精神分裂症患者在華人性格測量表第二版的人格特質表現

Personality traits in patients with schizophrenia measured by the Chinese Personality Assessment Inventory (CPAI-2)

姚林生(Lin-Sheng Yao)

指導教授 ： 吳英璋

國立臺灣大學/理學院/心理學研究所/碩士(2009年)

https://doi.org/10.6342/NTU.2009.10128

摘要

本研究目的是以「華人性格測量表-第二版(Chinese Personality Assessment Inventory-2, CPAI-2)」為工具，來探討精神分裂症患者的人格特徵表現。藉由比較精神分裂症患者與一般社區成人在CPAI-2上的差異，瞭解精神分裂症患者的人格特質表現形態，並探討此表現形態差異與首次發病年齡、罹病總時間的關聯性。本研究樣本包括精神分裂症患者組104人與對照組175人。除每位研究樣本均填寫CPAI-2以獲得人格特質表現形態外，並委請患者的主治醫師填寫「病人診斷問卷」（包括：確定診斷、發病年齡、罹病總時間及目前精神症狀等資料）。本研究結果發現，(1)人格表現型態差異：以CPAI-2的因素層次而言，患者組在臨床量尺組合的「情緒問題因素」與「行為問題因素」顯著高於對照組；在一般人格量尺組合的「領導性因素」與「容納性因素」顯著低於對照組。以CPAI-2的量尺層次而言，在CPAI-2的臨床量尺組合中，患者組在「情緒問題因素」的「自卑-自信」、「焦慮緊張」、「憂鬱」、「軀體化」、「性適應問題」等量尺，以及「行為問題因素」的「興奮性」、「反社會行為」、「需要關注」、「脫離現實」、「猜疑」等量尺皆顯著高於對照組。在CPAI-2的一般人格量尺組合中，患者組在「領導性因素」的「新穎性」、「多樣性」、「多元思考」、「開拓性」等量尺，以及「容納性因素」的「寬容-刻薄」與「容人度」量尺皆顯著低於對照組；而在「容納性因素」的「防衛性量尺」明顯高於對照組。除了上述具有顯著差異的因素與其量尺之外，同時並發現：患者組在「可靠性因素」的「自卑-自信」量尺、「人際取向因素」的「傳統-現代性」與「紀律性」量尺顯著高於對照組;在「可靠性因素」的「樂觀-悲觀量尺」、「人際取向因素」的「人際觸覺」量尺顯著低於對照組。(2)患者組人格表現型態與首次發病年齡的關聯性：在因素層次中，發病年齡與「情緒問題因素」、「行為問題因素」呈顯著負相關；與「容納性因素」呈顯著正相關。在量尺層次中，發病年齡與「自卑-自信」、「焦慮」、「憂鬱」、「性適應問題」、「興奮性」、「需要關注」、「猜疑」等量尺呈顯著負相關；與「樂觀-悲觀」、「寬容-刻薄」量尺呈顯著正相關。(3)患者組人格表現型態與罹病總時間的關聯性：在因素層次中，罹病總時間與「情緒問題因素」、「行為問題因素」呈顯著負相關。在量尺層次中，罹病總時間與「自卑-自信」、「憂鬱」、「反社會行為」、「猜疑」等量尺呈顯著負相關；與「樂觀-悲觀」量尺呈顯著正相關。總結上述發現，相較於一般人，精神分裂症患者在人格特質上傾向傳統化、刻板化、保守、狹隘且畏縮的人際方式、高防衛性、消極與悲觀；臨床表現上，患者也有較多自卑、焦慮、憂鬱、難以直接表達心理困擾等情緒問題，與較為衝動、自我中心、不守規範，思想、知覺經驗跟現實脫離等行為方面問題。上述患者人格特質的表現可能反應出患者在面對環境變遷或心理壓力時，不利於個人身心調適的弱項。而患者的人格特質表現與發病年齡、罹病時間有明顯的關聯性，支持本研究對精神分裂症會干擾心理社會發展的假設。研究結果發現：發病年齡越早，患者表現出自卑、焦慮、憂鬱、性適應問題、興奮性、需要關注、猜疑的傾向越高，且寬容、樂觀與容納的傾向越低，推測可能與發病年齡越年輕者的心理社會發展越早受到疾病之干擾有關。罹病總時間愈長，患者表現自卑、憂鬱、反社會、需要關注、猜疑的傾向越弱，且樂觀程度越高，此發現則較難以過去研究疾病慢性化對個體所造成的衝擊之文獻結果來解釋，建議未來研究可進一步驗證一般人格特質與臨床特質受疾病影響或受治療設計影響的可能性。

關鍵字

精神分裂症 ； 人格 ； 人格特質 ； 華人性格測量表第二版 ； CPAI-2

並列摘要

The primary aim of this study is to explore the personality characteristics of patients with schizophrenia measured by the Chinese Personality Assessment Inventory (CPAI-2).The differences of personality presentation between schizophrenic patients and community adults on CPAI-2 were compared, and the correlations of patients’ personality pattern with age of onset, and with duration of illness were also explored. There were 104 schizophrenic patients and 175 community controls completed the CPAI-2 questionnaire, and the attending psychiatrists also completed the Patient’s Diagnostic Schedule, including the information of the diagnosis, age of onset, duration of illness, and current psychiatric symptoms. The findings from this study are summarized below. (1) Differences of personality pattern between two groups：In terms of the factorial level of CPAI-2(higher level of traits), schizophrenic patients are scored significantly higher than comparison group on emotional problem factor and behavioral problem factor, which are both composed of clinical scales. In addition, the patient group is scored significantly lower than comparison group on social potency factor and accommodation factor, which both are composed of normal personality scales. In terms of the scale level of CPAI-2(lower level of traits), schizophrenic patients are scored significantly higher than comparison group on the scales of inferiority v.s. self-acceptance, anxiety, depression, somatization, and sexual maladjustment in the emotional problem factor. They are also showed higher scores on the scales of hypomania, antisocial behavior, need for attention, distortion of reality, and paranoia in the behavioral problem factor. As to the normal personality scales, schizophrenic patients are scored significantly lower than comparison group on the scales of novelty, diversity, divergent thinking, and enterprise in the social potency factor; and they are also scored significantly lower on the scales of graciousness-meanness and interpersonal tolerance scales in the accommodation factor though are scored significantly higher on the defensiveness scale in the accommodation factor. Furthermore, the study also found that patients’ scores are significantly higher on the inferiority v.s. self-acceptance scale in the dependability factor, on the traditionalism-modernity and discipline scales in the interpersonal relatedness factor, but significantly lower on the optimism-pessimism scale in the dependability factor, on the social sensitivity scale in the interpersonal relatedness factor. (2) Correlation between personality pattern of patient group on CPAI-2 and age of onset in patient group: On the factorial level, age of onset has a significant negative correlation with emotional problem and behavioral problem factors, and has a significant positive correlation with accommodation factor. On the scales level, age of onset is negatively correlated with the scales of inferiority v.s. self-acceptance, anxiety, depression, sexual maladjustment, hypomania, need for attention, and paranoia, and positively correlated with scales of optimism-pessimism and graciousness-meanness. (3) Correlation between personality pattern of patient group on CPAI-2 and duration of illness: On the factorial level, duration of illness has a significant negative correlation with emotional problem and behavioral problem factors. On the scales level, duration of illness is negatively correlated with scales of inferiority v.s. self-acceptance, depression, antisocial behavior, and paranoia; and positively correlated with scale of optimism-pessimism. The above results shows that when compared with community subjects, personality traits of patients with schizophrenia tend to be more traditional, rigid, conservative, restricted, withdrawal in interpersonal interactions, defensive, and pessimistic. In clinical characteristics, they tend to be more inferior, anxious, depressive, hard to express feelings of personal disturbance, more impulsive, ego-centric, disobedient on the rule, and distorted from reality in thinking and perception. Those traits stated above may weaken their ability in personal adjustment to the challenge of environmental change or stress. The hypothesis that patient’s psycho-social development of personality would be disrupted by schizophrenia is supported by the significant correlations revealed among the patients’ personality traits, age of onset, and duration of illness. Results of this study indicated that the earlier the age of onset is; the higher the patients’ inferiority, anxiety, depression, sexual maladjustment, hypomania, need for attention, and paranoia would be. It also combined with lower graciousness, optimism, and accommodation. This finding might be explained by that the younger the schizophrenic patients get the illness; the earlier the psycho-social development would be disrupted. Another finding of this study indicated that the longer the illness duration is; the lower the patients’ inferiority, depression, antisocial behavior, need for attention, and paranoia would be. It also combined with higher optimism. This finding is difficult to be explained by the previous literatures related to the impact of chronicity on patients with schizophrenia. Further studies to test the influences of illness and treatment on personality traits and clinical personality characteristics in patients with schizophrenia are warranted.

並列關鍵字

schizophrenia ； personality ； personality trait ； Chinese Personality Assessment Inventory-2 ； CPAI-2

參考文獻

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