反芻與擔憂對憂鬱與焦慮的影響：重複性負向思考之中介效果研究

一直以來，反芻反應被認為是憂鬱的重要因素，擔憂則是焦慮的重要因素，因此兩者皆作為獨特的認知歷程而各自被探討。然而兩者相似的認知特徵以及憂鬱和焦慮間的高共病性，許多研究開始嘗試探討反芻和擔憂的異同以及背後可能的原因。許多研究支持反芻和擔憂間有共同的造成非適應結果的認知歷程，即為「重複性負向思考(Repetitive Negative Thinking)」。亦有研究認為，此重複性負向思考可能是許多心理疾患在類似症狀的跨診斷因子。目前國外已有相關研究，而國內仍未正式進行相關研究，故本研究希望探討重複性負向思考在國內一般人樣本對於憂鬱和焦慮的預測效果，並驗證反芻與擔憂是否透過重複性負向思考影響憂鬱及焦慮。本研究以網路問卷收集了505份未曾被診斷有精神疾病的一般人樣本，以刪題後的反芻反應風格量表(RRS)、賓州擔憂量表(PSWQ)、固著性思考量表(PTQ)、臺灣憂鬱症量表以及特質焦慮量表(STAI-T)來測量反芻、擔憂、重複性負向思考、憂鬱和焦慮這五個潛在變項，以結構方程模型驗證重複性負向思考的中介效果。研究結果顯示，反芻、擔憂和重複性負向思考分別皆能正向解釋憂鬱和焦慮，而重複性負向思考可部分中介擔憂對憂鬱和焦慮的效果，但在反芻對憂鬱和焦慮的中介效果未達顯著。將反芻和擔憂個別分析後發現，重複性負向思考可各自中介反芻和擔憂對於憂鬱和焦慮的效果。本研究將針對此研究結果、研究限制和應用價值進行討論。

關鍵字

反芻；憂鬱；擔憂；焦慮；重複性負向思考

並列摘要

Rumination has long been considered an important factor in depression and worry as an important factor in anxiety, so both have been explored separately as unique cognitive processes. However, the similar cognitive characteristics of the two and the high comorbidity between depression and anxiety, many studies have begun to try to explore the similarities and differences between rumination and worry and the possible causes behind them. Many studies support a common cognitive process between rumination and worry that leads to non-adaptive outcomes, known as "Repetitive Negative Thinking." It has also been suggested that this repetitive negative thinking may be a cross-diagnostic factor for many mental disorders in similar symptoms. 　At present, there are no relevant studies in Taiwan, so this study hopes to explore the predictive effect of repetitive negative thinking on depression and anxiety in the general sample of people in China, and verify whether rumination and worry affect depression and anxiety through repetitive negative thinking. In this study, 505 samples of the general population who had not been diagnosed with mental illness were collected by online questionnaires, and the five potential variables of rumination, worry, repetitive negative thinking, depression and anxiety were measured by the Ruminative Response Scale (RRS), Penn State Worry Questionnaire (PSWQ), Perseverative Thinking Questionnaire (PTQ), Taiwan Depression Scale, and State-Trait Anxiety Inventory - Trait Anxiety (STAI-T). The mediating effect of repetitive negative thinking was verified by structural equation model. 　The results showed that rumination, worry and repetitive negative thinking could all positively explain depression and anxiety, respectively, while repetitive negative thinking could partially mediate the effect of worry on depression and anxiety, but the mediating effect of rumination on depression and anxiety was not significant. After analyzing rumination and worry separately, it was found that repetitive negative thinking could mediate the effects of rumination and worry on depression and anxiety. This study will discuss the findings, research limitations, and application value.