思考行動混淆對強迫傾向者負向評價的影響

思考行動混淆是強迫症一個重要的認知構念。思考行動混淆可能影響個體對其侵入性想法、相關事件的負向評價。過去有研究發現高思考行動混淆者對於負向評價的反應時間較短；然而，該研究為相關研究，並未操弄思考行動混淆。因此，本研究擬誘發思考行動混淆，以探討思考行動混淆在強迫傾向者之負向評價所扮演的角色。本研究依照莫斯利強迫量表及思考行動混淆量表篩選出高、低強迫傾向的大學生各24位，透過改良之句子填空作業來誘發思考行動混淆，並以字詞判斷作業探討思考行動混淆對強迫傾向者負向評價的影響。本研究包含兩個受試者間因子強迫組別（高、低強迫傾向）、操弄作業（思考行動混淆誘發作業、控制作業），兩個受試者內因子字詞種類（清潔、檢查、憂鬱、一般負向、中性）與時間（前測、後測）。本研究假設在誘發思考行動混淆後，相較於低強迫組，高強迫組對強迫詞的反應時間變快。本研究結果部分支持假設：在檢查詞的部分，接受誘發作業的高強迫組的參與者在後測反應時間顯著變快了，但是低強迫組的參與者反應時間在前、後測之間沒有顯著變化；相反的，接受控制作業的低強迫組參與者在後測反應時間顯著變快了，但是高強迫組參與者的反應時間在前、後測之間沒有顯著變化。透過本研究結果將可釐清思考行動混淆對強迫傾向者之負向評價的影響，作為未來探討思考行動混淆與其他心理疾患的病理機制之參考，亦可提供未來強迫症心理治療的方向。具體而言，緩和強迫疾患者對其因思考行動混淆而引發的負向情緒、評價的涵容度，或調整相關認知偏誤，以減緩心理困擾。

關鍵字

強迫症；思考行動混淆；負向評價；字詞判斷作業

並列摘要

Thought-action fusion (TAF) is an important cognitive construct in obsessive-compulsive disorder (OCD). TAF may affect individuals' negative evaluation of their intrusive thoughts and events. Previous research found that individual with high-TAF showed shorter reaction times (RT) to negative evaluation words; however, this study was a correlational research which did not manipulate TAF. Therefore, the present study aimed to induce TAF to explore the role of TAF in the negative evaluation of individuals with high obsessive-compulsive (OC) tendency. The participants consist of 24 high OC tendency and 24 low OC tendency individuals screened by the Maudsley Obsessional-Compulsive Inventory and TAF Scale. The modified sentence completion task was used to induce TAF, and lexical decision task (LDT) was used to explore the influence of TAF on the negative evaluation of OC-related words for those with high OC tendency. A 2 (OC group: high, low OC tendency) × 2 (manipulation task: TAF induction task, control task) × 5 (word valence: cleaning, checking, depressive, general negative, neutral) three-factor mixed factorial design was conducted, with word valence being the within-subject variables, and change scores in the reaction times being the dependent variable. We hypothesized that in the LDT, after TAF induction, participants with high OC tendencies showed greater amount of RT change to OC-related words . That is, the post-test RTs would be significantly shorter than the pre-test RTs. The hypotheses were partially supported in terms of only for the checking words. Specifically, RTs for the participants with high OC tendency were significantly reduced after TAF induction, while RTs for participants with low OC tendency were not changed; conversely, RTs for the participants with low OC tendency were significantly reduced after non-TAF induction, while RTs for participants with high OC tendency were not changed. The results of this study will clarify the role of TAF in the negative evaluation of people with high obsessive-compulsive tendencies, and can be used as a reference for the psychotherapy of the OCD. Specifically, when individuals with OCD have been trapped by TAF, we can start with modification of evaluation of their thoughts, loosening their thoughts caused by TAF, and changing the negative evaluation and interpretation of their thoughts, accordingly. In addition, psychotherapist can provide the OCD patients with alternatives thoughts, or improve tolerance of their thoughts and self-evaluation, etc., thereby change the emotion of the OCD patients and alleviate their life-distress.