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研究生： 林彥鴻
Lin, Yann-Hung
論文名稱： 焦慮症、憂鬱症及混合焦慮與憂鬱症之婦女在史楚普作業及回想作業上的差異
Women with Anxiety, Depression, and Mixed Anxiety-Depression on Stroop Task and Recall Test
指導教授： 柯慧貞
Ko, Huei-Chen
學位類別： 碩士
Master
系所名稱： 醫學院 - 行為醫學研究所
Institute of Behavioral Medicine
論文出版年： 2003
畢業學年度： 91
語文別： 中文
論文頁數： 102
中文關鍵詞： 憂鬱症 、焦慮症 、共病 、注意力 、記憶力
外文關鍵詞： anxiety, depression, comorbidity, attention, memory
相關次數： 點閱：116  下載：31 
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    • 目的：過去研究顯示焦慮和憂鬱情緒會影響個體的訊息處理過程；焦慮情緒主要是影響個體的注意力，而憂鬱情緒則影響個體的記憶力。本研究針對患有單純焦慮症、單純憂鬱症，以及混合焦慮與憂鬱症的婦女進行注意力及記憶力的測驗。並且採用情緒引發程序來引起受試者的情緒，藉以探討情緒狀態對訊息處理過程的影響，為了確保受試者在實驗中的情緒狀態成功地被引發，因此又分成情緒升高與情緒未升高的受試者：在本研究中分為焦慮引發程序中焦慮情緒升高（簡稱焦慮升高）與焦慮情緒未升高（簡稱焦慮未升高）的受試者；另外也分為憂鬱引發程序中憂鬱情緒升高（簡稱憂鬱升高）與憂鬱情緒未升高（簡稱憂鬱未升高）的受試者。

    方法：實驗過程中，安排三種情緒引發程序：分別為焦慮情緒、憂鬱情緒以及中性情緒。在測量工具上，使用情緒性Stroop作業來測量受試者的注意力，而用自由回想作業測量受試者的記憶力。實驗中所採的刺激類型分為正性、負性及中性。

    結果：關於注意力方面，研究發現，在焦慮引發程序中焦慮情緒升高的單純憂鬱組在Stroop作業上所表現的反應時間比焦慮升高的控制組還快；但是另一群在焦慮引發程序中焦慮情緒未升高的受試者中卻沒有顯現組別差異。如果比較相同診斷分組中焦慮升高與焦慮未升高受試者的反應時間，結果發現在Stroop作業上，焦慮升高的單純憂鬱組及共病組所表現的反應時間快於焦慮未升高的同組受試者；但是焦慮升高的單純焦慮組及控制組所表現的反應時間卻慢於焦慮未升高的同組受試者。另外研究也發現，憂鬱引發程序中憂鬱情緒升高的單純焦慮組所表現的反應時間快於憂鬱未升高的同組受試者。此外，關於記憶力方面，研究發現焦慮升高的正常受試者在自由回想測驗上回憶的正性詞多於負性詞和中性詞，而且也比焦慮未升高的正常受試者回憶出更多的正性詞；然而其他診斷分組的回憶結果並沒有顯著差異。

    結論：當焦慮診斷與憂鬱情緒，或焦慮情緒與憂鬱診斷同時存在時，會使個體對外在干擾刺激的選擇性注意力受到抑制。另外，研究也發現焦慮狀態會影響個體的回憶表現。

    摘要………………………………………………………………………………I 誌謝………………………………………………………………………………III 目錄………………………………………………………………………………IV 表目錄……………………………………………………………………………VIII 圖目錄……………………………………………………………………………X 緒論………………………………………………………………………………1 　第一節　焦慮症憂鬱症及其共病的情形……………………………………1 　第二節　認知理論與焦慮症及憂鬱症的關係………………………………4 　　壹、基模理論………………………………………………………………4 　　貳、網絡理論………………………………………………………………5 　　叁、整合模式………………………………………………………………6 　第三節　運用整合模式在焦慮症與憂鬱症之認知偏誤上的實徵研究……8 　　壹、焦慮症的認知偏誤……………………………………………………8 　　　一、注意力偏差…………………………………………………………8 　　　二、記憶力偏差…………………………………………………………9 　　貳、憂鬱症的認知偏誤……………………………………………………11 　　　一、注意力偏差…………………………………………………………11 　　　二、記憶力偏差…………………………………………………………12 　第四節　對過去研究的討論…………………………………………………14 　　壹、過去研究的受試者問題………………………………………………14 　　貳、焦慮受試者及憂鬱受試者所呈現的認知偏誤現象…………………15 　　叁、研究認知偏誤的測驗工具問題………………………………………16 　　　一、注意力作業…………………………………………………………16 　　　　1、Emotional Stroop Task………………………………………………16 　　　　2、Dot Probe Detection Task……………………………………………17 　　　　3、Deployment of Attention Task………………………………………18 　　　二、記憶力作業…………………………………………………………19 　　　　1、自傳式回憶測驗……………………………………………………19 　　　　2、自由回想測驗………………………………………………………20 　肆、情緒狀態與認知的關係…………………………………………………20 　　一、焦慮情緒………………………………………………………………21 　　二、憂鬱情緒………………………………………………………………22 　　三、情緒狀態的探討………………………………………………………22 　　伍、認知處理的內容………………………………………………………23 　第五節　研究目的……………………………………………………………25 　第六節　研究假設……………………………………………………………26 　　壹、注意力方面……………………………………………………………26 　　貳、記憶力方面……………………………………………………………26 研究方法…………………………………………………………………………28 　第一節　研究設計……………………………………………………………28 　第二節　受試者………………………………………………………………28 　第三節　材料…………………………………………………………………29 　　壹、材料的編製……………………………………………………………29 　　貳、Emotional Stroop task……………………………………………………30 　　叁、自由回憶作業（Free Recall Test）……………………………………30 　　肆、情緒引發程序（Mood Induction Procedure, MIP）……………………31 　　　一、焦慮引發情境………………………………………………………31 　　　二、憂鬱引發情境………………………………………………………32 　　　三、中性情緒程序………………………………………………………32 　　　伍、Visual Analogue Scale (VAS)…………………………………………33 　　陸、生活適應量表（Anxiety-Depression Scale)……………………………33 　第四節　過程…………………………………………………………………34 結果………………………………………………………………………………36 　第一節　人口學變項…………………………………………………………36 　第二節　情緒引發的效果……………………………………………………39 　第三節　注意力表現…………………………………………………………41 　第四節　記憶力表現…………………………………………………………45 討論………………………………………………………………………………48 　第一節 Stroop作業……………………………………………………………48 　第二節 自由回想作業…………………………………………………………52 　第三節 焦慮狀態與焦慮特質…………………………………………………53 　第四節 主要發現………………………………………………………………54 　第五節 臨床應用………………………………………………………………54 　第六節 研究限制………………………………………………………………55 　第七節 未來研究方向…………………………………………………………56 參考文獻…………………………………………………………………………58 附錄一 實驗採用的中文雙字詞…………………………………………………99 附錄二 生活適應量表……………………………………………………………100 自述………………………………………………………………………………102 表目錄 表1-1 焦慮升高受試者的年齡、教育年數、焦慮症狀及憂鬱症狀……………68 表1-2 焦慮未升高受試者的年齡、教育年數、焦慮症狀及憂鬱症狀…………68 表2-1 憂鬱升高受試者的年齡、教育年數、焦慮症狀及憂鬱症狀……………69 表2-2 憂鬱未升高受試者的年齡、教育年數、焦慮症狀及憂鬱症狀…………69 表3-1 焦慮升高受試者在不同情緒引發程序前後的焦慮情緒變化……………70 表3-2 焦慮升高受試者在不同情緒引發程序前後的憂鬱情緒變化……………70 表4-1 焦慮未升高受試者在不同情緒引發程序前後的焦慮情緒變化…………71 表4-2 焦慮未升高受試者在不同情緒引發程序前後的憂鬱情緒變化…………71 表5-1 憂鬱升高受試者在不同情緒引發程序前後的焦慮情緒變化……………72 表5-2 憂鬱升高受試者在不同情緒引發程序前後的憂鬱情緒變化……………72 表6-1 憂鬱未升高受試者在不同情緒引發程序前後的焦慮情緒變化…………73 表6-2 憂鬱未升高受試者在不同情緒引發程序前後的憂鬱情緒變化…………73 表7 焦慮升高與焦慮未升高受試者在Stroop作業上反應時間的變異數分析…74 表8 焦慮升高受試者在Stroop作業上表現之反應時間的平均數與標準差……76 表9 焦慮未升高受試者在Stroop作業上表現之反應時間的平均數與標準差…77 表10 焦慮升高與焦慮未升高受試者在Stroop作業上正確率的變異數分析……78 表11 焦慮升高受試者在Stroop作業上表現之正確率的平均數與標準差………80 表12 焦慮未升高受試者在Stroop作業上表現之正確率的平均數與標準差……81 表13 憂鬱升高與憂鬱未升高受試者在Stroop作業上反應時間的變異數分析…82 表14 憂鬱升高受試者在Stroop作業上表現之反應時間的平均數與標準差……84 表15 憂鬱未升高受試者在Stroop作業上表現之反應時間的平均數與標準差…85 表16 憂鬱升高與憂鬱未升高受試者在Stroop作業上正確率的變異數分析……86 表17 憂鬱升高受試者在Stroop作業上表現之正確率的平均數與標準差………88 表18 憂鬱未升高受試者在Stroop作業上表現之正確率的平均數與標準差……89 表19 焦慮升高與焦慮未升高受試者在回想作業上 　　　之正確回憶個數的變異數分析…………………………………………90 表20 焦慮升高受試者在回想作業上之正確回憶個數的平均數與標準差……92 表21 焦慮未升高受試者在回想作業上之正確回憶個數的平均數與標準差…93 表22 憂鬱升高與憂鬱未升高受試者在回想作業上 　　　之正確回憶個數的變異數分析…………………………………………94 表23 憂鬱升高受試者在回想作業上之正確回憶個數的平均數與標準差……96 表24 憂鬱未升高受試者在回想作業上之正確回憶個數的平均數與標準差…97 圖目錄 圖1 威廉斯等人的整合模式圖……………………………………………………98

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