- 學位論文
臉部表情的情緒辨認能力缺損： 不同情緒狀態下的雙極性疾患患者比較
Recognition Deficits of Emotional Facial Expressions: Comparison of Patients with Different Emotional States in Bipolar Disorder
摘要
臉部表情的情緒辨認能力對人類的社交生活非常重要，被認為是一種內隱且自動化的行為模式，使得人能在幾秒鐘內就能以直覺判斷他人表情，瞬間知道對方有著開朗的笑容、悲傷的眼神、或生氣地面紅耳赤。從以往的研究中，已經證實精神分裂症的患者在表情辨認能力上有明顯的困難，反觀其他疾病，學者們也逐漸發現情感性疾患患者同樣有此問題。本研究有三個研究目的，第一是探討雙極性疾患患者有無臉部表情辨認上的缺損，第二則是探討此缺損是否受雙極性疾患患者本身情緒狀態所影響，表情辨認表現與自身情緒狀態一致，第三是欲了解雙極性疾患患者在躁期、鬱期、緩解時是否對某些情緒有較佳的辨認。 本研究招募躁期患者7位、鬱期患者16位、緩解期患者19位，另有健康者17位為對照組，以漢氏憂鬱症狀量表、楊氏躁症量表等情緒量表問卷記錄其情緒狀態，採用許惠淳(民87)拍攝的49張臉部表情照片作為刺激材料，比較四組受試者在表情判斷作業上的表現，照片分為快樂、生氣、悲傷、驚訝、厭惡、害怕等六種表情，另加上中性表情作為對照。 研究結果發現雙極性疾患患者的臉部表情辨認確實有缺損，同時證實雙極性疾患的臉部表情辨認缺損表現與自身情緒狀態一致，躁期有正偏向、鬱期有負偏向、緩解期無正負偏向，符合「情緒狀態一致論」，支持的證據有七點。本文中有兩點反對證據是因為有混淆因素未排除所導致，混淆因素為：疾病本身導致患者認知功能低落。此外，躁期患者在悲傷、驚訝、厭惡、害怕表情上有較差的辨認表現；鬱期患者在快樂、驚訝、厭惡表情上有較差的辨認表現；緩解期患者在驚訝表情上有較差的辨認。
並列摘要
The ability of recognition of emotional facial expressions is very important to human to have good social relationship. Recognizing others’ expressions intuitively in a few seconds is supposed to be an inner and automatic behavior. People realize happy smiles, sad eyes, and glow of anger immediately. Previous research showed that schizophrenia patients have obvious deficits of recognition of facial expressions. Other scholars gradually found out that bipolar patients also have the same deficits. This study has three aims: (1) To examine whether bipolar patients have deficits of recognition of emotional facial expressions; (2) To examine whether mood-congruent biases affect recognition of emotional facial expressions; (3) To find out which emotional facial expressions are recognized better by manic, depressed, and euthymic patients respectively. The manic group consisted of 7 patients. The depressed group consisted of 16 patients. The euthymic group consisted of 19 patients. The comparison group consisted of 17 healthy people. The Hamilton Rating Scale for Depression and Young Mania Rating Scale are used to assess emotional states. The assessment instrument was a set of 49 facial expression pictures taken from Hui-Chun Xu (1998) with six different emotions in addition to neutral expression. The performances on the facial expression recognition task of the four groups were compared. The data provide clear evidence for deficits of recognition of emotional facial expressions and mood-congruent biases of bipolar patients. Manic patients have positive biases. Depressed patients have negative biases. Euthymic patients do not have any biases. There are seven evidences in this study to support mood-congruent biases. However, there are two evidences against mood-congruent biases, which may be due to the confounding factor of patients having low cognitive function because of their illness. Besides, manic patients recognize worse on facial expressions with sadness, surprise, disgust, and fear. Depressed patients recognize worse on facial expressions with happiness, surprise, and disgust. Euthymic patients recognize worse on facial expression with surprise.