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研究生:楊美婷
研究生(外文):Mei-Ting Yang
論文名稱:神經生理回饋對注意力不足/過動症青少年之注意力與自尊效益研究
論文名稱(外文):The study on the effectiveness of attention and self-esteem resulted from neurofeedback trainings on adolescent with Attention-Deficit/Hyperactivity Disorder
指導教授:李仁豪李仁豪引用關係
指導教授(外文):Ren-Hau Li
口試委員:彭秀玲游森期
口試委員(外文):Hsiu-Ling PengSen-chi Yu
口試日期:2020-07-21
學位類別:碩士
校院名稱:中山醫學大學
系所名稱:心理學系暨臨床心理學系
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:2020
畢業學年度:108
語文別:中文
論文頁數:115
中文關鍵詞:注意力不足/過動症神經生理回饋自我調節注意力自尊
外文關鍵詞:Attention deficit/hyperactivity disorderneurofeedbackself-regulationattentionself-esteem
DOI:10.6834/csmu202000123
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目的:注意力不足/過動症是一種自我調節受損之慢性神經發展障礙,核心症狀是注意力不足、衝動與過動。注意力就像是大腦的過濾器,協助個體在有限的心理資源下,讓生活效能達到最佳狀態。當注意力資源不足,大腦將無法過濾環境中多餘的訊息,對生活影響層面極大,也會危及到個體的自尊維持。隨著腦科學蓬勃發展,大量文獻一致指出注意力不足/過動症患者在特定腦波的活性不同於一般人,尤其是額葉區,而此區正與注意力不足/過動症的症狀有關。本研究目的,期待以本土角度探討神經生理回饋對注意力不足/過動症青少年在注意力方面之療效,以及對其自尊改善之影響。
方法:本研究所採用之研究方法為單一個案研究法之撤回設計(A-B-A-B),並進行多次訪談。研究參與者為一名早期經醫師診斷為注意力不足/過動症之16歲青少年,研究期間未接受研究設計之外的任何治療。透過蒐集研究參與者在整個研究歷程之腦波數據(採用ProComp & BioGraph Infiniti System為測量工具)、注意力行為表現(採用CPT II V. 5為測量工具,並以行為觀察、訪談與SNAP-IV量表蒐集相關資料)、智力表現(採用WICS-IV與WAIS-IV為測量工具)與自尊(採用Rosenberg自尊量表-八題版為測量工具,並以行為觀察與訪談蒐集相關資料)等變化,以驗證研究假設。
研究結果:研究參與者在接受神經生理回饋後,不僅腦波朝理想方向變化,在CPT II V. 5測驗中的表現已不具有『不專注』、『衝動』與『警覺低』等症狀,智力測驗分數相較於兩年前也有提升。透過行為觀察、訪談內容與家長填寫之SNAP-IV量表資料顯示,接受神經生理回饋後,研究參與者不僅學習到注意力控制技能,注意力覺察度也有提升。此外,自尊量表與訪談資料都支持神經生理回饋對其自尊有所改善。
Attention deficit/hyperactivity disorder is a chronic neurodevelopmental disorder with impaired self-regulation. The core symptoms are insufficient attention, impulsivity and hyperactivity. Attention resources are like the filters of the brain, helping individuals to achieve the best life performance under limited psychological resources. When the attention resources are insufficient, the brain will not be able to filter the excess information in the environment, and the impact on life is extremely broad. It will also endanger the self esteem of individual. With the vigorous development of brain science, a large number of documents have consistently pointed out that the activity of specific brain waves in patients with attention deficit/hyperactivity disorder is different from that of ordinary people, especially the frontal lobe area, which is related to the symptoms of attention deficit/hyperactivity disorder. The purpose of this study is to explore from a local perspective the effect of neurophysiological feedback on attention deficit/hyperactivity disorder in adolescents with attention deficit/hyperactivity disorder, as well as its influence on self-esteem improvement.
The research method used in this study is a single case study method: withdrawal design (A-B-A-B), and qualitative interviews. The study participant was a 16-year-old adolescent who was early diagnosed by a physician with attention deficit/hyperactivity disorder. During the study period, he did not receive any treatment outside the designed study. With the collection of brainwave data of the participant throughout the study process (using ProComp & BioGraph Infiniti System as the measurement tool), the research studied the changes on the attention behavior performance (using CPT II V. 5 as the measurement tool, and using behavior observations, interviews and the SNAP-IV scale to collect relevant information), on the intelligence performance (using WISC-IV and WAIS-IV as measurement tools) and on the self-esteem (using the Rosenberg Self-Esteem Scale-Eight Questions Edition as the measurement tool, and using behavior observations and interviews to collect relevant information) to verify the research hypothesis.
Research results: After the study participants received neurofeedback, not only did their brain waves change in the desired direction, their performance in the testing of CPT II V. 5 no longer had symptoms such as "inattentiveness", "impulsiveness" and "low alertness". The full scale of the SNAP-IV has improved, and the intelligence quotient of the Intelligence Test has improved compared with the score obtained two years ago. The behavior observations and the interview content revealed that after receiving neurofeedback, study participants not only learned attention management skills, but also improved their attention awareness. Moreover, the the Self-Esteem Scale and the interview data showed improvements on their self-esteem in the intervention of neurofeedback.
誌 謝 II
中文摘要 III
Abstract V
目 次 VII
圖 次 X
表 次 XI
附 錄 XI
第一章 緒 論................................................... 1
第一節 研究背景與動機.......................................... 1
第二節 研究目的與研究問題....................................... 5
(一) 研究目的................................................... 5
(二) 研究問題................................................... 5
第三節 名詞釋義 ................................................6
第二章 文獻探討 ................................................8
第一節 注意力不足/過動症 ........................................8
(一) 注意力的定義................................................8
(二) 注意力不足/過動症之沿革......................................9
(三) 注意力不足/過動症的診斷工具.................................. 10
(四) 注意力不足/過動症之特徵與診斷準則.............................11
第二節 注意力不足/過動症之病理觀點................................ 14
(一) 遺傳因子................................................... 15
(二) 神經生物危險因子............................................ 16
(三) 環境因素................................................... 18
第三節 注意力不足/過動症之影響與多樣性........................... 20
(一) ADHD對患者生命長遠之影響.................................... 20
(二) ADHD對患者生活各層面之影響.................................. 22
第四節 注意力不足/過動症患者之自尊.............................. 27
第五節 神經生理回饋在注意力不足/過動症之應用..................... 31
(一) 大腦可塑性................................................. 31
(二) 腦電圖..................................................... 32
(三) 腦波型態................................................... 34
(四) 神經生理回饋之療效研究...................................... 35
(五) 神經生理回饋治療模式........................................ 39
第三章 研究方法................................................. 43
第一節 研究設計................................................. 43
第二節 研究架構................................................. 47
第三節 研究參與者............................................... 48
第四節 研究工具................................................. 49
(一) 多媒體生理回饋儀............................................ 49
(二) 克氏持續度表現測驗.......................................... 50
(三) 魏氏智力量表第四版.......................................... 52
(四) Rosenberg自尊量表(八題版).................................. 53
(五) 中文版Swanson, Nolan, and Pelham, Version IV量表........... 54
第五節 研究程序................................................. 55
(一) 收案....................................................... 55
(二) 研究前之準備事項............................................ 57
(三) 研究程序................................................... 59
第四章 資料處理與統計分析........................................ 66
第一節 腦波變化................................................. 66
第二節 不專注、衝動和警覺低之行為變化............................. 77
第三節 智力變化................................................. 82
第四節 自尊變化................................................. 84
第五節 行為觀察與訪談............................................ 85
第五章 討論與建議............................................... 91
第一節 研究結果與討論.......................................... 91
第二節 研究限制 ................................................94
(一) 研究參與者人數太少.......................................... 94
(二) 無法嚴格管理研究參與者的睡眠時間............................. 94
(三) 無法提供一個具個性化的治療協議............................... 95
第三節 研究貢獻與未來展望....................................... 96
(一) 研究貢獻................................................... 96
(二) 未來展望................................................... 96
參考文獻........................................................ 98
附 錄..........................................................111
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