思覺失調症（Schizophrenia）是一種嚴重且會令患者失能之疾病，患者症狀包含妄想、幻覺等正性症狀，情緒平板、無動機等負性症狀，以及混亂／認知缺損、憂鬱／焦慮、及激動／興奮等症狀，其中，患者的症狀反覆出現與其社會認知功能的缺損，是造成患者難以重回社會的主要因素，而過去有研究顯示社會認知功能表現與患者的症狀是有關連的，因此，許多學者紛紛投入思覺失調症症狀與社會認知功能的關連性研究，使得社會認知功能成為思覺失調症的一個重要研究領域。
個體對他人的情緒、動機等狀態有較好的理解能力，有助於使其展現較具適應性的社交表現，非語言情緒辨識與心智理論等能力則為社會認知功能重要的一環。非語言情緒辨識被認為是社會認知功能完整性的基礎，能夠促進社會行為。個體在人際互動中透過辨識對方臉部表情或聲音語調提供之社交線索，使得個體能夠展現出相對應的社交行為。而在社交互動中，展現同理心的前提為個體能夠正確的辨識他人的情緒，並了解他人的情緒經驗，因此非語言情緒辨識成為社會認知功能中重要的基石，特別是臉部表情或聲音語調等非語言情緒的辨識。過去研究顯示，思覺失調症患者在辨識不同非語言情緒的表現確實存在損害，但其與患者症狀之間的關連未有一致結論。
心智理論是指推斷自己和他人心理狀態的能力，1992年Frith首先將思覺失調症患者之症狀與其心智理論能力做連結，認為思覺失調症患者之症狀是因其無法監控自己和他人的心智狀態和行為而產生的損害，有些研究甚至指出心智理論的缺損會導致症狀的產生，然而目前心智理論與思覺失調症患者症狀的關連性仍有許多爭議，仍待釐清。
綜上，思覺失調症患者在心智理論及非語言情緒辨識能力具有缺損存在，故本研究欲同時探討思覺失調症患者在非語言情緒辨識與心智理論能力的缺損，並釐清兩者缺損與思覺失調症患者正負性與其他症狀的關連性。
本研究結果顯示，無論是心智理論還是非語言情緒能力，思覺失調症患者確實較一般人差，且該缺損與患者的混亂／認知缺損症狀有顯著的負相關。此外，本研究發現心智理論能力、非語言情緒辨識與部分的神經認知功能存在著一定的關連性，包括注意力和執行功能，顯示神經認知功能可能參與了心智理論和非語言情緒辨識的歷程，未來研究可進一步探討社會認知功能的完整歷程。

目錄
摘要 i
致謝 iii
目錄 v
圖目錄 vii
表目錄 viii
第一章 研究動機 1
第二章 文獻探討 2
第一節 思覺失調症2
第二節 社會認知功能 3
壹、心智理論 5
貳、非語言情緒辨識 6
第三節 思覺失調症與社會認知功能缺損 7
壹、研究目的 12
貳、研究假設 12
第三章 研究方法與結果 13
研究一：中文版評估社會認知電影作業的信效度檢驗 13
壹、研究對象 14
貳、研究工具 14
參、研究程序 17
肆、研究結果 17
研究二：思覺失調症患者症狀與其社會認知功能之關連性探討 19
壹、研究對象 19
貳、研究工具 20
參、研究程序 24
肆、研究結果 24
第四章 討論與建議 33
第一節 思覺失調症患者與正常對照組在社會認知表現的差異 35
第二節 思覺失調症患者症狀與其非語言情緒辨識之間的相關性 37
第三節 思覺失調症患者症狀與其心智理論錯誤類型之間的相關性 39
第四節 研究限制與未來方向 40
第五節 研究貢獻與臨床應用 42
中文文獻 43
英文文獻 43

圖目錄
圖1、MASC的範例，正確反應和心智理論錯誤類別 63
圖2、思覺失調症的社會認知歷程 64

表目錄
表1、研究參與者之基本人口變項 14
表2、 MASC-TW與其他社會認知工具作業得分相關分析 19
表3、思覺失調症組與正常對照組之基本人口變項 20
表4、控制智力和執 行功能後患者組與對照組之MASC-TW差異比較 25
表5、控制智力和執行功能後患者組與對照組之DANVA-2-TW差異比較 26
表6、控制智力和執行功能後患者組與對照組之2ndFB差異比較 27
表7、控制智力和執行功能後患者組與對照組之ToM差異比較 27
表8、病患組之臨床相關變項 28
表9、思覺失調症症狀與MASC-TW指標之相關分析 29
表10、思覺失調症症狀與DANVA-2-TW指標之相關分析 30
表11、思覺失調症症狀與2ndFB 指標之相關分析 30
表12、思覺失調症症狀與ToM指標之相關分析 31
表13、 MASC-TW指標預測患者混亂／認知缺損症狀之迴歸分析 32
表14、研究假設驗證結果 34
表15、思覺失調症症狀與心智理論能力缺損之研究發現整理 61

中文文獻
汪永光、汪凱、朱春燕、汪暉（2006）。首發精神分裂症患者心靈理論損傷的研究。中國神經精神疾病雜誌，32，481-486。
曾懷萱（2003）。情緒性非語言行為的覺知特性與精神分裂病質傾向的關連性探討（未出版之碩士論文）。臺灣大學心理學研究所，臺北市。
葉在庭、花茂棽、劉珣瑛（2009）。猜猜我在想什麼？中文版心智推理作業的信效度研究及其在老年人的表現初探。中華心理學刊，51（3），375-395。
鄭若瑟、何海、張景瑞、藍先元、胡海國（1996）。活性與負性症狀量表（PANSS）：中文版本建立及信度研究。中華精神醫學，10（3），251-258。

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