高職特教班心智障礙學生的焦慮與焦慮等值行為之研究

The Study of the Anxiety and the Behavioral Equivalents of Anxiety of Students with Intellectual Disabilities in the Public Vocational Schools

黃裕惠(Yuhuei, Huang)

指導教授 ： 林幸台

國立臺灣師範大學/教育學院/特殊教育學系/博士(2011年)

摘要

一般人常認為心智障礙學生是無憂無慮，但是否真的如此?當心智障礙學生焦慮時，心智障礙學生會表現在甚麼部分?本研究目的旨在透過調查心智障礙學生的焦慮與問題行為，建構高職特教班心智障礙學生的焦慮等值行為。研究分為三個研究問題，一是探究心智障礙學生的焦慮現況；二是探究問題行為和焦慮之關聯；三為以問題行為預測焦慮與憂鬱，確認焦慮等值行為。
本研究以台北市與新北市共263名高職特教班心智障礙學生為對象，以學生自陳量表、訪談心智障礙學生以及教師評量問題行為，探究心智障礙學生的焦慮及其與問題行為的關聯。主要的發現有：
一、高職特教班心智障礙學生焦慮分數顯著高於一般同儕，約有四成六符合焦慮標準（以下簡稱為焦慮組，低於焦慮標準的心智障礙學生則為一般組）。若將標準提高到中度焦慮之標準，則有三成一符合焦慮標準（以下簡稱為高分組）。
二、焦慮組與一般組出現率達顯著差異之部分包括焦慮心智障礙學生較擔憂發生恐怖的事情、擔憂自己的外表、別人不喜歡自己，恐懼狗，以及較多腸胃常不舒服、心跳很快以及快要呼/喘不過氣等生理反應。
三、焦慮組約有六成有焦慮與憂鬱共存之現象。焦慮組符合憂鬱比例高於一般組，心智障礙女生符合憂鬱比例高於心智障礙男生。
四、焦慮組問題行為和焦慮有顯著正相關，但一般組無此相關；以憂鬱為共變項與否，影響心智障礙學生的問題行為和焦慮的關聯。
五、焦慮組與一般組有8項問題行為平均數達顯著差異，以8項問題行為總分診斷焦慮與憂鬱並無差異。以憂鬱為共變項，全體心智障礙學生的問題行為和焦慮達顯著相關有10項問題行為。以此10項行為預測焦慮優於預測憂鬱，且10項問題行為總分診斷焦慮之準確性顯著優於診斷憂鬱之準確性，故為本研究之焦慮等值行為。
六、高分組的焦慮等值行為總分達顯著高於一般組、低分組，焦慮組的焦慮等值行為也高於一般組、低分組；但憂鬱組與非憂鬱組的焦慮等值行為並無顯著差異。
綜合本研究結果與討論，提出下列結論:
一、本研究結果支持自陳方式，輔以適當的協助，就能以自陳方式於評量心智障礙學生的焦慮；心智障礙學生自陳的焦慮和教師評量之問題行為結果有顯著相關，顯示評量心智障礙學生的問題行為可做為評量焦慮的方式之一。
二、心智障礙學生的焦慮高於一般同儕，焦慮內容反應其心理年齡落後生理年齡之事實。焦慮組符合憂鬱標準高於一般組；焦慮組的憂鬱分數不見得高，但符合憂鬱切截點之心智障礙學生，焦慮分數通常偏高。
三、心智障礙學生問題行為和焦慮關聯有三個可能性，一是焦慮反應在問題行為，有所謂的焦慮等值行為；二是中重度焦慮心智障礙學生的問題行為顯著較高，提供焦慮為問題行為的情境事件之證據；三是照顧者對問題行為的立即反應與心智障礙者問題行為之研究，間接提供焦慮使問題行為變成操作行為之證據。
基於研究結果與發現，本研究進一步提出評量心智障礙學生的焦慮與焦慮等值行為之實務運用以及未來研究的相關建議。

關鍵字

心智障礙學生 ； 焦慮 ； 焦慮等值行為 ； 問題行為 ； 焦慮與憂鬱

並列摘要

Abstract
Individuals with intellectual disabilities are viewed as careless and non-anxious, but it is true? If the students with intellectual disabilities (SID) are anxious, what make them different with other individuals with intellectual disabilities? The purpose of the study is to investigate the anxiety levels and problem behaviors of SID and the behavioral equivalents of anxiety. There are two parts in the study, one is to explore the anxiety levels of SID and compare the results with those of the normal peers, and the other is to analyze the anxiety score with the individual problem behavior and figure out the specific problem behaviors that the anxious SID displaying more than the non-anxious SID.
The subjects are 266 SID that enrolled in special classes of 10 vocational schools in Taipei and New Taipei City participating the study. The data are collected by the self-report, interviewing students with intellectual disabilities, and the problem behavior scale. There are 263 valid cases. Major findings are as following: 1. Students with intellectual disabilities are more anxious than the normal peers, and 46% are anxious. 2. The anxious students with intellectual disabilities, comparing to the non-anxious students with intellectual disabilities, have more symptoms of uncomfortable stomach. The items in the interview that differential the anxious students with intellectual disabilities with other students with intellectual disabilities are worrying something awful to happen, own appearance, classmates disliking me, fearing dogs, heart beating faster, uncomfortable stomach, and feeling breathless. 3. Among the anxious students with intellectual disabilities, about 60% are above the cut score of depression, higher than other students with intellectual disabilities. The percentage of girls with intellectual disabilities that the scores are above the cut score of depression is higher than boys’. 4. The problem behaviors of anxious students with intellectual disabilities and their anxiety scores are significantly positive related, but the problem behaviors of non-anxious students with intellectual disabilities are not related to their anxiety scores. 5. Depression as a covariate, 10 problem behaviors and the anxiety scores reach a significantly positive relationship. Ten problem behaviors, having better accuracy in prediction anxiety, not depression, are as the behavioral equivalents of anxiety. 6. The scores of behavioral equivalents of anxiety (BEA) of anxious students with are higher than
Based on the abovementioned results, the conclusion are drawn as following: 1. Self-report methods, with some accommodations, are available to assess the anxiety of students with intellectual disabilities. The correlation of some problem behaviors and the anxiety scores is significantly positively related. The problem behaviors are a resource of anxiety. 2. Students with intellectual disabilities are more anxious than their peers. The worries and objects making SID anxious reflect the fact that their mental age is left behind their age. The percentage of the anxious students with intellectual disabilities who are also depressed is higher than the non-anxious students with intellectual disabilities. The depression scores of the anxious students with intellectual disabilities are not necessarily high, but the anxiety scores of the depressed students with intellectual disabilities are also high. 3. There are three possible hypotheses of the problem behavior and the anxiety scores. One is that there are possible behavioral equivalents of anxiety; the second is that the anxiety is a setting events; the last one is that the anxiety accidently makes problem behaviors operant behaviors.
The recommendations of future studies and applications on anxiety and behavioral equivalents of anxiety are made based on the results.

並列關鍵字

intellectual disabilities ； anxiety ； behavioral equivalents of anxiety ； problem behaviors ； anxiety and depression

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