疲勞為日趨嚴重的問題，對個體的身心與生活功能上均造成很大的困擾。慢性疲勞症候群(chronic fatigue syndrome)的患者常主訴持續性的疲勞、虛弱或無力，但有往往無法發現有明顯的器質性病因。過去研究建議以生理-心理-社會(biopsychosocial)的觀點探討慢性壓力與CFS之間的關連。本研究回顧慢性疲勞的生理機制與心理相關特質，奠基於HPA軸與SAM軸間失衡的現象，以及控制源信念的概念，欲針對職場的嚴重疲勞工作者探討其性格與知覺情境壓力對於壓力心理生理反應的影響。研究以問卷測量受試者的疲勞症狀、生活功能、工作態度與控制源傾向，運用噪音-認知典範(noise-cognitive paradigm)為實驗操弄，測量交感神經(HR、BVP、SC)的壓力反應與恢復能力。研究結果發現疲勞工作者的壓力反應率與一般健康工作者無異，然而其恢復率顯著低於健康工作者。另外，控制源性格因素亦影響壓力心理生理反應，外控傾向越高者其壓力心理生理反應越高，且當控制源信念與知覺到的壓力源可控制性不一致時，個體會產生越高的壓力反應。結論認為當個體知覺到自身控制信念與情境控制性不一致時，會激發較高的壓力心理生理反應，並於壓力過後仍延續激發，若長時間處於這樣的知覺不一致會使身體為了因應慢性壓力而調節HPA軸與SAM軸功能以穩定體內生物化學物質的平衡，但是另一方面由於過度的調節而產生失衡現象，HPA軸的鈍化會抑制SAM軸於壓力過後的恢復功能，使個體於壓力階段激發壓力心理生理反應以因應眼前壓力，但於壓力刺激結束後卻無法有效恢復至基礎水準，延長身體處於過度亢奮的狀態，耗損心理生理功能，使個體長期無法感受到有效放鬆，增加疲勞與壓力感受度。

Fatigue physically and psychologically causing great troubles in life for individuals has become a serious problem. People who suffer from chronic fatigue syndrome frequently complain about continuous tiredness, weakness or lack of strength, yet they are seldom able to discover apparent organic etiology. The research in the past focused on discussing the relationship between chronic stress and CFS from a biopsychosocial perspective. This study reviewed relevant characteristics of physiological mechanism and psychology, based on the unbalanced phenomenon between HPA axis and SAM axis as well as the concept of belief in locus of control, in order to reveal how personality of workers with severe exhaustion at work and perceived situational pressure influence psychophysiological response to stress through the questionnaire examining respondents’ fatigue symptoms, life function, working attitude and tendency of locus of control where noise-cognitive paradigm is experimental manipulation for measuring the stress reaction and recovery capability of the sympathetic nerve (HR, BVP, SC). The consequence suggested that tired workers have no difference from normal health workers regarding stress reaction; however, their recovery capabilities are significantly worse than health workers. Moreover, locus of control character has impact on psychophysiological response to stress too that the more external locus of control a person has, the more psychophysiological response to stress he shows; additionally, individuals will have more stress reaction when belief in locus of control is not consistent with perceived stressor controllability. The study also found that when individuals perceive that their beliefs in control is not consistent with situational control, they are stimulated to have more psychophysiological response to stress, even until the stress is gone; their bodies under this condition too long will on the one hand adjust the function of HPA axis and SAM axis to chronic stress for stabilizing the balance of biochemical substances inside the bodies, yet on the other hand, lead to unbalanced situation due to over-adjustment that HPA axis inactivation will inhibit SAM axis from recovering after stress, and therefore extend hyperarousal state, damage psychophysiological functions, make individuals unable to relax over a long period of time, and increase the degree of tiredness and stress.

中文摘要I
英文摘要II
謝誌IV
目錄V
圖目錄VII
表目錄VIII

第一章 研究動機與目的 1
第二章 文獻探討 4
第一節 慢性疲勞症候群(CFS) 4
第二節 慢性疲勞症候群的壓力心理生理反應 17
第三節 慢性疲勞症候群與內-外控性格 23
第四節 研究架構與假設 35
第三章 研究方法 37
第一節 研究對象 37
第二節 研究工具 42
第三節 研究程序 55
第四章 研究結果 59
第一節 篩選受試者的有效性 59
第二節 知覺控制感操弄的有效性 64
第三節 壓力操弄的有效性 69
第四節 主要實驗結果 74
第五章 討論與建議 96
第一節 疲勞組受試者的特性 96
第二節 疲勞、性格、情境與壓力心理生理反應 98
第三節 綜合討論 103
第四節 研究貢獻、限制、與未來方向 105
參考文獻 108
附錄一 基本資料問卷 118
附錄二 個人體力檢核表(CIS) 120
附錄三 CDC慢性疲勞症候群症狀檢核表 121
附錄四 工作控制源量表(WLCS) 122
附錄五 簡短健康量表-36(SF-36) 123
附錄六 犬儒主義、組織公民行為、組織承諾、退縮行為128
附錄七 研究參與同意書 131
附錄八 個人體力檢核表(CIS)授權使用同意書 132
附錄九 中文版簡短健康量表-36(SF-36)授權使用同意書 133
附錄十 中文版工作控制源量表(WLCS)授權使用同意書 134

圖2-4-1 研究概念 36
圖4-3-1皮膚導電反應(SC)折線圖 73
圖4-4-1 SC恢復率為組別、WLCS與兩者交互作用的函數 86
圖4-4-2 HR恢復率為不同情境、WLCS與兩者交互作用的函數 92

表2-1-1 CDC所公佈的CFS定義 5
表2-1-2 綜合性疲勞評估工具的比較 12
表2-1-3 疲勞症狀與憂鬱性疾患的異同 14
表2-2-1 CFS與LOC的相關研究 27
表2-2-2 LOC與情境因素的交互作用 31
表3-1-1 受試者的產業類別、職稱、年資、工作時數與教育水準 40
表3-1-2 疲勞組與健康控制組的受試者變項 41
表3-2-1 噪音分配 50
表3-2-2 生理指標數值一覽表 53
表3-3-1 實驗流程 58
表4-1-1 CIS與SF-36分數的相關 60
表4-1-2 疲勞組與健康控制組在各量表平均分數上的差異 62
表4-2-1 主觀壓力感受的平均數(標準差) 65
表4-2-2 主觀壓力感受變異數分析報表 65
表4-2-3 評估知覺控制感(1)的平均數(標準差) 66
表4-2-4 評估知覺控制感(2)的平均數(標準差) 66
表4-2-5 知覺控制感共變數分析報表 67
表4-3-1 心跳速率(HR)的平均數(標準差) 69
表4-3-2 心跳速率(HR)變異數分析報表 70
表4-3-3 手指末梢血流波動(BVP)的平均數(標準差) 70
表4-3-4 手指末梢血流波動(BVP)變異數分析報表 71
表4-3-5 皮膚導電反應(SC)的平均數(標準差) 71
表4-3-6 皮膚導電反應(SC)變異數分析報表 72
表4-4-1 HR反應率的平均數(標準差)75
表4-4-2 HR反應率共變數分析報表 75
表4-4-3 BVP反應率的平均數(標準差) 76
表4-4-4 BVP反應率共變數分析報表 76
表4-4-5 SC反應率的平均數(標準差) 77
表4-4-6 SC反應率共變數分析報表 77
表4-4-7 HR恢復率的平均數(標準差) 78
表4-4-8 HR恢復率共變數分析報表 78
表4-4-9 BVP恢復率的平均數(標準差) 79
表4-4-10BVP恢復率共變數分析報表 79
表4-4-11 SC恢復率的平均數(標準差) 80
表4-4-12 SC恢復率共變數分析報表 80
表4-4-13 HR反應率階層迴歸分析摘要表 82
表4-4-14 BVP反應率階層迴歸分析摘要表 83
表4-4-15 SC反應率階層迴歸分析摘要表 83
表4-4-16 HR恢復率階層迴歸分析摘要表 84
表4-4-17 BVP恢復率階層迴歸分析摘要表 85
表4-4-18 SC恢復率階層迴歸分析摘要表 86
表4-4-19 HR反應率階層迴歸分析摘要表 88
表4-4-20 BVP反應率階層迴歸分析摘要表 89
表4-4-21 SC反應率階層迴歸分析摘要表 90
表4-4-22 HR恢復率階層迴歸分析摘要表 92
表4-4-23 BVP恢復率階層迴歸分析摘要表 93
表4-4-24 SC恢復率階層迴歸分析摘要表 94
表4-4-25 主觀知覺控制感階層迴歸分析摘要表 95

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