人格特質及作業執行情形對正念療法成效之預測

The associations among personality, home meditation practice and the outcome of Mindfulness-Based psychotherapy

鄭雅之(Ya-Chih Cheng)

指導教授 ： 黃淑玲

中山醫學大學/醫學科技學院/心理學系暨臨床心理學碩士班/碩士(2013年)

摘要

正念療法(Mindfulness-Based Psychotherapy)包含正念減壓療法(Mindfulness-Based Stress Reduction, MBSR)與正念認知療法(Mindfulness-Based Cognitive Therapy, MBCT)。MBSR由Jon Kabat-Zinn所創立，藉由靜坐、瑜珈、身體掃描等方法來協助慢性疼痛者減少因疼痛帶來的壓力；MBCT由Mark Williams等人將其整合認知行為治療，作為預防憂鬱症復發之心理治療方法。正念療法目前發現可降低許多疾病患者的負向情緒，並在疾病適應與心理健康上有正向成效。
本研究採用量性與質性之研究方法，旨在探討正念療法介入對個體心理衛生之影響、了解不同人格特質在成效上的差異，並探討作業練習與正念療法成效的關係。以有動機參與正念療法之健康成人為研究對象。量性研究採用準實驗設計之非隨機控制組前後測實驗設計，實驗組接受為期兩個月的正念療法介入。控制組採配對方式，尋求與實驗組樣本之人口學特性相近之控制組樣本。49名實驗組成員與31名控制組成員皆接受正念團體介入前後的前測及後測各一次。此外，針對實驗組另行團體結束後一個月的追蹤調查。質性研究部分，對實驗組成員進行三次焦點團體訪談以收集資料。
量性研究結果發現透過正念療法介入後，正念覺察程度可顯著提升，憂鬱與焦慮情緒顯著下降，且一個月後追蹤仍有成效，但同理心僅有部分提升。而人格特質會影響個體在評估自己練習時的專注度與收穫度，但不影響個體參與正念療法之意願、投入程度及成效。質性結果亦發現正念培育有其一定的歷程進展，且學習正念的歷程中知識的獲得與經驗的體會是相等重要的，而正念作業練習便是在其中提供體驗與熟悉正念的管道。
總之，正念療法可提供一般人作為提升正念，減少憂鬱、焦慮的有效策略。本研究結果也提出未能成功培育正念的可能性，協助正念療法帶領者及早發現，及早處置，以協助所有成員成功培育正念。

關鍵字

正念 ； 作業練習 ； 人格特質 ； 心理健康

並列摘要

Mindfulness-Based Psychotherapy includes both Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT). MBSR is developed by Jon Kabat-Zinn. It integrates meditation, yoga and body scan to release the pressure caused by chornic pain for the patients. MBCT is combined from mindfulness interventions and cognitive-behavioral psychotherapy by Mark Williams, John Teasdale and Zindel Segal. This is known as a psychological treatment to prevent relapse of depression. The positive effects of Mindfulness-Based Psychotherapy for patients, in terms of declineing negative emotions and improving well-being, have been evidenced. However, the research regarding the effects of Mindfulness-Based Psychotherapy for heathy adults is limited.
A two-part research strategy using both quantitative and qualitative methods was employed. The aims of this study were (1) to investigate the effects of Mindfulness-Based Psychotherapy on mental health, (2) to explore the differences of effects among different personality traits, and (3) to analyze the relations between meditation practices and the effects. In total, 80 participants were recruited in the study, including 49 in experimental group and 31 in control group. The quantitative survry collected data by a self-reported questionnaire which was composed of personal basic information, Chinese Mindful Awareness Attention Scale, Hospital Anxiety and Depression Scale, the Interpersonal Reactivity Index, NEO Five-Factor Inventory, and meditation practices record form. The questionnaire was distributed and returned at pre-, post- Mindfulness-Based Psychotherapy and one month after completion of Mindfulness-Based Psychotherapy. Focus group interviews were conducted to collect qualitative information from participants in experimental group.
The qualitative survry showed that mindfulness awareness was increased and depression and anxiety were decreased after Mindfulness-Based Psychotherapy. The effects still sustained at one month follow-up. Personality was associated with the extent of attention and attainment in meditation practice. The qualitative reseach found that the process of cultivating mindfulness had specific pathways. In addition, in the process of cultivating mindfulness, the acquisition of knowledge and the perception of experiences were equally important. In particular, homework practice was a good way to experience and becme habituated to mindfulness awareness in the learning course.
In general, the study showed Mindfulness-Based Psychotherapy is able to promote mindfulness awarness and decrease negative feelings for healthy adults. We also indicated the possibilities of whom and when the cultivation of mindfulness may fail. These possibilities would enable mindfulness teachers to detect and assist earlier so that all members in the group cultivate mindfulness smoothly and successfully.

並列關鍵字

Mindfulness ； Meditation Practice ； Personality ； Mental Health

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