臺灣博碩士論文加值系統

憂鬱人口逐年增加，研究指出透過覺察與增進正向情緒可改善憂鬱症狀並增加情緒適應；且憂鬱者之情緒能力不足，因此本研究目的為以情緒成長團體為基礎，加入正向情緒概念，發展針對憂鬱症的團體心理治療，期待藉由提升憂鬱者之正向情緒與情緒能力以改善症狀。
本研究採二因子混合設計，分為不同組別（正向情緒組、無正向情緒組、對照組）與時間變項（團體前、後測），參與之憂鬱症患者中，22位為正向組，24位為無正向組，15位為對照組。正向組與無正向組皆完整參與六週之團體療程，兩組皆教導情緒能力，正向組特別強調正向情緒概念，對照組無介入，比較組間療效。此外也初步探討其中有助於療效之因子。
研究結果發現相較於對照組，正向情緒團體可顯著改善憂鬱症患者之憂鬱、焦慮症狀，並提升其自我效能與情緒效能，且同時也可提升憂鬱症患者之正向情緒（快樂強度、快樂指數、生活滿意度）、情緒覺察表達（感覺辨識困難、感覺描述困難、外在中心思考）、情緒調節（發展新觀點、增加正向情緒）、反思能力；相較於無正向組，正向組在改善症狀、情緒適應及提升情緒能力的效果皆更顯著。透過迴歸分析，發現正向情緒與情緒能力的提升，對症狀（憂鬱、焦慮）與情緒適應（自尊、自我效能與情緒效能）的提升具有顯著解釋力，快樂強度、感覺辨識困難、發展新觀點、增加正向情緒、降低負向情緒、失能調節與認知式反思皆為重要的療效因子。
因此強調正向情緒與情緒能力之團體治療對於憂鬱症患者有顯著之療效，不僅可改善症狀亦可提升正向情緒與情緒能力，開拓新的治療走向。此外研究中探討有助於症狀改善之情緒能力與正向情緒變項，也為未來的研究方向與臨床介入提供重要的訊息。

Depression is the leading cause of disability as measured by YLDs and the 4th leading contributor to the global burden of disease (DALYs) in 2000. Recently, researchers suggest that treatments for depression usefully be supplemented by increasing positive emotions. And the emotion abilities of depressive patients show some deficiencies. Therefore, this study will take emotion experiences of the depressive patients as the intervention focus, and emphasizing the importance of positive emotions and emotion abilities, developing a group therapy treatment to promote positive emotions and emotion abilities, and discuss the relationships between the change of positive emotions, emotion abilities, and symptoms.
The study adopted a 2x2 factoral mixed design (Factor 1. pretest vs. posttest; Factor 2. positive emotion growth group, non-positive emotion growth group, control group). There were 22 participants in positive group, 24 in non-positive group, and 15 in control group. The results were as following: Patients who participated in the positive group show significant symptom improvements, and its helpful to promote depressive patients’ positive emotions and emotion abilities (emotion awareness and expression, emotion regulation & emotion utilization and reflection). The treatment effect of positive group is superior to non-positive group. Hierarchical regression analyses indicated that the improvement of different positive emotion and emotional abilities had significant correlations with the improvement of symptoms, such as, the intensity of happiness, difficulty identifying feelings, developing new reason, increasing positive emotion, decreasing negative emotion, and emotional reflection were important treatment change factors.
We are encouraged by the potency of positive emotion growth group. Combing emotion abilities and positive emotions indeed helpful to reduce depressive patients’ symptoms and promote their positive emotions and emotion abilities. Besides, the change factors discovered between symptoms, emotion abilities and positive emotions provide important information for future pathology research and treatment of depressive disorder.

第一章 緒 論 1
第二章 文獻回顧 6
第一節 憂鬱疾患之介紹 6
第二節 正向情緒 13
第三節 情緒能力 22
第四節 情緒的覺察表達與憂鬱 26
第五節 情緒調節與憂鬱 30
第六節 情緒運用反思與憂鬱 35
第七節 正向情緒與情緒能力 38
第八節 研究目的、假設與研究架構 40
第三章 研究方法 44
第一節 研究設計 44
第二節 研究對象 45
第三節 研究程序 49
第四節 研究工具 52
第五節 團體實施方案 64
第六節 參與研究人員 66
第七節 資料分析方法 68
第四章 研究結果 71
第一節 團體介入檢核 71
第二節 正向組與對照組之成效評估 79
第三節 正向組與無正向組團體成效評估 91
第四節 憂鬱症狀與情緒適應之正向情緒與情緒能力改變因子 99

第五章 討論與結論 132
第一節 研究結果整理 132
第二節 討論 141
第三節 研究限制與未來研究方向 153
參考文獻 157
附錄一 情緒歷程評估同意書與指導語171
附錄二 團體回饋表（以單元一為例）173
附錄三 正向情緒日記 175
附錄四 心情札記（以單元一為例） 176
附錄五 正向情緒團體單元介紹 177
附錄六 未加入正向情緒課程之情緒成長團體單元介紹182
附錄七 團體觀察項目 186

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