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精神健康与风险社会：澳门青年企图自杀的个案研究—— 生物—心理—社会模型的整合分析

作者：梁启贤^1,*，陆晴²，秦伟燊³

¹澳门理工大学澳门

²澳门城市大学创新社会工作系澳门

³香港教育大学香港

^*标记署名为通讯作者

提交：2026-05-01录用：2026-06-14出版：2026-06-30

社会工作与志愿服务 2026, 3(1), 34-51; https://doi.org/10.58244/jswv.260006

摘要：

自杀是青年人的主要死因之一，持续构成全球重要的公共卫生议题。本研究以风险社会理论及Engel的生物—心理—社会模型为分析框架，采用探索性个案研究设计，分析澳门五名15至34岁曾有企图自杀行为青年的二手质性数据，旨在探讨多层次风险因素在澳门青年企图自杀个案中的关联与交互作用。研究发现，个案的企图自杀风险不能仅理解为个人的心理问题，而是生物层面（睡眠困扰、疲劳及身心症状）、心理层面（焦虑、低自我价值感、绝望感及自我认同困难）与社会层面（校园欺凌、家庭逆境、社会支持不足及教育压力）因素交互累积的结果；且在华人文化脉络下，“成就孝道”与“面子文化”进一步将制度性风险转化为个体内在的道德负担与归属感受挫。本文建议澳门采取“全社会参与模式”推动自杀防治工作，重点包括预防校园欺凌、强化家庭支持、提升校本精神健康服务的可及性、建立及时的跨专业转介机制，以及发展以社区为本的支持网络。

关键词：精神健康；风险社会；澳门青年；企图自杀；生物—心理—社会模型；成就孝道

Abstract:

Suicide is a leading cause of death among young people and remains a major global public health concern. Drawing on risk society theory and Engel’s biopsychosocial model, this exploratory case study examines multi-level factors associated with suicide attempts among young people aged 15–34 in Macao. Secondary qualitative data, including de-identified case records and professional accounts from frontline social workers, were analysed for five young people with a history of suicide attempts. The findings indicate that suicide-attempt risk in these cases cannot be understood solely as an individual psychological problem. Rather, the cases reflected interacting biological factors (sleep disturbance, fatigue, and somatic symptoms), psychological factors (anxiety, low self-worth, hopelessness, and identity-related difficulties), and social factors (school bullying, family adversity, limited social support, and educational pressure). Interpreted through the lens of risk society theory, these patterns are associated with uncertainty in life transitions, pressure to manage personal risks, and weakening sources of social support. Moreover, within the Chinese cultural context, “achievement filial piety”and “face culture” further transform institutional risks into internalized moral burdens and thwarted belongingness, constituting a distinctive cultural pathological mechanism. As the study is based on a small number of secondary case records, it does not establish causal relationships or claim statistical generalizability. The paper recommends a whole-of-society approach to suicide prevention in Macao, with priority areas including school-bullying prevention, family support, accessible school-based mental health services, timely cross-sector referral pathways, and community-based support networks, so as to strengthen early identification, continuity of care, and social connectedness among young people experiencing psychological distress.

Keywords: Mental health; Risk society; Young people in Macao; Suicide attempts; Biopsychosocial model; Achievement filial piety

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