https://scholars.lib.ntu.edu.tw/handle/123456789/40127
標題: | 身體化反應與無助狀態之確認的前瞻性臨床研究(II) | 作者: | 陳淑惠 | 關鍵字: | 無助狀態之確認;壓力;焦慮;憂鬱;臨床診斷樣本;Certainty of Helplessness;Stress;Anxiety;Depression;Clinical Samples | 公開日期: | 1999 | 出版社: | 臺北市:國立臺灣大學心理學系暨研究所 | 摘要: | 本報告是前瞻性長期研究之第二年中途性研究成果。本研究計畫在「壓力/認知特異質模式(Stress-Cognitive Diathesis Model)」之架構下,以「無助/絕望理論(Helplessness-Hopelessness Theory)」為概念之依歸,選取焦慮與憂鬱的高罹患危險群以及正常成人兩組,來探討無助狀態之確認與身體化反應之間的關係。本研究的樣本包括臨床焦慮病患組(N=99)與正常成人組(N=317)。研究結果發現:(一)無論是臨床病患組或正常成人組,其焦慮與憂鬱傾向均與壓力量呈正相關。而比較兩組之壓力量、焦慮症狀與憂鬱症狀,發現病患並未感受到較高的壓力量,但卻呈現較多的焦慮與憂鬱症狀( p<.001)。(二)針對壓力下的各項認知評估因素之比較,臨床病患組在最大壓力的重要性、威脅感、傷害性、失落感等認知評估因子上顯著高於正常成 人組,在掌控感上則顯著較低。但是,在挑戰性、無助的預期、負向結果的預期、與其確認程度等認知評估因子上,則與正常成人組並無顯著差異。(三)因徑分析的結果顯示,在「壓力之認知評估®焦慮®憂鬱」的歷程中,病患組與正常成人組之焦慮傾向與憂鬱傾向分別由不同的認知評估因子所組成之因徑來預測。本研究的結果,雖未完全支持「無助/絕望理論」對焦慮憂鬱病患的獨特解析效力,然而藉由對壓力與症狀的關係之再度檢驗,並比較臨床組與正常組之影響因徑模式,很可能對焦慮與憂鬱的心理病因之瞭解,以及臨床防治工作之應用有所助益。 As the second-year study of the threeyear longitudinal Research Project, the goal of the proposed research is to investigate the association of helplessness, certainty of helplessness, anxiety, and depression in those who are at higher risk for anxiety or depression disorders. As widely noted in 2 several studies, Taiwanese tend to express psychological distress via somatization, which may be manifested by symptoms parallel to anxiety. A question thus arises as to whether holding a pattern of somatization and seeking medical help may be associated with elevated helplessness and lower certainty of helplessness while encountering stress. Hence, such a pattern may maintain the mixed anxiety-depressive state, and may in turn prevent the less depressed from becoming more depressed. In order to examine the above-mentioned postulation, a prospective research with three-year longitudinal design among high risk groups will be in order. In the first year, the proposed research aimed to research on stress measures. In the second year, the proposed study was designed to test the association among cognitive appraisal factors such as importance, helplessness, and certainty of helplessness, and symptoms like anxiety and depression between psychiatric anxiety/depression patients and normal controls. The present study recruited both psychiatric patients (N=99) and normal adults (N=317). The results show that: 1) Correlation analyses yield significantly positive correlation among total stress, anxiety, and depression in both samples. Although both samples encountered similar amounts of stress, patients displayed significantly more symptoms. 2) In terms of cognitive appraisal factors, patients endorsed significantly higher on importance, threat, harm, loss and lower on controllability, whereas both samples endorsed similar amounts of challenge, negative outcome expectancy, helplessness expectancy, and certainty of helplessness. 3) Path analyses yield that anxiety and depression were independently predicted by different patterns of cognitive appraisal factors for patients and normal adults. Future research and clinical application of helplessness-hopelessness model are also discussed. |
URI: | http://ntur.lib.ntu.edu.tw//handle/246246/9659 | 其他識別: | 882413H002021 | Rights: | 國立臺灣大學心理學系暨研究所 |
顯示於: | 心理學系 |
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882413H002021.pdf | 54.68 kB | Adobe PDF | 檢視/開啟 |
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