研究背景 憂鬱症狀會影響一個人的情緒、認知、生理與行為方面的各種表現，也是預測自殺行為中，最具解釋力與最重要的預測因子。研究指出國內外大學生憂鬱症狀的盛行率達14.8%，顯示憂鬱問題在國內外大學生中有相當程度的嚴重性，因此本研究針對大學生憂鬱症狀的相關預測因子及相關因素作研究。過去研究顯示負向生活事件對於憂鬱症狀的影響結果不一致，而逃避/情緒失調因應型態可能扮演著調節變項的角色。
研究目的與假設 本研究的目的即在調查國內大學生之逃避/情緒失調因應與負向生活事件對憂鬱症狀的影響機制，以期望能作為日後制定大學生憂鬱症狀防治措施之參考。本研究假設逃避/情緒失調因應可調節負向生活事件對憂鬱症狀的影響。
研究方法 (1)參與者：使用分層叢集抽樣方式，在南部地區大專院校中抽出14間學校。本研究在第一年回收3,743份問卷，回收率為72.9%，其中可追蹤人數為3,246人，次年回收1,532份，回收率為47.02%。完成本研究使用的所有問卷之人數為1,267人。(2)研究工具：個人資料表、柯氏憂鬱量表、壓力因應量表、生活事件量表。(3)研究程序：本研究為一年縱貫性大樣本研究，分別在2003年(T1)與2004年(T2)11月開始為期六週進行問卷施測(4)資料分析：由描述性統計分析樣本特性；以多元階層迴歸分析以及t-test來分析逃避/情緒取向因應調節負向生活事件對憂鬱症狀的預測效果。
研究結果 結果顯示控制了T1的憂鬱症狀後，T1逃避/情緒失調因應可調節T1負向生活事件和T2負向生活事件對T2憂鬱症狀的影響。進一步將T1逃避/情緒失調因應代入高、中、低分的情形，發現T1負向生活事件和T2負向生活事件對T2憂鬱症狀的預測效果最高的為T1逃避/情緒失調因應高分的情形，其次為中分的情形，最低為低分的情形。
結論與建議 本研究利用縱貫式大樣本資料，發現大學生的逃避/情緒失調因應可調節負向生活事件對憂鬱症狀的影響。這個結果解釋了為何過去研究發現負向生活事件對憂鬱症狀影響的結果會出現不一致，亦即有時負向生活事件不一定會造成憂鬱症狀，本研究證實了逃避/情緒失調因應扮演重要的角色。本研究發現對於高度使用逃避/情緒失調因應的大學生而言，其遭遇越多負向生活事件，則可預測未來越多的憂鬱症狀，因此對這群學生來說，其負向生活事件可以預測憂鬱症狀；而少用逃避/情緒失調因應的大學生族群，其遭遇負向生活事件，亦不會導致未來的憂鬱症狀。在臨床貢獻性上，未來可針對壓力因應方式進行個別介入與治療，改善個體之壓力因應技巧，減少負向生活事件其對憂鬱症狀的影響效果。

This study examined whether avoidance/emotional dysregulation coping moderated the effect of negative life events (NLE) on depressive symptoms using a longitudinal design. 1,267 college students (62.2 % female) were recruited in 2003(T1) and 2004(T2). Each participant completed self-reported measures including the Ko Depression Inventory, Life Event Questionnaire, and Coping Styles Inventory, for both time periods. Hierarchical multiple regression analyses showed that T1 avoidance/emotional dysregulation coping moderated the impact of T1 NLE and T2 NLE on T2 depressive symptoms. Further analyses indicated that the predictive effect of T1 NLE or T2 NLE for T2 depressive symptoms was lowest for low-level avoidance/emotional dysregulation coping, followed by mid- and high-level, suggesting that less use of avoidance/emotional dysregulation coping would decrease the impact of negative life events on depressive symptoms among college students.

中華民國教育統計指標（2002）：〈高等教育－九十學年度大專院校學生數分析〉。台北市：教育部。
孔繁鐘與孔繁錦譯（民89）。DSM-IV 精神疾病診斷手冊。台北市：合記。

柯慧貞（1989）：《內因性與非內因性憂鬱症在腎上腺皮質素抑制反應、認知偏差及生活壓力上之比較》。台北市：博士論文─國立台灣大學心理學研究所。
柯慧貞、廖聆岑、林美芳、蘇鈴茱、丁建谷、林依靜、蔡均棠、劉秀霞、陳孟莉、傅木龍、何進財（2003）：〈南區大專校院學生憂鬱與自殺之現況與其成因分析〉。台南：論文發表於成功大學主辦之「南區大專院校學務長諮詢會議─憂鬱與自殺研討會」。
陸洛(1994)：〈壓力、人格特質及心理健康：一項縱貫分析〉。《高醫雜誌》，卷10，頁492-496。
張宇岱(2003)：《焦慮合併酒癮與焦慮患者在酒精效果預期、拒酒自我效能及壓力因應方式上的差異》。碩士論文─國立成功大學行為醫學研究所。
Aiken, L. S., & West, S. G. (1991). Multiple regression: Testing and interpreting interactions: Sage Publications Inc.
Arria, A.M., O’Grady, K.E., Caldeira, K. M., Vincent, K. B., Wilcox, H. C., & Wish, E. D. (2009). Suicide ideation among college students: A multivariate analysis. Archives of Suicide Research, 13(2), 230-246.
Blalock, J. A., & Joiner, T. E. (2000). Interaction of cognitive avoidance coping and stress in predicting depression/anxiety. Cognitive Therapy and Research, 24(1), 47-65.
Blankstein, K., Flett, G., & Johnston, M. (1992). Depression, problem-solving ability, and problem-solving appraisals. Journal of Clinical Psychology, 48(6), 749-759.
Brown, S. L., & Ireland, C. A. (2006). Coping style and distress in newly incarcerated male adolescents. Journal of Adolescent Health, 38(6), 656-661.
Campbell-Sills, L., Barlow, D., Brown, T., & Hofmann, S. (2006). Effects of suppression and acceptance on emotional responses of individuals with anxiety and mood disorders. Behaviour Research and Therapy, 44(9), 1251-1263.
Chiu, S., Ko, H., & Wu, J. (2007). Depression moderated the effect of exposure to suicide news on suicidality among college students in Taiwan. Suicide and Life-Threatening Behavior, 37(5), 585-592.
Compas, B., Boyer, M., Stanger, C., Colletti, R., Thomsen, A., Dufton, L., Cole, D.. (2006). Latent variable analysis of coping, anxiety/depression, and somatic symptoms in adolescents with chronic pain. Journal of Consulting and Clinical Psychology, 74(6), 1132.
Dyson, R., & Renk, K. (2006). Freshmen adaptation to university life: Depressive symptoms, stress, and coping. Journal of Clinical Psychology, 62(10), 1231-1244.
Enns, M. W., & Cox, B. J. (2005). Psychosicial and clinical predictors of symptom persistence vs remission in major depressive disorder. Canadian Journal of Psychiatry, 50 (12), 769-777.
Fergusson, D. M., Horwood, L. J., Ridder, E. M., & Beautrais, A. L. (2005). Subthreshold depression in adolescence and mental health outcomes in adulthood. Archives of General Psychiatry, 62(1), 66-72.
Folkman, S., & Lazarus, R. S. (1980). An analysis of coping in a middle-age community sample. Journal of Health and Social Behavior, 21(3), 219-239.
Folkman, S., & Lazarus, R. S. (1985). If it changes it must be a process: Study if emotion and coping during there stages of a college examination. Journal of personality and Social Psychology, 48(1), 150-170.
Folkman, S., Lazarus, R. S., Dunkel-Schetter, C., Delongis, A., & Gruen, R. J. (1986). Dynamic of a stressful encounter: Cognitive appraisal, coping, and encounter outcomes. Journal of Personality and Social Psychology, 50(5), 992-1003.
Franko, D., Striegel-Moore, R., Brown, K., Barton, B., McMahon, R., Schreiber, G., Crawford, P., Daniles, G. (2004). Expanding our understanding of the relationship between negative life events and depressive symptoms in black and white adolescent girls. Psychological Medicine, 34(07), 1319-1330.
Fresco, D., Williams, N., & Nugent, N. (2006). Flexibility and negative affect: Examining the associations of explanatory flexibility and coping flexibility to each other and to depression and anxiety. Cognitive Therapy and Research, 30(2), 201-210.
Friis, R. H., Wittchen, H. U., Pfister, H., & Lieb, R. (2002). Life events and changes in the course of depression in young adults. European Psychiatry, 17(5), 241-253.
Garnefski, N., Legerstee, J., Kraaij, V., van den Kommer, T., & Teerds, J. (2002). Cognitive coping strategies and symptoms of depression and anxiety: A comparison between adolescents and adults. Journal of Adolescence, 25(6), 603-611.
Gross, J. (1998). The emerging field of emotion regulation: An integrative review. Review of General Psychology, 2(3), 271-299.
Harley, R., Sprich, S., Safren, S., Jacobo, M., & Fava, M. (2008). Adaptation of dialectical behavior therapy skills training group for treatment-resistant depression. The Journal of Nervous and Mental Disease, 196(2), 136-143.
Hays, S.C. (1999). Acceptance and Commitment Therapy: An Experiential Approach to Behavior Change. New York: Guilford Press.
Holahan, C. J., Moos, R. H., & Schaefer, J. A. (1996). Coping, stress resistance, and growth: Conceptualizing adaptive functioning. Handbook of coping: Theory, research, applications, pp.24-43.
Holahan, C., Moos, R., Holahan, C., Brennan, P., & Schutte, K. (2005). Stress generation, avoidance coping, and depressive symptoms: A 10-year model. Journal of Consulting and Clinical Psychology, 73(4), 658-666.
Holahan, C., Moos, R., Holahan, C., Cronkite, R., & Randall, P. (2004). Unipolar depression, life context vulnerabilities, and drinking to cope. Journal of consulting and clinical psychology, 72(2), 269-275.
Horwath, E., Johnson, J., Klerman, G. L., & Weissman, M. M. (1992). Depressive symptoms as relative and attributable risk factors for first-onset major depression. Archives of General Psychiatry, 49(10), 817-823.
Jose, P. E., & Huntsinger, C. S. (2005). Moderation and mediation effects of coping by Chinese American and European American adolescents. The Journal of Genetic Psychology, 166(1), 16-44.
Judd, L. L., Rapaport, M. H., Paulus, M. P., & Brown, J. L. (1994). Subsyndromal symptomatic depression: a new mood disorder? The Journal of Clinical Psychiatry, 55(7), 18-28.
Jung, J., & Khalsa, H. (1989). The relationship of daily hassles, social support, and coping to depression in Black and White students. Journal of General Psychology, 116(4), 407-417.
Kabat-Zinn, J (1990). Full Catastrophe Living: Using the Wisdom of your Body and Mind to Face Stress, Pain, and Illness. New York: Delacorte
Kawachi, I., & Berkman, L. F. (2001). Social ties and mental health. Journal of Urban Health, 78(3), 458-467.
Kendler, K., Kessler, R., Walters, E., MacLean, C., Neale, M., Heath, A., & Eaves, L. (1995). Stressful life events, genetic liability, and onset of an episode of major depression in women. American Journal of Psychiatry, 152(6), 833-842.
Kuyken, W., Byford, S., Taylor, R., Watkins, E., Holden, E., White, K., et al. (2008). Mindfulness-based cognitive therapy to prevent relapse in recurrent depression. Journal of Consulting and Clinical Psychology, 76(6), 966-978.
Lazarus, R., & Folkman, S. (1984). Stress, appraisal and coping.New York: Springer.
Lewinsohn, P. M., Gotlib, I. H., & Seeley, J. R. (1995). Adolescent psychopathology: IV. Specificity of psychosocial risk factors for depression and substance abuse in older adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 34(9), 1221-1229.
Lweinsohn, P.M., Rohde, P., Seeley, J.R. (1998). Major depressive disorder in older adolescents: prevalence, risk factors, and clinical implications. Clinical Psychology Review, 18(7), 765-794.
Lewinsohn, P. M., Solomon, A., Seeley, J. R., & Zeiss, A. (2000). Clinical implications of" subthreshold" depressive symptoms. Journal of Abnormal Psychology, 109(2), 345-351.
Li, C., DiGiuseppe, R., & Froh, J. (2006). The roles of sex, gender, and coping in adolescent depression. Adolescence, 41(163), 409.
Linehan, M. M. (1993). Cognitive-Behavioral Treatment of Borderline Personality Disorder. New York: Guilford Press
Liverant, G., Brown, T., Barlow, D., & Roemer, L. (2008). Emotion regulation in unipolar depression: The effects of acceptance and suppression of subjective emotional experience on the intensity and duration of sadness and negative affect. Behaviour Research and Therapy, 46(11), 1201-1209.
Michael, Y., Wisdom, J., Perrin, N., Bowen, D., Cochrane, B., Brzyski, R., et al. (2006). Expression and ambivalence over expression of negative emotion: cross-sectional associations with psychosocial factors and health-related quality of life in postmenopausal women. Journal of Women and Aging, 18(2), 25-40.
Moo-Estrella, J., Perez-Benitez, H., Solis-Rodriguez, F., & Arankowsky-Sandoval, G. (2005). Evaluation of depressive symptoms and sleep alterations in college students. Archives of Medical Research, 36(4), 393-398.
Morgan, D. (2003). Mindfulness-based cognitive therapy for depression: A new approach to preventing relapse. Psychotherapy Research, 13(1), 123-125.
Mundt, C., Reck, C., Backenstrass, M., Kronmuller, K., & Fiedler, P. (2000). Reconfirming the role of life events for the timing of depressive episodes A two-year prospective follow-up study. Journal of Affective Disorders, 59(1), 23-30.
Nakano, K. (1991). Coping strategies and psychological symptoms in a Japanese sample. Journal of Clinical Psychology, 47(3), 346-350.
Ottenbreit, N., & Dobson, K. (2004). Avoidance and depression: The construction of the cognitive-behavioral avoidance scale. Behaviour Research and Therapy, 42(3), 293-313.
Pilkonis, P., Imber, S., & Rubinsky, P. (1985). Dimensions of life stress in psychiatric patients. Journal of Human Stress, 11(1), 5-10.
Roemer, L., & Orsillo, S. (2007). An open trial of an acceptance-based behavior therapy for generalized anxiety disorder. Behavior Therapy, 38(1), 72-85.
Schuppert, H., Giesen-Bloo, J., van Gemert, T., Wiersema, H., Minderaa, R., Emmelkamp, P., et al. (2009). Effectiveness of an emotion regulation group training for adolescents-a randomized controlled pilot study. Clinical Psychology and Psychotherapy, 16(6), 467-478.
Schwartz, J.M., Stoessel, P.W., Baxter, L.R., Martin, K.M., & Phelps, M.E. (1996). Systematic changes in cerebral glucose metabolic rate after successful behavior modification treatment of obsessive compulsive disorder. Archives of General Psychiatry, 53(2), 109-113.
Seiffge-Krenke, I., & Klessinger, N. (2000). Long-term effects of avoidant coping on adolescents' depressive symptoms. Journal of youth and adolescence, 29(6), 617-630.
Seqal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse. New York: Guilford Press.
Snyder, C.R., Ford, C.E., & Harris, R. N.(1987). The effects of theoretical perspective on the analysis of coping with negative life events. In C.R. Snyder & C.E. Frod(Eds.), Coping with negative life events: Clinical and social psychological perspectives(pp. 1-14). New York: Plenum Press.
Spirito, A., Valeri, S., Boergers, J., & Donaldson, D. (2003). Predictors of continued suicidal behavior in adolescents following a suicide attempt. Journal of Clinical Child and Adolescent Psychology, 32(2), 284-289.
Szadoczky, E., Rozsa, S., Zambori, J., & Furedi, J. (2004). Predictors for 2-year outcome of major depressive episode. Journal of Affective Disorders, 83(1), 49-57.
Teasdale, J., Segal, Z., Mark, J., Williams, G., Ridgeway, V., Soulsby, J., et al. (2000). Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology, 68(4), 615-623.
Tobin, D. L., Holroyd, K. A., Reynolds, R. V., & Wigal, J. K. (1989). The hierarchical factor structure of the Coping Strategies Inventory. Cognitive Therapy and Research. 13(4), 343-361.
Votta, E., & Manion, I. (2003). Factors in the psychological adjustment of homeless adolescent males: The role of coping style. Journal of Amer Academy of Child and Adolescent Psychiatry, 42(7), 778.
Williams, R. A., Hagerty, B. M., Yousha, S. M., Hoyle, K. S., & Oe, H. (2002). Factors associated with depression in Navy recruits. Journal of Clinical Psychology, 58(4), 323-337.
Yang, H. J., Chiu, Y. J., Soong, W. T., CHEN, W. J., (2008). The roles of personality traits and negative life events on the episodes of depressive symptoms in nonreferred adolescents: a 1-year follow-up study. Journal of Adolescent Health, 42(4), 375-385.
Yap, M., Allen, N., & Ladouceur, C. (2008). Maternal socialization of positive affect: the impact of invalidation on adolescent emotion regulation and depressive symptomatology. Child Development, 79(5), 1415-1431.