思覺失調症患者正負性症狀、心智推理與情緒辨識之關聯研究

The Relationship between Positive and Negative Symptoms, Theory of Mind and Emotion Cognition in Patients with Schizophrenia

吳佳霖 ； 劉宜釗 ； 簡玉坤 ； 葉在庭

《臨床心理學刊》 預刊文章 Pp. 15-25

https://doi.org/10.6550/ACP.0802.002

摘要

目的：思覺失調症患者的社會互動一直是重要的探討議題，本研究的目的為一、思覺思調症患者在推論他人想法，情緒與動機的能力（心智推理）是否缺損。二、思覺思調症患者在臉孔及聲調的情緒辨識是否缺損。三、思覺思調症患者在情緒辨識以及心智推理的能力是否可以解釋其正負性症狀。方法：本研究以20位思覺失調症和20位健康的受試者進行研究，兩組在性別、年齡及教育程度上並無差異，評估工具為心智推理作業，包括失態偵測、弦外之音、非語言心智推理作業，佛羅里達情緒測驗，及思覺失調症正負性症狀檢核表，以一對一方式進行評估。結果：思覺失調症患者在心智推理能力、情緒辨識能力的表現顯著低於控制組，思覺失調症的心智推理及情緒辨識和其正性與負性症狀呈現顯著高度負相關，迴歸分析發現情緒性聲調辨識總分可以解釋將近30%思覺失調症患者的負性症狀。結論：思覺失調症患者的社會互動能力不佳，可能受到心智推理能力、情緒辨識能力表現影響，且此兩項社會認知功能與正負性症狀的嚴重程度有關，其中情緒性聲調的辨識缺損可能是其重要因素。

關鍵字

思覺失調症 ； 心智推理 ； 情緒辨識 ； 正負性症狀

並列摘要

Purpose: Impairments in social function in the patients with schizophrenia is an important issue. The purpose of our study are to examine; 1. whether the abilities of inference of others’ thoughts, emotion and motion impaired in patients with schizophrenia, and understand; 2. if emotion-face recognition and emotion-prosody recognition are dysfunctional in patients with schizophrenia, and then explore; 3. whether emotion recognition and the ability of theory of mind can be interpretation the positive and negative symptoms in patients with schizophrenia. Methods: 20 clinical patients with schizophrenia and healthy 20 participates were recruited. There is no significantly different between schizophrenia and healthy control group on sex, age or education. The faux pas, advance theory of mind, non-verbal ToM tasks, Florida affect battery, positive and negative syndrome scale were assessed. Results: Overall, the patients with schizophrenia in the ability of ToM, emotion recognition were significantly lower than that of healthy control group. Regression analysis showed that the scores of emotion-prosody recognition can explain 30% negative symptoms in patients with schizophrenia. Conclusion: The social maladaptive in schizophrenia may be influenced by the ability of theory of mind and emotion recognition, and the above social cognition functions are associated with the severity of positive and negative symptoms. The impairment in the emotion-prosody recognition may be the essential factor that lead to the poor social function in the patients with schizophrenia.

並列關鍵字

schizophrenia ； theory of mind, emotional recognition ； positive and negative symptoms

參考文獻

胡海國、林信男、陳建仁(1995)。活性與負性症狀評量表使用手冊。台北市:國家衛生研究院。

葉在庭、花茂棽、劉珣瑛(2009)。猜猜我在想什麼？─中文版心智推理作業的信效度研究及其在老年人的表現初探。中華心理學刊。51，375-395。

劉又綺、葉在庭、蔡明成(2012)。中文版佛羅里達情緒測驗的效度研究及其在前額葉腦傷患者的表現探討。中華心理衛生學刊。25，299-334。

歐陽文貞、林朝誠(2013)。DSM-5、DSMIV-TR、ICD-10 及 ICD-9 中英文精神疾病診斷分類詞彙對照。台北市:台灣精神醫學會。

American Psychiatric Association(2013).Diagnostic and statistical manual of mental disorders: DSM-5.Washington, DC:Author.