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研究生:李采凌
研究生(外文):LI, TSAI-LING
論文名稱:注意力不足過動症高風險成人在誘發生氣情境的情緒調控探討
論文名稱(外文):Emotion Regulation in High Risk Adults with Attention Deficit / Hyperactivity Disorder to An Anger Provocation
指導教授:徐儷瑜徐儷瑜引用關係
指導教授(外文):SHYU, LI-YU
口試委員:林旻沛王韋婷
口試委員(外文):LIN, MIN-PEIWANG, WEI-TING
口試日期:2021-04-15
學位類別:碩士
校院名稱:東吳大學
系所名稱: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:2021
畢業學年度:109
語文別:中文
論文頁數:73
中文關鍵詞:注意力不足過動症成人生氣情緒調控實驗情境再評估
外文關鍵詞:adults with ADHDangeremotion regulationexperiment conditionreappraisal
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研究背景與目的
注意力不足/過動症(attention-deficit/hyperactivity disorder, ADHD)是最常見的兒童神經發展疾患之一,然而,到了成年早期,仍有約3.55%的人符合診斷或是受到相關症狀所困擾(Matte et al., 2015)。ADHD成人的情緒失調問題在近年逐漸受到許多關注,尤其是生氣情緒的調控能力,且難以調控生氣情緒也會廣泛影響ADHD患者的人際、情緒、工作、駕駛行為等生活功能。對於一般成人來說,要調控生氣情緒,再評估策略是非常具適應性的方法之一,但這對於有情緒失調及神經生理缺陷的ADHD成人是否有效,目前相關研究較少,且過去大多僅以自評問卷測量其情緒調控能力,因此本研究目的為針對ADHD高風險成人,設計具有生態效度的實驗情境,誘發真實的生氣情緒反應,而後再引導受試者使用再評估策略,希望了解高風險ADHD成人的生氣情緒調控與一般成人之差異。

研究方法
本研究對象為62位20到30歲年輕成人,其中31位為ADHD高風險成人、31位為控制組成人。所有成人來到實驗室後,需進行注意力症狀檢核,評估工具為成人ADHD自填量表(ASRS)、克氏注意力持續度表現測驗第三版(CPT3)、阿肯巴克實證衡鑑系統成人版自陳報告表(ASR / 18-59);接著進行自傳式回憶實驗,請參與者回想自身的生氣經驗,之後跟隨指導語以再評估策略重新思考生氣事件,並在不同階段填寫主觀情緒評量及思考內容。研究者將以「語文探索與字詞計算」(Linguistic Inquiry and Word Count ,LIWC)軟體分析其回憶與調控階段文本,確認再評估調控策略之使用。最後,成人需填寫認知情緒調控量表中文版(CERQ-C)。統計方法以相依樣本t檢定,分析不同階段再評估策略相關字詞使用變化;以二因子混合設計共變數分析,比較兩組成人在不同階段的主觀情緒反應程度;以單因子共變數分析,探討兩組在CERQ-C各分量表之差異。

研究結果
在實驗操弄部分,自傳式回憶可有效誘發生氣情緒,且當成人使用再評估策略時,第一人稱單數代名詞、感知歷程詞減少,正向情緒詞、認知歷程詞增加,而生氣詞與負向情緒詞無明顯變化。在實驗中,ADHD高風險組與控制組的情緒反應程度有顯著差異,ADHD高風險組在整個實驗過程的生氣、負向情緒反應較強烈,特別在回憶生氣事件時,伴隨了罪惡、羞恥、害怕等內化情緒;在日常生活中,CERQ-C量表結果顯示,比起一般成人,ADHD高風險成人較少使用積極重新關注、積極重新評價策略調控情緒,且災難化想法較多。

研究結論
根據本研究結果發現,CLIWC2015可作為檢驗受試者在實驗中使用再評估策略之客觀工具。ADHD高風險組在日常生活中較習慣聚焦於事件的負向線索,透過情境實驗也發現,他們在回憶生氣事件時,生氣及負向情緒反應較強烈,且伴隨罪惡、羞恥、害怕等內化情緒,然而,當我們試圖引導ADHD成人使用再評估策略,他們可執行策略並調降生氣、負向情緒,只是整體情緒調控能力仍較一般成人弱。此結果可提供未來介入方向,教導ADHD成人使用再評估策略是重要的,且同時需留意其生氣情緒背後可能的內化問題及災難化想法,並建議增加陪伴者對於ADHD情緒調控缺陷的了解,適時給予ADHD成人同理及包容。
Background and Reaserch Objectives
Attention-Deficit / Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental disorders with childhood onset. However, there are still 3.55% of adults meet the ADHD criteria or suffered by related symptoms (Matte et al., 2015). Emotion dysregulation of adults with ADHD have been concerned in recent years, especially the regulation of anger. In addition, the difficulty of anger control will influence their daily function like interpersonal relationship, emotion, occupation, and driving behavior. Generally, reappraisal is a very adaptive strategy to regulate anger, but there are no enough research about wheather it is effective for adults with ADHD who have emotion dysregulation and neurophysiological deficits. Moreover, most of the research only used self-rating scale to measure the ability of emotion regulation. So that our study design an experiment with ecological validity for high risk adults with ADHD, inducing their anger emotion and then guiding them control emotion with reappraisal strategy. The purpose of this study is to find out the difference of anger regulation between high risk adults with ADHD and the control group.

Method
The participants in this study were 62 adults aged from 20 to 30. They were divided into two groups: a group of 31 high risk adults with ADHD, and a control group of 31 adults without ADHD. After arrived at the laboratory, all of the participants had to check their ADHD symptoms first by Adult ADHD Self-Report Scale(ASRS), Conners Continuous Performance Test 3(CPT3), and Achenbach System of Empirically Based Assessment (ASEBA:ASR / 18-59). Next, during the experiment, the participants recalled an autobiographical memory about anger event, and after the recall, they were asked to follow the instruction to rethink the anger-inducing event with reappraisal strategy. Feelings had been recorded on Emotion Experience Scale and the details of the event were written down at each experiment stage. As a manipulation check of reappraisal strategy, written texts from memory recall stage and reappraisal stage were analyzed using Linguistic Inquiry and Word Count (LIWC) program. Finally, participants should complete the Cognitive Emotion Regulation Questionnaire – Chinese Version (CERQ-C). Data were analyzed by paired sample t-test to compare the reappraisal related words at each stages. Another data were analyzed by two-way mixed design ANCOVA to compare the emotion reaction of two groups at different stages. One-way ANCOVA was also used to analyze the difference on CERQ-C score of two groups.

Results
About the manipulation checks, autobiographical memory recall was proven an effective way to evoke anger. At the reappraisal stage, participants used less “I” statement and percept words, and they used more positive emotion and cognitive process words, however, anger and negative emotion words were no different. About the experiment, the group of high risk adults with ADHD had significant more anger and negative emotion reactions than control group, especially at memory recall stage, they thought the anger-inducing event with guilty, ashamed, and afraid. About the daily life, according to the results of CERQ-C, the group of high risk adults with ADHD used less positive refocusing and positive reappraisal to regulate their emotion. Besides, they had more catastrophizing thoughts.

Discussion
According to the results, CLIWC2015 could be an objective way to make sure that participants had used reappraisal strategy during the experiment. The high risk adults with ADHD are used to focusing on negative clue in daily life, also, through our experiment, we found that their anger and negative emotion reactions were stronger during anger recall, even mixed with guilty, ashamed, and afraid. However, when they were instructed to use the reappraisal strategy, it could reduce their anger and negative emotion, although their emotion regulation was still less capable than control group. This finding offers an orientation of intervention in the future, it is important to teach adults with ADHD to use reappraisal strategy. At the same time, we should pay attention to their internalized problems and catastrophizing thoughts behind anger. Also, we should help their family and close friends increase the understanding about emotion dysregulation of ADHD, and give adults with ADHD appropriate empathy and tolerance.
第一章、緒論 1
第二章、文獻探討 3
第一節、ADHD成人的情緒調控 3
第二節、ADHD個案的情緒調控測量 10
第三節、情緒調控策略 19
第四節、研究目的與假設 25
第三章、研究方法 27
第一節、研究對象 27
第二節、研究工具 30
第三節、研究步驟與程序 35
第四節、統計分析 38
第四章、研究結果 39
第一節、實驗操弄檢核 39
第二節、ADHD高風險成人與健康成人在生氣情境的情緒調控差異 42
第三節、ADHD高風險成人與健康成人自評生活中使用情緒調控策略差異 47
第四節、研究結果統整 48
第五章、討論 49
第一節、情緒調控的實驗情境與調控策略操弄 49
第二節、ADHD高風險成人的生氣情緒調控能力 51
第三節、研究貢獻與限制 57
參考文獻 59
附錄 67
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