校園霸凌與面部表情辨識在高功能自閉症青少年的相關性研究

Association between School Bullying and Facial Emotion Recognition in Adolescents with High Functioning Autism Spectrum Disorder

劉黛玲(Tai-Ling Liu)

指導教授 ： 顏正芳

高雄醫學大學/醫學院/醫學研究所博士班/博士(2020年)

摘要

青少年涉入校園霸凌事件的問題日漸受到重視，許多研究都顯示霸凌施暴和受害者都會增加精神健康問題的危險性，所以及早確認出涉入霸凌的青少年並加以協助是非常重要的。由於社會互動困難是自閉症光譜疾患（autism spectrum disorders, ASD）核心症狀之一，可推測具有ASD診斷的青少年可能比無ASD者有較高涉入校園霸凌的危險性。然而與一般青少年比較，迄今調查具有高功能ASD診斷的青少年涉入校園霸凌經驗的相關研究仍相當少，因此本研究將針對此族群進行研究，了解高功能ASD診斷的青少年涉入校園霸凌經驗的盛行率及相關危險因子，期能發展有效的介入策略。
本計畫分為兩個研究主題，第一研究主題為檢驗高功能ASD的青少年其面部表情辨識、內隱態度和對照組之差異；第二研究主題為分析精神科門診中高功能ASD的青少年涉入校園霸凌之危險因子。
第一研究主題最後共收案71位11-18歲門診診斷為高功能ASD的青少年，63位11-18歲未有精神科診斷之青少年，分別予以問卷、電腦施測面部表情及內隱測驗。結果顯示：高功能ASD組在面部表情的判別、強度區辨能力、表情強度判讀上比對照組來的弱，且其表情辨識所需的時間較長；此外，在內隱測驗的結果顯示高功能ASD 組在內隱態度測驗分數較高，表示高功能ASD組在表情及文字內容的連結或轉換上有所缺損，尤其對於正負向情緒的調節或是情緒線索不一致時存在缺損。
第二研究主題最後共分析138位符合高功能ASD診斷之青少年，其中高功能ASD青少年自陳為霸凌施暴者有41位，盛行率29.7%；自陳為霸凌受害者有24位，盛行率17.4%。在霸凌的危險因子分析上，焦慮、憂鬱均為霸凌施暴者及受虐者之危險因子；進一步回歸分析，在控制性別、年齡、憂鬱、焦慮及注意力不足過動之嚴重度下，霸凌施暴者其面部表情辨識能力在表情強度的判讀上優於非施暴者，霸凌受害者在表情圖片的強度區辨能力上差於非受害者。此結果顯示不同的霸凌型態其面部表情缺損有所差異，且涉入霸凌相關因子也有所不同。因此後續應針對此結果進一步去探討並針對不同霸凌型態發展不同的介入模式，以協助高功能ASD青少年降低涉入霸凌的危險性。

關鍵字

青少年 ； 自閉症 ； 霸凌 ； 面部表情辨識 ； 內隱態度

並列摘要

The involvement of adolescents in school bullying has received increasing attention. Studies have indicated that the bullying perpetrators and victims increase risks of mental health problems; therefore, early identification and assistance of adolescents involved in bullying is crucial. Social interaction difficulties are core symptoms of Autism Spectrum Disorders (ASD), and adolescents with ASD diagnosis may have a higher risk of participating in school bullying than those without ASD. However, although some studies have explored bullying among typically developing adolescents, relatively few studies have investigated school bullying among adolescents with high-functioning ASD. Therefore, this cohort should be investigated to understand the prevalence and risk factors of school bullying among adolescents with high-functioning ASD and to develop effective intervention strategies.
This study comprised two research topics. First, facial emotion recognition and implicit attitude were compared between adolescents with high functioning ASD and a control group. Second, the risk factors for school bullying among adolescents with high-functioning ASD in psychiatric clinics were analyzed.
For the first stage, 71 adolescents aged 11–18 years with high-functioning ASD and 63 adolescents aged 11–18 years without a psychiatric diagnosis were recruited as participants. They were tested using questionnaires, Facial Emotion Recognition Task, and Implicit Association Tests (IAT). The results revealed that the high-functioning ASD group had lower correct rate for facial emotion differentiation, ranking, and rating than the control group did, and they required a longer time for facial emotion differentiation. In addition, the IAT scores of the high-functioning ASD group was higher than that of the control group, hence indicating that they had deficit in emotional interference. In particular, the participants experienced difficulties in regulating positive and negative emotions or demonstrated incongruent emotional cues.
During the second stage, school bullying was investigated among 138 adolescents with high-functioning ASD. Among these participants, 41 (29.7%) were reported as bullying perpetrators, and 24 (17.4%) were victims of bullying. An analysis of the risk factors of bullying revealed that anxiety and depression were risk factors for bullying perpetrators and victims. After controlling for the effects of age, gender, depression, anxiety, inattention, hyperactivity/impulsivity and opposition, we observed that bullying perpetrators performed significantly better on rating the intensity of emotion in the Facial Emotion Recognition Task; bullying victims performed significantly worse on ranking the intensity of facial emotion. The results of this study support the different deficits of facial emotion recognition in various types of bullying involvement among adolescents with high-functioning ASD. The different directions of association between bully involvement and facial emotion recognition must be considered when developing prevention and intervention programs.

並列關鍵字

Adolescent ； autism spectrum disorder ； bullying ； facial emotion recognition ； implicit attitude

參考文獻

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