目的：隨著網路的普遍性和Covid-19疫情導致網路使用的增加，網路成癮(Internet Addiction, IA)議題受到更多的重視，而近年也發現注意力不足/過動症(Attention Deficit/Hyperactivity Disorder, ADHD)和IA有很高的共病風險。其中，神經回饋(Neurofeedback, NF)訓練可作為IA/ADHD青少年之有效介入方式。不過，自我覺察對於日後療效、功能性結果及日常生活有著負面影響，然針對IA/ADHD個體的自我覺察差異和介入療效的研究甚少。因此，本研究旨在探討低自我覺察之IA/ADHD的青少年於神經回饋訓練後之療效，以作為未來個別治療計畫之參考依據。
方法：本研究先依據校園青少年的自評和家長評之CIAS差異平均作為分組依據，分為自我覺察低組14名和自我覺察高組12名，並將研究分成兩部分。首先，比較兩組在神經生理、神經心理及日常生活功能層次的差異，第二部分則探討各組在經20小時的Modified Will Well Neurofeedback 訓練模組(MWWNF)介入後，自我覺察低組於神經生理、神經心理及日常生活功能層次的後測表現是否與自我覺察高組表現一致。
結果：第一部分，在神經生理層次，自我覺察低組於複雜注意力分測驗的腦波有效性顯著差於自我覺察高組；在神經心理層次上，唯注意力監控有差異趨勢，其餘則未有顯著差異；在日常生活功能層次，自我覺察低組之青少年自覺其時間管理表現顯著優於自我覺察高組，然家長評則顯示自我覺察低組的日常執行功能及衝動性等指標顯著差於自我覺察高組。第二部分，介入後的自我覺察低組於自評之CIAS、神經生理及神經心理功能指標皆與自我覺察高組一致，然於家長評之日常生活功能指標（如：日常注意力、時間管理、一般適應、概念知能及實用技巧）仍顯著差於自我覺察高組。
討論：(1)於自我覺察低、高組之功能差異比較顯示，隨著注意力作業複雜度增加，自我覺察低組之作答狀態須更費力，以致其反應躁動而出現雜訊多，使其有效性腦波明顯減少，且注意力監控能力不穩定；另，其傾向認為自己的時間管理佳，也較難自覺網路成癮問題嚴重度。(2)經神經回饋訓練介入後，自我覺察低組於各項神經生理和神經心理指標上都與自我覺察高組表現一致，顯示其介入後的表現可接近於自我覺察高組表現，然家長評之日常生活功能層面仍明顯報告有較多困擾。未來方向則建議可擴大受試者數量以持續探討，以及可納入日常生活功能的衡鑑工具進行功能差異探討，並能以其結果作為後續個別化治療之計畫。

This study aims to investigate whether adolescents with the low self-awareness at high-risk of Internet addiction (IA) and Attention Deficit/Hyperactivity Disorder (ADHD), show similar improvements as the high self-awareness group after neurofeedback. Functional differences between the groups were examined in neurophysiology, neuropsychology, and daily function. Adolescents were recruited from schools, and their self-report and parent-report differences in the Chinese Internet Addiction Scale (CIAS) were used as the basis for self-awareness grouping, an low self-awareness group (n=14) and an high self-awareness group (n=12). The low self-awareness group exhibited worse in neurophysiology, neuropsychology, and daily function compared to the high self-awareness group. After neurofeedback training intervention, the performance of the low self-awareness group aligned with the high self-awareness group in various neurophysiological and neuropsychological indicators, indicating that their post-intervention performance could approach that of the high self-awareness group. However, significant difficulties were still reported in daily functioning aspects according to parental assessments. This suggests that neurofeedback has efficacy for the low self-awareness group, but additional therapeutic techniques may be needed to enhance their daily function.

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