新北市自閉症青少年自殺行為之相關危險因子初探

Abstract

「青少年自殺防治策略及作為等情案」調查報告中指出，衛福部2020年統計，青少年族群自殺死亡率連續20年攀升，15至24歲人口群自殺通報更是逐年增加，2016至2020年分別為4,365、4,905、6,352、7,991及10,659人次，2020年該人口群通報人次已佔所有通報人口群中的26.4%。在青少年十大死因中，自殺排名占第二位，僅次於意外，顯示青少年自殺問題、自傷議題的嚴重性。許多不同的研究均指出，不同的青少年族群都有自殺行為的可能性；然而，身心障礙青少年自殺風險高於一般青少年，其可能原因來自於自我形象的改變、相關情緒困擾及壓力、家庭內部壓力、學習困擾及同儕關係，以及社會適應等多重因素複雜交互作用下之結果。國內目前對於身心障礙青少年之自殺相關研究，多以零星個案報告為主，對於此族群自殺相關之危險因子、有效之介入方式，尚未有系統化的研究。本研究使用新北市自殺防治通報系統，與新北市特殊教育通報網之資料庫進行分析，收集2019至2022年間，年齡介於10歲至21歲且具有身心障礙身分或取得特殊教育鑑定之自閉症青少年共92位，並隨機抽樣具自殺行為之一般青少年92位作為對照組，針對其過往之自殺行為，分析其自殺相關風險因子。研究結果指出，自閉症青少年有較高的自殺發生率，其中自閉症青少女自殺發生率較男性高，除此之外，同儕關係衝突及童年逆境此兩項風險因子，在兩組之間具有顯著差異。本研究作為自閉症青少年之自殺相關風險因子之前導研究，期能持續深入發展，獲取更多的研究數據與證據，進而為第一線自殺防治工作政策擬定提供相關建議。According to the"Adolescent Suicide Prevention Strategies and Actions" Investigation Report, the suicide mortality rate in Taiwan among adolescents has been rising for 20 consecutive years. In 2020, the number of notifications from this population group accounted for 26.4% of all notification population groups. The number of self-injury reported by schools at all levels has increased exponentially, highlighting the seriousness of the issue of youth suicide attempts and self-injury. Disabilities put adolescentsat risk of poor self-image, learning obstacles, difficult peer relationships, and intra-family conflicts. Adolescents with disabilities often suffer from different levels of stress. The suicide rate of adolescents with disabilities is higher than that of ordinary adolescents under the influences of complexity in multiple risk factors. However, there is still a lack of relevant research to investigate the possible risk factors among adolescents with disabilities.The aim of this study is to investigate the possible risk factors of suicide among adolescents with autism spectrum disorder aged 10-21 registered in New Taipei City Suicide Prevention System and Special Education in New Taipei. Secondary data analysis was applied to inspect the correlation of different risk factors.This study was divided into a control group and an experimental group, and 92 subjects were collected respectively. For different risk factors, we used the chi-square test to investigate the differences in various variables between the two groups. Logistic regression was also applied to examine the influences between different variables.The results showed that ASD adolescents has higher suicide rate and conflicts with peers, adverse childhood experiences are two main differences between two groups. In addition, comorbid with other psychiatric disorder increases the impact of peer conflict. As a pilot study on suicide-related risk factors for autistic adolescents, this study is expected to continue to develop in depth, obtain more research data and evidences. It may provide relevant suggestions for the formulation of front-linesuicide prevention policies.