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  • 學位論文

具被害妄想症狀之思覺失調症患者於脈絡情境下對臉部情緒判斷之影響

Context effects on facial recognition in paranoid schizophrenia

指導教授 : 洪福建

摘要


研究背景與目的:過去研究發現思覺失調症患者(SZ)對負向臉部情緒之辨認能力出現缺損與偏誤,然而個體在辨認他人的情緒時,並非單純以臉部情緒為依據,亦會受到外在環境中的脈絡訊息所影響。思覺失調症患者於上述研究表現差異可能受到是否具有被害妄想症狀而有所不同,因具被害妄想症狀的個體會出現被害妄想症狀可能來自其異常的內在經驗,此經驗患者難以由自身內在所解釋,進而轉換從外在環境中來獲得解答,並將模糊、中性的刺激判斷為威脅,且具被害妄想症狀會導致個體對於人際情境過度敏感,因而將人際情境視之為威脅。故研究目的為探討具被害妄想之思覺失調症患者於文字脈絡影響下對於他人臉部情緒知覺能力是否受到被害妄想症狀所影響而出現缺損與偏誤。研究方法:受試者分為具被害妄想症狀之思覺失調症患者(PSZ,n = 34),無被害妄想症狀之思覺失調症患者(NSZ,n = 26),與一般控制組(HC,n = 30),受試者觀看威脅、中性兩種文字脈絡後,接續憤怒、害怕、中性其中一種臉部情緒,請受試者辨認所看到之情緒種類與憤怒、害怕評分,並額外計算威脅情緒率。研究結果:如同過去研究發現SZ之臉部情緒辨認能力出現缺損,且SZ會將威脅臉部情緒誤判為中性臉部情緒,或將中性臉部情緒誤判為威脅情緒,PSZ偏誤明顯高於HC。SZ對於他人臉部情緒之憤怒、害怕評分較HC高。但本研究預期SZ對於社交脈絡情境的判斷能力將出現缺損或偏誤,然而結果發現SZ出現能力缺損或偏誤多受到臉部情緒,而非文字脈絡。 討論:SZ可正確判斷威脅、中性脈絡情緒,但後續臉部情緒辨認能力缺出現缺損與偏誤,患者作業表現可能受到文字脈絡複雜程度、所選情緒種類、脈絡呈現方法、臉部情緒種類以及脈絡、臉部情緒之一致性等因素所影響。 關鍵字:思覺失調症、被害妄想、威脅、文字脈絡、臉部情緒辨認、情緒強度評比

並列摘要


Background and purpose: Facial affect recognition was impaired and biased in schizophrenia (SZ) in evidences. When an individual recognize others facial affect is influenced by the situational context. Schizophrenia has the impairment of social perception and this impairment might be influenced by paranoid symptom. The individual who has paranoia symptom might source from the internal abnormal experience, but they can’t explain this experience reasonably, so they turn to find out the interpretation from the environment. They tend to consider ambiguous or neutral stimulus as threats, and overly sensitive to the interpersonal situation. The goal of the research is to investigate whether paranoid schizophrenia would show the deficit and bias in facial recognition. Method: Three groups for paranoid schizophrenia (PSZ, n = 34), non-paranoid schizophrenia (NSZ, n = 26) and health control (HC, n = 30). All participants read out “threat” and “neutral” two types of sentence for situational context, one face photo preceded to present 500msec. (We select anger, fear, and neutral three kinds of facial expression.) Then participants should choose what kind of emotion was the person feel and rated the intensity of anger, fear with that person. We account the rate that participants answer the faces as “emotion of threat”. Result: SZ showed the impairment in the accuracy of facial recognition. SZ has the tendency to treat neutral face as threat, but anger, fear as neutral. Compared to HC, PSZ had more biases in neutral face significantly. And SZ also rated the face more angry or fearful to HC. We expected that we would assess significant impairments of SZ in verbal context as social perception, but the result that SZ had deficit and biases in facial recognition and rating, but not verbal context. Discussion: SZ could recognize threat or neutral situational context as HC, but their ability of facial recognition and the intensity of affect still showed the deficit and bias. The responses of SZ may influence by the complexity of context, chosen types of affect, different types of material, kinds of facial emotion, and the congruence between situational context and facial expression. Key words: schizophrenia, paranoid, threat, verbal context, emotion intensity rating

參考文獻


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