[국내논문]A Comparative Study of Permissive Attitudes Toward Suicide : An Analysis of Cross-National Survey in South Korea, Japan, and the United States원문보기
Park, C. Hyung Keun
(Department of Neuropsychiatry, Seoul National University Hospital)
,
Kim, Bora
(Department of Psychiatry, University of California at San Francisco)
,
Lee, Sang Sin
(Korean Institute for National Unification)
,
Ha, Kyooseob
(Department of Neuropsychiatry, Seoul National University Hospital)
,
Baek, Chang-Jae
(Department of Political Science and International Relations, College of Social Sciences, Seoul National University)
,
Shin, Min-Sup
(Department of Neuropsychiatry, Seoul National University Hospital)
,
Ahn, Yong-Min
(Department of Neuropsychiatry, Seoul National University Hospital)
Objectives There were previous studies which indicated that attitude toward suicide is able to influence the suicide outcome in both individual and group levels. In regard to the highest suicide rate in Korea, our study aims to explore the influence that attitude toward suicide has on suicide by com...
Objectives There were previous studies which indicated that attitude toward suicide is able to influence the suicide outcome in both individual and group levels. In regard to the highest suicide rate in Korea, our study aims to explore the influence that attitude toward suicide has on suicide by comparing the national attitude towards suicide with a representative sample of the general population. Methods The target population was 20- to 59-year-old adults from South Korea, Japan, and the United States. The panel data were divided according to gender, age, and residential area of individuals, and an email with a hyperlink to our web survey was sent to the randomly selected participants in each stratum. To measure the perceptual differences about suicide in different cultures, this study adopted the Attitudes Toward Suicide questionnaire. Results A total of 2247 subjects in three countries participated in this study. According to results from factor analysis, there were different structure of factors and included items within factors in the three countries : five factors with nineteen items in South Korea, five factors with nineteen items in the United States, and five factors with twenty-five items in Japan. With regard to permissive attitude toward suicide, the mean value of permissiveness was not significantly different among countries, but permissiveness according to education level, gender, and marital status was different in each country. Conclusions This study is the first nationwide comparative study about attitude toward suicide with a representative sample. Our findings suggest that permissive attitude toward suicide influence the suicide phenomenon in each country ; however, its impact is not a mean score of permissiveness, but the detailed difference by various demographics.
Objectives There were previous studies which indicated that attitude toward suicide is able to influence the suicide outcome in both individual and group levels. In regard to the highest suicide rate in Korea, our study aims to explore the influence that attitude toward suicide has on suicide by comparing the national attitude towards suicide with a representative sample of the general population. Methods The target population was 20- to 59-year-old adults from South Korea, Japan, and the United States. The panel data were divided according to gender, age, and residential area of individuals, and an email with a hyperlink to our web survey was sent to the randomly selected participants in each stratum. To measure the perceptual differences about suicide in different cultures, this study adopted the Attitudes Toward Suicide questionnaire. Results A total of 2247 subjects in three countries participated in this study. According to results from factor analysis, there were different structure of factors and included items within factors in the three countries : five factors with nineteen items in South Korea, five factors with nineteen items in the United States, and five factors with twenty-five items in Japan. With regard to permissive attitude toward suicide, the mean value of permissiveness was not significantly different among countries, but permissiveness according to education level, gender, and marital status was different in each country. Conclusions This study is the first nationwide comparative study about attitude toward suicide with a representative sample. Our findings suggest that permissive attitude toward suicide influence the suicide phenomenon in each country ; however, its impact is not a mean score of permissiveness, but the detailed difference by various demographics.
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제안 방법
The target population was 20- to 59-year-old adults from South Korea, Japan, and the United States. The panel data was divided according to gender, age, and residential area of individuals, and an email with a hyperlink to our web survey was sent to the randomly selected participants in each stratums. The surveys were conducted by three survey companies – Macromill Embrain in South Korea, Global Mappping International in the United States, and Micromill in Japan.
In addition, individual factors, such as psychiatric problem and experience contacting suicidal people, should also be considered. Our follow up study plan is to build an integrated model combined with those elements based on this study. Our study has several important implications and strengths.
Lastly, there might have been some limitations in explaining the related attitude toward suicide and suicide rate in different countries because it should be explained through an integrated model including factors influencing general thought or attitude, such as sex, age, income, religion, and relative’s or familial experience of suicide. In this study, we performed a cross-sectional analysis and plan further research for an integrated model.
In conclusion, this study explored the comparison of the national attitudes toward suicide with a representative sample of the general population in three countries, Korea, Japan and the United States. The structure of factors and composed items in ATTS were different in each country.
The Korean permissiveness factor has five items, and these items are also commonly found in the Japanese and American models. Based on these factor analyses, a summation scale for permissiveness of suicide is constructed with the five common items that all three country models shared. Cronbach’s alpha for this permissiveness scale is 0.
대상 데이터
Our study aims to explore and compare the national attitudes towards suicide with a representative sample of the general population. For this purpose, we carried out a survey in three countries: South Korea, Japan, and the United States. South Korea and Japan share many cultural similarities : strong tradition of Confucianism ; highly homogeneous ethnic demographics ; long history of nationalism ; importance of collectivism, etc.
The surveys were conducted by three survey companies – Macromill Embrain in South Korea, Global Mappping International in the United States, and Micromill in Japan.
The data for this study was gathered by a multi-stage stratified sampling method. The target population was 20- to 59-year-old adults from South Korea, Japan, and the United States. The panel data was divided according to gender, age, and residential area of individuals, and an email with a hyperlink to our web survey was sent to the randomly selected participants in each stratums.
The web survey questionnaire contained a self-administered questionnaire and information about the purpose of the research. The total number of the respondents was 2247 (790 from South Korea, 730 from the United States, and 727 from Japan). The web-questionnaire was designed to not allow a respondent to skip an item, so that there were no missing values in the dataset.
데이터처리
In addition, the national characteristics of the items in the permissiveness factor that were not shared by all three countries were examined using one-way ANOVA and Tukey’s post hoc test.
이론/모형
The data for this study was gathered by a multi-stage stratified sampling method. The target population was 20- to 59-year-old adults from South Korea, Japan, and the United States.
To measure the perceptual differences on suicide in different cultures, this study adopted the Attitudes Toward Suicide questionnaire (ATTS). The ATTS was originally developed by Swedish researchers.
20)21) Out of the forty items from the 2008 version of ATTS, thirty-seven items were employed in this study. The ATTS items were measured with a five-point Likert Scale, which ranged from Strongly Agree to Strongly Disagree. The ATTS had been translated into Japanese by Japanese researchers,20) and this study utilized this version of the Japanese translation.
23-25) Parallel analysis reveals that the ATTS items converge into five factors in all three countries. After deciding the number of factors, exploratory factor analysis with maximum likelihood extraction method and promax rotation is performed. The items for which the factor loading value are smaller than 0.
성능/효과
Our study also has several limitations. First, because of our web-survey method, the adult population over 60 was excluded from the sampling, due to their lack of internet access and skills. This is an unavoidable shortcoming of web-surveys.
For the former, significantly higher agreement was observed in Japan than in both South Korea and the United States (p < 0.001, one-way ANOVA, Tukey’s post hoc test), between which there was no significant difference, and, for the latter, significantly higher agreement was shown in the United States than in Japan (p < 0.001, one-way ANOVA, Tukey’s post hoc test) and in Japan than in South Korea (p < 0.001, one-way ANOVA, Tukey’s post hoc test).
This is the first report to compare the attitude toward suicide between countries with a large number of representative sample and a full 37 items of the ATTS Scale. Next, with regard to permissive attitude toward suicide, the mean value of permissiveness was not significantly different between countries, but permissiveness according to education level, gender, and marital status was different in each country. This result seems to be a little different than we expected, in part, regarding higher permissiveness toward suicide in countries with high suicide rates.
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