表達與壓抑敵意在血壓與自主神經之反應型態: 以生氣回憶作業為例

The relationship of Expressive/Suppressive hostility, blood pressure and autonomic nervous system reaction : induced by anger recall task

林詩穎(SHIH-YING LIN)

指導教授 ： 翁嘉英

國立中正大學/社會科學院/臨床心理學研究所/碩士(2016年)

摘要

摘要
目的：近來有許多研究指出敵意行為高血壓風險有關，但敵意行為介入高血壓病程及疾病控制之機制尚不清楚。過去學者提出個體經驗到生氣時，使交感神經活化上升，血壓隨之上升；同時，若在生氣情境中採取壓抑生氣的行為，將使生理激發維持在較高的狀態，造成副交感活動受到抑制，在生氣情境後出現延遲恢復的情形。本研究旨在檢驗高血壓族群之敵意行為特質(包含「表達敵意」及「壓抑敵意」)，在生氣情緒誘發下與血壓及自主神經反應之關聯性，以了解敵意行為對於高血壓疾病控制之影響。
方法：本研究資料取自翁嘉英教授於民國102年主持的科技部專題研究計畫(NSC102-2410-H-194-022)，作者為此計畫的兼任助理，經翁嘉英教授指導，負責部分計畫撰寫與問卷施測。共納入68位高血壓患者進行資料分析，平均年齡55.49歲(SD=8.31)，女性33人，男性35人。敵意行為評估則使用華人短式敵意量表，並依據中位數將個案區分為高、低表達敵意組及高、低壓抑敵意組。實驗採雙盲設計，使用生氣回憶作業誘發參與者生氣情緒及生理反應。生氣回憶作業共4個階段，包含基準期、生氣回憶期、生氣陳述期、恢復期，每階段各5分鐘。
結果：研究結果發現，壓抑敵意方面，高壓抑敵意組相較於低壓抑敵意組，在生氣回憶期、生氣陳述期有較大的DBP反應(F(1,34)= 5.868, p < .05；F(1,34)= 6.724, p < .05)。控制年齡與基準期的偏相關分析則顯示壓抑敵意與生氣陳述期及恢復期的SBP、DBP呈顯著正相關(SBP : r = .474, p < .05；r = .393, p < .05; DBP : r = .420, p < .05；r = .465, p < .05)；控制年齡的偏相關則顯示壓抑敵意與基準期、生氣回憶及生氣陳述的pNN50(由基準期至生氣陳述期依序為r = .272, p < .05；r = .301, p < .05；r = .243, p < .05)及rMSSD呈顯著正相關(由基準期至生氣陳述期依序為r = .281, p < .05；r = .280, p < .05；r = .259, p < .05)。此外，男性的高壓抑敵意組相較於低壓抑敵意組，在生氣陳述期與恢復期的LF/HF反應量較小(F(1,32)= 8.279, p < .01；F(1,32)= 5.193, p < .05)。表達敵意方面，控制年齡與基準期的偏相關分析顯示表達敵意與生氣陳述期及恢復期的DBP呈顯著正相關(r = .376, p < .05；r = .411, p < .05)，表達敵意與自主神經則無顯著關聯。
結論：高血壓族群的表達敵意及壓抑敵意皆與壓力期、恢復期較大的血壓表現有關。高壓抑敵意者在基準期、壓力期與恢復期較高的副交感活性有關。因此研究結果支持高血壓族群的壓抑敵意與血壓及自主神經反應型態之關聯性。

關鍵字 : 壓抑敵意、表達敵意、高血壓、自主神經

關鍵字

自主神經 ； 高血壓 ； 表達敵意 ； 壓抑敵意

並列摘要

Abstract
Objective : Recent research has found that expressive hostility and suppressive hostility is relate to essential hypertension(HT). However, the relationship of these hostility behaviors linking to cardiac autonomic activations in hypertension is unclear. Therefore, the purpose of this study is to investigate the association between hostility behavior pattern, blood pressure, autonomic nervous system (ANS) reactivity during anger recall task among patients with hypertension disease.
Methods : The database collected by the projects supported by the grants from Ministry of Science and Technology(NSC102-2410-H-194-022) to Chia-Ying Weng. The author served as a part-time research assistant in the projects, and participated in parts of drafting the project proposals, and data collecting through survey administration. Under the supervision and assistance of Chia-Ying Weng. Sixty- eight (mean age = 55.49 ± 8.31 years; 48.53%were female) patients with hypertension were recruited from a general hospital in Taiwan. Hostility behaviors are assessed by Chinses Hostility Inventory Short From(comprehend expressive hostility and suppressive hostility), and participants are classified into high/low expressive hostility and high/low suppressive hostility by using median-splits respectively. All Participants underwent the anger recall task and their blood pressure, heart rate variety (HRV) was recorded during the following stages: baseline (B), anger recall (AR), anger description (AD), and recovery (R).
Result : The result showed that high-suppressive hostility group had greater diastolic blood pressure reactivity than low-suppressive hostility group during AR and AD stages. After controlling age and baseline, expressive hostility is positively correlated with systolic blood pressure and diastolic blood pressure during AD and R stages. After controlling age, expressive hostility is positively correlated with parasympathetic activations during B, AR, and AD stages.
Conclusion : The results support that suppressive hostility is associated to blood pressure and autonomic activations during anger recall task, which may be risk of progressing the hypertension disease.

Key words : suppressive hostility, expressive hostility, hypertension, autonomic nervous system

並列關鍵字

autonomic nervous system ； hypertension ； expressive hostility ； suppressive hostility

參考文獻

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