憂鬱症患者人際認知模式之探討： 憂鬱人格傾向與臉部情緒認知基模反應

A Clinical Investigation of Cognitive Interpersonal Model of Depression：Personality Predispositions and Schematic Responses to Facial Emotions

張曉慧(Hsiao-Hui Chang)

指導教授 ： 陳淑惠

國立臺灣大學/理學院/心理學研究所/碩士(2010年)

https://doi.org/10.6342/NTU.2010.00669

摘要

憂鬱的認知理論認為憂鬱衍生基模經由壓力事件的活化造成憂鬱的初發及維持，人際理論則認為憂鬱個體在與環境的互動中持續得到負向回饋是憂鬱持續的原因。依循認知及人際理論的脈絡，本研究嘗試探討負向的非語言訊息在憂鬱的人際認知整合模式中所扮演的角色，進一步探討社交�依賴型人格傾向與自主�自責型人格傾向的素質壓力模式。研究的樣本是31位憂鬱症患者，以電腦化的作業評估針對臉部情緒表情刺激的負向認知基模反應及人際情緒經驗，以問卷評估人格傾向、尋求再保證後果及憂鬱狀態。研究結果發現：（一）憂鬱症患者的負向認知基模反應與憂鬱嚴重度呈正相關，在負向及正向臉部情緒表情刺激時均有此一現象。（二）負向人際情緒經驗及他人的負向回饋在憂鬱衍生負向認知基模反應影響憂鬱的歷程中並無調節的效果，亦不經由憂鬱衍生負向認知基模反應的中介影響憂鬱狀態，但憂鬱衍生負向認知基模反應可經由正向人際情緒經驗的中介影響憂鬱狀態。（三）社交�依賴型人格傾向可經由負向人際情緒經驗的調節影響憂鬱，而自主�自責型人格傾向則經由憂鬱衍生負向認知基模反應的中介降低正向人際情緒經驗進而影響憂鬱狀態。本文最後針對憂鬱衍生負向認知基模反應、臉部情緒表情刺激與憂鬱的關係及社交�依賴型人格傾向與自主�自責型人格傾向的素質壓力模式進行討論，並提出臨床應用上的可能性及進一步的研究方向。

關鍵字

憂鬱 ； 人際認知模式 ； 臉部情緒表情 ； 憂鬱衍生基模 ； 負向認知基模反應 ； 社交�依賴型人格傾向 ； 自主�自責型人格傾向

並列摘要

In the cognitive view of depression, depressogenic schmata activated by stressful events often cause an individual to become depressed and sustaine depressive mood. Interpersonal model of depression postulates that negative feedbacks from others during the interpersonal interactions cause one to maintain depressed mood. Accordingly, this study aimed to explore the functions of nonverbal information acquired based on the framework of integrated interpersonal-cognitive model of depression, and to examine the differences of diathesis stress paths between sociotropic/dependent and autonomous/self-critical types and depression. Participants were 31 clinically depressed patients. Negative schemata activation toward facial emotional expressions was evaluated by a computerized program. Personality trait, reassurance seeking outcome and depression were evaluated by questionnaires. The results showed that, first, negative schemata activation correlated positively with depression severity for both negative and positive facial emotions in depressed patients. Second, neither negative interpersonal emotion experience nor negative feedback from others moderated the relation between negative schemata activation and severity of depression. Negative schemata activation did not mediate either the path from negative interpersonal emotion experience or negative feedback from others to severity of depression. Third, negative interpersonal emotion experience had moderating effects on the path from sociotropic/dependent personality trait to depression. It is suggested that an individual with autonomous/self-critical personality trait may reduce positive interpersonal experience through activation of negative schemata and then become depressed. Finally, this thesis discusses the relation among negative schemata activation, facial emotional expression and depression. More discussions are addressed on the diathesis stress model of sociotropic/dependent personality trait and autonomous/self-critical personality trait. According the results, suggestions for clinical practice and future researches are also provided.

並列關鍵字

depression ； interpersonal-cognitive model of depression ； facial emotional expression ； depressogenic schemata ； negative schemata activation ； sociotropic/dependent personality trait ； autonomous/self-criticial personality trait

參考文獻

黃玉蓮（2006）。「憂鬱症患者之非語言情緒辨識表現初探」(未發表之碩士論文)。台北：國立台灣大學心理學研究所。

黃天豪（2004）。「憂鬱人際模式之探討：尋求再保證的促發、調節與補償機制」(未發表之碩士論文)。台北：國立台灣大學心理學研究所。

王敏璇（2007）。「憂鬱人際認知模式之前瞻性探討：憂鬱與臉部情緒之辨識、判斷及認知基模反應」(未發表之碩士論文)。台北：國立台灣大學心理學研究所。

Baron, R., & Kenny, D. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173-1182.

Beck, A. T., & Alford, B. A. (2009). Depression : Causes and treatment. Philadelphia: University of Pennsylvania Press.