臺灣博碩士論文加值系統

研究背景：經前症候群為婦女於月經來潮前所經驗情緒、生理、行為之改變，許多研究證據顯示經前症候群和其他精神疾病之關聯性，且症狀可由青春期持續至成人。過去對經前症候群盛行率之研究多著重於成年女性，以年輕女性所做盛行率調查有樣本數太少或不具代表性之問題。
經前症候群成因迄今尚無定論，不同亞型可能具不同性格特質、認知功能及生物學過程，以亞型探討有助了解成因。易怒與憂鬱乃經前最相關症狀，常合併出現，是否為共病值得探討。諸多證據支持性格為情感性疾患之脆弱因子，過去以性格五因素模式探討經前症候群者性格，僅見於神經質向度，然其他性格向度亦和幾種情感性疾患相關。
研究目的：.探討大學一年級女生經前症候群盛行率、症狀表現、亞型分類，並以性格五因素模式探討經前症狀表現為非典型憂鬱合併敵意憂鬱型、非典型憂鬱型、敵意憂鬱型、其他憂鬱表現型、非憂鬱型之性格特質。
研究方法：以台灣地區大學一年級女生為對象，分北中南三區各抽取二所學校中三至四個班級女生，以「經前評估量表」及「五因素性格問卷」施測，共獲有效樣本809位。依「經前評估量表」亞型分類法區分亞型。
研究結果︰受試者中68.5%經前只有極少之症狀改變， 25.9%有輕度症狀改變，4.9%有中度症狀改變，0.7%有重度症狀改變。在分量表得分嚴重度以疲倦為最高，其次為社交退縮、一般生理不適、非典型憂鬱、情緒不穩定；單一症狀上腹部不適、疼痛最常見，其次為渴望某類食物、活力減少。在亞型分類上，合於重鬱或輕鬱症候群亞型分類準則者中，以非典型憂鬱型居多，退縮憂鬱型及敵意憂鬱型次之，較少的為焦慮憂鬱型及歇斯底里憂鬱型，在327位符合重鬱或輕鬱症候群受試者中，有185位(56.6%)至少同時合乎二種亞型。
五組受試者在性格特質上之差異僅見於「非典型憂鬱合併敵意憂鬱型」及「非典型憂鬱型」二組在神經質向度上得分顯著高於「非憂鬱型」，其餘不同組別間在外向性、開放性、親和性、嚴謹性等向度上均無顯著差異。
結論：台灣地區大學一年級女生經前症狀並不嚴重，經前生理、情緒均受影響。憂鬱症候群亞型分類中，以非典型憂鬱型居多，一位受試者可能同時合乎數種亞型，顯示經前症狀之多樣性，及亞型分類準則症狀嚴重度要求應提高。不同亞型之性格特質僅在神經質向度上，以具非典型憂鬱者和其他類型有顯著差異，顯示神經質在性格上扮演影響經前憂鬱症狀之主要角色，性格確為情感性疾患之脆弱因子。

摘 要……………………………………………………….....................I
誌 謝…………………………………………………….....................III
主目錄…………………………………………………….......................V
表目錄……………………………………………………........................VII
第一章 緒論………………………………………………..........................1
第一節 經前症候群之定義……………………………............................1
一、 一般定義………………………………………...…........................1
二、 症狀…………………………………………...................................1
三、 相關障礙診斷準則……………………………................................2
第二節 經前症候群與其他精神疾病之關係…………............................3
第三節 經前症候群盛行率…………………………......................….....5
第四節 經前症候群可能成因或危險因子……………………………….8
第五節 經前症候群亞型分類…………………………………………...10
第六節 經前症候群與性格特質………………………………………...12
一、 性格五因素模式………………………………………………...12
二、 性格特質為情感性疾患之脆弱因子…………………………...14
三、 經前症候群者之性格表現……………………………………...15
四、 經前症候群亞型者之性格特質………………………………...18
第七節 研究目的………………………………………………………...21
第二章 研究方法…………………………………………………..22
第一節 研究對象……………………………………………………….22
第二節 研究工具……………………………………………………….22
第三節 資料收集分類與統計………………………………………….26
第三章 研究結果………………………………………………….28
第一節 受試者基本資料………………………………………………28
第二節 經前症候群盛行率……………………………………………29
第三節 經前症候群不同亞型分類結果………………………………30
第四節 經前症候群不同亞型者性格特質差異………………………30
第四章 討論……………………………………………………….32
第一節 受試者基本資料之探討………………………………………32
第二節 經前症候群盛行率之探討……………………………………33
第三節 經前症候群亞型分類之探討…………………………………34
第四節 經前症候群不同亞型者性格特質差異之探討………………35
第五節 研究限制及未來方向…………………………………………37
第六節 結論……………………………………………………………38
參考文獻…………………………………………………………….39
表…………………………………………………………………….47
附錄一 經前評估量表…………………………………………….60
附錄二 經前評估量表分量表內容……………………………….66
附錄三 經前評估量表最大可能分數百分比計分法…………….68
附錄四 經前評估量表亞型分類準則…………………………….69
附錄五 五因素性格問卷………………………………………….72
附錄六 研究對象同意書………………………………………….75

孔繁鐘 編譯。（2000）。DSM-IV精神疾病的診斷與統計。台北市：合記圖書出版社。
周勵志、江美珠、孫樂潁（民82）。某中型綜合醫院護理人員經前緊張症候群及其相關因素之調查研究。公共衛生，20卷1期，99-109頁。
周勵志（民83）。大專女學生月經週期身心症狀調查研究。公共衛生，20卷4期，343-352頁。
陳淑月（民73）。中部地區五專女生經期不適及其相關因素之探討。公共衛生，11卷3期，360-375頁。
郭倩琳、史麗珠、徐麗華、李選（民86）。台灣地區護理人員經前不適症狀之調查。護理研究，5卷2期，149-158頁。
張麗滿。（1999）。「經前症狀與生活壓力感受的關聯性：前瞻性逐日記錄之研究取向」台灣大學心理所碩士論文。
詹淑敏、陳宜君（2001）。青少女經前症候群相關因素之初探。長榮學報，5卷1期，135-149頁。
Abraham, G.E. (1983). Nutritional factors in the etiology of the premenstrual tension syndrome. Journal of Reproductive Medicine. 28, 446-464.
Angst, J., Sellaro, R., Stolar, M., Merikangas, K.R., Endicott, J. (2001). The epidemiology of perimenstrual psychological symptoms. Acta Psychiatrica Scandinavica, 104, 110-116.
Anson, O. (1999). Exploring the bio-psycho-social approach to premenstrual expriences. Social Science & Medicine, 49, 67-80.
Arpels, J.C. (1996). The female brain hypoestrogenic continuum from the premenstrual syndrome to menopause. The Journal of Reproductive Medicine, 41, 633-639.
Bagby, R.M., Young, L.T., Schuller, D.R., Bindseil, K.D., Cooke, R.G., Dickens, S.E., Levitt, A.J., Joffe, R.T. (1996a). Bipolar disorder, unipolar depression and the five-factor model of personality. Journal of Affective Disorders, 41, 25-32.
Bagby, R.M., Schuller, D.R., Levitt, A.J., Joffe, R.T., Harkness, K.L. (1996b). Seasonal and non-seasonal depression and the five-factor model of personality. Journal of Affective Disorders, 38, 89-95.
Berlin, R.E., Raju, J.D., Schmidt, P.J., Aadms, L.F., Rubinow, D.R. (2001). Effects of the menstrual cycle on measures of personality in women with premenstrual syndrome: a preliminary study. Journal of Clinical Psychiatry, 62, 337-342.
Boyce, P., Parker, G., Barnett, B., Cooney, M., Smith, F. (1991). Personality as a vulnerability factor to depression. British Journal of Psychiatry, 159, 106-114.
Burt, V.K. & Stein, K. (2002). Epidemiology of depression throughout the female life cycle. Journal of Clinical Psychiatry, 63 (supplement 7), 9-15.
Campbell, E.M., Peterkin, D., O’Grady, K., Sanson-Fisher, R. (1997). Prememstrual symptoms in general practice patients. The Journal of Reproductive Medicine, 42, 637-646.
Chisholm, G., Jung, S.Q.J., Cumming, C.E., Fox, E.E., Cumming, D.C. (1990). Premenstrual anxiety and depression: comparison of objective psychological tests with a retrospective questionnaire. Acta Psychiatrica Scandinavica, 81, 52-57.
Chuong, C.J., Colligan, R.C., Coulam, C.B., Bergstralh, E.K. (1988). The MMPI as an aid in evaluating patients with premenstrul syndrome. Psychosomatics, 29, 197-202.
Clark, L.A., Watson, D., Mineka, S. (1994). Temperament, personality, and the mood and anxiety disorders. Journal of Abnormal Psychology, 103, 103-116.
Cleckner-Smith, C.S., Daughty, A. S., Grossman, J.A. (1998). Premenstrual symptoms-prevalence and severity in an adolescent sample. Journal of Adolesent Health, 22, 403-408.
Cohen, L.S., Soares, C.N., Otto, M.W., Sweeney, B.H., Liberman, R.F., Harlow, B.L. (2002). Prevalence and predictors of premenstrual dysphoric disorder (PMDD) in older premenopausal women. Journal of Affective Disorders, 70, 125-132.
Costa, P. T., McCrae, R.R. (1992). NEO PI-R & NEO-FFI Professional Manual. Odessa, Psychological Assessment Resources.
Corney, R.H., Stanton R. (1991). A survey of 658 women who report symptoms of premenstrual syndrome. Journal of Psychosomatic Research, 35, 471-482.
Critchlow, D.G., Bond, A.J., Wingrove, J. (2001). Mood disorder history and personality assessment in premenstrual dysphoric disorder. Journal of Clinical Psychiatry, 62, 688-693.
Diagnostic and Statistical Manual of Mental Disorder, 4th edition APA, 1994 /DSM- IV
Dooley, M.M Pre-menstrual syndrome. In Dooley, M.M., Brincat, M.P. eds. (1994). Understanding common disorders in reproductive endocrinology. John Wiley & Sons Ltd. 111-122.
Endicott, J., Amsterdam, J., Eriksson, E., Frank, E., Freeman, E., Hirschfeld, R., Ling, F., Parry, B., Pearlstein, T., Rosenbaum, J., Rubinow, D., Schmidt, P., Severino, S., Steiner, M., Stewart, DE., Thys-Jacobs, S. (1999). Is premenstrual dysphoric disorder a distinct clinical entity? Journal of Women’s Health Gender-Based Medcine, 8, 663-679.
Fisher, M., Trieller, K., Napolitano, B. (1989). Premenstrual symptoms in adolescents. Journal of Adolescent Health Care, 10, 369-375.
Fontana, A. M., Badawy, S. (1997). Perceptual and coping processes across the menstrual cycle: An investigation in a premenstrual syndrome clinic and a community sample. Behavior Medicine, 22, 152-159.
Frackiewicz, E.J., Shiovitz, T.M. (2001). Evaluation and management of premenstrual syndrome and premenstrual dysphoric disorder. Journal of the American Pharmaceutical Association, 41, 437-447.
Freeman, E.W., Schweizer, E., Rickels, K. (1995). Personality factors in women with premenstrual syndrome. Psychosomatic Medicine, 57, 453-459.
Gershuny, B.S., & Sher, K.J. (1998). The relation between personality and anxiety:
findings from a 3-year prospective study. Journal of Abnormal Psychology, 107, 252-262.
Glen, H., Gruba, G.H., Rohrbaugh, M. (1975). MMPI correlates of menstrual distress. Psychosomatic Medicine, 37, 265-273.
Graze, K.K., Nee, J., Endicott, J. (1990). Premenstrual depression predicts future major
depressive disorder. Acta Psychiatrica Scandinavica, 81, 201-205.
Gunderson, J.G., Triebwasser, J., Phillips, K.A., Sullivan, C.N. Personality and vulnerability to affective disorders. In Cloninger, C.R. eds.(1999). Personality and Psychopathology. American Psychiatric Press, Inc. Washington, DC 3-32.
Halbreich, U., Endicott, J. The classification of the premenstrual syndromes. In Friedman, R. ed. (1982a). Behavior and the menstrual cycle. Marcel Deckker, Inc., New York. 243-265.
Halbreich, U., Endicott, J., Nee, J. (1982b). The diversity of premenstrual changes as reflected in the Premenstrual Assessment Form. Acta Psychiatrica Scandinavica, 65, 46-65.
Halbreich, U., Endicott, J., Nee, J. (1983). Premenstrual depressive changes─value of differentiation. Archives of General Psychiatry, 40, 535-542.
Halbreich, U. (1997). Premenstrual dysphoric disorders: a diversified cluster of vulnerability traits to depression. Acta Psychiatrica Scandinavica, 95, 169-176.
Hallman, L., Orelan, L., Edman, G., Schalling, D. (1987). Thrombocyte monoamine oxidase activity and personality traits in women with severe premenstrual syndrome. Acta Psychiatrica Scandinavica, 76, 225-234.
Hallman, J. (1986). The premenstrual syndrome- an equivalent of depression? Acta Psychiatrica Scandinavica. 73, 403-411.
Hammarback, S., Backstrom, T. (1989). A demographic study in subgroups of women seeking help for premenstrual syndrome. Acta Obstetrics Gynecology Scandinavica, 68, 247-253.
Hart, W.G.., Coleman, G.J., Russell, J.W. (1987). Assessment of premenstrual symptomatology: a re-evaluation of the predictive validity of self-report. Journal of Psychosomatic Research, 31, 185-190.
Johnson, S.R. (1987). The epidemiology and social impact of premenstrual syndrome. Clinical Obstetric and Gynecology, 30, 367-376.
Johnson, S.R., McChesney, C., Bean, J.A. (1988). Epidemiology of premenstrual symptoms in a nonclinical sample. The Journal of Reproductive Medicine, 33, 340-346.
Kraemer, G.R., Kraemer, R.R. (1998). Premenstrual syndrome: diagnosis and treatment experiences. Journal of Women’s Health, 7, 893-907.
Kuczmiercyzk, A.R., Johnson, C.C., Labrum, A.H. (1994). Coping styles in women with premenstrual syndrome. Acta Psychiatrica Scandinavica, 89, 301-305.
Lingjarde, O., Foreland, A.R., Engvik, H. (2001). Personality structure in patients with depression, assessed in a depression-free state according to the five-factor model of personality. Journal of Affective Disorders, 62,165-174.
Logue, C.M., Moos, R.H. (1986). Perimenstrual symptoms; prevalence and risk factors. Psychosomatic Medicine, 48, 388-414.
Lu, Z.J. (2001). The relationship between menstrual attitudes and menstrual symptoms among Taiwanese women. Journal of Advanced Nursing, 33, 621-628.
McCrae, R.R., Costa, P.T. Toward a new generation of personality theories: theoretical contexts for the five-factor model. In Wiggins, J.S. ed. (1996).The Five-Factor Model of Personality theoretical perspectives. The Guilford Press. New York. 51-87.
Merikangas, K.R., Foeldenyi, M., Angst, J. (1993). The Zurich study XVII: patterns of menstrual disturbances in the community: results of the Zurich cohort study. European Archives of Psychiatry & Clinical Neuroscience, 243, 23-32.
Mira, M., Vizzard, J., Abraham, S. (1985). Personality characteristics in the menstrual cycle. Journal of Psychosomatic Obstetrics and Gynaecology, 4, 329-334
Mira, M., Abraham, S., McNeil, D., Vizzard, J., Macaskill, P., Fraser, I., Llewellyn-Jones, D. (1995). The inter-relationship of premenstrual symptoms. Psychological Medicine, 25, 947-955.
Norris E, Sullivan C. (1983). The PMS prescription. Family Circle, 156-8.
Palmer, S.A., Lambert, M.J., Richards, R.L. (1991). The MMPI and premenstrual syndrome: profile fluctuations between best and worst times during the menstrual cycle. Journal of Clinical Psychology, 47, 215-221.
Parry, B. L., Ehlers, C. L., Mostofi, N., Phillips, E. (1996). Personality traits in LLPDD and normal controls during follicular and luteal menstrual-cycle phase. Psychological Medicine, 26,197-202.
Pearlstein, T.B. (1995). Hormones and depression: what are the facts about premenstrual syndrome, menopause, and hormone replacement therapy? American Journal of Obstetrics Gynecology, 173, 646-653.
Pires, M.L.N., Calil, H.M. (2000) Clinical utility of the premenstrual assessment form as an instrument auxiliary to the diagnosis of premenstrual dysphoric disorder. Psychiatry Research, 94, 211-219.
Rivera-Tovar, A.D., Frank, E. (1990). Late luteal phase dysphoric disorder in young women. American Journal of Psychiatry, 147, 1634-1636.
Roca, C.A., Schmidt, P.J., Rubinow, D.R., (1999). A follow-up study of premenstrual syndrome. Journal of Clinical Psychiatry, 60, 763-766.
Ross, C., Coleman, G.., Stojanovska, C. (2001). Relationship between the NEO Personality Inventory Revised neuroticism scale and prospectively reported negative affect across the menstrual cycle. Journal of Psychosomatic Obstetrics Gynecology, 22, 165-176.
Rubinow, D. R., Roy-Byrne, P. (1984a). Premenstrual syndromes: overview from a methodologic perspective. American Journal of Psychiatry, 141, 163-172.
Rubinow, D.R., Roy-Byrne, P., Hoban, M.C. (1984b). Prospective assessment of menstrually related mood disorders. American Journal of Psychiatry, 141, 684-686.
Rubinow, D.R., Schmidt, P. J., Roca, C. A. (1998). Estrogen-serotonin interactions: implications for affective regulation. Biological Psychiatry, 44, 839-850.
Sanders, D., Warner, P., Backstrom, T., Bancroft, J. (1983). Mood, sexuality, hormones and the menstrual cycle. I. Changes in mood and physical state: description of subjects and method. Psychosomatic Medicine, 45, 487-501.
Smith, S. Diagnosis of premenstrual syndrome. In Smith, S., Schiff, I. eds. (1993). Modern management of premenstrual syndrome. W. W. Norton & Company. New York. 3-21.
Stanton, A.L., Gallant, S.J. (1995). The psychology of women’s health. American Psychological Association. Washington, DC.
Stearns, S. (2001). PMS PMDD in the domain of mental health nursing. Journal of Psychosocial Nursing, 39, 17-27.
Sternfeld, B., Swindle, R., Chawla, A., Long, S., Kennedy, S. (2002). Severity of premenstrual symptoms in a health maintenance organization population. Obstetrics & Gynecology, 99, 1014-1024.
Sugawara, M., Toda, M. A., Shima, S., Mukai, T., Sakakura, K., Kitamura, T. (1997). Premenstrual mood changes and maternal mental health in pregnancy and the postpartum period. Journal of Clinical Psychology, 53, 225-232.
Sveindottir, H., Backstrom, T. (2002). Prevalence of menstrual cycle symptom cyclicity and premenstrual dysphoric disorder in a random sample of women using and not using oral contraceptives. Acta Obster Gynecol Scund, 79, 405-413.
Ugrriza, D.N., Klingner, S., O’Brien, S.O. (1998). Premenstrual syndrome: Diagnosis and intervention. The Nurse Practioner, 23, 40-58.
Wittchen, H.U., Becker, E., Lieb, R., Krause, P. (2002). Prevalence, incidence and stability of premenstrual dysphoric disorder in the community. Psychological Medicine, 32, 119-132.
Woods, N.F., Lentz, M., Mitchell, E.S., Heitkemper, M., Shaver, J. (1997). PMS after 40: Persistence of a stress-related symptom pattern. Research in Nursing & Health, 20, 329-340.
Yonkers, K.A. (1997). The association between premenstrual dysphoric disorder and other mood disorders. Journal of Clinical Psychiatry, 58 (supplement 15), 19-25.
Yonkers, K.A.,Chantilis, S.J. (1995). Recognition of depression in obstetric/gynecology practices. American Journal of Obstetrics Gynecolology, 173, 632-638.
Yu, M.Y., Zhu X., Li J., Oaklet D., Reame N.E. (1996). Perimenstrual symptoms among Chinese women in an urban area of China. Health Care for Women International, 17, 161-172.