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  • 學位論文

強迫症患者的性格特徵之探討

The discussion of the personality in patients with obsessive compulsive disorder

指導教授 : 吳英璋

摘要


本研究是以台灣版本之「華人性格測量表-第二版(CPAI-2)」為工具來瞭解強迫症患者的性格特徵。藉比較強迫症患者、社區成人、以及恐慌症患者在CPAI-2上的差異,瞭解強迫症患者的性格特徵。研究對象包括強迫症病患受試者50名,社區成人112名,恐慌症病患受試者28名。強迫症與恐慌症受試者來源以台北某市立精神科專科醫院病患為主,加上另十家台北縣市綜合醫院精神科的病患共同組成,社區成人則以台北社區的成人為受試者。在本研究中,首先請病患之主治醫師或心理師填寫「病人診斷問卷(DIS)」以確認病人診斷與最近兩週內的症狀嚴重度;繼之,請病患受試者填寫CPAI-2,而社區成人受試者則只填寫CPAI-2。在臨床量尺上,強迫症組與恐慌症組在情感問題的自卑、焦慮緊張、憂鬱、身體症狀、軀體化分量尺,以及行為問題的反社會行為、需要關注、猜疑分量尺顯著高於社區成人組。另外,強迫症組在性適應問題、興奮性、脫離現實分量尺顯著高於社區成人組。在一般性格量尺上,社區成人組在領導性因素的領導性、新穎性、外向性、開拓性、理智性分量尺,可靠性因素的務實性、樂觀-悲觀、親情分量尺,容納性因素的容人度、寬容-刻薄分量尺,人際取向因素的和諧性、紀律性、人情分量尺均顯著高於強迫症組。社區成人組在多樣性、理智分量尺上顯著高於恐慌症組;恐慌症組在面子分量尺顯著高於社區成人組;紀律性、和諧性分量尺顯著高於強迫症組;強迫症組在阿Q精神分量尺顯著高於社區成人組。前述結果指出CPAI-2的臨床量尺,以及一般性格量尺中的某些分量尺可以區辨社區成人、強迫症患者與恐慌症患者之間的性格特徵。另外,強迫症組區分成早發型組與晚發型組,與區分成嚴重型組與輕度型組,兩種亞型分組方式在CPAI-2的臨床量尺上都無顯著性差異,且在一般性格量尺中的大多分量尺也無顯著性差異,因而推論若以性格特徵做為強迫症的亞型分類較有困難。

並列摘要


The present study used Chinese Personality Assessment Inventory-2 (CPAI-2) as the assessment tool to understand the personality characteristics of patients with obsessive compulsive disorder (OCD). Obsessive compulsive disorder patients, community control group, and panic disorders (PAD) patients were compared on the differences of CPAI-2 to further understand the personality characteristics of OCD patients. The participants include 50 OCD patients, 112 community controls, and 28 PA patients. Obsessive compulsive disorder and PAD patient samples come from a Taipei City psychiatric hospital along with 10 other Taipei County general hospitals. The community control sample composed of community adults in Taipei City. The study first have the psychiatrists or psychologists filled out the Diagnostic Interview Sheet (DIS) on patients to confirm with the diagnosis and the severity of their symptoms in the past two weeks; patients then filled out the CPAI-2; the community controls filled out only CPAI-2. On clinical scales, OCD group and PAD group in emotional problems factors of anxiety, depression, physical symptoms, and somatization subscales and behavior problems factors of antisocial behavior, needing for attention, paranoia subscales are significantly higher than the community control group. In addition, OCD group in adjustment problem, excitement and distortion of reality subscales are significantly higher than the community control group. In personality scales, community control group on social potency factors of novelty, extraversion vs. introversion, enterprise, and logical vs. affective orientation factors; dependability factors of practical mindedness, optimism vs. pessimism, and family orientation; accommodation factor of graciousness vs. meanness; interpersonal relatedness factors of discipline, harmony, and relationship orientation subscales are significantly higher than the OCD group. Community control group in diversity and logic vs. affective orientation subscales are significantly higher than the OCD group, while OCD group on face subscale is significantly higher than the community control group. The above results showed that some of the CPAI-2’s clinical scales and personality scales could differentiate the personality characteristics among community control, OCD and PAD patients. However, early/late onset OCD sub-types and severe/less severe sub-types show no significant differences in the clinical scales of CPAI-2, and no significant differences among the majority of personality subscales. The results of the present study thus conclude that there are some difficulties in using personality characteristics as a way to sub-categorize OCD.

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