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  • 學位論文

青少年憂鬱症狀變化與生活事件數目之探討:短期追蹤及人格面向的影響

The relationship between life events and the change of depressive symptoms in adolescents: effects of personality traits in a short-term follow-up study

指導教授 : 楊浩然

摘要


目的:本研究探討青少年憂鬱症狀與生活事件之相關,並就不同人格面向青少年在憂鬱症狀程度變化與事件數量增減的關聯性加以分析。 方法:透過以學校為基礎(school-based)的設計,在彰化縣市高中職學校中採行多階段抽樣程序(multistage sampling procedure)進行樣本收集(N=3065)。同時為釐清青少年憂鬱症狀程度變化與生活事件數量增減之相關,研究以縱貫方式進行觀察。在追蹤間隔約半年的前、後時間點,以流行病學研究中心憂鬱量表(Center for Epidemiologic Studies-Depression Scale, CES-D)、生活事件檢核表(Life Event Checklist, LEC),及艾氏少年人格量表(Junior Eysenck Personality Questionnaire, JEPQ)進行問卷施測。憂鬱症狀的變化情形及周遭生活事件數目的增減,以「追蹤結果」減「基線結果」的差值來表示;而人格高、低程度的區別,則將分數較高的前10%的人定義為程度較高,另外90%則為程度較低。填答結果有遺漏值的部分則採多重填補(multiple imputation)的方式進行補填,最終將保有基線與追蹤完整資訊2297人納入分析。分析程序上先以描述性統計說明樣本特性,再進行獨立樣本t檢定、單因子變異數分析(one-way ANOVA)及薛費氏事後比較(Scheffe post-hoc method)檢定上述量表於人口學變項之差異,並為考量基線與追蹤之兩波問卷填答結果一致性,以配對t檢定(paired t-test)檢定之。此外在藉由皮爾森淨相關(Partial coefficient of correlation)了解各量表之間的相關後,於不同人格面向下,使用迴歸分析去探討青少年憂鬱症狀程度與周遭生活事件多寡之相關,及追蹤前、後之間其症狀程度改變所對應的生活事件數目增減之情形。 結果:高神經質較低神經質之青少年具較高的憂鬱症狀程度。高神經質青少年只在周遭衍生性事件數增減時與憂鬱症狀程度之變化呈現相關,當事件性質屬於負向(斜率=1.1597, p<0.0001)為正相關,若屬於正向(斜率=-0.8170, p=0.002)則有緩衝作用;而低神經質青少年在周遭負向事件數增減時,無論是獨立性(斜率=0.5412, p<0.0001)或衍生性(斜率=1.0013, p<0.0001)事件都與憂鬱症狀程度之變化呈現正相關。內向人格較外向人格之青少年具較高的憂鬱症狀程度。內、外向人格青少年均在周遭負向事件數增減與憂鬱症狀程度之變化呈現正相關,無論事件是獨立性(斜率=0.3653, p=0.0021;斜率=0.8798, p<0.0001)或衍生性(斜率=1.0220, p<0.0001;斜率=1.1766, p<0.0001)。低精神病質青少年中周遭負向衍生性事件多者比少者在憂鬱症狀程度的差異大於高精神病質者。低精神病質青少年在周遭負向事件數增減時,無論事件是獨立性(斜率=0.5442, p<0.0001)或衍生性(斜率=1.1956, p<0.0001)都與憂鬱症狀程度之變化呈現正相關;高精神病質青少年只在周遭負向衍生性事件(斜率=0.5395, p=0.032)數增減時與憂鬱症狀程度之變化呈現正相關。 結論:本研究發現青少年憂鬱症狀與生活事件之相關會被人格特質所修飾,使得負向事件為低神經質青少年罹患憂鬱之關鍵,而高神經質青少年除了是罹患憂鬱的高危險群,其也易招致負向衍生性事件來提高罹患憂鬱的危險性;負向事件為外向人格青少年罹患憂鬱之關鍵,而內向人格青少年除了是罹患憂鬱的高危險群,隨周遭負向衍生性事件的發生也將提高罹患憂鬱的危險性。負向事件為低精神病質青少年罹患憂鬱之關鍵,尤其是負向衍生性事件,此可由低精神病質青少年在負向衍生性事件增減所反映的憂鬱症狀程度變化大於高精神病質者得知。

並列摘要


Objectives: To examine the relationship between depressive symptoms and life events in adolescents with different levels of personality traits. Methods: Participants were ascertained by a school-based design in 4 high (vocational) schools of Chunghua (N=3065) using the multistage sampling procedure. In addition, in order to examine the relationship between the change of depressive symptoms and life events, this study was conducted by a longitudinal approach in a period of 6 months. All participants self-administered the Center of Epidemiologic Studies-Depression Scale (CES-D), the Life Event Checklist (LEC), and the Junior Eysenck Personality Questionnaire (JEPQ) in each of the two waves. The changes of depressive symptoms and life events were calculated by the differences between values of baseline and follow-up. In addition, the level of personality trait were categorized by the cutoff of 10%, which means that individuals with personality score of 10% high were designated as high personality trait whereas the rests were low. The missing values were imputed by the Multiple Imputation procedure of SAS software. Thus, a number of and 2297 participants with complete information of both baseline and follow-up were included for analyses in this study. The statistical strategies were 1) to account sample characteristics by using descriptive statistical method, 2) to examine the differences of demographic variables by using t test, one-way ANOVA, and Scheffe post-hoc method, and then 3) to examine the consistency between the responses of baseline and follow-up by using paired t test. Moreover, after using Pearson Correlation Coefficients to examine the correlations between these scales, simple regression analysis was also used for examining the relationship between the depressive symptoms and life events in adolescents by different domains of personality traits. Results: Adolescents with high neuroticism personality had higher degree of depressive symptoms than those with low neuroticism personality. The change of depressive symptoms in adolescents with high neuroticism personality was correlated with that of dependent life events only. It exhibited positive correlation in negative life events (slope=1.1597, p<0.0001) and protective effect in positive life events (slope=-0.8170, p=0.002). For low neuroticism personality adolescents, both independent (slope=0.5412, p<0.0001) and dependent (slope=1.0013, p<0.0001) life events were positively correlated with the change of depressive symptoms. Adolescents with low extrawersion personality had higher degree of depressive symptoms as compared to those with high extraversion. The depressive symtoms were positively correlated with negative life events, regardless of independent (slope=0.3653, p=0.0021; slope=0.8798, p<0.0001) or dependent (slope=1.0220, p<0.0001; solid=1.1766, p<0.0001). Adolescents with low psychoticism personality had higher degree of depressive symptoms as compared to those with high psychoticism. The depressive symtoms were positively correlated with negative life events, regardless of independent (slope=0.5442, p<0.0001) or dependent (slope=1.1956, p<0.0001). The change of depressive symptoms in adolescents with high psychoticism personality exhibited positive correlation with negative dependent life events only (slope=0.5395, p=0.032). Conclusions: The main finding of this study is that the relationship between depressive symptoms and life events in adolescents was moderated by personality trait. Negative life events were the pivotal risk factors of depression in adolescents with low neuroticism personality. Adolescents with high neuroticism personality were the high-risk population of depression. They exhibit increased risk to have depression because easy to suffer from negative dependent life events. Additionally, negative life events were the key risk factors of depression in adolescents with extroverted personality. Adolescents with low extraversion personality were at high-risk on depression. The risk will increases when negative dependent life events occur. Negative life events were potent risk factors of depression in low psychosis personality adolescents, especially in negative dependent life events. In addition, adolescents with low psychoticism personality were in response to higher degree of depressive symptoms because of negative dependent life events than those with high psychosis personality.

參考文獻


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被引用紀錄


黃聖雄(2009)。青少年人格特質與行為問題之關係:生活事件類型的中介作用及憂鬱狀態的修飾作用〔碩士論文,中山醫學大學〕。華藝線上圖書館。https://doi.org/10.6834%2fCSMU.2009.00161
林勻筑(2014)。傾聽內在心世界- 內向性格學生的自我認同與禪修實踐〔碩士論文,國立中正大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0033-2110201614002539
曾堉桁(2017)。跨區域青少年心理健康調查研究-台灣澳門二地青少年心理健康比較〔碩士論文,中山醫學大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0003-3008201715091100

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