整合憂鬱人際與認知模式：苦惱自責式反芻及因果不確定感於過度尋求再保證與憂鬱間之多重中介效果

An Interpersonal-Cognitive Integration Model of Depression: Multi-Step-Multi-Mediator Effect of Brooding Rumination and Causal Uncertainty on the Relation between Excessive Reassurance-Seeking and Depression

楊如泰(Ju-Tai Yang)

指導教授 ： 陳淑惠

國立臺灣大學/理學院/心理學研究所/碩士(2010年)

https://doi.org/10.6342/NTU.2010.02899

摘要

前言：過度尋求再保證為人際取向憂鬱理論之核心，其相關研究著重於行為層面，然而，該理論之認知因素的影響則有待後續研究加以驗證。過去有研究指出過度尋求再保證透過因果不確定感信念維持或惡化憂鬱症狀程度，本研究將建基於此中介路徑之驗證，再從反芻型反應風格激發負向自我基模的觀點出發，並同時探討過度尋求再保證與不具適應性面向之反芻思考—苦惱自責式反芻的關聯。此外，本研究探討之變項與性別相關，所以將針對性別差異進行探討。目的：本研究將整合憂鬱之人際與認知理論，以苦惱自責式反芻與因果不確定感作為中介因子，提出過度尋求再保證與憂鬱之間的多重中介路徑模式，以探討憂鬱個體之尋求再保證行為的認知機制。方法：研究一採用175名大學生為樣本，旨在發展中文因果不確定感量表在本地的心理計量特性與因素結構。研究二採用101名大學生為受試者，旨在探討憂鬱、因果不確定感及過度尋求再保證之關聯，並提供初步效度資料。研究三採用248名大學生為受試者，以驗證因果不確定感之中介效果為基礎，初探苦惱自責式反芻、因果不確定感之多步驟多重中介效果，並釐清此潛在認知機制的性別差異。結果：(1)中文因果不確定感量表具良好心理計量特性，且與憂鬱症狀、過度尋求再保證呈顯著正相關。(2)因果不確定感對於過度尋求再保證與憂鬱症狀之間的關係具中介效果。(3)因果不確定感對於苦惱自責式反芻與憂鬱症狀之間的關係具中介效果，顯示苦惱自責式反芻具激發因果不確定感信念之效果；此外，苦惱自責式反芻與因果不確定感對過度尋求再保證與憂鬱症狀之間的關係具多重中介效果。(4)反芻思考、憂鬱症狀嚴重程度不具性別差異，僅過度尋求再保證具性別差異；苦惱自責式反芻與因果不確定感的多重中介效果具性別差異。討論：最後以人際取向憂鬱理論的認知層面切入，討論不具適應性之反芻思考激發負向自我基模的影響。接著，說明研究結果在臨床應用上的啟示，與未來可行的實際治療與研究方向。

關鍵字

過度尋求再保證 ； 因果不確定感 ； 苦惱自責式反芻 ； 憂鬱

並列摘要

Introduction: Excessive reassurance seeking (ERS) was deemed as the core of Coyne’s Interactional theory of depression. Though behaviors of depressed individuals have been studied extensively, influences of cognitive factors after seeking reassurances are less explored. Past research indicated that causal uncertainty belief, a self-construct, has mediation effect on the association between ERS and depression. On the other hand, brooding, the maladaptive aspect of rumination, might activate negative self schema, and then influence the development and maintenance of depression. However, no studies up to date have examined the activating effect of brooding on causal uncertainty belief. In addition, past research suggested gender differences in depression, ERS, and rumination. Therefore, gender difference is also examined in the present study.
Purpose: To examine the possible links among brooding, causal uncertainty, reassurance-seeking, and depression, the present study will examine the multiple mediation effect of brooding and causal uncertainty on the relationship between ERS and depression.
Method: Study 1 examined psychometric properties of the Causal Uncertainty Scale-Chinese version (CUS-C) with a sample of 175 undergraduate students. Study 2 examined the relation of causal uncertainty, ERS, and depression with a sample of 101 undergraduate students and provided validity evidence for the CUS-C. In study 3, the mediation effect of causal uncertainty was replicated by using 248 undergraduate students. The multiple-step-multiple-mediator effect of brooding and causal uncertainty was examined in order to further investigate the cognitive mechanism in the interpersonal theory of depression. Finally, gender differences of the cognitive mechanisms were also examined.
Results: The results indicate that: (1) The CUS-C yielded good psychometric properties. Moreover, CUS-C scores correlated significantly and positively with ERS and depressive symptoms. (2) Causal uncertainty was found to mediate the relationship between ERS and depressive symptoms. (3) Brooding had the effect on activating causal uncertainty beliefs. Moreover, the indirect effect of multiple mediations was significant. (4) Contrary to the hypothesis, no gender difference was yielded in depressive symptoms and rumination except ERS. Furthermore, the mediation effect of causal uncertainty and the multiple mediations had gender differences.
Discussion: Based on the above findings, the activating effect of brooding on negative self schema and the cognitive mechanism in interpersonal theory of depression were discussed to elucidate the appropriateness of applying the interpersonal-cognitive theory of depression in non-clinical samples. Possible application and future directions were also addressed.

並列關鍵字

Excessive Reassurance Seeking ； Causal Uncertainty ； Brooding Rumination ； Depression

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