非臨床受試者認知偏誤、注意力控制能力和妄想意念之關係

研究背景與目的：思覺失調症症狀影響患者生活許多部份，症狀中被害妄想是最常見的妄想類型。近幾年在一般非臨床群體和臨床上皆顯示有認知偏誤的現象，認知偏誤亦被證明對形成精神病症狀有所影響，現今研究以認知心理學的訊息處理模式為基礎分為兩大方面作為探討，一方面為社會認知，另一方面則是神經認知心理學來探討妄想的病理歷程，故本研究將兩者納入作為變項，並以一般非臨床群體作為受試者，探討認知偏誤、注意力控制與被害意念之間的關係，以及中文化Davos認知偏誤量表，檢驗其因素結構與信效度。研究方法：本研究招募大學生受試者，填寫四項自陳式問卷，分別為基本調查問卷、Green被害妄想量表、Davos認知偏誤量表和注意力控制量表，共344名有效受試者，其中有128位於四周至五周再次填寫Davos認知偏誤量表。接著採一對一施測，完成珠子作業、次級錯誤信念作業和彩色路徑描繪測驗，最後自陳式問卷完成Green被害妄想量表、Davos認知偏誤量表和中文版內在、他人與環境歸因量表。共98名有效受試者。研究結果：於Davos認知偏誤量表於信度分析有不錯的分析結果（α=.59 ~ .801），僅在信念彈性偏誤上內部一致信較低，再測信度間隔四至五周為.55 ~ .69。Davos認知偏誤量表同時有良好的效標關聯效度。於驗證性因素分析和探索性因素分析中，發現四因素17題具有較佳適配性，四個因素分別為認知限制、安全行為、妄下結論及威脅偏誤。根據第一階段的大樣本將被害意念切分為高、中及低分三組，於單因子變異數分析中發現在認知偏誤量表中，三組僅在妄下結論未達顯著，其餘在信念彈性偏誤、注意到威脅偏誤、外歸因偏誤、社會認知問題、主觀認知問題以及安全行為分量表皆有達顯著差異；在其它量表和作業中惟有自利性歸因偏誤達顯著，顯示被害意念低分組較被害意念高分組較容易有自利性偏誤。四因素17題在單因子變異數分析中亦有相似的結果。檢驗調節及中介效果，顯示注意力聚焦會調節注意到威脅偏誤和信念彈性偏誤預測被害意念之間的關係。額外亦發現外歸因偏誤預測被害意念的關係中，心智理論能力具有調節效果；自利性偏誤在為信念彈性偏誤預測被害意念時，具有部分中介效果。結論：在Davos認知偏誤量表具有良好的信效度，因素分析則是四因素17題具有最佳適配性。歸因的異常在不同被害意念程度中達顯著，推論可能因被害妄想中有不同的類型所導致，似展現出形成被害妄想的病理歷程。另外，可發現注意力控制會調節認知偏誤預測被害意念之間的關係，與過去文獻結果一致。本研究於最後亦提出可能的限制，以及未來的方向。

關鍵字

被害意念；被害妄想； Davos認知偏誤量表；認知偏誤；注意力控制；心智理論；歸因型態

並列摘要

Background and purpose：Symptoms of schizophrenia affect many parts of a patient's life. Among the symptoms, persecuted delusions are the most common type of delusions. In recent years, both the non-clinical groups and clinical group have shown cognitive biases. Cognitive biases have also been shown to have an impact on the formation of psychotic symptoms. Current research is based on the information processing model of cognitive psychology and is divided into two major areas for discussion. One is social cognition, and the other is neurocognitive psychology to explore the pathological process of delusions. Therefore, this study includes the two as the variables, and the non-clinical group as subjects, to explore the relationship between cognitive bias, attention control and paranoid ideations, as well as the examined the factor structure and psychometric properties of the Taiwanese version of the Davos cognitive bias scale. Methods：This study recruited college students to complete the Basic Information Questionnaire, the Green et al. Persecution Delusion Scale(GPTS), Davos Assessment van Cognitive Biases Scale(DACOBS), and the Attention Control Scale(ACS). A total of 344 effective subjects were included. Of the 344 participants, 128 participants were asked to complete the DACOBS after four to five weeks. 98 participants were invited to test the Bead Task, Second-Order False Belief Task, Color Trail Test(CTT), Green et al. Persecution Delusion Scale(GPTS), and the Chinese Internal Personal and Situational Attributions Questionnaire(CIPSAQ). Results：The DACOBS and its subscales most have good internal consistency (α=.59 ~ .801), the internal consistency is low only on the belief inﬂexibility bias. The 4-5 weeks test-retest reliabilities are .55 ~ .69. The DACOBS also has good criterion-related validity. The DACOBS has the best of fit with four-factor model. The four factors are Cognitive Limitations, Safety Behaviors, Jumping to Conclusions Bias and Attribution Bias. The participants were divided into three groups according to the scores of the paranoid ideation scale of GPTS. One way ANOVA found that participants had significant differences in all of cognitive bias except jumping to conclusions bias. In other scales, participants had no significant differences except self-serving bias. In mediator and moderator analysis, we found attentional focus will moderator the relationship between attentional threat bias and belief inﬂexibility bias in predicting paranoid ideations. In addition, it was also found that theory of mind has a moderator in the relationship between external attribution bias and paranoid ideations ; self-serving bias has a partial mediating between belief inﬂexibility bias and paranoid ideations. Conclusion：The DACOBS has good reliability and validity. The DACOBS has the best of fit with four-factor model. The abnormality of attribution is significant in different levels of paranoid ideations. In addition, we found the relationship between attention control, theory of mind, and attribution in paranoid ideations. At the end of this study discussed possible limitations and still need further studies and explorations.

並列關鍵字

Persecutory Delusion ； Paranoid Ideation ； Davos Assessment van Cognitive Biases Scale(DACOBS) ； Cognitive Bias ； Attention Control ； Theory of Mind ； Attributional Style