失樂傾向者的決策歷程：物質與社交酬賞的效果

Reward-based decision making in anhedonic individuals: The effects of physical and social rewards

林品如(Pin-Ru Lin)

指導教授 ： 梁記雯

中原大學/理學院/心理學研究所/碩士(2020年)

https://doi.org/10.6840/cycu202000221

摘要

研究背景與目的：失樂症狀為思覺失調症的核心症狀之一。失樂症狀會造成個體對於未來事件缺乏預期性愉悅感，由於缺乏對物質或社交酬賞的渴望，使得個體在日常生活中缺少主動從事休閒或人際活動的動機，並導致社會退縮。本研究的主要目的是嘗試以動機酬賞決策的角度來探討失樂症狀的認知機制。研究一檢驗中文版愉悅時間經驗量表（Temporal Experience of Pleasure Scale, TEPS）以及中文版預期與立即性人際互動愉悅感量表（Anticipatory and Consummatory Interpersonal Pleasure Scale, ACIPS）的因素結構與信效度；研究二探討失樂傾向者面對物質與社交酬賞的動機決策歷程。
研究方法：研究一中招募530位大學生於課堂間填寫TEPS、ACIPS、抑鬱焦慮和壓力量表21題版本（Depression Anxiety Stress Scales-21, DASS-21）、行為抑制與行為激發量表（Behavioral Inhibition Activation Scales, BISBAS）及賓州憂慮量表（Penn State Worry Questionnaire, PSWQ），其中有94位大學生於四週後再次填寫TEPS及ACIPS。研究二有32位失樂傾向參與者及31位非失樂參與者，所有參與者先填寫基本資料、TEPS、ACIPS、BIS/BAS，接著完成魏式成人智力量表的詞彙與圖形設計分測驗，最後完成酬賞付出作業（Effort-Expenditure for Rewards Task, EEfRT）。
研究結果：在研究一中，TEPS以二因素15題模型具有最佳的適配度，兩個因素分別為立即性愉悅感與預期性愉悅感。TEPS全量表及立即性和預期性愉悅感分量表均具有良好的內部一致性（α = .70 ~ .82），以及良好的再測信度（間隔四週的再測信度為 .78 ~ 82）。TEPS同時具有良好的效標關聯效度。ACIPS以三因素模型具有最佳的適配度，三個因素分別為與家人及朋友的休閒互動、團體互動，以及社交連結與建立關係。ACIPS具有良好的內部一致性（α = .91），間隔四週的再測信度為.76，ACIPS同時具有良好的效標關聯效度。研究二的結果發現失樂傾向組的物質性愉悅感及社交性愉悅感皆低於非失樂組，但在EEfRT中並未發現缺乏動機行為。在中酬賞機率（50%）的情況下，失樂傾向組在物質酬賞階段選擇的困難任務比社交酬賞階段還多，但非失樂組在兩種酬賞情境下沒有差異。在高酬賞機率（88%）的情況下，失樂傾向組在兩種酬賞情境下沒有差異，但非失樂組在物質酬賞階段選擇困難任務的比率比社交酬賞階段還多。另外，無論酬賞機率高低，非失樂組在中/高酬賞的情境中選擇困難任務的比率皆大於低酬賞的情境；失樂傾向組在高酬賞機率時，在中/高酬賞的情境中選擇困難任務的比率大於低酬賞，在低/中酬賞機率時，失樂傾向者在高酬賞時選擇困難任務的比率最高，其次是中酬賞，小酬賞的比率最低。
結論：中文版TEPS及ACIPS具有良好的信效度。失樂傾向者與非失樂者的酬賞決策會受到酬賞類型、酬賞機率與酬賞大小的影響而不同。

關鍵字

失樂症 ； 為酬賞而付出作業 ； 社會性酬賞 ； 物質性酬賞

並列摘要

Background: Anhedonia is one of the core symptoms of Schizophrenia. Individuals with anhedonia show decreased anticipatory pleasure in daily life. They have lost interest in leisure activities and social contact due to an inability to experience physical and social pleasures. As a result, individuals with anhedonia commonly experience social withdrawal in their lives. This study aimed to explore the underlying cognitive mechanism of anhedonia by investigating reward-based decision making in individuals with anhedonia. Study 1 examined the factor structure and psychometric properties of the Taiwanese version of the Temporal Experience of Pleasure Scale (TEPS) and Anticipatory and Consummatory Interpersonal Pleasure Scale (ACIPS). Study 2 investigated physical and social reward-based decision making processes in individuals with anhedonia.
Methods: A total of 530 undergraduate students participated in the Study 1. All participants completed TEPS, ACIPS, Depression Anxiety Stress Scales-21(DASS-21), Behavioral Inhibition and Activation Scales (BISBAS), and Penn State Worry Questionnaire (PSWQ). Of the 530 participants, 94 participants were asked to complete the TEPS and ACIPS again after four weeks. Thirty-two anhedonic and 31 non-anhedonic participants completed the Study 2. All participants filled in demographic questionnaire, TEPS, ACIPS and BIS/BAS. Then they completed Block Design and Vocabulary subtests form the WAIS-IV and the Effort-Expenditure for Rewards Task (EEfRT).
Results: Results from Study 1 suggests that the TEPS has the best fit with a two-factor model with 15 items. The two factors are including Consummatory Pleasure and Anticipated Pleasure. The TEPS and its subscales, Consummatory pleasure and Anticipated pleasure subscales all have good internal consistency (α= .70~ .82), and good test-retest reliability (the 4-weeks test-retest reliabilities are .78~ 82). The TEPS also has good criterion-related validity. The ACIPS has the best fit with a three-factor model. The three factors are Casual Bonding with Friends and Family, Group Social Interactions, and Social Bonding and Making Connections. The ACIPS has a good internal consistency (α= .91), good retest reliability (the 4-weeks test-retest reliability is .76), and good criterion-related validity. Study 2 found that the physical pleasure and social pleasure of the anhedonic group were lower than those of the non-anhedonic group. However, anhedonic participants did not show deficits in motivational behaviors in the EEfRT. When the reward probability was medium (50%), the anhedonic group selected to complete difficult tasks for physical rewards more frequently than for social rewards, whereas the non-anhedonic group did not show this difference. When the reward probability was high (88%), the non-anhedonic group selected to complete difficult tasks for physical rewards more frequently than for social rewards, whereas the anhedonic group did not this difference. Regardless of the probability of reward, the non-anhedonic group chose to complete difficult tasks for high and medium rewards more than for low rewards. The anhedonic group chose to complete difficult tasks for high and medium rewards more than for low rewards when the reward probability was high (88%). When the reward probability was medium (50%) and low (12%), the anhedonic group chose to complete difficult tasks for high rewards more than for medium rewards and for medium rewards more than for low rewards.
Conclusion: Study 1 suggests that TEPS and ACIPS have good reliability and validity. Study 2 suggests that reward-based decision making in anhedonic and non-anhedonic individuals can be influenced by reward type, reward probability and reward size, and their interactions.

並列關鍵字

Anhedonia ； EEfRT ； Social Reward ； Physical Reward

參考文獻

李雅萍（2010）。情緒低落者注意力現象初探：行為抑制與行為激發系統的調節角色（碩士論文）。國立臺灣大學，臺北市。

張本聖、徐儷瑜、黃君瑜、古黃守廉、曾幼涵（譯）（2014）。變態心理學第二版 (Ann M. Kring, Gerald C. Davison, John M. Neale, Sheri L. Johnson ed.)。台北：雙葉書廊有限公司（2013）

鄧閔鴻、翁嘉英、李毅達 (2003)。憂慮的正向預期與憂慮程度之間的關係。中華心理衛生學刊，16(3)，61-77。

Antony, M. M., Bieling, P. J., Cox, B. J., Enns, M. W., Swinson, R. P. (1998). Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales in clinical groups and a community sample. Psychological assessment, 10(2), 176.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). Washington, D.C: American Psychiatric Association.