憂鬱症父母對子女成長歷程影響之探究

近年來衛福部資料統計，顯示出憂鬱症已成為現今社會的普遍疾病，近幾年來憂鬱症罹患率與就診率更是有愈漸上升之趨勢，憂鬱症也分布於各年齡層且不分性別，如此結果即顯示出憂鬱症及因病而衍生之相關現象，已是現今社會所面臨且須重視之一大議題。同時，憂鬱症所影響的並非僅有疾病者本身，或疾病的照顧者，身處同一家庭內的成員同樣深受影響。因此當罹病者為父母的其中一方時，對家庭的未成年孩子是有著極大影響的，不論是在情感方面的依附狀況，或是病父母因疾病發作對孩子造成的疏忽行為，還是病父母對孩子進行負向情緒的發洩等，孩子們皆因著父母罹患憂鬱症的因素，加上疾病帶來的污名化效應或被標籤化，以及孩子擔心通報後導致家庭破碎的可能性，使得這些孩子是難以向外界求助，並處於孤立無援的狀態，同時在憂鬱症家庭中未成年子女的資源與服務方面，是少有研究予以討論和關注的，大多研究、法規與社會福利機構僅關注罹病者與照顧者的需求，而忽視了這群孩子同樣需要關懷與照顧的。因此本研究以憂鬱症家庭下的子女為對象，並關心憂鬱症子女於成長過程的經歷與感受。至此研究者的研究目的為：(一)了解憂鬱症父母對於子女產生的影響；(二)了解子女在這樣的成長脈絡下的因應經驗。研究方法則為：採用質性研究典範，並以半結構的方式進行訪談，由淺入深地聆聽憂鬱症家庭孩子所述說之生命故事及相關感受，理論則透過Bowen的家庭系統理論與McMaster model向度探討憂鬱症之家庭功能，並以壓力因應模型為觀點看見孩子在困境中所使用的因應模式，以及本研究亦將Irvin Yalom的存在主義觀點納入研究分析過程中，瞭解孩子是有什麼力量支撐他們繼續生活，甚至在成年後仍與罹病父母共同生活的。本研究經過招募後，最後獲得10位符合研究條件並同意接受訪談的對象，研究對象資料進入分析後，研究者以Nvivo質性軟體進行訪談文本的分析，並透過反覆閱讀文本與進行整理，同時將研究相關的資料、概念予以歸納各個研究之分類架構中，透過不斷比對與分析資料，以整合出研究成果。研究結論方面：本研究除了看見罹病父母對孩子的影響，以及孩子的因應措施之外，同時研究者亦討論到憂鬱症家庭在親子間的關係，與孩子所展現的優勢與生命力現象。同時研究發現即便家庭中僅有父母一方罹病，但在研究呈現的結果中，發現有七成的未患病父母是離世或選擇離開家庭的，另外三成留下的未患病父母也無法降低罹病者對孩子的傷害，甚至是站在罹病者的角度要求孩子順服聽話。因此不論未患病父母是否存在，孩子都難以脫離病父母的疾病影響，也難以避免罹病者對他們施加的情緒壓力和勒索。至此，研究者針對憂鬱症家庭中的未成年孩子，所給予之研究建議如下：(一)不應將目光放在罹病者身上，也需看見同住孩子或其他家屬的需要；(二)給予孩子在心理方面的支持與實質上的協助。希望能夠透過本研究對社會的呼籲，使現今仍身處於憂鬱症家庭的未成年孩子，讓他們的需要與訴求能夠被看見、被發覺、被重視，並使這些孩子能獲得關懷與相關支持。

關鍵字

憂鬱症家庭功能；親子關係；成長歷程；壓力因應模型；存在主義觀點；憂鬱症汙名化效應；標籤化

並列摘要

Statistics from the Ministry of Health and Welfare in recent years have shown that depression has become a common disease in today’s society. In recent years, the incidence rate of depression and the rate of medical treatment have been increasing. This illness can be found in all age groups and in both genders. This leads to a result that depression and its related impact have become the major issues in today’s society. Meanwhile, the impact of depression not only affects patients themselves and their caretakers, the negative effect actually reaches all the members of patients’ families. When a parent has depression, it produces negative impacts on the minor children inside the family. These impacts can be attachment issues, neglectful behaviors or improper conducts towards children. Minor children are influenced by the parents who suffer from depression, and the stigmatization effect or being labeled by the outside world. Furthermore, these children are afraid to seek help from the outside world due to fear of breaking their families apart. Consequently, they are in a state of isolation. At the same time, in terms of resources and services for minor children from depressive families, only few studies have focused on them. Most of the research, regulations and social welfare agencies concentrate on the needs of the ill parents and their caretakers. The needs of the children with depressive parents have been ignored. Therefore, this research tends to the needs of these children, it documented their experience and feelings while growing up. The research purpose: (1) to understand the influence of depressive parents have brought upon their children; (2) to understand the children’s coping mechanism under such a growing environment. Research Methods: using the qualitative research paradigm, conducting semi-structured interviews, and listening to the life stories and feelings of the children from the depressive families with different angles. The researching theories are based on Bowen’s family systems theory and McMaster model dimension, it is to explore the family function of a depressive family. The researcher uses the stress coping model as a perspective to see the coping modes used by these children in difficult situations. It also incorporates Irvin Yalom’s existential perspective into the research analysis process, it explores what kinds of strength these children possess in order to carry on their daily living into their adulthood. After the recruitment of this research, ten subjects who met the research conditions agreed to be interviewed. The collected data was entered into the analysis, the researcher used Nvivo qualitative software to analyze the interview content. The data was read repeatedly and sorted, at the same time the research-related concepts were summarized into each case study. Finally, the research results are integrated into continuous comparison and analysis. Research Conclusions: In addition to witnessing the impact of ill parents on their children and the children’s coping mechanism, the researcher also discussed the parent-child relationship in depressive families and the children’s strengths and vitality. At the same time, the research also reveals that among depressive families 70% of the non-depressive parents died or chose to leave the families, the remaining 30% could not reduce the damage brought upon the children from the ill parents. The non-depressive parents usually adopt the ill parents’ points of view and demand the children to obey in any kind of circumstance. Therefore, regardless of the presence or absence of the non-depressive parents, it is difficult to avoid the emotional pressure and blackmail exerted on them from the depressive parents. Currently, the researchers have given the following suggestions for minor children from families with depressive parents: (1) do not only focus on the needs of the ill parents, but also meet the needs of their children or other family members; (2) give psychological support and practical assistance to the children. It is the aim of this research to reveal the difficulties children with depressive parents are facing. By discovering and providing the needs for these children, they can be better cared for and assisted.

並列關鍵字

Depression Family function ； Parent-child Relationship ； Child’s Development ； Stress Coping Model ； Existentialism ； Stigmatization Effect of Depression ； Labelling