焦慮特質與認知因素對雙相情緒障礙症的解釋模型：以大學生樣本為例

Role of Trait Anxiety and Cognitive Factors in the Psychopathology of BAD: An Example of College Sample

黃文翰(Wen-Han Huang)

指導教授 ： 張素凰

國立臺灣大學/理學院/心理學研究所/碩士(2017年)

https://doi.org/10.6342/NTU201700400

摘要

過去研究多半將情感性疾患與焦慮一併討論，但關於焦慮特質對情感性疾患的影響之闡述並不多。近年來研究者常將情感性疾患分成憂鬱症與雙相情緒障礙症，其中雙相情緒障礙症的探討多半從遺傳因子與生物觀點介入，較少以情緒特質與認知狀態為出發點進行深入探討，但最新的精神疾病診斷準則第五版（DSM-5）則將焦慮特質納入雙相情緒障礙症的嚴重度考量中，顯示情緒因素與其他因素逐漸受到重視。因此本研究企圖整合過去理論及研究，提出與雙相情緒障礙症相關之重要變項，利用自陳式量表測量負向生活事件、焦慮特質、憂鬱、反芻、認知風格與衝動因素，蒐集台灣的大學生樣本共 290 人，以相關法探討躁症與鬱症之心理病理歷程有關的因素彼此間的關聯。本研究所提出假設模型，其模型適配度為中度以上。具體而言，研究結果發現負向生活壓力對於焦慮特質、常態化認知風格與負向認知風格具有正向影響，對於正向認知風格則為負向影響；情緒因素方面，焦慮特質對動作性衝動、不善計畫性衝動與鬱症為正向影，對躁症則為負向影響，動作性衝動對躁症有正向影響，而不善計畫性衝動對鬱症有些微的負向影響；認知因素方面，正向認知風格對躁症為正向影響，對鬱症有些微負向影響；常態化認知風格對躁症有些微的正向影響；負向認知風格對鬱症有些微的正向影響。本研究之研究結果可做為臨床工作者對躁鬱個案進行介入方針與三級預防之參考。

關鍵字

焦慮特質 ； 衝動 ； 認知因素 ； 雙相情緒障礙症 ； 結構方程模型

並列摘要

While mood disorder has been known to be highly comorbid with anxiety, the influences of anxiety to the severity of mood disorder have seldom been investigated. In recent years, mood disorder is divided into depressive disorder and bipolar affective disorder (BAD), and is widely discussed from the perspective of genetic and biological factors but has rarely been considered from the perspectives of emotional trait and cognitive factors. Moreover, in DSM-5, anxiety is included as an indicator of severity in the diagnosis of BAD, which highlights the importance of more research into the roles of emotional and cognitive factors in BAD. Therefore, the purpose of this study was to examine the roles of emotion and cognition in the pathology of BAD. In this study, we recruited 290 participants from the undergraduate students of Taiwan. Negative life events, trait anxiety, depression, rumination, cognitive style and impulse factors were measured by self-report inventories. Structural equation modeling (SEM) was used to test the hypothesized model. The result revealed that the hypothesized model had an above moderate level of model fitting. Specifically, the negative life events had positive effects on trait anxiety, normalizing of symptoms and negative cognitive style. On the other hand, the negative life events had a negative effect on positive cognitive style. For emotional factors, trait anxiety had positive effects on behavioral impulsivity, non-planning impulsivity and depression and had a negative effect on mania. Behavioral impulsivity had a positive effect on mania while non-planning impulsivity had a negative effect on depression. For cognitive factors, positive cognitive style had a positive effect on mania and a negative effect on depression. Normalizing of symptoms had a positive effect on mania, and negative cognitive style had a positive effect on depression. The results of this study could shed light to clinical intervention guideline for bipolar affective disorder, and contribute to the primary, secondary, and tertiary prevention and intervention and improve their effectiveness.

並列關鍵字

trait anxiety ； impulse ； cognitive factors ； bipolar affective disorder ； structural equation model

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