臺灣博碩士論文加值系統

羞愧與罪惡感在憂鬱症的心理病理扮演重要的角色。近年來，以正念為基礎的治療法逐漸被廣泛使用為情緒及壓力調適的方式。目前已有許多療效研究指出此種治療方式能夠有效預防憂鬱症的復發，然而，對於其療效機制仍未十分明確。本研究以擴張建構理論作為以正念為基礎的心理治療之療效機制，探討個體被引發羞愧感之後，是否能透過三分鐘呼吸空間正念練習來引發正向認知—情緒螺旋，以降低後續可能產生的負向情緒，並提升正向情緒。本研究探討的負向情緒為與憂鬱症相關的羞愧、罪惡、憂鬱，以及緊張情緒，正向情緒則包含自豪、高興、平靜，及自我接納。本研究假設對於高、低特質傾向的個體，三分鐘呼吸空間練習對於其正向以及負向情緒有不同程度的影響，在兩組有差異。
本研究以230位大學生及研究生為研究對象，為一2×3×3三因子混合設計，第一因子為個體之「羞愧特質傾向」，分為高、低傾向兩組；第二因子為「情緒調適介入方式方式」，分為三分鐘呼吸空間正念練習、肌肉放鬆練習，以及算數作業練習三組；第三因子為評估情緒狀態的時間點，分別為接受情緒誘發作業前、後，以及接受情緒調適介入後三個時間點。本研究結果顯示，和過去研究結果一致的部分是：羞愧特質傾向與憂鬱特質傾向有顯著正相關，而罪惡感特質傾向與憂鬱特質傾向則無顯著相關。本研究亦發現，在負向情緒方面，三分鐘呼吸空間僅對於緊張狀態具有情緒調適的效果，且此效果和肌肉放鬆練習的效果相似。在正向情緒方面，三分鐘呼吸空間對於自我接納狀態的提升效果，顯著高於肌肉放鬆以及算數練習的效果；對於自豪狀態的提升效果顯著高於算數練習，且有優於肌肉放鬆練習的趨勢；對平靜狀態的影響和放鬆練習相似，都有提升平靜情緒的效果。值得注意的是，高興情緒方面，三分鐘呼吸空間有降低高興程度的效果。綜合以上，本研究結論如下: （1）對於和自我概念有關的情緒，如自豪和自我接納，三分鐘呼吸空間的情緒調適效果優於肌肉放鬆練習和算數練習，其效果可能來自於指導語中自我覺察的部分。另外，三分鐘呼吸空間有提升平靜和降低高興程度的效果，這可能是因為降低個體情緒反應度所致；（2）對於負向情緒，三分鐘呼吸空間僅對緊張情緒具有調適效果，且和肌肉放鬆練習的效果類似，這可能是由於兩者指導語中都有和身體緊繃感相關的內容，調適效果來自於生理激發程度降低；（3）對於罪惡、羞愧，及憂鬱情緒，三分鐘呼吸空間無明顯調適效果，這可能是由於練習時間短，情緒調適程度只能達到引發正向情緒的水準，尚未進入正向認知的層次，亦尚未能削弱負向情緒的強度。易言之，三分鐘呼吸空間對於負向情緒的主要情緒調適效果並非減緩衝擊，而是增進辨識能力。故本研究建議，在臨床上運用三分鐘呼吸空間做為治療方式時，須注意高羞愧特質傾向者可能需要更長的時間達到情緒恢復效果，也可視情況讓個體以正念的態度覺察更精細的正負向情緒變化。

Shame and guilty play important roles in the pathology of depression. In recent years, mindfulness based interventions have gradually been used as means of emotion or stress regulations to help individuals improve their life quality. Lots of research indicate that mindfulness based cognitive therapy has remarkable efficacy on preventing recurrence of depressive disorders; notwithstanding, the mechanisms of change have remained unclear. In this study the broaden-and-build theory was adopted as mechanism of change for the effects of emotion regulations. We hypothesized that, because the practice of the three-minute breathing space would induce the positive cognitive-emotion spiral, the induced shame feelings could therefore be alleviated after the practice, and positive emotions could be promoted. Furthermore, the practice could also interrupt the process of negative cognitive thoughts and depressive emotion subsequently. Effects of emotion regulation on other negative emotions related to depression, such as guilt and anxiety, were also investigated in this study. Positive emotions investigated were pride, happy, calm, and self-acceptance. We hypothesized that there would be different impacts of 3-minute breathing space on positive and negative emotions between the high and low shame proneness individuals.
The participants consisted of 230 college or graduated students. An experiment with 2 (shame proneness: high/low) x 3 (emotion regulation intervention: three minute breathing space/muscle relaxation/calculation task) x 3 (the time points on which participants’ emotional state are measured: before and after the emotional induction task, and after the intervention of emotional regulation) mixed factorial design was conducted. The results revealed that there was a positive correlation between shame and depressive feelings; as compared to a nonsignificant correlation between guilt and depressive feelings. Furthermore, it showed that only the three-minute breathing space influenced the state of nervousness among the negative emotions, and the effect was similar to the muscle relaxation. It also revealed that the three-minute breathing space had greater impact on the positive emotions. Specifically, the 3-minute breathing space promoted the state of self-acceptance than muscle relaxation and counting task. Similarly, it also promoted significant state of pride than counting task, and to a nonsignificant trend superior to the muscle relaxation. Both the 3-minute breathing space and muscle relaxation could promote significant state of calm, indicating that their efficacy on calm was similar. The level of happy feelings decreased after the practice of the 3-minute breathing space was also noted.
Based on the above, the conclusions included: (1) the efficacy of the three-minute breathing space on the self-conscious emotions (pride and self-acceptance) was better than the muscle relaxation, which might result from the instructions for self-awareness of the three-minute breathing space. Besides, the efficacy of the three-minute space on promoting calm and reducing happy feelings might result from the effect of decreasing the emotionality; (2) both the three-minute breathing space and muscle relaxation had efficacy on nervousness, which might result from the lower level of physical arousal induced by the instruction contents about physical feelings; (3) That the three-minute breathing space had no significant effects on the guilty, shame, and depression might due to the duration of the practice was too short to induce changes of negative feelings and cognitions. We suggest that longer period of practice must be taken into consideration when using the three-minute breathing space for the high shame tendency individuals in the clinical situation. Also, they could be reminded of awaring of the changes of their positive and negative emotions through mindful attitude during therapy sessions.

第一章 緒論 1
第一節 羞愧感及罪惡感之憂鬱心理病理模式 2
第二節 認知—情緒螺旋 6
第三節 以正念為基礎的情緒調適介入方式以及其對負向情緒的介入 7
第四節 三分鐘呼吸空間 9
第五節 以正念為基礎的情緒調適方式與正向情緒：自豪、高興、平靜，及自我接納 10
第六節 研究目的 13
第七節 研究假設 14
第二章 研究方法 17
第一節 參與者 17
第二節 儀器及實驗材料 17
第三節 實驗設計 21
第四節 研究程序 21
第三章 研究結果 24
第一節 參與者基本資料與自陳式量表分析 24
第二節 憂鬱情緒、罪惡感與羞愧感之相關分析 26
第三節 情緒狀態評量檢核 27
第四節 負向情緒之多變量分析 37
第五節 正向情緒之多變量分析 46
第四章 討論 61
第一節 綜合結果與討論 61
第二節 研究貢獻與應用 65
第三節 研究限制與未來研究方向 66
參考文獻 68

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