研究背景：(一)過去研究指出酒癮與焦慮症具有高共病性，而對於酒癮與焦慮症共病的機制，學者提出「焦慮症導致酒癮」與「焦慮症和酒癮有共同致病因子」的不同假設。過去的研究發現，酒精效果預期與酒癮有關；而在氣質的相關研究中也發現，行為抑制系統可能與焦慮症有關，但行為激發系統則可能與酒癮有關。因此，本研究取樣單純酒癮、單純焦慮、焦慮合併酒癮與健康正常人的受試者，比較四組在行為激發系統/行為抑制系統與酒精效果預期上之差異，以驗證焦慮症和酒癮共病的可能假設。 (二)過去研究指出酒精效果預期在個體的飲酒行為中可能為調節變項或中介變項，但過去研究並未深入探討氣質和酒精效果預期在臨床個案的飲酒行為中扮演何種角色， 因此，本研究探討行為激發系統/行為抑制系統與酒精效果預期在臨床酒癮個案的飲酒行為中所扮演的角色，以釐清問題飲酒行為的可能機制。

　　研究目的：本研究之主要目的有二：(一)驗證「焦慮症導致酒癮」與「酒癮和焦慮症有共同致病因子」的假設。本研究假設單純酒癮患者具有高行為激發系統，且對酒精有較多尋求刺激興奮的正向預期；單純焦慮患者和焦慮合併酒癮患者皆具有高行為抑制系統，但焦慮合併酒癮患者對酒精有較多消除負向情緒的正向預期。(二)探討行為激發系統/行為抑制系統與酒精效果預期在個體飲酒行為中所扮演的角色，以驗證酒精效果預期在飲酒行為中是否扮演調節或中介作用的角色。

　　研究方法：本研究採用個案對照研究，蒐集單純酒癮患者、單純焦慮患者、焦慮合併酒癮患者以及健康正常人各30名。所有受試者皆由研究人員以終生診斷晤談量表進行晤談而確定臨床診斷，並以飲酒行為量表蒐集前三個月之喝酒量；另外，由受試者自填行為激發系統/行為抑制系統量表與酒精效果預期量表。

　　研究結果：(一)在驗證焦慮症和酒癮共病的假設部分，以單因子變異數分析比較四組在行為激發系統/行為抑制系統與酒精效果預期上之差異，結果發現單純焦慮組和焦慮合併酒癮組在行為抑制分量表的得分均顯著地高於單純酒癮組和正常控制組；而單純酒癮組在行為激發分量表的得分，則明顯高於焦慮合併酒癮組和正常控制組。 此外，單純酒癮組和焦慮合併酒癮組在正向酒精預期分量表的得分均顯著高於單純焦慮組和正常控制組；但單純酒癮組與焦慮合併酒癮組在「藉酒尋求刺激興奮」和「藉酒消除負向情緒」的正向預期上無顯著差異。以行為激發系統/行為抑制系統與正向酒精預期為獨變項，以臨床診斷為依變項，進行羅吉士迴歸分析。結果發現若以正常控制組為對照組，行為激發系統和正向酒精預期是單純酒癮診斷的顯著預測變項；行為抑制系統和正向酒精預期是焦慮合併酒癮診斷的顯著預測變項；行為抑制系統是單純焦慮診斷的顯著預測變項。若以單純焦慮組為對照組，低行為抑制系統、高行為激發系統與高正向酒精預期是單純酒癮的顯著預測變項，高正向酒精預期則是焦慮症合併酒癮的顯著預測變項。若以單純酒癮組為對照組，則高行為抑制系統是焦慮症合併酒癮的顯著預測變項。(二)在探討酒精效果預期在酒癮個案之飲酒行為中所扮演的角色部分，以行為激發系統/行為抑制系統與正向酒精預期為獨變項，以每週飲酒量為依變項，進行階層迴歸分析。結果發現在單純酒癮組中，只有正向酒精預期是飲酒量之顯著預測變項；正向酒精預期並非行為激發系統和飲酒量間的調節和中介變項。對於焦慮合併酒癮組而言，行為激發系統與正向酒精預期之交互作用是飲酒量之顯著預測變項，行為激發系統是正向酒精預期和飲酒量間的調節變項，且正向酒精預期亦為行為激發系統和飲酒量間的調節變項。

　　結論：(一)將酒癮區分為單純酒癮和焦慮症合併酒癮兩種亞型，單純酒癮患者具有高行為激發系統，而焦慮症合併酒癮患者則有高行為抑制系統，兩者在天生的氣質型態上可能有所差異，但兩者皆對酒精有較高的正向預期。單純酒癮患者和單純焦慮症患者可能有不同的氣質表現型態，且兩者對於酒精的正向預期亦有明顯差異。焦慮症合併酒癮患者和單純焦慮症患者皆有高行為抑制系統的特性，但合併出現酒癮問題的焦慮症患者對酒精有較高的正向預期，故單純焦慮症與焦慮合併酒癮患者雖在先天氣質上可能具有同源性，但酒精預期可能是影響焦慮症患者發展出酒癮的重要因素。 (二)在單純酒癮患者中，正向酒精預期是飲酒量的主要預測變項；在焦慮合併酒癮患者中，行為激發系統是正向酒精預期和飲酒量間的調節變項，且正向酒精預期亦是行為激發系統和飲酒量間的調節變項。因此，單純酒癮患者和焦慮合併酒癮患者在飲酒量的發展機制上可能有所差異，其他生理、心理和社會因素可能造成的影響仍應一倂考慮。

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