簡易檢索 / 詳目顯示

研究生: 張曉芳
Chang, Hsiao-Fang
論文名稱: 記憶遊戲介入改善憂鬱症情緒調節之先導性研究
A Pilot Study of Memory Game Intervention for Improving Emotional Regulation in Depression
指導教授: 方晶晶
Fang, Jing-Jing
張芸瑄
Chang, Yun-Hsuan
學位類別: 碩士
Master
系所名稱: 工學院 - 機械工程學系
Department of Mechanical Engineering
論文出版年: 2026
畢業學年度: 114
語文別: 英文
論文頁數: 135
中文關鍵詞: 憂鬱症數位介入情緒調節認知訓練記憶遊戲
外文關鍵詞: Depression, Digital Intervention, Emotion Regulation, Cognitive Training, Memory Game
相關次數: 點閱:11下載:0
分享至:
查詢本校圖書館目錄 查詢臺灣博碩士論文知識加值系統 勘誤回報
  • 憂鬱症為全球主要的精神疾病之一,常伴隨注意力、記憶力與執行功能等認知障礙,進一步影響情緒調節與日常生活品質。近年來,數位心理健康介入逐漸興起,遊戲化訓練成為一種具潛力的非藥物介入方式。本研究開發一款結合五種記憶訓練遊戲與衛教內容的應用程式,並進行初步人體研究,以探討此系統對憂鬱症患者在情緒調節上的可行性與潛在成效。
    本研究納入精神科醫師診斷為憂鬱症之受試者四位,進行為期一個月的遊戲訓練,訓練前後皆填寫11份心理相關問卷。遊戲訓練完成時間的分析,部分受試者在完成時間、開始延遲時間、反應時間呈現顯著進步,也有部分受試者在壓力知覺、情緒調節能力與心理韌性量表上有改善。系統可用性量表平均分數為81.25,顯示使用者對系統易用性與接受度皆具高度肯定。
    本研究所開發遊戲化數位介入系統在改善憂鬱症患者調節情緒有可行性與初步人體研究成效,未來可進一步擴大樣本數、延長訓練週期並結合更多元的評估方式,以驗證其長期效益與臨床應用潛力。

    Depression is one of the most prevalent mental health disorders worldwide, often accompanied by cognitive impairments such as attention deficits, poor memory, and diminished executive function. These impairments can hinder emotion regulation and reduce overall quality of life. In recent years, digital interventions have gained attention as non-pharmacological alternatives, with gamified cognitive training showing promise in improving mental health outcomes.
    This study presents the development and preliminary evaluation of an Android-based e-mental health application designed for individuals with Major Depressive Disorder (MDD). The app integrates five types of memory games and psychoeducational content. A pilot human research study was conducted with four participants diagnosed with MDD by psychiatrists. Each participant underwent a one-month intervention. Pre- and post-assessment data were collected using psychological scales and in-game performance metrics.
    Results showed that some participants demonstrated significant improvement in specific performance metrics, including completion time, start time offset, and reaction time. Some participants also showed reduced perceived stress and enhanced resilience and emotional regulation. The average System Usability Scale (SUS) score was 81.25, indicating high usability and user satisfaction.
    These findings support the feasibility and preliminary efficacy of a gamified cognitive intervention for depression. Future studies with larger sample sizes, longer intervention durations, and objective assessments are warranted to further validate its clinical potential.

    摘要 i Abstract ii Acknowledgements iv Table of Contents vi List of Tables viii List of Figures ix 1 Introduction 1 1.1 Background 1 1.2 Motivation & Purpose 3 1.3 Structure of Thesis 3 2 Literature Review 5 2.1 Depression Overview and Treatments 5 2.2 Digital Psychological Intervention for Depression 14 3 Material and Method 19 3.1 Design Concept of the FlexiMind APP 19 3.2 Memory Training Games 21 3.2.1 Maze 23 3.2.2 Whack-a-Mole 32 3.2.3 Matching Cards 39 3.2.4 Rock-Paper-Scissors 46 3.2.5 Treasure Hunt 50 3.3 Self-Report Questionnaires 55 4 Preliminary Human Research 61 4.1 Patient Characteristics 61 4.2 Procedures and Intervention Design 63 4.3 Individual Analysis of Intervention Outcomes 66 4.3.1 Participant E1 67 4.3.2 Participant E2 68 4.3.3 Participant E4 70 4.3.4 Participant E5 72 4.4 Game Performance Across Sessions 73 4.4.1 Maze 74 4.4.2 Whack-a-Mole 76 4.4.3 Matching Cards 78 4.4.4 Rock-Paper-Scissors 80 4.4.5 Treasure Hunt 82 4.5 Feasibility Evaluation and Participant Feedback 84 5 Discussion, Conclusion, and Future Work 88 5.1 Discussion 88 5.2 Conclusion 91 5.3 Future Work 92 References 94 Appendix A. Social Rhythm Metric 100 Appendix B. Pittsburgh Sleep Quality Index 103 Appendix C. Mindful Attention Awareness Scale 105 Appendix D. Daily Hassles Scale 107 Appendix E. Peace of Mind Scale 110 Appendix F. Connor-Davidson Resilience Scale 111 Appendix G. Chinese 14 item Perceived Stress Scale 113 Appendix H. Multidimensional Sense of Humor Scale 114 Appendix I. Cognitive Control and Flexibility Questionnaire 117 Appendix J. Brief-Coping Orientation to Problems Experienced Inventory 119 Appendix K. Resilience Scale for Adults 121 Appendix L. System Usability Scale 123

    [1] W. H. Organization, "Depression and other common mental disorders: global health estimates," 2017.
    [2] 張家銘. "台灣憂鬱症就醫現狀與問題." 社團法人臺灣憂鬱症防治學會. https://www.depression.org.tw/knowledge/info.asp?/71.html (accessed 1 October, 2025).
    [3] S. M. Levens, L. Muhtadie, and I. H. Gotlib, "Rumination and impaired resource allocation in depression," Journal of abnormal psychology, vol. 118, no. 4, p. 757, 2009.
    [4] U. Zetsche, P. Neumann, P.-C. Bürkner, B. Renneberg, E. H. Koster, and K. Hoorelbeke, "Computerized cognitive control training to reduce rumination in major depression: a randomized controlled trial," Behaviour Research and Therapy, vol. 177, p. 104521, 2024.
    [5] A. Wols, M. Pingel, A. Lichtwarck-Aschoff, and I. Granic, "Effectiveness of applied and casual games for young people's mental health: A systematic review of randomised controlled studies," Clinical psychology review, vol. 108, p. 102396, 2024.
    [6] E. J. Edwards et al., "Cognitive control training for children with anxiety and depression: A systematic review," Journal of affective disorders, vol. 300, pp. 158-171, 2022.
    [7] M. Bergmann et al., "Effects of a video game intervention on symptoms, training motivation, and visuo-spatial memory in depression," Frontiers in Psychiatry, vol. 14, p. 1173652, 2023.
    [8] A. P. Association, Diagnostic and statistical manual of mental disorders, 5 ed. American psychiatric association, 2022, pp. 593-595.
    [9] A. T. Beck and B. A. Alford, Depression: Causes and treatment. University of Pennsylvania Press, 2009.
    [10] D. B. Burt, M. J. Zembar, and G. Niederehe, "Depression and memory impairment: a meta-analysis of the association, its pattern, and specificity," Psychological bulletin, vol. 117, no. 2, p. 285, 1995.
    [11] B. Beats, B. J. Sahakian, and R. Levy, "Cognitive performance in tests sensitive to frontal lobe dysfunction in the elderly depressed," Psychological medicine, vol. 26, no. 3, pp. 591-603, 1996.
    [12] B. Ravnkilde, P. Videbech, K. Clemmensen, A. Egander, N. A. Rasmussen, and R. Rosenberg, "Cognitive deficits in major depression," Scandinavian journal of psychology, vol. 43, no. 3, pp. 239-251, 2002.
    [13] L. Chen, Q. Wang, and T. Xu, "Working memory function in patients with major depression disorder: a narrative review," Clinical psychology & psychotherapy, vol. 30, no. 2, pp. 281-293, 2023.
    [14] I. H. Gotlib and J. Joormann, "Cognition and depression: current status and future directions," Annual review of clinical psychology, vol. 6, no. 1, pp. 285-312, 2010.
    [15] H. C. Ellis, "Resource allocation model of the effect of depressed mood states on memory," Affect, cognition, and social behavior, 1988.
    [16] H. C. Ellis, "Focused attention and depressive deficits in memory," 1991.
    [17] G. J. Siegle, R. E. Ingram, and G. E. Matt, "Affective interference: An explanation for negative attention biases in dysphoria?," Cognitive Therapy and Research, vol. 26, no. 1, pp. 73-87, 2002.
    [18] E. Goeleven, R. De Raedt, S. Baert, and E. H. Koster, "Deficient inhibition of emotional information in depression," Journal of affective disorders, vol. 93, no. 1-3, pp. 149-157, 2006.
    [19] A. Cipriani et al., "Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis," The Lancet, vol. 391, no. 10128, pp. 1357-1366, 2018.
    [20] P. Cuijpers, A. S. Geraedts, P. Van Oppen, G. Andersson, J. C. Markowitz, and A. Van Straten, "Interpersonal psychotherapy for depression: a meta-analysis," American Journal of Psychiatry, vol. 168, no. 6, pp. 581-592, 2011.
    [21] J. S. Beck, Cognitive behavior therapy: Basics and beyond. Guilford Publications, 2020.
    [22] S. G. Hofmann, A. Asnaani, I. J. Vonk, A. T. Sawyer, and A. Fang, "The efficacy of cognitive behavioral therapy: A review of meta-analyses," Cognitive therapy and research, vol. 36, no. 5, pp. 427-440, 2012.
    [23] J. N. Motter, M. A. Pimontel, D. Rindskopf, D. P. Devanand, P. M. Doraiswamy, and J. R. Sneed, "Computerized cognitive training and functional recovery in major depressive disorder: a meta-analysis," Journal of affective disorders, vol. 189, pp. 184-191, 2016.
    [24] J. Firth et al., "The efficacy of smartphone‐based mental health interventions for depressive symptoms: a meta‐analysis of randomized controlled trials," World psychiatry, vol. 16, no. 3, pp. 287-298, 2017.
    [25] J. A. Anguera et al., "Video game training enhances cognitive control in older adults," Nature, vol. 501, no. 7465, pp. 97-101, 2013.
    [26] L. Aschentrup, P. A. Steimer, K. Dadaczynski, T. Mc Call, F. Fischer, and K. J. Wrona, "Effectiveness of gamified digital interventions in mental health prevention and health promotion among adults: a scoping review," BMC Public Health, vol. 24, no. 1, p. 69, 2024.
    [27] J. Joormann and M. E. Quinn, "Cognitive processes and emotion regulation in depression," Depression and anxiety, vol. 31, no. 4, pp. 308-315, 2014.
    [28] J. Joormann and W. M. Vanderlind, "Emotion regulation in depression: The role of biased cognition and reduced cognitive control," Clinical Psychological Science, vol. 2, no. 4, pp. 402-421, 2014.
    [29] A. Diamond, "Executive functions," Annual review of psychology, vol. 64, no. 1, pp. 135-168, 2013.
    [30] A. D. Peckham and S. L. Johnson, "Cognitive control training for emotion-related impulsivity," Behaviour research and therapy, vol. 105, pp. 17-26, 2018.
    [31] C. MacLeod and P. J. Clarke, "The attentional bias modification approach to anxiety intervention," Clinical psychological science, vol. 3, no. 1, pp. 58-78, 2015.
    [32] E. H. Koster, K. Hoorelbeke, T. Onraedt, M. Owens, and N. Derakshan, "Cognitive control interventions for depression: A systematic review of findings from training studies," Clinical psychology review, vol. 53, pp. 79-92, 2017.
    [33] G. Andersson and N. Titov, "Advantages and limitations of Internet‐based interventions for common mental disorders," World Psychiatry, vol. 13, no. 1, pp. 4-11, 2014.
    [34] M. C. Klos, M. Escoredo, A. Joerin, V. N. Lemos, M. Rauws, and E. L. Bunge, "Artificial intelligence–based chatbot for anxiety and depression in university students: pilot randomized controlled trial," JMIR formative research, vol. 5, no. 8, p. e20678, 2021.
    [35] C. Chung and J. Pennebaker, "The psychological functions of function words," in Social communication: Psychology Press, 2011, pp. 343-359.
    [36] D. Richards and N. Viganó, "Online counseling: A narrative and critical review of the literature," Journal of clinical psychology, vol. 69, no. 9, pp. 994-1011, 2013.
    [37] C. Botella, J. Fernández-Álvarez, V. Guillén, A. García-Palacios, and R. Baños, "Recent progress in virtual reality exposure therapy for phobias: a systematic review," Current psychiatry reports, vol. 19, no. 7, p. 42, 2017.
    [38] S. Yan et al., "Virtual reality working memory training improves cognitive performance of acute and remitted patients with major depressive disorder," Journal of Affective Disorders, vol. 344, pp. 267-276, 2024.
    [39] D. Huang et al., "Effects of virtual reality working memory training on event-based prospective memory in patients with major depressive disorder," Journal of Psychiatric Research, vol. 156, pp. 91-99, 2022.
    [40] K. M. Griffiths, A. J. Mackinnon, D. A. Crisp, H. Christensen, K. Bennett, and L. Farrer, "The effectiveness of an online support group for members of the community with depression: a randomised controlled trial," PloS one, vol. 7, no. 12, p. e53244, 2012.
    [41] T. M. Fleming et al., "Serious games and gamification for mental health: current status and promising directions," Frontiers in psychiatry, vol. 7, p. 215, 2017.
    [42] S. N. Merry, K. Stasiak, M. Shepherd, C. Frampton, T. Fleming, and M. F. Lucassen, "The effectiveness of SPARX, a computerised self help intervention for adolescents seeking help for depression: randomised controlled non-inferiority trial," Bmj, vol. 344, 2012.
    [43] M. Li, Q. Jiang, C.-H. Tan, and K.-K. Wei, "Enhancing user-game engagement through software gaming elements," Journal of Management Information Systems, vol. 30, no. 4, pp. 115-150, 2014.
    [44] G. Andersson, N. Titov, B. F. Dear, A. Rozental, and P. Carlbring, "Internet‐delivered psychological treatments: from innovation to implementation," World Psychiatry, vol. 18, no. 1, pp. 20-28, 2019.
    [45] J. Linardon, P. Cuijpers, P. Carlbring, M. Messer, and M. Fuller‐Tyszkiewicz, "The efficacy of app‐supported smartphone interventions for mental health problems: A meta‐analysis of randomized controlled trials," World Psychiatry, vol. 18, no. 3, pp. 325-336, 2019.
    [46] S. D. Porteus, Porteus maze test. Psychological Corporation, 1959.
    [47] D. F. Dinges and J. W. Powell, "Microcomputer analyses of performance on a portable, simple visual RT task during sustained operations," Behavior research methods, instruments, & computers, vol. 17, no. 6, pp. 652-655, 1985.
    [48] J. R. Stroop, "Studies of interference in serial verbal reactions," Journal of experimental psychology, vol. 18, no. 6, p. 643, 1935.
    [49] H. E. Rosvold, A. F. Mirsky, I. Sarason, E. D. Bransome Jr, and L. H. Beck, "A continuous performance test of brain damage," Journal of consulting psychology, vol. 20, no. 5, p. 343, 1956.
    [50] E. Drewe, "Go-no go learning after frontal lobe lesions in humans," Cortex, vol. 11, no. 1, pp. 8-16, 1975.
    [51] R. C. Prim, "Shortest connection networks and some generalizations," The Bell System Technical Journal, vol. 36, no. 6, pp. 1389-1401, 1957.
    [52] E. F. Moore, "The shortest path through a maze," in Proc. of the International Symposium on the Theory of Switching, 1959: Harvard University Press, pp. 285-292.
    [53] S. E. Clark, A. S. Benjamin, J. T. Wixted, L. Mickes, and S. D. Gronlund, "Eyewitness identification and the accuracy of the criminal justice system," Policy Insights from the Behavioral and Brain Sciences, vol. 2, no. 1, pp. 175-186, 2015.
    [54] I. H. Robertson, T. Manly, J. Andrade, B. T. Baddeley, and J. Yiend, "Oops!': performance correlates of everyday attentional failures in traumatic brain injured and normal subjects," Neuropsychologia, vol. 35, no. 6, pp. 747-758, 1997.
    [55] T. H. Monk, J. F. Flaherty, E. Frank, K. Hoskinson, and D. J. Kupfer, "The social rhythm metric an instrument to quantify the daily rhythms of life," The Journal of nervous and mental disease, vol. 178, no. 2, pp. 120-126, 1990.
    [56] D. J. Buysse, C. F. Reynolds III, T. H. Monk, S. R. Berman, and D. J. Kupfer, "The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research," Psychiatry research, vol. 28, no. 2, pp. 193-213, 1989.
    [57] K. W. Brown and R. M. Ryan, "Mindful attention awareness scale," Journal of personality and social psychology, 2003.
    [58] A. D. Kanner, J. C. Coyne, C. Schaefer, and R. S. Lazarus, "Comparison of two modes of stress measurement: Daily hassles and uplifts versus major life events," Journal of behavioral medicine, vol. 4, no. 1, pp. 1-39, 1981.
    [59] Y.-C. Lee, Y.-C. Lin, C.-L. Huang, and B. L. Fredrickson, "The construct and measurement of peace of mind," Journal of Happiness studies, vol. 14, no. 2, pp. 571-590, 2013.
    [60] K. M. Connor and J. R. Davidson, "Development of a new resilience scale: The Connor‐Davidson resilience scale (CD‐RISC)," Depression and anxiety, vol. 18, no. 2, pp. 76-82, 2003.
    [61] S. Cohen, T. Kamarck, and R. Mermelstein, "Perceived stress scale," Measuring stress: A guide for health and social scientists, vol. 10, no. 2, pp. 1-2, 1994.
    [62] 陳淑蓉 and 陳學志, "幽默感的定義與測量:多向度幽默感量表之編製," (in 繁體中文), 應用心理研究, no. 26, pp. 167-187, 2005.
    [63] R. L. Gabrys, N. Tabri, H. Anisman, and K. Matheson, "Cognitive control and flexibility in the context of stress and depressive symptoms: The cognitive control and flexibility questionnaire," Frontiers in psychology, vol. 9, p. 2219, 2018.
    [64] C. S. Carver, "You want to measure coping but your protocol’too long: Consider the brief cope," International journal of behavioral medicine, vol. 4, no. 1, pp. 92-100, 1997.
    [65] O. Friborg, O. Hjemdal, J. H. Rosenvinge, and M. Martinussen, "A new rating scale for adult resilience: what are the central protective resources behind healthy adjustment?," International journal of methods in psychiatric research, vol. 12, no. 2, pp. 65-76, 2003.
    [66] L. Xiu, J. Wu, L. Chang, and R. Zhou, "Working memory training improves emotion regulation ability," Scientific Reports, vol. 8, no. 1, p. 15012, 2018.
    [67] R. Pemberton and M. D. F. Tyszkiewicz, "Factors contributing to depressive mood states in everyday life: a systematic review," Journal of affective disorders, vol. 200, pp. 103-110, 2016.
    [68] G. Murray, J. Gottlieb, and H. A. Swartz, "Maintaining daily routines to stabilize mood: theory, data, and potential intervention for circadian consequences of COVID-19," The Canadian Journal of Psychiatry, vol. 66, no. 1, pp. 9-13, 2021.
    [69] R. Alroobaea and P. J. Mayhew, "How many participants are really enough for usability studies?," in 2014 science and information conference, 2014: IEEE, pp. 48-56.
    [70] L. Faulkner, "Beyond the five-user assumption: Benefits of increased sample sizes in usability testing," Behavior Research Methods, Instruments, & Computers, vol. 35, no. 3, pp. 379-383, 2003.

    QR CODE