一、研究背景：
　　臨床與流行病學研究已證實酒癮與焦慮症具有高共病性，但兩者共病的機制仍無一致的結論，其中一個最常被提出的解釋為「自我醫療假設」 (self-medication)，此假設認為若焦慮個案藉由使用酒精來降低其焦慮症狀，將會提高發展出酒精依賴的高危險性；不過，已有研究修正自我醫療假設，提出焦慮個案中僅有某一群特質的個案會藉由使用酒精來因應其焦慮症狀。另外，以往研究指出性格與酒精效果預期都是酒癮的重要致病因子，因此本研究取樣單純焦慮患者、焦慮合併酒癮患者、控制組個案，檢驗三組在逃避傷害、尋求刺激、藉酒消除負向情緒預期、藉酒尋求正向情緒預期上的差異，以驗證自我醫療假設；並探討性格、酒精效果預期與飲酒行為的關係。其中焦慮合併酒癮組特別收集先發作焦慮再發作酒癮的個案，以進一步釐清先焦慮後發展出酒癮的共病現象。

二、研究目的：
本研究之主要目的為：(一) 探討性格與單純焦慮、酒癮合併焦慮的關係；(二) 探討酒精效果預期與單純焦慮、酒癮合併焦慮的關係；(三) 探討性格與酒精效果預期對於飲酒行為的影響。

三、研究方法：
(一) 受試者：本研究使用個案對照研究設計，分別至精神科門診收集27名男性單純焦慮症患者、27名男性焦慮合併酒癮患者、與至社區收集48名正常控制組男性個案。(二) 研究工具：分別以最近飲酒量與飲酒頻率問卷評估個案收案前三個月的飲酒量與飲酒頻率、三向度性格量表評估性格變項、以及酒精效果預期量表評估酒精使用預期變項。(三) 研究流程：所有參與者均在完整、詳細的說明與填寫同意書後，才開始接受資料之收集。三組參與者均先接受精神疾病診斷晤談以確定終生診斷，確定診斷並符合各組之篩選條件後正式收案。所有參與者自填最近飲酒量與飲酒頻率問卷、三向度性格量表與酒精效果預期量表。(四) 統計分析：以卡方檢定、t檢定與單因子變異數分析分別比較各組人口學資料的差異；以單因子變異數分析分別比較各組在性格量表、酒精效果預期的總分與分量表分數上的差異；使用階層迴歸分析，探討逃避傷害、藉酒消除負向情緒預期、尋求刺激、藉酒尋求正向情緒預期與飲酒行為的關係。

四、研究結果：
(一) 在性格方面，結果發現焦慮組與焦慮合併酒癮組此兩組個案，相較於控制組有較高的逃避傷害得分；且焦慮合併酒癮組個案比焦慮組個案或控制組有較高的尋求刺激得分；(二) 在酒精效果預期方面，結果發現焦慮合併酒癮組個案比焦慮組個案或控制組有較高的正向酒精效果預期、藉酒消除負向情緒預期分量表、藉酒尋求正向情緒預期分量表的得分；(三) 在預測飲酒行為方面，結果發現逃避傷害、尋求刺激、藉酒消除負向情緒預期、藉酒尋求正向情緒預期均可以單獨的預測飲酒量或飲酒頻率。研究結果也發現逃避傷害主要透過尋求刺激的中介效果來影響飲酒量與飲酒頻率；藉酒消除負向情緒預期主要透過藉酒尋求正向情緒預期的中介效果來影響飲酒量與飲酒頻率。另外，尋求刺激可直接預測飲酒量與飲酒頻率，但部分透過藉酒尋求正向情緒預期預測飲酒量與飲酒頻率。

五、結論：
本研究發現焦慮合併酒癮患者不僅具有高逃避傷害、高藉酒消除負向情緒預期，同樣也具有高尋求刺激、高藉酒尋求正向情緒預期；因此本研究祇部分支持自我醫療假設，本研究結果顯示焦慮合併酒癮患者除了降低焦慮或緊張而飲酒，也會為了尋求刺激而有飲酒並隨後發展出酒癮。此外，本研究支持若男性個體具有逃避傷害的性格特質，則較容易發展出焦慮症；而男性焦慮症個體若有越高的尋求刺激性格特質與正向酒精效果預期，則越提高發展出酒精依賴的危險性。

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