情緒處理歷程評量表之發展：其構念面向與成人憂鬱關聯研究

重鬱症盛行率逐年增加，研究指出情緒處理能力與重鬱症狀有關，然目前國內尚無較完整且具臨床研究應用性之測量情緒處理能力工具，因此本研究目的為發展一客觀、具信效度之情緒處理歷程評量表，以做為臨床工作者對於重鬱症患者之介入指標與客觀衡鑑參考，以及探討情緒處理與重鬱症狀關聯機制的基礎。 Greenberg與Pascual-Leone(2006)認為情緒處理能力包含四個向度：情緒覺察與表達、情緒調節、情緒反思、及情緒轉化，其中歷程中對於初始情緒處理為重要元素，向度間互相相關，且情緒處理能力與重鬱症狀負相關；另外，研究者認為情緒處理能力為個體可於經驗中實際應用之能力，與自我效能概念不同。本研究以過去學者之情緒處理概念設計一包含四向度、十五題項之評量式量表，並以之探討重鬱症患者之情緒處理能力與症狀間之關聯。本研究採調查研究、立意取樣，邀請臨床重鬱症患者83名及配對年齡之一般無心理疾患民眾46名參與研究、填寫情緒處理歷程評量表、貝克憂鬱量表、一般性自我效能量表。利用項目分析及相關分析考驗量表之信度；利用Schimid與Leiman法階層式因素分析(Schimid & Leiman, 1957; Wolff & Preising, 2005)、結構方程模型、區辨分析、與淨相關分析評估量表之建構效度、並訂定量表切截分數。研究結果顯示量表具信效度，量表初階因素結構可區分為：情緒覺察/反思、情緒表達、情緒調節、及情緒轉化，初始情緒為情緒處理重要成分，量表可抽取單一高階因素：情緒處理能力，此能力與自我效能無關、與重鬱症狀負相關；顯示情緒處理能力並非僅為一般性對於自我能力之觀感，且與重鬱症狀的降低有關，以量表標準化總分百分等級80(4.718)做為切截分數時能正確辨別超過八成之重鬱症患者，顯示量表為一適當之篩檢工具。因素結構中情緒覺察與反思能力受同一因素所解釋、情緒表達為獨立因素，與過去研究不符，且量表特異性不佳，將於文中探討原因、提出可能之運用及改善方式並延伸量表概念探討情緒處理之意涵。

關鍵字

重鬱症；情緒處理歷程；初始情緒；自我效能；評量式量表

並列摘要

The prevalence rate of major depressive disor has increased with year. Researches indicated that emotional processing capability is related to MDD symptoms, however hitherto, there is no complete clinical applicable scale that can be used to assess emotional processing capability in Taiwan. Therefore, the aim of the present study was to develop an objective, reliable and valid emotional processing capability scale which can be used as an indicator for clinical intervention reference and assessment for patients with MDD, and a medium to investigate the mechanism of emotional procession and major depressive symptoms. Greenberg and Pascual-Leone (2006) posited that emotional processing capability includes four dimensions of emotional awareness and expression, emotional regulation, emotional reflection, and emotional transformation. Furthermore, primary emotion played a key role in emotional processing, the dimensions correlated with each other, and emotional processing capacity was related to the decrease in MDD symptoms. On the other hand, researchers have found that emotional processing capability was a concrete skill and ability that could be practically used in personal experience, and can be discriminated from the concept of self-efficacy. The present study used the concept of emotional processing from many researchers to develop a rating scale which contained fifteen items and the four dimensions. The scale was used to discuss the relationship between emotional processing capability and symptoms in patients with MDD. The present study is a survey study, using purposive sampling. The researcher invited 83 clinical patients with MDD and 46 aged matched normal people from the community to fill out the Emotion Processing Rating Scale, Beck Depression Inventory(BDI), and General Self-Efficacy Scale(GSES). The researcher used item analysis and correlation analysis to test the reliability of emotion processing scale. The researcher used Schimid and Leiman solution of hierarchical factor analysis (Schimid & Leiman, 1957; Wolff & Preising, 2005), structural equation modeling, discriminant analysis, and partial correlation analysis to test the constructive validity of the emotion processing scale and set the cutoff point. The results suggested that the scale was reliable and valid, containing four factor dimensions of emotional awareness and reflection, emotional expression, emotional regulation, and emotional transformation. Primary emotion is crucial to emotional processing. There was a higher order factor: emotional processing, which was not correlated with general self-efficacy and was negatively correlated with MDD symptoms, suggesting emotional processing was conceptually different from self-efficacy, and related to the severity of MDD symptoms. The scale correctly identified over 80% of the patients with MDD using the cutoff point of 80 percentile rank of the standardized total score (4.718), showing that the scale is an appropriate screening instrument. Factor structure results indicated emotional awareness and emotional reflection were explained by the same construct, emotional expression was an independent construct, which was inconsistent with the results of previous studies, and the scale failed to meet satisfactory level of specificity. Possible reasons, applicability, ways to improve the weakness of the scale, and the extended theoretical conception of emotional processing were further discussed in the content.