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研究生:潘元健
研究生(外文):Yuan-Chien Pan
論文名稱:創傷後壓力疾患個體對情緒訊息的自動化情緒處理:以人際創傷事件倖存者為例
論文名稱(外文):Automatic Emotional Information Processing in Interpersonal Trauma Survivors with Posttraumatic Stress Disorder (PTSD)
指導教授:陳淑惠陳淑惠引用關係
指導教授(外文):Sue-Huei Chen
學位類別:碩士
校院名稱:國立臺灣大學
系所名稱:心理學研究所
學門:社會及行為科學學門
學類:心理學類
論文種類:學術論文
論文出版年:2010
畢業學年度:98
語文別:中文
論文頁數:126
中文關鍵詞:自動化情緒訊息處理創傷後壓力疾患人際創傷事件情緒促發作業
外文關鍵詞:Automatic emotional information processPosttraumatic stress disorderInterpersonal traumaAffective priming task
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根據過去創傷後壓力疾患(posttraumatic stress disorder, PTSD)的心理病理模式,創傷記憶本質上的個別差異是影響疾病是否發展與維持的重要因子。在認知取向的心理病理模式中多半主張,個體具有兩種不同本質的記憶問題,一種是難以主動提取對創傷事件的完整記憶;另一種是非自主但會被自動激發的侵入式記憶,時常會以鮮活的多感官形式伴隨強烈情緒出現。後者被認為與創傷記憶之自動化激發有密切關聯,而創傷記憶被激發後,對後續行為、認知與情緒帶來之影響,也可能是造成創傷後壓力症狀維持的主要原因。以上現象皆涉及對情緒訊息的自動化處理歷程,然而,在創傷後壓力疾患的研究領域中,關於此歷程之機制目前仍未有定論,研究結果也不一致,仍需要更多研究來對其探討。本研究主要目的在於探索發展出創傷後壓力疾患之人際創傷倖存者對情緒性臉部表情的自動化處理,並且嘗試連結此自動化處理歷程與臨床症狀,期能提供後續心理專業介入之參考。
本研究參與者來源為大學部/研究所學生,依照其創傷經驗與創傷後壓力症狀嚴重度分為三組,分別為人際創傷PTSD組(18人)、人際創傷控制組(46人)與健康控制組(38人)。本研究採用情緒促發作業進行,刺激材料為彩色的人類臉部表情圖片,共有生氣、快樂與中性三種情緒,分別作為促發刺激與目標刺激。促發刺激與目標刺激之呈現間隔時間為200毫秒。研究程序方面,將會先進行創傷經驗、臨床症狀與相關特質之測量,接著完成以電腦施測的情緒促發作業與刺激材料威脅評估作業,最後進行簡短晤談。本研究假設在情緒促發作業中,人際創傷PTSD組將會和兩控制組展現出不同的反應傾向,而此組間差異僅會呈現在以生氣表情為促發刺激之情況下。
研究結果發現:(1)人際創傷PTSD組在情緒促發作業之表現明顯與兩控制組不同;(2)在情緒促發作業中,人際創傷PTSD組在生氣—快樂配對下的妨礙效果顯著小於其他兩控制組,其他配對情況則無任何顯著組間差異;(3)人際創傷倖存者在情緒促發作業上之表現和PTSD症狀嚴重度的相關達顯著。本研究結果支持人際創傷PTSD個體在自動化情緒訊息處理上,和一般個體具有不同傾向。當外界出現創傷相關訊息使PTSD個體的創傷記憶被激發後,可能會促使他們產生逃避處理創傷訊息之傾向,推論此自動化處理傾向或許為PTSD中情感麻木症狀的可能機制。本研究將根據上述結果提出臨床應用建議與後續研究方向。


According to past psychopathological models of posttraumatic stress disorder (PTSD), the individual differences of trauma memory may impact the development and maintain of PTSD. Based on cognitive approach to the psychopathology of PTSD, trauma memory may reveal two different kinds of problems. One is difficulty in intentionally retrieving a complete memory of the traumatic event; another is high frequency of involuntary triggered intrusive memories in a very vivid and emotional way. The later related to cue-driven process and have been commonly linked to automatic information processing. When trauma memory was automatically activated by trauma-related cues, it can have impact on subsequent behavioral, cognitive or emotional processes. That involves the automatic emotional information processing and may be one probable interpretation of why posttraumatic stress symptoms maintain. However, only few studies have investigated automatic emotional information processing in trauma survivors with PTSD but the findings were still inconsistent. Therefore, more studies focus on this topic is needed. This study aimed to explore the automatic information processing toward emotional facial expression in interpersonal trauma survivors with PTSD and to investigate the relationship between this automatic process and clinical symptoms.
Recruited undergraduate students were divided into three groups depend on their traumatic experience and the intensity of posttraumatic stress symptoms: interpersonal trauma survivors with PTSD (PTSD group, n = 18), interpersonal trauma survivors without PTSD (C_IPT group, n = 46), and healthy control group without interpersonal trauma history (C_H group, n = 38). Affective priming paradigm was used, with colorful photos of angry, happy, and neutral human faces as priming and target materials. Stimulus onset asynchrony between prime and target was 200ms. In experimental procedure, all participants will complete the measurements of trauma experience, clinical symptoms, and other related trait first. Then finish computerized affective priming task and material threatening evaluation task. After all, a brief semi-structured diagnostic interview was delivered. It is hypothesized that PTSD group would show different response tendency to C_IPT and C_H group. This effect only appears when angry face as prime stimulus.
Results revealed: (1) The performance of PTSD group in affective priming task was different from the other two control groups; (2) PTSD group showed less interference effect than the other two groups when the angry prime was followed by happy target; (3) The performance of interpersonal trauma survivors in affective priming task was significant related to their posttraumatic stress symptoms. These results suggested that, when trauma memory was activated by trauma-related stimulus, PTSD individuals may automatically try to minimize the impacts of such stimulus. The findings suggest that automatic activation of trauma memory has more impacts on consequent evaluative process in interpersonal trauma survivors inclined to PTSD psychopathology, such as emotional numbing. Based on these results, implication for clinical intervention and future research are discussed.


目 錄
第一章 緒論 1
第一節 人際創傷事件與創傷後壓力疾患 ………………………… 1
第二節 創傷後壓力疾患的心理病理機制 ………………………… 8
第三節 創傷後壓力疾患與情緒性訊息處理 ……………………… 19
第四節 創傷後壓力疾患對情緒性訊息的自動化處理 …………… 25
第五節 研究目的、架構與假設 ……………………………………. 36
第二章 研究方法 40
第一節 情境與特質焦慮量表—特質焦慮的信效度建立 ………… 40
第二節 情緒促發作業 ……………………………………………… 46
第三章 研究結果 61
第一節 情境與特質焦慮量表—特質焦慮的信效度檢驗結果 …… 61
第二節 情緒促發作業結果分析 …………………………………… 67
第四章 綜合討論 82
第一節 人際創傷PTSD個體之特性與臨床症狀呈現 ……………. 82
第二節 自動化情緒訊息處理與PTSD心理病理機制之關聯 ……. 85
第三節 自動化情緒訊息處理傾向與PTSD臨床現象之連結 ……. 92
第五章 結論 94
第一節 研究貢獻 …………………………………………………… 94
第二節 研究限制 …………………………………………………… 98
第三節 未來研究方向 ……………………………………………… 101
參考文獻 103
附錄
附錄一: 創傷生活事件量表
附錄二: 創傷後壓力診斷量表
附錄三: 情境與特質焦慮量表—特質焦慮
附錄四: 行為抑制與行為激發量表
附錄五: 症狀檢核表—焦慮與人際敏感度分量表
附錄六: 研究參與同意書

表 圖 目 次
表2-1 : 因素分析研究參與者基本人口變項特性 …………………………… 41
表2-2 : 再測研究參與者者基本人口變項特性 ……………………………… 42
表2-3 : 情緒促發作業參與者基本人口變項特性 …………………………… 47
表2-4 : 納入與未納入分析者在各變項上的差異檢定 ……………………… 48
表2-5 : 各類型創傷事件在各組參與者之發生率 …………………………… 49
表2-6 : 各組參與者標定之最大困擾事件分佈 ……………………………… 50
表2-7 : 刺激材料配對列表 …………………………………………………… 55
表3-1 : 中文版情境與特質焦慮量表—特質焦慮的因素結構與內部一致性係數… 63
表3-2 : 中文版情境與特質焦慮量表—特質焦慮再測樣本的描述統計 ………… 64
表3-3 : 中文版情境與特質焦慮量表—特質焦慮和各效標之描述統計與相關分析 65
表3-4 : 刺激材料威脅程度之描述統計 ……………………………………… 67
表3-5 : 刺激材料威脅程度之二因子變異數分析 …………………………… 68
表3-6 : 各組在背景資料與測量變項上的描述統計 ………………………… 69
表3-7 : 各組在不同刺激材料配對反應正確率之單因子變異數分析 ……… 71
表3-8 : 各組參與者在不同情緒刺激配對與不同促進分數的描述統計 …… 71
表3-9 : 各組參與者在不同刺激材料配對之原始反應時間分析 …………… 72
表3-10: 所有參與者促進分數與量表總分之相關 …………………………… 73
表3-11: 各組參與者在情緒促發作業中促進分數的三因子變異數分析 …… 74
表3-12: 健康控制組(C_H)促進分數的二因子變異數分析 ……………...... 75
表3-13: 人際創傷控制組(C_IPT)促進分數的二因子變異數分析 ………… 75
表3-14: 人際創傷PTSD組(PTSD)促進分數的二因子變異數分析 ………. 75
表3-15: 健康控制組(C_H)配對樣本t檢定 ………………………………… 76
表3-16: 人際創傷控制組(C_IPT)配對樣本t檢定 …………………………. 77
表3-17: 人際創傷PTSD組(PTSD)配對樣本t檢定 ……………………..... 77
表3-18: 各組參與者在不同促進分數的單因子變異數分析與事後比較 …… 79
表3-19: 健康控制組促進分數與量表總分之相關 …………………………… 80
表3-20: 人際創傷倖存者促進分數與量表總分之相關 ……………………… 81
圖3-1 : 各組參與者在情緒促發作業上之表現 ……………………………… 78


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