透過您的圖書館登入
IP:44.215.110.142
  • 學位論文

憂鬱症患者認知易脆性與負向情緒持續之探討

Cognitive vulnerability and negative emotional persistence in depression

指導教授 : 洪福建

摘要


研究背景與目的. 近年雖然大多研究支持認知易脆性在憂鬱症形成和維持上的重要性,但仍有部分不一致的研究結果,並不支持這個假說。先前研究多使用自陳報告,所測量到的是外顯認知。然而個體的認知系統,可分成內隱和外顯兩個彼此獨立又相互關連的系統(Cunningham, Preacher & Banaji,2001; SchacteL 1987),且內隱認知對於外顯認知有相當影響,但個體往往未覺察。因目前少有研究將這兩個領域整合探討,故本研究引用Beevers(2005)的憂鬱症雙歷程模式,將認知易脆性分成內隱認知與外顯認知兩個角度,並做一整合性探討。此外,低落情緒的持續,常是憂鬱症形成之開端,也是聯結歷程的負向偏誤未被思考歷程適當修正之結果。Forgas(2002)提出雙歷程情緒調節模式,並證實一般正常個體的負向情緒會隨著時間,自動朝向正面情緒發展。此一結果,從Beevers(2005)的憂鬱症雙歷程模式來看,代表一般個體的負向情緒產生後,可引發思考歷程有效修正聯結歷程的負向偏誤,所以產生良好情緒。因此,本研究另一目的冀望從內隱歷程角度探討憂鬱症患者,是否有相同的情緒調節能力,即探討Beevers(2005)所謂引發思考歷程有效修正聯結歷程負向偏誤之能力。 研究方法. 分成兩個研究進行。研究一選取重度憂鬱症與憂鬱症緩解患者各9名,另外選取9名社區居民為控制組,比較三組在情緒觸發後,內隱認知與外顯認知之認知易脆性情況。研究二選取重度憂鬱症患者11名、憂鬱症緩解患者10名,以及10名社區居民為控制組,比較三組的情緒觸發後,負向句子比率在句子完成的前半部份與後半部份的比率。 研究結果. 研究一發現情緒觸發後,三組的外顯認知都沒有出現認知易脆性; 內隱認知方面,重度憂鬱症組和憂鬱症緩解組有認知易脆性出現,自我關連訊息 的正向自我偏誤大幅降低,但控制組沒有類似情況。研究二發現重度憂鬱症組和 憂鬱症緩解組的負向句子比率高於控制組;控制組後半部份的負向句子比率明顯 低於前半部分,但其他兩組前、後半部份的負向句子比率相似。 討論. 研究一證實重度憂鬱症組和憂鬱症緩解組的認知易脆性,雖然仍穩定存在於內隱歷程中並未消失,卻不一定會顯現於外顯認知上,且此認知易脆性和自我關連訊息之間的相關性高。研究二則證實重度憂鬱症組和憂鬱症緩解組的情緒調節能力不但比控制組差,且無法像控制組一樣,其正向情緒會隨著時間介入,以調節負向情緒。綜合上述結果,顯示重度憂鬱症組和憂鬱症緩解組聯結歷程的偏誤,長期以往,可能已形成負向偏誤的完成模式機制,且此機制在內隱聯結歷程上,因平時不容易為個體意識、知覺,更增添憂鬱症形成與維持風險。

並列摘要


Background and purpose. There were many studies tended to support the vulnerability of depression, despite a few studies that did not find support for these ideas. Most of studies used self-report, it measured is explicit cognition. But, implicit and explicit systems of cognition are distinct (Cunningham, Preacher & Banaji,2001; Schacte.L.,1987). Although individuals can not always aware, but implicit process will impact explicit process. Until now, few studies have tried to integrate these relatively independent lines of research. The purpose of present research is to recommend the dual process model of depression that proposed by Beevers(2005), and tried to examine the vulnerability of depression in implicit and explicit process. In addition, serious and persistent dysphoria will be at risk for depression, and dysphoric mood meaned that reflective processing does not adequately adjust biased associative processing. Forgas (2002) proposed the dual-process mood-management model and provided evidence to support that individual’s negative mood will turn to positive mood over time. When reflective processing adequately adjust biased associative processing, will produce euthymic mood means. The another purpose of present research is to examine the ability of emotional regulation of depression. Method. First research, 9 formerly depressed patients (FD) and 9 currently depressed patients(CD) were recruited from out-patient. Another 9 never-depressed participants(ND) were recruited from community. After mood introduction, the vulnerability of depression in implicit and explicit cognition were compared with three groups. Second research, 11 FD and 10 CD were recruited from out-patient. Another 10 ND were recruited from community. After mood introduction, the rate of negative sentences of first and later half were compared with three groups. Result. First study found that after mood introduction, explicit cognition of three groups all did not appear the cognitive vulnerability. About implicit cognition, FD and CD appeared the cognitive vulnerability and positive self bias decreased significantly, but ND did not. Second study found that the ratio of negative sentences in FD and CD, were higher than ND significantly. In ND, the ratio of later half of negative sentences was lower than the first half of negative sentences. But in FD and CD, the ratio of the first and later half of negative sentences were similarly. Discussion. First study demonstrated that although FD and CD did not show cognitive vulnerability in explicit process, but showed cognitive vulnerability in implicit process. In addition, the cognitive vulnerability was importance of negatively self-referent information. Second study demonstrated that negative mood could be adequately adjust in CD over time, but FD and CD did not. So, the ability of emotional regulation in ND was better than FD and CD. Integrating two studies, we argued that negatively associative processing bias became pattern completion mechanism over time. Although individuals did not aware of it, but the cognitive vulnerability in implicit process raised risk of onset and maintenance in depression.

參考文獻


陳學志、李威震、周泰安、卓淑玲 (2002)。以內隱聯結測驗(IAT)測量國人自尊
Miranda, J., Gross, J. J., Persons, J. B., & Hahn, J. (1998). Mood matters: Negative
Erber, M. W., & Erber, R. (2001). The role of motivated social cognition in the regulation of affective states. In J. P. Forgas (Ed.), The handbook of affect and social cognition. Mahwah, NJ: Lawrence Erlbaum.
prevention of relapse. In D. J. A. Dozois, & K. S. Dobson (Eds.), The prevention of anxiety and depression: Theory, research, and practice. Washington, DC: American Psychological Association Press.
Christine D. Scher, Rick E. Ingram,T, Zindel V. Segal(2005). Cognitive reactivity and

被引用紀錄


沈柏良(2015)。憂鬱反芻對於憂鬱個體於認知控制功能之影響〔碩士論文,中原大學〕。華藝線上圖書館。https://doi.org/10.6840%2fcycu201500360
余君庭(2011)。大學生情緒低落者正向與負向情緒調適之探討〔碩士論文,中原大學〕。華藝線上圖書館。https://doi.org/10.6840%2fcycu201100952
張凱評(2011)。以基模糾結模式探討憂鬱傾向之偏頭痛患者的解釋偏差〔碩士論文,中原大學〕。華藝線上圖書館。https://doi.org/10.6840%2fcycu201100794
李明姝(2010)。基督教教牧輔導對憂鬱傾向受輔者的影響歷程分析 ~~~以「內在治癒」模式為例〔碩士論文,中原大學〕。華藝線上圖書館。https://doi.org/10.6840%2fCYCU.2010.00581

延伸閱讀