班達測驗於評量震災兒童青少年創傷身心反應之適用性的探索性研究

An Explorative Research on the Bender Gestalt Test: Evaluation of Post-traumatic Stress Reactions in Children and in Adolescents

林希陶(Shi-Tao Lin)

指導教授 ： 吳英璋

國立臺灣大學/理學院/心理學研究所/碩士(2004年)

https://doi.org/10.6342/NTU.2004.00772

摘要

本研究是以班達測驗為主要研究工具，區辨921大地震之後兒童與青少年創傷身心反應之嚴重程度。經由修編Pascal 與 Suttell（1951）和Koppitz（1975）的班達測驗計分系統作為評量之依據，再配合訪問法與自陳式量表之結果，企圖找出創傷身心反應在班達測驗上之徵象，以確認班達測驗可實際應用於評估受災兒童與青少年的創傷身心反應之效能。本研究取用九二一災後心理因應狀況調查計畫（吳英璋、陳淑惠、曾旭民，2000）中之學生樣本，包括埔里鎮一所國小、一所國中及一所高中的樣本，共計118名。從所收集的資料中分析其身心症狀量表、災難經驗量表、結構式診斷會談三部分評量結果與班達測驗評分結果之間的關係。在結果上，首先是整合出創傷身心反應在班達測驗上之徵象，男生為Koppitz計分系統修訂版情緒指標中的「過度描繪」及行為記錄中的「總時間」、「總視動次數」等三項；女生為Pascal和Suttell計分系統修訂版中「不對稱」、「畫兩列」、「所有圖形只占版面1/2」及Koppitz計分系統修訂版情緒指標中的「波浪線」等四項。其次是班達測驗第一階段之Pascal和Suttell計分系統修訂版中「圖六總分」及行為記錄之「總時間」可區辨不同程度之創傷身心反應。本研究並在班達測驗本身，發現性別之評分結果有顯著差異存在，且最近一個月創傷身心反應輕微者在班達測驗第一階段與第二階段之評分結果亦有顯著差異。研究結果支持不同程度之創傷身心反應有不同之班達測驗表現。本研究並進一步針對性別差異集結出創傷身心反應在班達測驗上之徵象，有利於未來臨床與研究之應用與參照。

關鍵字

兒童青少年之創傷身心反應 ； 班達測驗 ； 創傷後壓力疾患（PTSD）

並列摘要

The Bender Gestalt Test is used as a main measurement tool in this thesis to determine the degrees of post-traumatic stress reactions in children and adolescents who have experienced the Chi-Chi Earthquake in Taiwan. The study uses the Pascal & Suttell Scoring System (1951) and the Koppitz’s Emotional Indicators (1975), both of which have been revised in this research as a mean to investigate possible signs related to post-traumatic stress reactions. From the participants, we also gathered information from their diagnostic interviews and self-report scales in order to gain a better understanding of the participants’ performances on the Bender Gestalt test and moreover, to cross-validate this information with the data from the Bender Gestalt test. In sum, the purpose of the study is to identify responses on the Bender Gestalt test that are indicative of participants’ pos-traumatic stress reaction and to evaluate the validity of this test as a practical measurement tool for assessing post-traumatic stress reaction among children and adolescents. Participants were recruited from the subject pool in the research of Post-traumatic Stress Reactions After the Taiwan Chi-Chi Earthquake (Wu, Y. C., Chen, S. H., & Tseng, H. M., 2000). They included 118 students currently attending the elementary school, junior high school and senior high school in Puli Town. The relationships between the data obtained from the Psycho-Physical Reaction Scale, the Disaster Experiences Scale, the Structured Diagnosis Interview and the scoring results of the Bender Gestalt Test are examined. Signs in the Bender Gestalt Test that were indicative of post-traumatic stress reactions were first identified. The study’s result indicated that the signs in the boys’ Bender Gestalt Test that were associated with post-traumatic stress reactions were ‘Workover’ in the Koppitz’s Emotional Indicators and the ‘Total time’ and ‘Total eye movement’ in the Behavior Recordings. For girls, the signs that were most relevant to post-traumatic stress reactions were ‘Asymmetry’, ‘Double line’ and ‘Compression’ in the Pascal & Suttell Scoring System, and ‘Wavyline’ in the Koppitz’s Emotional Indicators. The ‘Total scores in design six’ in the Pascal & Suttell Scoring System and ‘Total time’ in the Behavior Recordings were found to have good ability to discriminate between different degrees of the post-traumatic stress reactions. Lastly, the study found a sex difference in the scoring results of the Bender Gestalt Test. Specifically, the difference was observed in the first and the second sections in the scoring results of the Bender Gestalt Test, particularly among participants who had mild post-traumatic stress reactions in the last month. Children and adolescents with varying degrees of post-traumatic stress reactions have different scores on the Bender Gestalt Test. The signs in the Bender Gestalt Test indicative of the post-traumatic stress reactions were different for boys and girls. The study has clinical implications and can be applied to clinical research in the future.

並列關鍵字

post-traumatic stress disorder (PTSD) ； post-traumatic stress reactions in children and ad ； Bender Gestalt Test

參考文獻

吳英璋、陳淑惠、曾旭民（2000）。「九二一災後心理因應狀況調查計畫」。國家地震工程研究中心研究計畫成果報告。

Honig, R. G., Grace, M. C., Lindy, J. D., Newman, C. J., & Tichener, J. L. (1999). Assessing long-term effects of trauma: diagnosing symptoms of avoidance and numbing. American Journal of Psychiatry, 156:3, 483-485.

Watkins, E. O. (1976). The Watkins Bender-Gestalt Scoring System. California: Academic Therapy Publications.

American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorder(3rd Ed.-revised). Washington, DC: Author.

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorder(4th Ed.). Washington, DC: Author.