- 學位論文
精神分裂症患者之情緒感知:不同情緒類別之缺失差異及持續注意力缺損的修飾作用
Emotion Perception of Schizophrenia:Differential Deficits in Emotion Categories and Moderation by Sustained Attention Deficit
摘要
主旨 精神分裂症患者的情緒感知已被認為有所缺損，並且影響社會功能甚鉅。但目前情緒感知的缺損是否因個別情緒類別的不同所知有限；同時持續注意力缺損所帶來的修飾作用亦甚少研究探討。本篇研究旨在以臉部情緒與音韻情緒測驗，來探索台灣精神分裂症患者在感知不同情緒類別上的能力。同時，利用分層進一步探討情緒感知是否會因為病患帶有持續注意力之缺損，而有所改變。 方法 研究樣本包含健康受試者127位，精神分裂症患者213位。臉部情緒與音韻情緒測驗採用本土標準化之情緒感知測驗Diagnostic Analysis of Nonverbal Accuracy-2，情緒類別包含有開心、傷心、生氣、與害怕。持續注意力則以Continuous Performance Test加以測量，並依此將病患分層為兩組，一組為持續注意力無缺損(n = 126)，另一組為持續注意力缺損(n = 87)。分析方式採用Mixed-effects model來校正重複測量，以此檢視不同知覺測驗與情緒類別在組別間之差異。 結果 與健康受試者相比較，持續注意力無缺損之精神分裂症患者在辨別臉部害怕情緒、音韻害怕情緒、音韻開心、以及音韻傷心之情緒已有出現缺損。而當精神分裂症患者有持續注意力缺損時，所有的情緒感知均出現障礙。並且兩組患者之間在情緒感知的正確率上有所差異。 結論 精神分裂症患者的情緒感知障礙會因情緒類別而有所不同，同時亦受持續注意力之缺損所修飾。這些發現有助於瞭解精神分裂症的致病機轉，以及提供後續治療之基礎。
並列摘要
Objectives: Patients with schizophrenia often display impaired emotion perception, yet it remains little known whether the impairment varies across emotion categories and perceiving modalities and whether sustained attention deficit moderates such impairment. This study aimed to examine the perception accuracy of individual emotion categories for both facial and prosodic expressions among patients with schizophrenia in Taiwan. The influence of sustained attention on these emotion perception tasks was evaluated by stratifying patients with schizophrenia into those with attention deficit and those without. Methods: In a sample of 127 healthy controls and 213 patients with schizophrenia, the perception of both facial and prosodic affect was measured using a locally standardized version of the Diagnostic Analysis of Nonverbal Accuracy 2, including happiness, sadness, anger, and fear. Each subject’s sustained attention was assessed using the Continuous Performance Test, which was used to divide schizophrenia patients into those without attention deficit (n = 126) versus those with attention deficit (n = 87). The mixed-effect models were used to adjust for repeated measures in terms of two emotion perception tasks and four emotional categories. Results: Compared with healthy controls, schizophrenia patients without attention deficit still exhibited impairment in the perception of facial affect in fear as well as of prosodic affect in happiness, sadness, and fear. Meanwhile, schizophrenia patients with attention deficit showed across-the-board impairment in emotion perception, regardless of facial or prosodic affect, as compared with healthy controls. Their accuracy rates were also worse than those of patients without attention deficit in three out of four categories of emotion, in both facial and prosodic affect. Conclusions: The emotion perception of schizophrenia is impaired differentially in terms of emotional categories, and is moderated by sustained attention deficit. These findings have implications for the underlying pathophysiology and intervention for schizophrenia.
參考文獻
延伸閱讀
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