精緻性複誦技巧訓練對慢性精神分裂症住院病人之語文工作記憶的效果

The effect of elaborative rehearsal training on verbal working memory in chronic schizophrenic inpatients

杜家興(Juia-Hsin Tsu)

指導教授 ： 譚偉象 ； 郭乃文

中原大學/理學院/心理學研究所/碩士(2003年)

https://doi.org/10.6840/cycu200300044

摘要

本研究的目的在於調查精緻性複誦技巧訓練方案在矯治慢性精神分裂症患者語文工作記憶的效果。五十六名慢性精神分裂症患者，三十名男性與二十六名女性，以配對方式隨機分派去接受精緻性複誦技巧訓練（實驗組：十五名男性、十四名女性）以及認知活動（控制組：十五名男性，十二名女性）。統計T考驗結果指出，實驗組與控制組在年齡（平均數分別為40.00/37.78）、受教育年數（10.78/11.43）以及中文版簡短式心智狀態檢查表得分（MMSE；30.07/30.26）等基本變項上沒有顯著差異。接著，在十二次訓練課程進行之前與之後，測量所有受試者在各項語文工作記憶測驗和精神病正性與負性症狀量表上的得分。使用的衡鑑工具包括，精神病正性及負性症狀量表（測量精神病正性及負性症狀）、中文版簡短式心智狀態檢查表、數字廣度測驗（Digit Span）、曾氏語文工作記憶測驗、日常生活之工具性語文工作記憶量表、中文版盧-尼氏神經心理測驗組合之記憶量表（C-10）。實驗組接受為期十二次、每週進行兩次、每次各三十分鐘的精緻性複誦技巧（elaborative rehearsal）訓練課程。控制組則是接受同樣時間、同樣材料但不強調策略教導的認知活動課程。

本研究結果指出，十二次的認知矯治，不管是精緻性複誦技巧訓練還是認知活動，都有助於慢性精神分裂症住院病人的語文工作記憶，並且對於精神病理有一些正面效果。我們的結果確認了認知介入在慢性精神分裂症住院患者之復健工作上的可行性，並且實驗組的記憶訓練問卷結果指出該組受試者對於記憶策略的認識與使用有所增加，意謂著慢性精神分裂症患者有關記憶策略之知識及使用能力具有改善的空間，且這方面的改善對他們的語文工作記憶能力有正面的效果；但是，本研究結果未能明確指出教導這類患者精緻性複誦的效果明顯比強調互動的認知活動方案還要來得大。最後，討論本研究結果對於精神科住院病人認知復健工作的意義，並且提出一些建議供未來研究參考。

關鍵字

精神分裂症 ； 工作記憶 ； 認知復健 ； 精緻性複誦

並列摘要

This study was to investigate the effect of elaborative rehearsal skill training program at ameliorating deficits in verbal working memory in hospitalized patients with chronic schizophrenia. Fifty-sixth inpatients with chronic schizophrenia, thirty males and twenty-sixth females, were matched equally into two groups: the experimental group (treated with the elaborative rehearsal skill training: fifteen males and fourteen females) and the control group (treated with cognitive exercises: fifteen males and twelfth females). T-test analysis showed that experimental and control group had no significant group differences in age (40.00/37.78)、level of education (10.78/11.43) and MMSE scores (30.07/30.26)

The subjects’ scores on tests of verbal working memory and on the scales of psychiatric positive and negative symptoms were measured before and after the 12-session treatment. Assessment tools used by this study included scales of psychiatric positive and negative symptoms, Chinese version of Mini-Mental Status Examination (MMSE-C), Digit Span test, Zing’s scale of verbal working memory, the scale of instrumental verbal working memory of daily life, and Chinese version of memory scale (C-10) of Luria-Nebraska neuropsychological battery.

The result indicated that the brief 12-session course of cognitive remediation, either elaborative rehearsal skill training or cognitive exercise, was sufficient to benefit verbal working memory of inpatients with chronic schizophrenia and had some positive effects on psychopathology. The result confirmed feasibility of cognitive intervention in rehabilitation of inpatients with chronic schizophrenia; The questionnaires about memory strategies reflected that experimental group had improved on knowledge and use of memory strategies, it means that knowledge and use of memory strategies which meant cognitive intervention could improve knowledge and use of memory strategies in such patients, and improvement in such aspects of memory strategies had positive effects on their performance on verbal working memory tasks. However, the result cannot specifically point out whether the effect of elaborative rehearsal skill training was significantly better than the effect of cognitive exercise program.

並列關鍵字

cognitive rehabilitation ； elaborative rehearsal ； Schizophrenia ； working memory

參考文獻

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