創傷後壓力疾患個體對情緒訊息的自動化情緒處理：以人際創傷事件倖存者為例

Automatic Emotional Information Processing in Interpersonal Trauma Survivors with Posttraumatic Stress Disorder (PTSD)

潘元健(Yuan-Chien Pan)

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.2010.02984

摘要

根據過去創傷後壓力疾患（posttraumatic stress disorder, PTSD）的心理病理模式，創傷記憶本質上的個別差異是影響疾病是否發展與維持的重要因子。在認知取向的心理病理模式中多半主張，個體具有兩種不同本質的記憶問題，一種是難以主動提取對創傷事件的完整記憶；另一種是非自主但會被自動激發的侵入式記憶，時常會以鮮活的多感官形式伴隨強烈情緒出現。後者被認為與創傷記憶之自動化激發有密切關聯，而創傷記憶被激發後，對後續行為、認知與情緒帶來之影響，也可能是造成創傷後壓力症狀維持的主要原因。以上現象皆涉及對情緒訊息的自動化處理歷程，然而，在創傷後壓力疾患的研究領域中，關於此歷程之機制目前仍未有定論，研究結果也不一致，仍需要更多研究來對其探討。本研究主要目的在於探索發展出創傷後壓力疾患之人際創傷倖存者對情緒性臉部表情的自動化處理，並且嘗試連結此自動化處理歷程與臨床症狀，期能提供後續心理專業介入之參考。
本研究參與者來源為大學部/研究所學生，依照其創傷經驗與創傷後壓力症狀嚴重度分為三組，分別為人際創傷PTSD組（18人）、人際創傷控制組（46人）與健康控制組（38人）。本研究採用情緒促發作業進行，刺激材料為彩色的人類臉部表情圖片，共有生氣、快樂與中性三種情緒，分別作為促發刺激與目標刺激。促發刺激與目標刺激之呈現間隔時間為200毫秒。研究程序方面，將會先進行創傷經驗、臨床症狀與相關特質之測量，接著完成以電腦施測的情緒促發作業與刺激材料威脅評估作業，最後進行簡短晤談。本研究假設在情緒促發作業中，人際創傷PTSD組將會和兩控制組展現出不同的反應傾向，而此組間差異僅會呈現在以生氣表情為促發刺激之情況下。
研究結果發現：（1）人際創傷PTSD組在情緒促發作業之表現明顯與兩控制組不同；（2）在情緒促發作業中，人際創傷PTSD組在生氣—快樂配對下的妨礙效果顯著小於其他兩控制組，其他配對情況則無任何顯著組間差異；（3）人際創傷倖存者在情緒促發作業上之表現和PTSD症狀嚴重度的相關達顯著。本研究結果支持人際創傷PTSD個體在自動化情緒訊息處理上，和一般個體具有不同傾向。當外界出現創傷相關訊息使PTSD個體的創傷記憶被激發後，可能會促使他們產生逃避處理創傷訊息之傾向，推論此自動化處理傾向或許為PTSD中情感麻木症狀的可能機制。本研究將根據上述結果提出臨床應用建議與後續研究方向。

關鍵字

自動化情緒訊息處理 ； 創傷後壓力疾患 ； 人際創傷事件 ； 情緒促發作業

並列摘要

According to past psychopathological models of posttraumatic stress disorder (PTSD), the individual differences of trauma memory may impact the development and maintain of PTSD. Based on cognitive approach to the psychopathology of PTSD, trauma memory may reveal two different kinds of problems. One is difficulty in intentionally retrieving a complete memory of the traumatic event; another is high frequency of involuntary triggered intrusive memories in a very vivid and emotional way. The later related to cue-driven process and have been commonly linked to automatic information processing. When trauma memory was automatically activated by trauma-related cues, it can have impact on subsequent behavioral, cognitive or emotional processes. That involves the automatic emotional information processing and may be one probable interpretation of why posttraumatic stress symptoms maintain. However, only few studies have investigated automatic emotional information processing in trauma survivors with PTSD but the findings were still inconsistent. Therefore, more studies focus on this topic is needed. This study aimed to explore the automatic information processing toward emotional facial expression in interpersonal trauma survivors with PTSD and to investigate the relationship between this automatic process and clinical symptoms.
Recruited undergraduate students were divided into three groups depend on their traumatic experience and the intensity of posttraumatic stress symptoms: interpersonal trauma survivors with PTSD (PTSD group, n = 18), interpersonal trauma survivors without PTSD (C_IPT group, n = 46), and healthy control group without interpersonal trauma history (C_H group, n = 38). Affective priming paradigm was used, with colorful photos of angry, happy, and neutral human faces as priming and target materials. Stimulus onset asynchrony between prime and target was 200ms. In experimental procedure, all participants will complete the measurements of trauma experience, clinical symptoms, and other related trait first. Then finish computerized affective priming task and material threatening evaluation task. After all, a brief semi-structured diagnostic interview was delivered. It is hypothesized that PTSD group would show different response tendency to C_IPT and C_H group. This effect only appears when angry face as prime stimulus.
Results revealed: (1) The performance of PTSD group in affective priming task was different from the other two control groups; (2) PTSD group showed less interference effect than the other two groups when the angry prime was followed by happy target; (3) The performance of interpersonal trauma survivors in affective priming task was significant related to their posttraumatic stress symptoms. These results suggested that, when trauma memory was activated by trauma-related stimulus, PTSD individuals may automatically try to minimize the impacts of such stimulus. The findings suggest that automatic activation of trauma memory has more impacts on consequent evaluative process in interpersonal trauma survivors inclined to PTSD psychopathology, such as emotional numbing. Based on these results, implication for clinical intervention and future research are discussed.

並列關鍵字

Automatic emotional information process ； Posttraumatic stress disorder ； Interpersonal trauma ； Affective priming task

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