憂鬱反芻對於憂鬱個體於認知控制功能之影響

The effect of depressive rumination on the cognitive control with depressive individuals

沈柏良(Bo-Liang Shen)

指導教授 ： 洪福建

中原大學/理學院/心理學研究所/碩士(2015年)

https://doi.org/10.6840/cycu201500360

摘要

研究目的：過去研究發現，憂鬱症患者通常會習慣性以反芻的方式來因應自身負向心情，而此因應風格會導致惡化患者的症狀，甚而導致憂鬱症的再發與復發。然而，反芻為什麼會發生呢？以認知的角度來看，可能與個體本身的認知控制功能有關，特別是抑制功能與轉換功能，因此瞭解反芻與此兩功能間的關係或許有助於在憂鬱症患者的介入。然而，過去在此研究的結果呈現不一致的結果，及研究方法上的限制，難以確定反芻與認知控制功能間的關係。
研究方法：本研究使用後向抑制作業派典作為認知控制功能的測量，藉以同時測量抑制功能與轉換功能。分為兩個研究族群進行研究，研究一的參與者為一般大學生，並區分成情緒低落組與健康控制組；研究二的參與者為社區民眾，包含憂鬱症患者與一般社區控制組。本研究整合過去研究的限制，包含負向心情誘發、不同反應風格誘發等操弄，以重新確認反芻與認知控制間的關係。
研究結果：(1)研究一結果發現，在情緒線索的抑制功能中，情緒低落組在接受分心轉移後的抑制功能有較接受憂鬱反芻誘發後差的情形，健康控制組在接受憂鬱反芻誘發後的抑制功能有較接受分心轉移誘發後差的情形，在接受分心轉移誘發的狀況下，情緒低落組的表現有較健康控制組差的情形；在性別線索的抑制功能中，在接受分心轉移誘發的狀況下，情緒低落組的表現有較健康控制組差的情形；在顏色線索的抑制功能中，接受分心轉移誘發參與者的表現較接受憂鬱反芻誘發參與者佳。在轉換功能部分，僅在性別線索中發現情緒低落組的表現較健康控制組差。(2)研究二結果發現，在情緒線索的抑制功能中，重鬱症組在接受憂鬱反芻誘發後的抑制功能有較接受分心轉移誘發後差的情形。在轉換功能部分，性別線索中，重鬱症組的表現較社區控制組差；接受憂鬱反芻誘發的參與者其表現較分心轉移佳；在重鬱症組中，接受憂鬱反芻誘發的參與者其表現較分心轉移佳；在分心轉移的狀況下，重鬱症組的表現較社區控制組差。
結論：整體研究結果可發現情緒低落組與重鬱症組在兩個功能的表現皆有較差的趨勢。細部結果發現，在投入程度的控制下，接受憂鬱反芻誘發的參與者，對於情緒線索的抑制功能表現有較差的趨勢；而在轉換功能中，僅在性別線索中發現有顯著的效果，而此效果與預期相反，結果發現憂鬱症患者在接受分心轉移誘發後，其轉換功能有明顯較接受憂鬱反芻誘發參者者差的情形。此結果與過去文獻認為分心轉移誘發為較好的因應策略所認定的不同。

關鍵字

反應風格理論、逃脫困難假說 ； 轉換功能 ； 抑制功能 ； 憂鬱反芻 ； 認知控制

並列摘要

Background and Purpose. Previous studies had found that patients, who have been diagnosticed as depression disorder, are always used to coping negative mood with rumination. But this coping style would exacerbate depressive symptoms, and even lead to depression recurrence and relapse. However, why the patients engage in rumination is unclear. According to cognitive perspective, the persons who engage in rumination may result in impaired cognitive control functions, especially in the inhibition and set switch. Therefore, understanding the relationship between rumination and cognitive control functions will contribute to the intervention of depression patients. However, the research evidences in this field are inconsistent, and the present research methods also have some limitations. Therefore, it is difficult to clarify the relationship between rumination and cognitive control functions.
Methods. In this study, we use the backward inhibition task to measure inhibition and set switch. There are two experiments in this study. In the experiment 1, we compare the dysphoric undergraduates and the control group; in the experiment 2, we compare the depressive patients and the control group. Moreover, we manipulate the sad mood and different response style in order to improve the limitations in previous studies.
Results. In the experiment 1, we found that manipulatuion have different effects between the groups in the inhibition functions of the emotion cues. The dysphoric group who received the rumination induction have better inhibition functions than the dysphoric group who received the distraction induction. The control group who received the rumination induction have poor inhibition functions than the dysphoric group who received the distraction induction. In the distraction induction condition, the dysphoric group have poor inhibition functions than the control group. On the other hand, that manipulatuion also have different effects between the groups in the inhibition functions of the gender cues and the color cues. In the distraction induction condition, the dysphoric group have poor inhibition functions than the control group (gender cues). And the group who received the rumination induction have poor inhibition functions than the dysphoric group who received the distraction induction(color cues). In the set switch functions, we only found that the dysphoric group have poor set switch functions than the control group in the gender cues. In the experiment 2, we found that manipulatuion have different effects between the groups in the inhibition functions of the emotion cues. The depressive patients who received the rumination induction have poor inhibition functions than the depressive patients who received the distraction induction. we also found that manipulatuion have different effects between the groups in the set switch functions of the gender cues. The depressive patients have poor set switch functions than the control groups; the participants who received the rumination induction have better set switch functions than who received the distraction induction. The depressive patients who received the rumination induction have better set switch functions than who received the distraction induction. In the distraction induction condition, the depressive patients have poor set switch functions than the control group.
Conclusions. The overall reults have found that the dysphoric group and the depressive patients have poor functions which is inhibition and set switch than the control groups. Furthermore analysis displays that under the control of the degree of engagement, who received the rumination induction have poor inhibition functions about the emotion cues than who received the distraction induction. But in the set switch function, we only found significant effects in the set switch functions of the gender cues. Different with our expectations, who received the rumination induction have better set switch functions than who received the distraction induction. The unexpectedly result is different from the previous study who think the distraction coping style is the good one.

並列關鍵字

Impaired Disengagement Hypothesis ； Response Style Theory ； set switch ； inhibition ； Depressive Rumination ； Cognitive Control

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