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研究生: 林砡如
Lin, Yu-Ju
論文名稱: 憂鬱症患者於選擇性注意歷程對正性與負性干擾物之抑制現象
Selective Processing of Positive and Negative Information inClinical Depression : The Bias of Activation and Inhibition
指導教授: 謝淑蘭
Hsieh, Shulan
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: 2007
畢業學年度: 95
語文別: 中文
論文頁數: 73
中文關鍵詞: 記憶提取負向促發注意力抑制憂鬱症
外文關鍵詞: depressive disorder, memory retrieval, attention inhibition, negative priming
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  • 研究目的:本研究主要以負向促發作業探討憂鬱症患者選擇性注意力功能,並瞭解在不同詞性干擾下對注意力抑制或記憶提取歷程的影響。研究方法:受試者為診斷處於憂鬱發作期之憂鬱症患者22名,配對正常受試者30名。實驗設計為干擾物(全中性、中性、正性與負性)本體重複,呈現時間為500毫秒,然後受試者以顏色線索配對目標物按鍵位置反應。研究結果:反應時間以無母數分析進行檢定,結果發現憂鬱組在全部情況下負向促發效果均下降,在全中性與正性情況出現正向促發現象。正常組在全中性情況出現負向促發效果,在正性、中性與負性情況負向促發效果下降。憂鬱組與正常組在全中性情況下負向促發效果達顯著差異。研究結論:以抑制理論與回溯提取理論解釋本研究結果,憂鬱症患者對干擾訊息之注意抑制功能與回溯提取功能出現受損現象,並於全中性情況下呈現與正常人不同的訊息處理歷程。

    The present study was designed to examine selective attentional functioning in clinical depressive participants. Experimental variables were repetition (repeating and non-repeating) and stimulus valence (neutral, positive and negative contents). The participants included 22 major depressive patients and 30 matched healthy participants. A negative priming task included prime and probe pairs. The repeated condition differed from the non-repeated one in that the probe display target was the same words as the prime display distractor. Color cue, distractor and target were simultaneously presented for 500 msec, and then the participants quickly pressed an assigned key. The recorded key-press time was analyzed by the nonparametric statistical method. Results showed that depressive patients failed to exhibit negative priming at all conditions, and that healthy subjects revealed negative priming only at the neutral condition. Compared to the healthy subjects, the depressive patients are not capable of inhibiting neutral distractors. The findings can be explained by the attention inhibition and memory retrieval hypotheses, which suggest depressive patients disrupt attention inhibition and memory retrieval function and that processing differences in neutral distractors exist between the healthy participants and depressive patients.

    摘要 ................................................................I 致謝 ..............................................................III 目錄 ...............................................................IV 第一章 導論.........................................................1 第一節:憂鬱症 ................................................1 一、憂鬱症診斷與盛行率................................ 1 二、憂鬱症成因與影響.................................. 2 第二節:憂鬱症患者認知因素研究.................................3 一、憂鬱症患者認知功能.................................3 二、憂鬱症患者神經生理機制............................ 5 三、憂鬱症患者神經心理機制............................ 7 四、研究動機 ......................................... 9 第三節:憂鬱者的選擇性注意力研究 ............................ 10 一、改良式叫色干擾作業 (Modified Stroop Task).........11 二、點偵測作業(Dot Probe Task) .......................12 三、Deployment Of Attention Task (DOAT)...............13 四、負向促發效果(Negative Priming Effect).............14 (一)理論學說........................................15 (1)抑制說(Inhibition Hypothesis)................16 (2)回溯提取說(Retrieval Hypothesis)............ 16 (二)負向促發現象的神經學基礎........................16 (三)一般人的負向促發現象............................17 (四)憂鬱症患者的負向促發現象........................17 第四節:研究目的假設..........................................20 第二章 研究方法....................................................22 第一節:研究架構..............................................22 第二節:研究對象..............................................23 第三節:實驗材料及設備........................................25 第四節:負向促發作業..........................................26 第五節:負向作業流程..........................................30 第六節:研究總流程............................................32 第七節:統計分析..............................................33 第三章 結果........................................................35 第一節:促發項分析............................................35 第二節:偵測項分析............................................41 第三節:相關分析..............................................48 第四章 結論與建議................................................. 49 第一節:負向促發作業之干擾效果................................49 第 二 節:負向促發作業之抑制效果..............................51 第三節:研究限制..............................................56 第四節:未來研究方向..........................................57 第五節:總結..................................................58 參考文獻............................................................59 附錄................................................................66 附錄一:詞性評估問卷..........................................66 附錄二:詞庫..................................................70 附錄三:負向促發作業說明流程..................................72 附錄四:受試者轉介單..........................................73 表目錄 表一:受試者基本資料.........................24 表二:十五種嘗試情況...................28 表三:憂鬱組與正常組促發項反應時間(毫秒)平均值與標準差及中位數與四分位差....................35 表四:以Wilcoxon-Mann-Whitney Test檢驗憂鬱組與正常組分別在十種促發情況之反應時間(毫秒)差異.......36 表五:憂鬱組與正常組促發項正確率平均值與標準差及中位數與四分位差....37 表六:以Two-Sample Kolmogorov-Smirnov Test檢驗憂鬱組與正常組分別在十種促發情況之正確率差異.......37 表七:以Wilcoxon-Mann-Whitney Test檢驗憂鬱組與正常組分別在有無干擾詞情況下之反應時間(毫秒).......38 表八:以Wilcoxon Signed Ranks Test檢驗憂鬱組在「正中」「中中」,「負中」「中中」之反應時間(毫秒)的差異。.........39 表九:以Wilcoxon Signed Ranks Test檢驗正常組在「正中」「中中」,「負中」「中中」之反應時間(毫秒)的差異。............39 表十:憂鬱組與正常組之正性與負性詞干擾效果平均值與標準差及中位數與四分位差(毫秒).............40 表十一:以Wilcoxon-Mann-Whitney Test檢驗憂鬱組與正常組分別在正性詞干擾效果與負性詞干擾效果(毫秒)下之差異.......40 表十二:憂鬱組與正常組在偵測項各情況反應時間(毫秒)之平均值與標準差及中位數與四分位差........42 表十三:憂鬱組與正常組在偵測項各情況正確率之平均值與標準差及中位數與四分位差......43 表十四:以Two-Sample Kolmogorov-Smirnov Test檢驗憂鬱組與正常組分別在十四種偵測情況之正確率差異.......44 表十五:Wilcoxon Signed Ranks Test檢驗憂鬱組在E1-C1,E2-C2,E3-C3,E4-C4,E5-C5,E6-C6與E7-C7間反應時間的差異(毫秒)。.........45 表十六:Wilcoxon Signed Ranks Test檢驗正常組在E1-C1,E2-C2,E3-C3,E4-C4,E5-C5,E6-C6與E7-C7間反應時間的差異(毫秒)。......45 表十七:憂鬱組與正常組於七種情況負向促發效果值之平均值與標準差及中位數與四分位差(毫秒)。........46 表十八:Friedman Test檢驗憂鬱組七種負向促發效果(毫秒)間比較.....46 表十九:Friedman Test檢驗正常組七種負向促發效果(毫秒)間比較.....46 表二十:Wilcoxon-Mann-Whitney Test檢驗憂鬱組與正常組分別在七種負向促發效果(毫秒)之差異..........47 圖目錄 圖一:憂鬱症患者與正常人大腦血流量正子斷層造影圖.....................6 圖二:Siegle 解釋憂鬱症患者注意力偏差現象之神經網絡模式..............8 圖三:點偵測作業....................................................13 圖四:DOAT(McCabe, Gotlib, and Martin, 2000)......................14 圖五:負向促發嘗試(包含促發項與偵測項)............................15 圖六:研究架構圖....................................................22 圖七:一個嘗試中包含促發項與偵測項(以全中性詞干擾重複為例)........29 圖八:憂鬱組與正常組之正性詞與負性詞干擾效果中位數(毫秒)..........40 圖九:憂鬱組與正常組在七種情況下負向促發效果中位數(毫秒)..........47

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