台湾人工生殖技术管制之回顾与前瞻

台湾地区人工生殖技术的管制先后经历了道德管制和行政管制两个阶段,目前正积极总结各阶段管制模式的成败得失,努力构造《人工生殖法》的原则和框架,以提高人工生殖技术管制的合法性和有效性。     

A Psychobiographical Analysis of Faith, Hope, and Despair in Suicide

This paper presents a psychobiographical analysis of a young woman who committed suicide over 50 years ago. Among the documents analyzed are her letters, a high-school diary, creative writing, college newspaper book reviews, and academic papers. Using both an Eriksonian and object-relational theoretical framework, the roles of faith, hope, and despair in suicide—and the ways in which these were represented in the young woman's self-system—are analyzed. Although she possessed strong elements of both faith and hope, along with a will to implement them in a purposeful manner, she was prone to the defense mechanisms of splitting, devaluation, and dissociation, which led to an inability to create an abiding sense of self that may have prevented her descent to despair. Among other issues discussed in the article are the usefulness of psychobiography as a method of studying suicide and both the benefits and limitations of spiritual faith in countering depression and suicide.     

The descent into suicide

Suicidal breakdown requires attention both to attack upon the self (ego) as aggressive forces are unleashed against it by the superego, but also to the phases of self-breakup (ego regression) that follow. Less attention has been directed to ego-regression in suicide than to superego-directed assault on the ego in the psychoanalytic literature; this paper directs attention to the phenomena of ego failure and disarticulation of the self-representation. Clinical study of suicidal patients shows four aspects of suicidal collapse as ego loosens: affective flooding, desperate maneuvering to counter the resulting mental emergency, loss of control as the self begins to disintegrate, and grandiose magical scheming for mental survival as the self-representation splits up and body jettison becomes plausible. These phenomena are discussed theoretically in terms of failed affect regulation, ego helplessness, narcissistic surrender, breakdown of the representational world, and loss of reality testing.     

辅助生殖技术与社会公正

从生命伦理学的角度看,以解决不育问题为最初目的的辅助生殖技术,实质上是实现社会公正的一种重要手段,但现实辅助生殖技术服务却也导致了一些社会不公正现象.就此提出某些实现辅助生殖技术服务社会公正的途径有重要意义.     

Dialectical Behavior Therapy Is Effective for the Treatment of Suicidal Behavior: A Meta-Analysis

Dialectical Behavior Therapy (DBT) prioritizes suicidal behavior and other self-directed violence as the primary treatment targets, and has been demonstrated to reduce self-directed violence in clinical trials. This paper synthesizes findings from controlled trials that assessed self-directed violence and suicidality, including suicide attempts, non-suicidal self-injury (NSSI), suicidal ideation, and accessing psychiatric crisis services. Eighteen controlled trials of DBT were identified. Random effects meta-analyses demonstrated that DBT reduced self-directed violence (d = -.324, 95% CI = -.471 to -.176), and reduced frequency of psychiatric crisis services (d = -.379, 95% CI = -.581 to -.176). There was not a significant pooled effect of DBT with regard to suicidal ideation (d = -.229, 95% CI = -.473 to .016). Our findings may reflect the prioritization of behavior over thoughts within DBT, and offer implications for clinical practice and future research concerning the implementation of DBT for acute suicidality.     

Association between substance use disorders and self- and other-directed aggression: An integrated model approach

Our study's objective is to determine whether substance use disorders’ association with aggression differs according to the type of substance and/or the form of aggression, within the same population. We used data from the National Survey on Drug Use and Health across 2008–2014, with a pooled sample of 270,227 adult respondents. We used regression models to estimate the odds ratios for those having alcohol and/or drug use disorder(s) perpetrating (a) each form of aggression compared with no aggression and (b) other-directed compared with self-directed aggression. Alcohol use disorder alone and drug use disorder(s) alone were both associated with significantly increased odds of committing self-directed, other-directed, and combined aggression. Individuals with drug use disorder(s) alone were more likely to commit other-directed than self-directed aggression (adjusted odds ratio = 1.46, 95% CI = 1.04–2.05). Individuals with alcohol use disorder alone were not likely to commit one over the other (adjusted odds ratio = 1.20, 95% CI = 0.90–1.61). In conclusion, the integrated model of aggression based on the stress–diathesis model is a relevant framework to study risk factors for aggression. Further research is needed to identify longitudinal predictors of directionality of aggression.     

大学生自杀现象的心理分析和干预

大学生的自杀已成为社会、教育和行政管理部门越来越关注的话题,对大学生自杀现象的心理进行了分析,结合工作实际,提出了一些心理干预的措施。     

Drug‐assisted rape and sexual assault: definitional,conceptual and methodological developments

This paper reviews the limited literature on drug‐assisted rape (DAR) and develops definitions and constructs. A novel data gathering method, the multiple sorting task, was adopted to explore lay understanding of DAR. Participants (N = 8) were drawn from the general public. Each of the 21 stimulus cards used had the name of one sexual or romantic encounter printed on it. Participants completed one fixed sort in terms of the motivation of the male involved in the encounter. Data were analysed by means of multiple scalogram analysis (MSA). Findings show that the key factors for distinguishing sexual and romantic encounters are whether the behaviour is: consensual, contracted or forced; planned or impulsive; motivated primarily by the desire for sex or for a relationship. When motivation of the offender is considered, drug‐assisted rape and sexual assault is distinguishable from other consensual sexual behaviours but not from other types of rape. Findings are discussed in terms of the limitations of the present study, the need for further research and practical applications for assisting police enquiries. Copyright © 2005 John Wiley & Sons, Ltd.     

Suicide is Neither Rational nor Irrational

Richard Brandt, following Hume, famously argued that suicide could be rational. In this he was going against a common ‘absolutist’ view that suicide is irrational almost by definition. Arguments to the effect that suicide is morally permissible or prohibited tend to follow from one’s position on this first issue of rationality. I want to argue that the concept of rationality is not appropriately ascribed – or withheld – to the victim or the act or the desire to commit the act. To support this, I explore how the concept is ascribed and withheld in ordinary situations, and show that it is essentially future-oriented. Since the suicide victim has no future, it makes no sense to call his act rational or irrational. The more appropriate reaction to a declared desire for suicide, or to the news of a successful suicide, is horror and pity, and these are absent from Brandt’s account, as is a humble acknowledgement of the profound mystery at the heart of any suicide.

The Interplay Among Risk Factors for Suicidal Ideation and Suicide: The Role of Depression, Poor Health, and Loved Ones' Messages of Support and Criticism

When individuals who receive social support are in poor physical or mental health and are criticized or made to feel unwanted, they may perceive themselves as a burden. Poor physical health and depression were hypothesized to exacerbate the harmful effects on suicidal ideation of receiving critical negative messages and of receiving social support. These hypotheses were tested using secondary analyses of data from a sample of 533 unemployed married individuals who were assessed shortly after job loss, and 6 months later. The results of our analyses supported the hypotheses and demonstrated that for participants with poor health or high level of depressive symptoms an increase in critical messages and social support (from Time 1 to Time 2) predicted increased suicidal ideation. This relationship was not observed for non- depressed participants in good health. The results are discussed in terms of their implications for suicide prevention.