眼動減敏訊息再處理法中「眼動」與「正向認知」成分對於懼蟑症之療效

The Efficacy of Eye Movement and Positive Cognition Components of EMDR in the Treatment of Cockroach Phobia

陳致豪(Chih-Hao Chen)

指導教授 ： 張素凰

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.2004.00942

摘要

眼動減敏訊息再處理法（Eye Movement Desensitization and Reprocessing; EMDR）是Shapiro（1989a, 1989b）所發展的一套治療方法，最早被用來治療創傷後壓力疾患（post traumatic stress disorder; PTSD），後來也被認為對其他心理疾患具有療效。雖然Shapiro認為眼動程序可以加速訊息處理並降低個案的焦慮與困擾，不同治療變項的療效仍待由控制性研究法進一步釐清。本研究以部分減除（dismantling）的方式，運用實驗法來探討「眼動」與「正向認知」對懼蟑症治療效果的影響。藉2（有眼動、無眼動）× 2（正向認知、減敏延長）受試者間設計，探討單一治療次對懼蟑症者的治療效果。受試者為自大樣本篩選出的40名懼怕蟑螂的大學女生。研究結果顯示治療程序的主要效果顯著，四組的療效相當。在治療階段中，受試者主觀害怕程度、對負向認知之相信程度皆呈顯著的線性下降；對正向認知之相信程度則僅眼動組呈顯著線性上升。雖然生理指標（心跳速率）在前測時顯著較基線時高，而在後測時回復至接近基線水準，但就微觀歷程分析，治療階段中各組之心跳速率變化為，在第一階段內逐漸上升，階段間休息時心跳速率略為降低，在第二階段開始又逐漸上升。本研究結果亦顯示，就微觀的治療歷程（micro process）而言，在正向認知的治療情境中，僅眼動組的受試者對正向認知之相信程度逐漸提高。在治療效果上，雖曝露法（exposure）本身便具有療效；但眼動能夠進一步促進受試者第二階段中正向認知的相信程度（可能藉由促進訊息處理）。就巨觀的療效指標而言，雖然單一治療次在各組皆有顯著的療效，但是正向認知對療效的影響無組別差異，該療效指標可能需要較多的治療次始能反映出來。本研究亦就研究結果所顯示的意義與未來的研究方向提出討論。

關鍵字

正向認知 ； 眼動 ； 眼動減敏訊息再處理法 ； 心理治療 ； 懼蟑症

並列摘要

Eye Movement Desensitization and Reprocessing (EMDR; Shapiro, 1989a, 1989b) was initially used to treat post-traumatic stress disorder (PTSD) and later has been thought to be effective in treating other psychological disorders also. Shapiro suggested that eye movement procedure could accelerate information processing and further reduced the client’s anxiety and disturbance. However, psychotherapy evaluation regarding crucial therapeutic parameters awaits elucidation. This dismantling study was to investigate the therapeutic effects of eye movement and positive cognition on phobias. Specifically, via a 2×2 between subject design, with “eye movement/non eye movement” and “treatment process” being two independent variables, a total of 40 female university students with fear of cockroaches were screened and recruited from introductory psychology class to explore the treatment effect of those two components. The results showed that, according to macro therapeutic indices, the effect of therapy was significant, and was not significantly different among groups. As to micro treatment process, while the participants’ SUDs decreased linearly, and so did the negative cognition VOCs, the positive cognition VOCs increased linearly only for the eye movement condition. In addition, while for macro index, the physical index, heart rate, was significantly higher at pre-test than at baseline and returned to baseline at post-test, the process measures indicated that heart rate increased during the first treatment stage, returned during rest period, and increased again during the second treatment stage. According to the micro process, the results also suggested that when presented with positive cognition participants’ VOCs of positive cognitions increased only for the eye movement condition. As to the therapeutic effects, although exposure by itself might be effective, eye movement could further promote participants’ VOCs of positive cognitions at the second treatment stage, probably by facilitating information processing. Nonetheless, regarding macro therapeutic index, there were equal therapeutic effects across groups within one-session therapy, and the superiority of positive cognition installation remained obscure, which implied that to become obvious more sessions might be called for. The implications of the present results and further research possibilities are postulated.

並列關鍵字

cockroach phobia ； positive cognition ； eye movement ； psychotherapy ； EMDR

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