. & Turk, D. C. (1981). Adaptation to divorce: Problems and coping strategies. Journal of Marriage and the Family, 43, 179-189.
Chan, D. W. (1995). Reasons for living among Chinese adolescents in Hong Kong. Suicide and Life-Threatening Behavior, 25, 347-357.
Chiles, J. A.,& Strosahl, K. D. (2005). Clinical manual for assessment and treatment of suicidal patients. American psychiatric publishing.
Cole, D. (1988). Hopelessness, social desirability, depression, and parasuicide in two college population. Journal of Consulting and Clinical Psychology, 56,131-136.
Cole, D. A. (1989). Validation of the Reasons for Living Inventory in general and delinquent adolescent samples. Journal of Abnormal Child Psychology, 17, 13-27
Connell, D. K., & Meyer, R. G. (1991). The Reasons for Living Inventory and college population: Adolescent suicidal behaviors, beliefs, and coping skills. Journal of Clinical Psychology, 47, 485-489.
Craig-Bray, L., Adams, G. R., & Dobson, W. R. (1988). Identity formation and social relations during late adolescence. Journal of Youth and Adolescence, 17, 173-188.
Dean, P. J., & Range, L. M. (1996). The escape theory of suicide and perfectionism in college students. Death Study, 20, 415-424.
Dervic, K., Oquendo, MA., Grunebaum, MF., Ellis, S., Burke, AK., & Mann, JJ. (2004). Religious affiliation and suicide attempt. The American Journal of Psychiatry, 161, 2303-2308.
Donna, N. (2000). The effects of adolescent and young adult suicide on family and friends: A meta-analysis[Abstract]. Unpublished doctoral dissertation, Hofstra University, New York. Retrieved from Proquest Dissertations And Theses.
Goodstein, J. L. (1982). Cognitive characteristics of suicide attempters[Abstract]. Unpublished doctoral dissertation, The Catholic University of American, Columbia. Retrieved from Proquest Dissertations And Theses.
Howard, S., Dryden, J., & Johnson, B. (1999). Childhood resilience: Review and critique of literature. Oxford Review of Education, 25, 307-324.
Ivanoff, A., Jang, S. J., Smyth, N. F., & Linehan, M. M. (1994). Fewer reasons for staying alive when you are thinking of killing yourself: The Brief Reasons for Living Inventory. Journal of Psychopathology and Behavioral Assessment, 16, 1-13.
Jobes, D. A., & Mann, R. E. (1999). Reasons for Living versus Reasons for Dying: Examining the Internal Debate of Suicide. Suicide & Life-Threatening Behavior, 29, 97-104.
Kessler, R. C., Borges, G., & Walters, E. E. (1999). Prevalence and risk factors for lifetime suicide attempts in the National Comorbidity Survey. Archives of General Psychiatry, 55, 617-626.
Kirkcaldy, B. D., Eysenck, M. W., & Siefen, G. R. (2004). Psychological and social predictors of suicidal ideation among young adolescents . School Psychology International, 25, 301-316.
Linehan, M. M., Goodstein, J. L., Nielsen, S. L., & Chiles, J. A. (1983). Reasons for staying alive when you are thinking of killing yourself: The Reasons for Living Inventory. Journal of Consulting and Clinical Psychology, 51, 276-286.
Macleod, A. K., Rose, G. S. & Williams, J. M. G. (1993) Components of hopelessness about the future in parasuicide. Cognitive Therapy and Research, 17, 441-455.
Malone, K. M., Oquendo, M. A., Haas, G. L., Ellis, S., & Mann, J. J. (2000). Protective factors against suicidal acts in major depression: Reasons for living. The American Journal of Psychiatry, 157, 1084-1088.
Maurizio, P., David, L., Marco, I., Valentina, N., Alessandro, V., Eleonora, D. P. et al. (2007). Risk-Taking and reasons for living in Non-Clinical Italian university students. Death Studies, 31, 751-762.
Nisbet, P. A. (2000). Age and the lifespan. In R. W. Maris, A. L. Berman, & M. M. Silverman (Eds.), Comprehensive textbook of suicidology. New York: The Guilford Press.
Oquendo, M. A., Dragatsi, D., Harkavy-Friedman, J., Dervic, K., Currier, D., Burke, A. K. et al. (2005). Protective Factors Against Suicidal Behavior in Latinos. The Journal of Nervous and Mental Disease, 193 , 438-443.
Osman, A., Gifford, J., Jones, T., Lickiss, L., Osman, J., & Wenzel, R. (1993). Psychometric evaluation of the Reasons for Living Inventory. Psychological Assessment, 5, 154-158.
Osman, A., Jones, K., & Osman, J. (1991). The Reasons for Living Inventory: Psychometric properties. Psychological Reports, 69, 271-278.
Pinto, A., Whisman, M. A., & Conwell, Y. (1998). Reasons for living in a clinical sample of adolescents. Journal of adolescence, 21, 397-405.
Plutchik, R. (2000). Aggression, violence, and suicide. In R. W. Maris, A. L. Berman, & M. M. Sliverman(Eds.), Comprehensive textbook of suicidology. New York: The Guilford Press.
Pompili, M., Girardi, P., Innamorati, M., Tatarelli, G., Ruberto, A., Ferrari, V. et al. (2007). Body uneasiness and suicide risk in a non-clinical sample of university students. Arch Suicide Res, 11, 193-202.
Range, L. M., & Knott, E. C. (1997). Twenty suicide assessment instruments: Evaluation and recommendations. Death Studies, 21, 25-58.
Range, L. M., & Penton, S. R. (1994). Hope, hopelessness, and suicidality in college students. Psychological Reports, 75, 456-458.
Range, L. M., Hall, D. L., & Meters K. (1993). Factor Structure of adolescents’ scores on the reasons for living inventory. Death Studies, 17, 257-266.
Roehrig, H. R., & Range, L. M. (1995). Recklessness, depression, and reasons for living in predicting suicidality in college students. Journal of Youth and Adolescence, 24, 723-729.
Rogers, J. R., & Hanlon, P. J. (1996). Psychometric analysis of the college student reasons for living inventory. Measurement and evaluation in counseling and development, 29, 13-24.
Ronald, L. B., & Alexander, R. R. (1987). Toward a Predictive Model of Suicidal Ideation and Behavior: Some Preliminary Data in College Students. Suicide and Life-Threatening Behavior, 17, 50-63.
Rudd, M, D. (1989). The prevalence of suicidal ideation among college students. Suicide and Life-Threatening Behavior, 19, 173-183.
Rudd, M, D. (1990). An Integrative model of suicidal ideation. Suicide and Life-Threatening Behavior, 20, 16-28.
Rudd, M. D. (1993). Social support and suicide. Psychological Reports, 72, 201-202.
Rudd, M. D., Joiner, T. E., & Rajab, M. H. (1996). Relationships among suicide ideators, attempters, and multiple attempters in a young adult sample. Journal of Abnormal Psychology, 105, 541-550.
Rudd, M. D., Joiner, T. E., & Rajab, M. H. (2001). Treating Suicidal Behavior: An effective, time-limited approach. New York: The Guilford Press.
Rutter, M. (1987). Psychological resilience and protective mechanisms. American Journal of Orthopsychiat, 57, 316-311.
Schotte, D., & Clum, G. (1987). Problem-solving skills in suicidal psychiatric patients. Journal of Consulting and Clinical Psychology, 55, 49-55.
Stack, S. (1990). The impact of divorce on suicide, 1959-1980. Journal of Marriage and Family, 52, 119-128.
Vedin, A. C., & Goka, E. (2002). Cognitive and emotional factors in major depression and suicide. Turk Psikiyatri Dergisi, 13, 33-39.
Wasserman, D. (2001). A stress-vulnerability model and the development of the suicidal process. In D. Wasserman (Eds.), Suicide-an unnecessary death. London : Martin Dunitz.
Westefeld, J. S., Badura, A., Kiel, J. T., & Scheel, K. (1996). The College Student Reason for Living Inventory: Additional psychometric data. Journal of College Student Development, 37, 348-351.
Westefeld, J. S., Cardin, D., & Deaton, W. L.(1992). Development of the College Student Reasons for Living Inventory. Suicide and Life-Threatening Behavior, 22, 442-452.
Westefeld, J. S., Scheel, K. & Maples, M. R. (1998). Psychometric Analyses of the College Student Reasons for Living Inventory Using a Clinical Population. Measurement and Evaluation in Counseling and Development, 31, 86-94.
Yang, B., & Clum, G. A. (1996). Effects of early negative life experiences on cognitive functioning and risk for suicide: A review. Clinical Psychology Review, 16. 177-195.
Yufit, R., & Bongar, B. (1992). Suicide, stress, and coping with life cycle events. In R. W. Maris, A. L. Berman, J. T. Maltsberger & R. I. Yufit(Eds.), Assessment and prediction of suicide. New York: The Guilford Press.