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研究生: 蔡均棠
Tsai, Chun-Tang
論文名稱: 母親憂鬱及子代之生活壓力、因應策略、社會支持與8至10歲子代憂鬱之關係
The Relations of Maternal Depression, Children’s Life Events, Coping Strategies, Social Support, and 8 to 10 Year Old Children's Depression
指導教授: 柯慧貞
Ko, Huei-Chen
學位類別: 碩士
Master
系所名稱: 醫學院 - 行為醫學研究所
Institute of Behavioral Medicine
論文出版年: 2005
畢業學年度: 93
語文別: 中文
論文頁數: 98
中文關鍵詞: 社會支持因應策略生活壓力憂鬱
外文關鍵詞: depression, life event, coping strategies, social support
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  • 研究背景與目的:從過去的研究中發現,憂鬱母親之子代罹患憂鬱或其他情緒行為問題的危險性亦會增加;然而之前的研究者大多是以回溯性的設計探討憂鬱之心理病理,此種研究設計容易受到個體回憶偏誤之影響而致使過去的研究結果不一致;因此,開始有研究者採用較具有前瞻性的縱貫式研究設計,高危險群(具有脆弱性者)的研究方法即為其中之一;然而,除了遺傳之外,個體的憂鬱症亦可能會受到社會環境變項如生活壓力或社會支持,以及個體本身的特質如因應方式所影響,因此,即使是高危險群的個體也不一定就必然會出現憂鬱。是故,本研究即是以心理社會的角度,並利用高危險群的研究設計,檢驗憂鬱症的致病機轉,探討母親的憂鬱,以及兒童的生活壓力、因應策略、社會支持與兒童本身憂鬱之關係;本研究假設其間關係可能有三:(1)母親的憂鬱,或兒童的生活壓力、因應策略、社會支持對兒童的憂鬱扮演主要效果的角色;(2)母親憂鬱與兒童憂鬱之關係會受到兒童的生活壓力、因應策略、社會支持之中介而有所影響;(3)母親憂鬱與兒童憂鬱之關係會受到兒童的生活壓力、因應策略、社會支持之調節效果而有所影響。

    研究方法:本研究之受試者係由長期追蹤之婦女及其目前為8至10歲之子代所組成,分別為憂鬱組共37對以及正常控制組共36對;依據半結構式診斷晤談與研究中所採用的分組定義,憂鬱組是指過去一生中曾出現過嚴重型憂鬱症者或嚴重型憂鬱症共病焦慮症者,而正常控制組是指過去一生中未曾出現過任何精神疾病者;除了半結構式的診斷晤談量表之外,所有受試者皆須填答貝氏憂鬱量表、兒童行為與情緒檢核表、兒童生活事件量表、兒童因應策略量表、以及兒童與青少年社會支持量表修訂版。

    研究結果:以皮爾森相關進行資料的分析後,結果發現兒童的憂鬱與兒童採用主動積極、尋求支持的因應策略呈顯著負相關;另外,兒童的憂鬱與兒童知覺獲得來自母親、同學的社會支持呈顯著負相關;然而,母親的憂鬱、兒童的生活壓力與兒童的憂鬱皆無關。
    以多元階層迴歸進行資料的分析後,結果發現母親的憂鬱對兒童的憂鬱並不具有顯著的預測力;然而,兒童採用主動積極的因應策略、以及知覺獲得來自同學與親密好友的社會支持皆對兒童的憂鬱扮演主要效果的角色,當兒童愈常採用主動積極的因應策略時,則其憂鬱情緒愈少,且當兒童知覺獲得來自同學與親密好友的社會支持愈多時,其憂鬱情緒亦愈少;研究結果並未發現兒童的負向與正向生活壓力、其他類型的因應策略(暫時擱置、尋求支持、改變想法、情緒逃避)、其他來源的社會支持(父親、母親、老師)對兒童的憂鬱具有顯著的主要效果或調節效果。

    結論:本研究發現母親憂鬱、兒童之生活壓力對目前8至10歲子代之憂鬱皆不具有顯著的預測力;然而,兒童之主動積極因應策略與同儕之社會支持皆扮演主要效果的角色,亦即對兒童憂鬱皆具有顯著的負向預測力;但須注意在考量樣本的特性方面,參與本研究的婦女比未參與者較不憂鬱,且在受教育的年數上較高,此可能為造成母親憂鬱對兒童憂鬱之預測力不顯著的原因之一。

    第一章 研究背景……………………………………… ………………………… 1 第一節 母親憂鬱與兒童憂鬱之關係………………… ………………………… 1 一. 母親的憂鬱與兒童的憂鬱…………………… ………………………… 1 二. 小結…………………………………………… ………………………… 5 第二節 生活壓力與兒童憂鬱之關係………………… ………………………… 5 一. 生活壓力的定義與測量……………………… ………………………… 5 (一) 生活壓力的定義……………………………… ………………………… 5 (二) 生活壓力的測量……………………………… ………………………… 9 二. 生活壓力與婦女憂鬱與兒童憂鬱之關係…… ………………………… 13 (一) 生活壓力與婦女的憂鬱……………………… ………………………… 13 (二) 生活壓力與兒童的憂鬱……………………… ………………………… 15 三. 小結…………………………………………… ………………………… 19 第三節 因應策略與兒童憂鬱之關係………………… ………………………… 20 一. 因應策略的定義與測量……………………… ………………………… 20 (一) 因應策略的定義……………………………… ………………………… 20 (二) 因應策略的測量……………………………… ………………………… 23 二. 因應策略與婦女憂鬱與兒童憂鬱之關係…… ………………………… 25 (一) 因應策略與婦女的憂鬱……………………… ………………………… 25 (二) 因應策略與兒童的憂鬱……………………… ………………………… 25 三. 小結…………………………………………… ………………………… 28 第四節 社會支持與兒童憂鬱之關係………………… ………………………… 28 一. 社會支持的定義與測量……………………… ………………………… 28 (一) 社會支持的定義……………………………… ………………………… 28 (二) 社會支持的測量……………………………… ………………………… 31 二. 社會支持與婦女憂鬱與兒童憂鬱之關係…… ………………………… 33 (一) 社會支持與婦女的憂鬱……………………… ………………………… 33 (二) 社會支持與兒童的憂鬱……………………… ………………………… 35 三. 小結…………………………………………… ………………………… 38 第五節 研究目的與假設……………………………… ………………………… 39 第二章 研究方法……………………………………… ………………………… 40 第一節 參與者………………………………………… ………………………… 40 第二節 研究工具……………………………………… ………………………… 41 第三節 研究程序……………………………………… ………………………… 44 第四節 統計分析……………………………………… ………………………… 45 第三章 研究結果……………………………………… ………………………… 46 第一節 憂鬱組與控制組在人口統計學上之比較…… ………………………… 46 第二節 憂鬱組與控制組在憂鬱、生活壓力、因應策略、社會支持上之 比較……………………………………………………………………… 46 第三節 憂鬱、生活壓力、因應策略、社會支持之相關分析…………………… 46 第四節 母親憂鬱以及兒童生活壓力、因應策略對兒童憂鬱之預測模式……… 47 第五節 母親憂鬱以及兒童生活壓力、社會支持對兒童憂鬱之預測模式……… 49 第四章 討論…………………………………………… ………………………… 52 第一節 本研究之主要發現與解釋…………………… ………………………… 52 第二節 本研究之限制與未來研究方向……………… ………………………… 56 第三節 本研究之應用價值…………………………… ………………………… 59 參考文獻 ………………………………………………… ………………………… 60 附錄一 兒童行為與情緒量表……………………… ………………………… 82 附錄二 兒童生活事件量表…………………………… ………………………… 90 附錄三 兒童因應策略量表…………………………… ………………………… 93 附錄四 兒童與青少年社會支持量表………………… ………………………… 95

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