一、研究目的與假設
憂鬱症與焦慮症共病的發生機率遠高於隨機出現可能性。Merikangas (1990)曾對憂鬱與焦慮的關係提出三個假設: 1) 兩者可能具有共同的病因基礎；2) 焦慮症導致憂鬱症的發生；3) 憂鬱與焦慮是獨立的兩種疾病，但另外存在一種混合憂鬱與焦慮的疾病類型。為驗證上述三種假設，Merikangas建議在方法學上取樣單純憂鬱組、單純焦慮組、混合焦慮與憂鬱組以及控制組，比較這四組在可能機制上的差異。
由於男女罹患憂鬱症與焦慮症之比例不同，故本研究控制性別變項，只以婦女為研究對象。此外，過去研究發現嚴重憂鬱症狀會明顯干擾氣質與性格評估結果，本研究僅取樣在憂鬱症緩解期之個案以控制憂鬱症狀對評估結果的影響。
本研究以Gray (1987)的假想神經模型做為探討憂鬱與焦慮共病機制的主體，並控制性別與嚴重憂鬱症狀之影響，比較單純憂鬱症、單純焦慮症及混合焦慮與憂鬱症之婦女在行為抑制系統（BIS）與行為激發系統（BAS）功能上之差異。研究假設為：1) 終生診斷為單純焦慮組之個案在BIS上的功能反應較為高，在BAS上與一般控制組並無差異；2) 終身診斷為單純憂鬱組之個案在BAS上的功能反應較為低，在BIS上與一般控制組並無差異；3) 相較於一般控制組，終身診斷為憂鬱與焦慮共病組之個案在BIS的功能反應高，BAS上的功能反應低。

二、研究方法：
（一）樣本：取樣自1996年國科會研究計畫『產後憂鬱症之前因與後果』所蒐集的婦女樣本，該計畫曾取樣單純憂鬱組（過去一生曾符合重度憂鬱症）59名，單純焦慮組（過去一生曾出現過焦慮症）126名，混合焦慮與憂鬱組（過去一生曾出現過焦慮症與嚴重型憂鬱症；以下簡稱共病組）71名，以及控制組（過去一生未曾出現任何精神疾病）156名。本研究從中邀請到單純憂鬱症組24名、單純焦慮症組61名、混合焦慮症與憂鬱症組31名、以及控制組70名參與本研究，四組樣本在教育年數與年齡上無顯著差異。
（二）工具：本研究使用半結構式終生診斷晤談量表、追蹤版、目前病情版以及身心適應量表做為疾病診斷分組與疾病症狀分組工具。並以中文版行為抑制/行為激發系統量表做為BIS/BAS功能的評估指標之一。並另以廖聆岑等人改編自Carver& White所設計之單獨誘發BIS與BAS反應的實驗情境做為另一評估指標，希望能提供更多線索，觀察個案在生活情境下的真實反應。最後以中文版艾氏性格量表中之神經質量表、外向性量表與中文版三向度性格問卷內之逃避懲罰及新奇刺激尋求分量表做為量表與實驗工具效度驗證之相關指標。
（三）方法：本研究以合併量表與實驗測量的方式進行BIS、BAS功能的評估。一開始先進行診斷性晤談以追蹤個案由初次診斷晤談之後至目前的身心健康狀況，並確立最後分組。除診斷分組外，另利用生活適應量表評估目前憂鬱與焦慮狀態。BIS/BAS量表填寫完畢後，進行BIS與BAS實驗，實驗順序採隨機方式進行，並嚴格遵守實驗標準化的要求。最後請個案將其餘性格量表帶回填寫，填寫完畢後寄回

三、研究結果：
以Pearson相關進行分析，行為抑制量表與外向性量表具顯著負相關，與神經質、逃避懲罰得分則是呈現顯著正相關；行為激發量表則與外向性及新奇刺激尋求量表也具顯著相關。但在實驗部分，行為抑制實驗指標與各性格向度皆無相關。行為激發實驗指標與各性格向度量表也無相關。
以單因子變異數分析比較四組在量表上的評估結果，各組在行為抑制量表得分有顯著差異，進一步以薛費氏事後比較進行分析發現混合焦慮與憂鬱組在行為抑制量表得分高於單純憂鬱組與控制組。但在行為激發量表與相關各分量表上則無顯著差異。以單因子變異數分析四組在實驗上的評估結果，各組在BIS與BAS系統上的功能沒有顯著差異。
以Pearson相關進行分析，行為抑制量表得分與目前焦慮、憂鬱症狀具顯著正相關。

四、結論
本研究發現行為抑制與行為激發量表具有良好信、效度。
此外，混合焦慮與憂鬱症之婦女在行為抑制量表上的得分顯著高於單純憂鬱組與焦慮組，且行為抑制量表得分與憂鬱、焦慮症狀具顯著正相關。推論BIS功能過度激發可能為憂鬱與焦慮的共同危險因子。

一、中文部份

王淑惠（民90）。由家庭功能與性格特質探討婦女憂鬱焦慮之共病現象。國立成功大學醫學院行為醫學研究所碩士論文。

孔繁鐘與孔繁錦 編譯（民85）。DSM-IV 精神疾病診斷手冊。台北市：合記出版社。

柯慧貞、孫苑庭、林木芬、葉宗烈、陸汝斌（民83）。由行為抑制探討婦女焦慮與憂鬱的共病機制。台灣精神醫學，14（1），13～21。

柯慧貞（民85）。產後憂鬱症致病機轉之前瞻性研究III。行政院國科會專題計畫成果報告，號編NSC-85-2331-13-006-108Y。

莊耀嘉（民75）。心理病態性格與犯罪行為。法務部犯罪問題研究中心。

曾美智、李宇宙、李明濱（民85）。憂鬱症與焦慮症之共患現象。台灣精神醫學，13（2），125～135。

謝玲玉（民89）。由兒童其與成人期依附關係探討婦女憂鬱與焦慮之共病。成功大學行為醫學研究所碩士論文。

廖聆辰（民91）。反社會性格障礙與非反社會性格障礙男性在行為抑制與行為激發系統上之探討。成功大學行為醫學研究所碩士論文。

二、英文部份

Allen, J. J., Iacono, W.G., Depue, R.A., & Arbisi, P. “Regional electroencephalographic asymmetries in bipolar seasonal affective disorder before and after exposure to bright light”. Biological Psychiatry, 33, 642~646, 1993.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders (4th edition). Washington, DC: Author, 1994.

Andrews, G., Nelson, M., Hunt, C., Stewart, G. & Kiloh, L.G. “Diagnosis, personality and long-term outcome of depression”. British Journal of Psychiatry, 157, 13~18, 1990.

Angst, J., Vollrath, M., Merikangas, K.R., Ernst, C. “Comorbidity of Anxiety and Depression in the Zurich Cohort Study of Young Adults ”. In Maser, J.D., &
Cloninger, C.R. (eds.), Comorbidity of Mood and Anxiety Disorders (pp.123~137). Washington, D.C：American Psychiatric Press, 1990.

Bagby, R.M., Joffe, R.T., Parker, J.D.A., Kalemba,V., Harkness, K.L.. “Major depression and the five-factor model of personality”. J. Pers. Dis. 9,224~234, 1995.

Barlow, D.H., Blanchard, E.B., Vermilyea, J.A., Vermilyea, B.B. &Dinardo, P.A. ”Generalized anxiety and generalized anxiety disorder: Description and reconceptualization”. American Journal of Psychiatry, 143, 40~44, 1986.

Breslau, N., & Peterson, E. “Sex differences in depression: a role for preexisting anxiety”. Psychiatry Research, 8, 1～12, 1995.

Burke, J.D., Wittchen,H.-U., Regier, D.A. & Sartorious, N. ” Extracting Information From Diagnostic Interviews on Co-Occurrence of Symptoms of Anxiety and Depression”. In Maser ,J.D., & Cloninger, C.R. (eds.), Comorbidity of Mood and Anxiety Disorders (pp.649~668). Washington, D.C：American Psychiatric Press, 1990.

Berenbaum, S.A., Kerns, K., Taylor, M.A. “A Neuropsychological Perspective on Cormorbid Disorders”. In Maser ,J.D., & Cloninger, C.R. (eds.), Comorbidity of Mood and Anxiety Disorders (pp.403~412). Washington, D.C：American Psychiatric Press, 1990.

Carver, C.S., & White, T.L. “Behavior Inhibition, Behavior Activation, and Affective Responses to Impending Reward and Punishment: The BIS/BAS Scale”. Journal of Personality and Social Psychology, 67, 319~333, 1994.

Carver, C.S., Meyer,B. & Antoni, M.H. “ Responsiveness to Threats and Incentives, Expectancy of Recurrence, and Distress and Disengagement: Moderator Effects in Women With Early Stage Breast Cancer”. Journal of Consulting and Clinical Psychology,68, 965~975, 2000.

Carver, C.S., Sutton, S.K., & Scheier, M.F. “Action, emotion, and personality : Emerging conceptual integration”. Personality and Social Psychology Bulletin, 26, 741~751, 2000.

Cloninger, C.R.” The Tridimentional Personality Questionnaire”. Department of Psychiatry and Genetics, Washington University School of Medicine, 1989.

Clark, L.A., Watson, D., &Mineka, S. “Temperament, Personality, and the Mood and Anxiety Disorders”. Journal of Abnormal Psychology, 103,103~116, 1994.

Clayton PJ. Grove WM. Coryell W. Keller M. Hirschfeld R. Fawcett J. “Follow-up and family study of anxious depression”. American Journal of Psychiatry.148:1512-1527, 1991.

Clayton PJ. ”Depression Subtyping: Treatment Implication”. Journal of Clinical Psychiatry. 59:5~12, 1998.

Davidson, R.J., & Fox, N. A. “Frontal brain asymmetry predicts infants’ response to maternal separation”. Journal of Abnormal Psychology, 98, 127~131, 1989.

Depue, R.A. & Collins, P.F. ”Neurobiology of the structure of personality: Dopamine, facilitation of incentive motivation, and extraversion”. Behavior and Brain Science, 22, 491~569, 1999.

Depue, R.A. & Iacono, W.G..(1989)Neurobehavioral aspects of affective disorders. Annual Review of Psychology, 40, 457-492.

Diego MA. & Field T. “ BIS/BAS scores are correlated with frontal EEGAsymmetry in intrusive and withdrawn depressed mothers”. Infant Mental Healthy Journal, 22, 665~675, 2001.

Eddie, H. J., & John, J. B. “Behavioral activation sensitivity and resting frontal EEG asymmetry: covariation of putative indicators related to risk for mood disorders”. Journal of Abnormal Psychology, 106, 159-163, 1997.

Elliot, AJ. & Thrash, TM. “Approach-Avoidance Motivation in Personality: Approach and avoidance temperaments and goals”. Journal of Personality and Social Psychology, 82, 804-818, 2002.

Feinstein, A.R. “The pre-therapeutic classification of co-morbidity in chronic disease”. Journal of Clinical Disease, 23, 455~468, 1970

Fowles, D.C. “Application of a behavioral theory of motivation to the concepts of anxiety and impulsivity”. Journal of Research in Personality, 21, 417~435, 1987.

Fowles, D.C. “Psychophysiology and Psychopathology: A motivational approach”. Psychophysiology, 25, 373~392, 1988.

Gable, S.L., Reis, H.T., & Elliot, A.J.” Behavior Activation and Inhibition in Everyday Life”. Journal of Personality and Social Psychology,78, 1135~1149, 2000.

Gater, R., Tansella, M., Korten, A. “ Sex Difference in the Prevalence and Detection of Depression and Anxiety Disorders in General Health Care Settings”. Archives General Psychiatry, 55, 405 ~ 413, 1998.

Germans, M.K., Kring, A.M. “Hedonic deficit in anhedonia: support for the role of approach motivation”. Personality and Individual Differences, 28, 659~672, 2000.

Gomez, R., Francis, L.M. “Generalized Anxiety Disorder: relationships with Eysenck’s, Gray’s and Newman’s theories”. Personality and Individual Differences, 34, 3~17, 2003.

Gray, J.A. ”Anxiety and the brain: Pigments aren’t colour names”. Bulletin of the British Psychological Society, 38, 299~300, 1985.

Gray, JA. ”The psychology of fear and stress (2nd ed.)”. New York: Cambridge, 1978.

Gray, J. A. “ Fear , panic, and anxiety: What ‘s in a name?” Psychological Inquiry, 2, 77~78, 1991.

Gray, J.A. “ Framework for a taxonomy of psychiatry disorder”. In S.H.M. Van
Goozen & N.E. Van de Poll (Eds.) Emotions: Essays on emotion theory (pp.29~59). Hillsdale, NJ: Erlbaum, 1994a.

Gray, J. A.”Personality dimensions and emotion systems ”. In P. Ekman & R.J. Davidson (eds.) The nature of emotion: Fundamental questions (pp.329~331).New York: Oxford University Press, 1994b.

Griens, A.M.G.F., Jonker, K., Spinhoven, P.H., Blom, M.B.J. “The influence of depressive state features on trait measurement”. Journal of Affective Disorders, 70, 95~99, 2002.

Harmon-Jones, E., & Allen, J.J.B. "Behavior Activation Sensitivity and Resting Frontal EEG Asymmetry: Covariation of Putative Indicators Related to Risk for Mood Disorders". Journal of Abnormal Psychology, 106, 159~163, 1997.

Harmon-Jones, E., Abramson, L. Y., Sigelman, J., Bohlig, A., Hogan, M.E., & Harmon-Jones, C. “Proneness to hypomania/mania symptoms or depression symptoms and asymmetrical frontal cortical responses to an anger-evoking event”. Journal of Personality and Social Psychology, 82, 610-618, 2002.

Henriques, J.B., & Davidson, R.J. ” Left frontal hypoactivation in depression”. Journal of Abnormal Psychology, 100, 535~545, 1991.

Heubeck, B. G., Wilkinson, R. B., & Cologon, J. ”A second look at Carver and White’s (1994) BIS/BAS scales”. Personality and Individual Differences, 25, 785-800, 1998.

Hirschfeld, R.M.A., Klerman, G.L., Clayton, P.J., Keller, M.B., McDonald-Scott, P., Larkin, B.H. “Assessing personality: effects of the depressive state on trait measurement”. American Journal of Psychiatry, 140,695~699, 1983.

Johnson, S.L., Turner, R.J. &Iwata, N. “BIS/BAS Levels and Psychiatric Disorder: An Epidemiological Study”. Journal of Psychopathology and Behavioral Assessment, 25, 25~36, 2003.

Jorm, A.F., Christensen, H., Henderson, A. S., Jacomb, P. A., Korten, A.E., & Rodger, B. “Using the BIS/BAS Scales to measure behavioral inhibition and behavior activation: Factor structure, validity, and norms”. Personality and Individual Differences, 26, 49~58, 1999.

Liau, L.C.& Ko, H.C.” The development of BIS/BAS scale: Psychometric properties and relation to antisocial personality disorder” (in press).

Lydiard, R.B., Brawman-Mintzer, O. “Anxious Depression”. Journal of Clinical Psychiatry. 59, 10~17, 1998.

Kasch, K.L., Rottenberg, J., Arnow, B.A. & Gotlib, I.H.” Behavioral Activation and Inhibition Systems and the Severity and Course of Depression”. Journal of Abnormal Psychology, 111, 589~597, 2002.

Klerman, G.L. “Approach to the Phenomena of Comorbidity”. In Maser ,J.D., & Cloninger, C.R. (eds.), Comorbidity of Mood and Anxiety Disorders (pp.13~40). Washington, D.C：American Psychiatric Press, 1990.

Maser, J.D. & Cloninger, C.R. “Comorbidity of Anxiety and Mood disorders: Introduction and Overview”. In Maser ,J.D., & Cloninger, C.R. (eds.), Comorbidity of Mood and Anxiety Disorders (pp.3~12). Washington, D.C：American Psychiatric Press, 1990.

Merikangas, K.R.” Comorbidity for Anxiety and Depression: Review of Family and Genetic Studies”. In Maser ,J.D., & Cloninger, C.R. (eds.), Comorbidity of Mood and Anxiety Disorders (pp.331~348). Washington, D.C：American Psychiatric Press, 1990..

Meyer, B., Johnson, S.L., Carver, C.S. “Exploring Behavioral Activation and Inhibition Sensitivities Among College Students at Risk for Bipolar Spectrum Symptomatology”. Journal of Psychpathology and Behavior Assessment, 21, 275~292, 1999.

Newman, J. P., Wallace, J. F., Schmitt, W. A., & Arnett, A. “Behavioral inhibition system functioning in anxious, impulsive and psychopathic individuals”. Personality and Individual Differences, 23, 583-592, 1997.

Oosterlaan J. & Sergeant JA. “ Inhibition in ADHD, Aggressive, and Anxious Children: A Biologically Based Model of Child Psychopathology”. Journal of Abnormal Child Psychology, 24, 19~35, 1996.

Quay, H. C. “Theories of ADDH”. Journal of American Acad Child and Adolescent Psychiatry, 27, 262-263, 1988.

Quay, H. C. “The psychobiology of undersocialized aggressive conduct disorder: a theoretical perspective”. Developmental Psychology, 5, 165-180, 1993.

Sutton, S.K. & Davidson, R.J. “ Prefrontal brain asymmetry: A biological substrate of the behavioral approach and the behavioral inhibition systems”. Psychological Science, 8, 204-210, 1997.

Watson, D. & Clark, L.A. “Negative affectivity: The disposition to experience aversive emotional states”. Psychological Bulletin, 96, 465~490, 1984.

Watson, D., Clark, L.A. &Carey, G. “Positive and negative affect and their relation to anxiety and depression disorders”. Journal of Abnormal Psychology, 97, 346~353, 1988.

Widger, T.A. & Anderson, K.G. “Personality and depression in women”. Journal of Affective Disorders, 74, 59~66, 2003.

Widger, T.A. “Personality and depression: assessment issues”. In: Klein, M.H., Kupfer, D.J., Shea, M.T. (Eds), Personality and Depression : A current View (pp. 77~118), Guilford Press, New York , 1993.