臺灣博碩士論文加值系統

研究目的：探討憂鬱個案持續憂鬱及引發憂鬱的因素，其中包括個案對外在壓力 的感受、負向思考習慣型態及認知監控力與心智專注覺察。進一步，在臨床上實證內觀認知心理治療能有效改善憂鬱。

研究方法：研究一，以門診憂鬱症個案為研究對象，共有102位研究參與者。每位研究參與者皆填寫五份問卷，其中包括基本資料調查表、貝克憂鬱量表、負向自我思考習慣量表、心智專注覺察量表、自我監控覺察量表。問卷資料根據研究目的以單因子變異數分析、多元階層迴歸進行假設考驗。研究二，以門診憂鬱症個案為研究對象，並依臨床醫師確診憂鬱症狀已緩解三個月以上，研究參與者共有10位。研究參與者參與八週內觀認知團體治療，團體開始前與八週團體後，研究參與者皆須填寫研究一使用的五份問卷，以檢驗團體對憂鬱程度的影響，問卷資料根據研究目的以重複樣本t檢定的平均數差異考驗進行假設考驗。

研究結果：研究一結果不支持心智專注覺察是負向自我思考習慣影響憂鬱程度的調節變項，亦不支持自我監控覺察是負向自我思考習慣影響憂鬱程度的調節變項。進一步檢驗中介效果時，結果發現心智專注覺察在負向自我思考習慣對憂鬱程度的影響上有部分中介效果，自我監控覺察在負向自我思考對憂鬱程度的影響有部分中介效果。研究二結果發現憂鬱程度、心智專注覺察、自我監控覺察在內觀認知治療團體前與團體後有顯著的差異，負向自我思考習慣差異接近顯著，主觀壓力感受方面則沒有差異。

結論：在本研究的門診憂鬱症個案中，當個案有負向自我思考時，憂鬱程度會增加，若加入心智專注覺察，則可以降低憂鬱程度；若加入自我監控覺察亦可降低憂鬱程度。心智專注覺察與自我監控覺察在負向自我思考習慣對憂鬱程度上有部分中介效果。而內觀認知治療可以增加個案的心智專注覺察及自我監控覺察，並降低憂鬱程度。

Objective: From cognitive strategies view points to test the maintenance factors of depression, including the subjective stress feelings, the habits of negative self-thinking, mindful attention awareness and self- metacognition were selected in our research .Further more in view of the clinical evidence of mindfulness-based cognitive therapy whether improve depression or not.
Research Methods: Study 1 total of 102 outpatients with major depression referred by psychiatrist were invited in our study. Each study’s participant completed all five questionnaires, including basic information questionnaire, Beck Depression Inventory II, the habit index of negative thinking, mindful attention awareness scale, self-metacognition awareness scale. Based on the purpose of the questionnaire data to a single factor analysis of variance, multiple hierarchical regression analysis to test hypothesis. Study 2, the participants were outpatient of depression but should be with remission of depressive symptoms more than three months. Ten participants attended eight weeks of mindfulness-based cognitive group therapy. Before and eight weeks after the study participants were required to complete a study of the five questionnaires were used to test the improvement of group therapy on the level of depression.
Results: study 1 results did not support mindful attention awareness played the moderated role between the habits of negative self-thinking and depression, and also do not support self metacognition moderated the relation between the habits of negative self-thinking and depression. Further examination mediate effects, mindful attention awareness is part of mediated the relation between the habits of negative self-thinking and depression, and self metacognition is also part of mediated the relation between the habits of negative self-thinking and depression. Study 2 found that level of depression, mindful attention awareness, self metacognition in group therapy has been found there were significant improvement differences between before and after group measurement and in negative self-thinking habit close to significant differences, in the subjective perception of stress while there is no difference.
Conclusion: In this study depressive clients, when cases who has ability of mindful attention awareness although their negative self-thinking induced depression, she or he will try to regulate her or his view to the present and could stop the negative loop and the inclusion of self-metacognition can also reduce the level of depression. Mindful attention awareness or self metacognition could mediate the negative thinking habits to the degree of depression so they played on the part of the intermediating results. Finally our research also suggested the mindfulness-based cognitive therapy can increase mindful attention and self-metacognition awareness and reduce the level of depression.
Keywords: depression, the habits of negative self-thinking, mindful attention awareness, self-metacognition, mindfulness-based cognitive therapy.

目錄
第一章 研究動機與目的………………………………………………………1
第一節 研究動機 …………………………………………………………… 1
第二節 研究目的 …………………………………………………………… 3

第二章 文獻探討 ………………………………………………………………4
第一節 憂鬱症 ……………………………………………………………… 4
第二節 憂鬱的認知模式 …………………………………………………… 7
第三節 憂鬱症復發及認知因子 …………………………………………10
第四節 心智專注覺察與內觀認知心理治療 ……………………………… 17
第五節 研究架構與假設………………………………………………………21

第三章 研究方法………………………………………………………………25
研究一 憂鬱症的心理病理模式
第一節 研究對象………………………………………………………………25
第二節 研究工具………………………………………………………………25
第三節 資料分析………………………………………………………………28
研究二 內觀認知團體的療效研究
第一節 研究對象………………………………………………………………29
第二節 研究工具………………………………………………………………29
第三節 研究程序………………………………………………………………29
第四節 資料分析………………………………………………………………30

第四章 研究結果………………………………………………………………31
研究一
第一節 樣本描述………………………………………………………………31
第二節 人口背景變項在研究變項上的差異性與相關………………………33
第三節 研究架構中各變項對憂鬱的預測力…………………………………39
第四節 心智專注覺察在負向自我與憂鬱程度之間的調節效果…… …… 42
第五節 自我監控覺察在負向自我與憂鬱程度之間的調節效果………… 43
研究二
第一節 樣本描述………………………………………………………………45
第二節 團體前後各研究變項的差異…………………………………………46

第五章 研究討論與建議………………………………………………………48
第一節 人口背景變項在各研究變項上的差異討論…………………………48
第二節 各研究變項之間的相關性討論………………………………………49
第三節 各研究變項對憂鬱程度預測力討論…………………………………50
第四節 認知策略對憂鬱程度的調節作用……………………………………51
第五節 研究架構的修訂與討論………………………………………………55
第六節 內觀認知治療團體療效討論…………………………………………56
第七節 研究限制與建議………………………………………………………56

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