述情障礙與創傷後壓力症狀對受虐青少年自傷行為預測效果之探討 摘 要 研究背景與目的:根據內政部兒童局在2007年兒少福利數據顯示國內受虐青少年共計4648人,且為歷年來創新高,而國內有關青少年受虐的心理病理及歷程的相關研究較少,受虐青少年問題,是值得被重視。童年遭受過性侵害、身體虐待者易出現自傷行為,但曾經有受虐創傷經驗的個體不一定出現自傷行為,亦即童年時期的受虐創傷經驗與自傷行為的出現雖然有關,兩者之間並非是因果關係。本研究採用情緒管理模式探討受虐青少年之自傷行為;目的為驗證青少年受虐創傷經驗與自傷行為之間的發展歷程,述情障礙對此二者的影響。 研究方法:本研究根據立意取樣方式決定參與之受試者,實驗組為收容機構之受虐青少年與社區之受虐青少年共計181人;對照組為其他創傷事件之青少年共計318人。研究工具為問卷的形式,共包含五個部份分別為:個人基本資料、「台灣版多倫多述情量表」、「情緒調節困難量表」、「自我傷害量表」、「UCLA創傷後壓力症狀量表」。 研究結果:研究結果發現在實驗組的受試者其創傷後壓力症狀嚴重度、包括再經歷症狀、迴避/麻木症狀與過度警醒症狀可顯著預測受虐青少年的自傷行為;在「述情障礙總分」與「辨識與表達情緒困難」可顯著預測自傷行為;而「辨識與表達情緒困難」在「再經歷症狀」預測自傷行為的關係中具有部份中介效果;此外,「辨識與表達情緒困難」在「過度警醒症狀」預測自傷行為的關係中具有部份中介效果。 討論:證實受虐創傷經驗之青少年創傷壓力症狀嚴重度預測自傷行為以及述情障礙預測自傷行為的關係存在,也證實述情障礙具部份中介效果。顯示受虐創傷經驗之青少年,若創傷後壓力症狀越嚴重則出現自傷行為的可能性亦越高,且自傷行為頻率會隨創傷後壓力症狀之嚴重度而增加。此外,青少年受虐創傷經驗易使他們發展出不適切的情感調節與述情障礙,當個體在辨認與描述情緒有困難時,易將這些情緒狀態轉換成行動而出現自傷行為。故受虐青少年的述情障礙程度在自傷行為中扮演重要的中介角色,因此,心理專業人員在協助此類個案時,提昇其情緒辨識與表達的能力,將可有效改善個案的心理適應。
Abstract According to Children Bureau Ministry of Interior R.O.C (CBI) data . In 2007, it is rank top one of childhood abuse. In reality , there are only few paper study this subject in demestic, so it is worth of studying. Prior research consistently has shown a strong relation between childhood abuse and self-injury, yet it is unclear why this relation exists,This paper adapt the affect regulation model to investigate the development of childhood abuse and self-injury and alexithymia influence to both of them. This survey consists two group for comparison.The clinical group has 181 persons who come from protective institution and community childhood abuse teenager. The nonclinical group has 318 persons who come from community for other trauma event. The survey tool is questionnaire including personal data , the Taiwan version of Toronto Alexithymia Scale-20、Difficulties in Emotion Regulation Scale、Deliberate Self-Harm Inventory 、UCLA-PTSD Reaction INDEX for DSM-IV. Tesults support a link between a history of childhood maltreatment and self-injury among dolescence and the hypothesis that alexithymia mediates this relationship. Therefore, phycologist can effective improve patient mental adaption by enhancing the ability of mood distinguish and express while handling the case. Results of the present study potentially have important implications in terms of intervention with this vulnerable group.