心理韌性與創傷後心理症狀之關聯性研究:以車禍創傷樣本為例

Association between Resilience and Posttraumatic Stress Symptoms among Motor Vehicle Accident Patients

盧佳慧(Chia-Hui Lu)

指導教授 ： 陳淑惠

國立臺灣大學/理學院/心理學研究所/碩士(2011年)

https://doi.org/10.6342/NTU.2011.03362

摘要

心理韌性(Resilience)可以被視為是一種特質，也被認為是個體在經歷逆境時所展現的動力過程，所強調的是個體在顯著的負向情境中所表現出的正向適應力。心理韌性在創傷領域的研究中，其方向著重於將幾乎沒有創傷後壓力症狀或是有少量症狀者，定義為具有心理韌性的群體，並研究其影響因子。本研究嘗試以心理韌性理論為基礎，以實徵方式研究台灣車禍受創者的心理狀態變化，期望經由穩定的心理韌性測量工具，了解創傷後心理韌性的動力過程，並且同時驗證心理韌性是否能使創傷後的心理症狀出現減緩的效果，且具有好的生活滿意度。並於本研究中檢驗急性創傷壓力症狀量表的計量特性，以及心理韌性量表在人格變項上的效度。本研究參與者為因車禍創傷三個月內至台灣大學醫學院附設醫院就醫者，填寫心理韌性量表、急性創傷壓力症狀量表、創傷後壓力診斷量表、貝克焦慮量表、貝克憂鬱量表第二版、神經質與外向性量表及生活品質量表，共122名參與者完成問卷。結果顯示，急性創傷壓力症狀量表中文版信效度佳；心理韌性量表在人格變項上亦具有良好的效度。基本變項方面顯示身體外傷嚴重度與創傷後心理症狀皆無顯著關聯性；在焦慮及憂鬱症狀部分女性顯著高於男性。在心理韌性部分顯示，車禍前心理韌性與創傷後急性壓力症狀及焦慮症狀無顯著相關，與創傷後壓力症狀呈曲線相關，與憂鬱症狀呈負相關，與生活品質滿意程度呈正相關。而創傷前後心理韌性的變化與警覺、焦慮及憂鬱症狀呈負相關，與生活品質呈現正相關。本研究與假設不一致之處在於心理韌性與創傷後症狀成曲線相關，顯示自覺高或低心理韌性者創傷後症狀較自覺中等心理韌性者高，此結果可能與高心理韌性者僵化的正向信念有關。最後，針對本研究的貢獻與臨床上可能應用方向進行討論，並提出未來研究方向。

關鍵字

心理韌性 ； 創傷後心理症狀 ； 車禍 ； 生活品質

並列摘要

Resilience has been regarded as a trait and a dynamic process with that people exposed to significant adversities and threats can achieve positive adaptation. During the past decades, studies on the association between resilience and trauma often define those who have never developed psychaitric symptoms or improved to levels of no psychiatric symptoms after trauma as resilient individuals. Based on the resilience theory, the main purpose of our study was to investigate the association between posttraumatic stress disorder (PTSD) symptoms and resilience in motor vehicle accident (MVA) survivors. We expected to understand the dynamic process of resilience and verify whether resilience could help to alleviate PTSD symptoms and enhance quality of life. This study first examined the psychometric properties of the Chinese versions of Acute Stress Disorder Scale (ASDS) and Resilience Scale (RS). Participants were recruited from the National Taiwan University Hospital. One hundred and twenty two participants who had undergone MVA were administered with the Chinese versions of RS, ASDS, Posttraumatic Diagnosis Scale (PDS), Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), NEO-FFI Neuroticism and Extraversion subscales, and Quality of life scale (QOL) within three month after the MVA. Results indicated satisfactory psychometric properties for the Chinese ASDS and RS. There was no significant correlation between injury severity and PTSD symptoms. Females had more anxiety and depressive symptoms than males. Moreover, pre-MVA resilience correlated negatively with depressive symptoms and positively with quality of life, but did not correlate with acute stress and anxiety symptoms. However, there was a curvilinear relationship between pre-MVA resilience and PTSD symptoms, suggesting that individuals who possessed high and low level of resilience before MVA tended to experience more PTSD symptoms. The pre-post MVA change score of resilience had negative correlation with hyperarousal, anxiety, and depressive symptoms, and had positive correlation with QOL. The limitations and implication of these findings are discussed, and recommendation for future research direction is thus suggested.

並列關鍵字

resilience ； posttraumatic stress symptoms ； motor vehicle accident ； quality of life.

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