- 學位論文
學前自閉症類群障礙症兒童在情緒Go/No-Go作業的情緒調控表現：反應抑制與情緒辨識的效果
Emotion Regulation in Preschoolers with Autism Spectrum Disorders during an Emotional Go/No-Go Task: Response Inhibition and Emotion Recognition Effects
摘要
研究背景：情緒調控問題常見於自閉症類群障礙症兒童（Autism Spectrum Disorder, ASD），其中情緒辨識與反應抑制被認為是導致此問題的潛在因子。然而，尚未有研究同時探討情緒辨識與反應抑制在ASD兒童情緒調控問題上的影響。本研究目的旨在以訊號偵測理論（signal detection theory）與逆向效能分數（inverse efficiency score）分析ASD兒童及一般發展兒童在情緒與非情緒Go/No-Go作業中的表現，除了應用過去研究常見的反應錯誤模式（誤判率）來探討表現差異，更近一步從反應敏感度、決策偏誤與訊息處理效能的角度表徵兒童的能力，以探究情緒辨識與反應抑制對情緒調控表現的預測以及在兩組兒童中的影響是否存在差異。研究方法：本研究納入5至6歲的ASD兒童（n = 68）及一般發展兒童（n = 68），使用以不同情緒臉孔為刺激（快樂、生氣與害怕）的情緒Go/No-Go作業、幾何圖形（綠色與紅色圓形）為刺激的非情緒Go/No-Go作業以及華人兒童情緒再認作業，量測反應誤判率、敏感度、決策偏誤、逆向效能分數與情緒臉孔辨識正確率。研究結果：ASD兒童在情緒再認作業的情緒臉孔辨識正確率顯著較低，非情緒Go/No-Go作業的反應偏誤與逆向效能分數顯著較高，快樂情境的情緒Go/No-Go作業反應誤判率顯著較高、敏感度顯著較低。多元階層迴歸分析發現情緒臉孔辨識正確率與非情緒Go/No-Go作業指標皆能顯著預測兩組兒童的情緒Go/No-Go作業表現。比較兩組間的預測力，發現在快樂情境的Go/No-Go作業反應敏感度上，ASD兒童中僅情緒辨識能顯著預測表現， 一般發展兒童中僅反應抑制能顯著預測表現。結論：學前階段已能觀察到ASD兒童的情緒臉孔辨識能力較弱，在反應抑制歷程中較缺乏決策策略、訊息處理效能較弱。同時，他們在情緒調控歷程中展現較弱的快樂情緒臉孔敏感度，這也可能影響他們的訊息誤判率較高。本研究的結果支持情緒辨識和反應抑制能力為ASD兒童情緒調控缺陷的潛在干擾因子，以及學前階段需特別關注情緒辨識在調控快樂情緒相關資訊上的影響。未來研究在應用Go/No-Go作業時，除了檢視反應錯誤模式，同時納入反應敏感度、決策偏誤與訊息處理效能等行為指標將更能夠完整了解ASD兒童與一般發展兒童能力表現上的不同。
並列摘要
Objectives. Deficits in emotion regulation (ER) is commonly reported in children with autism spectrum disorder (ASD), and emotion recognition and response inhibition have been suggested to contribute to these deficits. However, the associations between these two factors on ER deficits remain unclear. The current study examined the performance of children with ASD and typical developing (TD) children during emotional and non-emotional versions of a Go/No-Go task. As the majority of previous Go/No-Go studies looked into performance differences based on analysis of response errors (false alarm errors), we applied the signal detection theory and the inverse efficiency score (IES) to gain a more comprehensive view of performance patterns based on response sensitivity, bias and efficiency accounts. We aimed to evaluate the effects of emotion recognition and response inhibition on ER and to explore whether different patterns of relationships were present between groups. Methods. A total of 136 children aged 5 to 6 years, including 68 children with ASD and 68 TD children, completed an emotional Go/No-Go task with emotional faces stimuli (happy, angry and fear faces), a non-emotional Go/No-Go task with geometric shapes stimuli (green and red circles) and an affect recognition task to measure their false alarm rates, response sensitivity, response bias, IES and emotion recognition accuracy. Results. Children with ASD had poorer emotion recognition accuracy, demonstrated less bias towards Go responses and higher IES during non-emotional Go/No-Go task and had lower response sensitivity and greater false alarm rates during the happy condition of the emotional Go/No-Go task. Regression analysis showed that emotion recognition and response inhibition were significant predictors of emotional Go/No-Go task performance in both groups of children. Comparing the predictive patterns of relationship between group found that emotion recognition and response inhibition respectively predicted response sensitivity in the happy condition of emotional Go/No-Go task in children with ASD and TD children. Conclusions. In the preschool stage, children with ASD displayed poorer recognition of facial expression and poorer response strategy and information processing efficiency in the process of response inhibition. Meanwhile, they also present with possible limitations in perceptual sensitivity in recognizing happy faces from neutral faces and might contribute to their higher false alarm errors in the process of ER. These findings support emotion recognition and response inhibition as underlying factors of ER deficits in children with ASD, and further suggest a special emphasis on the influence of emotion recognition in ER of happy related information during the preschool age. Future research utilizing the Go/No-Go paradigm should not only examine performance in terms of response errors but also response sensitivity, bias, and efficiency to gain a more comprehensive view of the atypical patterns of response processes in children with ASD.