憂鬱症、焦慮症、以及焦慮和憂鬱共病婦女對負面情緒的因應

Coping with Negative Emotions in Women with Depressive, Anxiety, and Comorbid Anxiety-depressive Disorders

10.29478/TJP.200706.0006

謝毅興(Yi-Hsing Hsieh)；何慧貞(Huei-Chen Ko)；林彥鴻(Yan-Hong Lin)

混合焦慮與憂鬱 ； 注意偏誤 ； 情緒引發程序 ； 因應策略 ； comorbid anxiety-depressive disorders ； attentional bias ； mood induction procedure ； coping strategy

台灣精神醫學

21卷2期（2007 / 06 / 01）

117 - 126

繁體中文

目的：本研究探討負面情緒引發如何影響憂鬱症、焦慮症及混合焦慮症與憂鬱症患者對人臉情緒的注意偏誤。方法：一百十八名參與者係出自參加產後憂鬱研究的婦女樣本庫，根據半結構式終生診斷晤談，將參與者分成單純憂鬱組、單純焦慮組、憂鬱與焦慮共病組、與正常組。利用情緒引發程序，操弄參與者的焦慮或憂鬱情緒狀態，緊接著測量參與者在注意資源分配作業的表現。結果：當憂鬱情緒升高，憂鬱組抑制對悲傷人臉的注意；當焦慮情緒升高，焦慮組和共病組表現出對快樂人臉的注意偏誤。結論：共病組在負面情緒的因應策略和焦慮組類似，但不同於憂鬱組我們提出一個模式解釋此結果。

Objective: This study investigated the effect of negative mood induction on attentional biases in women with anxiety, depressive, or comorbid anxiety-depressive disorders. Methods: 118 participants were selected from a subject pool established for postpartum research. Participants were divided into four groups: depressive only, anxiety only, comorbid anxiety-depressive disorders, and normal controls, according to the lifetime version of the Modified Schedule of Affective Disorders and Schizophrenia. After procedures inducing either an anxious or a depressive state, attentional bias was measured using a deployment-of-attention task. Participants viewed an emotional face paired with a neutral face of the same individual, and were then required to identify on which one a colored patch had first appeared. The percentage of choices favoring happy, angry, or sad faces represented the selective attentional bias score for each emotion. Results: Attentional bias for sad faces was suppressed in depressed participants when their sad mood was evoked. When anticipatory anxiety was evoked, anxious participants and participants with comorbid anxiety-depressive disorders showed attentional bias for happy faces. Conclusion: In distress, individuals with mixed comorbid depressive disorders use the same coping strategy as individuals with only anxiety do. This differs from individuals with depression only. A model is proposed to account for the results.

1. Stroop JR: Studies of interference in serial verbal reactions. J Exp Psychol 1935;18:643-61.
2. American Psychiatric Association(1994).Diagnostic and Statistical Manul of Mental Disorders.Washington DC:American Psychiatric Association.
3. Amir, N,McNally, RJ,Reimann, BC,Burns, J,Lorenz, M,Mullen, JT(1996).Suppression of the emotional Stroop effects by increased anxiety in patients with social phobia.Behav Res Ther,34,945-48.
4. Beck, AT(1976).Cognitive Therapy and the Emotional Disorders.New York:International University Press.
5. Bower, GH(1981).Mood and memory.Am Psychol,6,129-48.
6. Bradley, BP,Mogg, K,Millar, N,Bonham-Carter, C(1997).Attentional biases for emotional faces.Cogn Emotion,11,25-42.
7. Burack, JA(ed.),Enns, JT(ed.)(1997).Attention, Development, and Psychopathology.New York:Guilford Press.
8. Dalgleish, T(ed.),Power, M(ed.)(1999).Handbook of Cognition and Emotion.New York:Wiley.
9. Davey, GC,Hampton, J,Farrell, J,Davidson, S(1992).Some characteristics of worrying: Evidence for worrying and anxiety as separate constructs.Pers Indiv Diff,13,133-47.
10. Endler, NS,Parker, JDA(1994).Assessment of multidimensional coping task, emotion and avoidance strategies.Psychol Assess,6,50-60.
11. Endler, NS,Parker, JDA,Butcher, JN(2003).A factor analytic study of coping styles and the MMPI-2 content scales.J Clin Psychol,59,1049-54.
12. Eysenck, MW(1997).Anxiety and Cognition.Hove, UK:Psychology Press.
13. Feldner, MT,Zvolensky, MJ,Leen-Feldner, EW(2004).A critical review of the empirical literature on coping and panic disorder.Clic Psychol Rev,24,12-48.
14. Gotlib, IH,McCann, CD(1984).Construct accessibility and depression: an examination of cognitive and affective factors.J Pers Soc Psychol,47,427-39.
15. Gotlib, IH,McLachlan, AL,Katz, AN(1988).Biases in visual attention in depressed and nondepressed in dividuals.Cogn Emotion,2,185-200.
16. Holahan, CJ,Moos, RH,Holahan, CK,Brennan, PL,Schutte, KK(2005).Stress generation, avoidance coping, and depressive symptoms: a 10-year model.J Consult Clin Psychol,73,658-66.
17. Hong, RY(2007).Worry and rumination: Differential associations with anxious and depressive symptoms and coping behavior.Behav Res Ther,45,277-90.
18. Hope, DA,Rapee, RM,Heimberg, RG,Dombeck, MJ(1990).Representations of the self in social phobia: vulnerability to social threat.Cogn Ther Res,4,177-89.
19. Hsieh, YH,Ko, HC(2004).Cognitive biases for emotional faces in high- and low-trait depressive participants.Kaohsiung J Med Sci,20(10),478-83.
20. Lazarus, RS,Folkman, S(1984).Stress, appraisal and coping.New York:Springer.
21. Lundh, LG,Oest, LG(1996).Stroop interference, self-focus and perfectionism in social phobics.Pers Indiv Diff,20,725-31.
22. MacLeod, C,Rutherford, EM(1992).Anxiety and the selective processing of emotional information: mediating roles of awareness, trait and state variables, and personal relevance of stimulus materials.Behav Res Ther,30,479-91.
23. Martin, RC,Dahlen, ER(2005).Cognitive emotion regulation in the prediction of depression, anxiety, stress, and anger.Pers Indiv Diff,39,1249-60.
24. Maser, JD(ed.),Cloninger, CR(ed.)(1990).Comorbidity of Mood and Anxiety Disorders.Washington DC:American Psychiatric Association.
25. Mathews, A,Mackintosh, B(1998).A cognitive model of selective processing in anxiety.Cogn Ther Res,22,539-60.
26. Mathews, A,Sebastian, S(1993).Suppression of the emotional Stroop effects by fear-arousal.Cogn Emotion,7,517-30.
27. McCabe, SB,Gotlib, IH(1995).Selective attention and clinical depression: performance on a deployment-of-attention task.J Abnorm Psychol,104,241-5.
28. McNally, RJ,Amir, N,Louro, CE,Lukach, BM,Riemann, BC,Calanari, JE(1994).Cognitive processing of idiographic emotional information in panic disorder.Behav Res Ther,32,119-22.
29. McNally, RJ,Riemann, BC,Kim, E(1990).Selective processing of threat cues in panic disorders.Behav Res Ther,28,407-12.
30. Mogg, K,Kentish, J,Bradley, BP(1993).Effects of anxiety and awareness on colour-identification latencies for emotional words.Behav Res Ther,31,559-67.
31. Segal,ZV,Truchon, C,Horowitz, LM,Gemar, M,Guirguis, M(1995).A priming methodology for studying self-representation in major depressive disorder.J Abnorm Psychol,104,205-13.
32. Williams, JMG,Mathews, A,MacLeod, C(1996).The emotional Stroop task and psychopathology.Psychol Bull,120,3-24.
33. Williams, JMG,Watts, FN,MacLeod, C,Mathews, A(1997).Cognitive Psychology and Emotional Disorders.Chichester, UK:Wiley.
34. 柯慧貞(1999)。行政院國家科學委員會專題研究成果報告行政院國家科學委員會專題研究成果報告,行政院國家科學委員會。
35. 柯慧貞(1996)。行政院國家科學委員會專題研究成果報告行政院國家科學委員會專題研究成果報告,行政院國家科學委員會。
36. 柯慧貞、孫苑庭、林木芬、葉宗烈、陸汝斌(2000)。由行為抑制探討婦女焦慮與憂鬱之共病機制。台灣精神醫學，14，13-21。

1. 蔡曉婷,陳玟伶,周汎澔(2015)。學齡期注意力缺陷過動症兒童之母親憂鬱及其相關因素之探討。護理雜誌，62(1)，39-49。