隨機控制情境短文探究憂鬱症生理、心理歸因之效果

The Effects of Biological and Psychological Attribution on Depression

韓德彥(Der-Yan Han) ； 劉嘉逸(Chia-Yih Liu) ； 陳淑惠(Sue-Huei Chen)

《中華心理衛生學刊》 29卷2期 (2016/06) Pp. 187-214

https://doi.org/10.30074/FJMH.201606_29(2).0003

摘要

研究目的：心理科學進展快速，憂鬱症的病因解釋已累積大量神經生理與社會心理證據，但實務上的推廣運用卻仍有疑慮。質、量化研究指出，採取生理取向的解釋，可降低憂鬱者的負面評價，但也有研究主張可能導致負面影響。本研究採用情境短文操弄，探討憂鬱症的生理與/或心理訊息的效果。研究方法：實驗參與者共128位大學生，以及104位門診憂鬱患者，測量工具包括責任歸因、可控性歸因、正向態度、污名感受、預後評估與治療意願量表，研究期間為2008年5月到2009年1月。研究結果：學生樣本接受生理訊息者對憂鬱者的責任歸因較未接受生理訊息者低，可控性歸因則較高；生理訊息與心理訊息二者間在責任歸因、污名感受與用藥意願上具交互作用。病患樣本有無接受生理或心理訊息，對任何依變項皆無顯著影響，但可控性歸因愈高，正向態度愈佳，可以此做憂鬱衛教的參考。研究結論：東方人習慣採取心理歸因方式看待他人憂鬱症的發生，然此種心理歸因訊息對當代憂鬱防治工作的推動效果未達預期；實務應用上或可先採生理解釋以降低對憂鬱者的歸咎，待進入治療後採取藥物與心理治療並行的方式，才能有效治療憂鬱症。

關鍵字

可控性歸因 ； 污名 ； 責任歸因 ； 預後

並列摘要

Purpose: Research evidence supports both neurobiological and psychosocial causes of depression. According to some studies, explaining depression from a biological viewpoint decreases negative evaluation of depressed people, but other studies have found that biological information leads to increased negative perceptions. We examined whether the type of causal attribution impacts perceptions surrounding depression. Methods: We used randomized controlled vignettes to examine the effects of biological and/or psychological causal attribution on responsibility attribution, controllability attribution, positive attitude toward depressed people, perceived stigma, the evaluation of the prognosis of depression, and willingness to receive treatment. Participants included 128 college students (age=20.45±1.75) and 104 depressive outpatients (age=43.63±12.91). These data were collected from May, 2008 to January 2009. Results: In the student sample, participants who received biological information had lower responsibility attribution and higher controllability attribution than participants who did not receive the biological information. In addition, biological and psychological information had interactive effects on responsibility attribution, perceived stigma, and willingness to take medicine. Receiving only biological information had the best effects on all these variables. In the patient sample, the type of information received had no effect on responsibility attribution, controllability attribution, positive attitude, perceived stigma, or willingness to seek help from medicine or counseling. However, the higher a person’s controllability attribution was, the more positive that person’s attitude toward depressed people. Conclusions: Taiwanese attribute depression of others to psychological factors. This attribution is not helpful for depression prevention. We suggest that using neurobiological information to explain depression may decrease blame of depressed people for their depression. Pharmacotherapy and psychotherapy should both be applied to treat the depression.

並列關鍵字

controllability attribution ； prognosis ； responsibility attribution ； stigma

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