強迫症狀的心理病理機制：責任感、完美主義、無法忍受不確定性之角色

Mechanism of Psychopathology of Obsessive Compulsive Symptoms: The Role of Responsibility, Perfectionism, and Intolerance of Uncertainty

10.6342/NTU201800070

吳語涵

強迫症 ； 強迫檢查 ； 責任感 ； 完美主義 ； 無法忍受不確定性 ； obsessive compulsive disorder ； checking ； responsibility ； perfectionism ； intolerance of uncertainty

國立臺灣大學心理學系學位論文

2018年

碩士

張素凰

繁體中文

強迫症的相關認知理論最早由Salkovskis於1985年時提出。過去數十年來，研究結果顯示多項認知因子對於了解強迫症的心理病理以及治療上具有重要的貢獻。然而，在認知理論中，各個因子所扮演的角色仍模糊不清。本研究的目的在於探討責任感（responsibility）、完美主義（perfectionism）、無法忍受不確定性（intolerance of uncertainty）三者之間彼此的關係，及其在強迫症嚴重程度與強迫檢查傾向中所扮演的角色，擬據以建立一個可能的病理模型。本研究透過自陳式量表，研究樣本為232名台灣大學大學生（男性88名，女性144名，平均年齡20.66歲）。本研究所提出之模型適配度大致落於良好之範圍。研究結果顯示，在預測強迫症狀嚴重程度方面，完美主義會透過無法忍受不確定性影響強迫症狀嚴重程度，責任感會透過無法忍受不確定性影響強迫症狀嚴重程度，完美主義會透過責任感影響無法忍受不確定性、進而影響強迫症狀嚴重程度，控制前述間接效果後，完美主義對於強迫症狀嚴重程度仍具有直接預測力；在預測強迫檢查傾向方面，研究顯示，完美主義會透過責任感和無法忍受不確定性影響強頗檢查傾向，責任感會透過無法忍受不確定性影響強迫檢查傾向，而完美主義會透過責任感影響無法忍受不確定性、進而影響強迫檢查傾向，完美主義對強迫檢查傾向之直接效果達邊緣顯著。在此二模型中，責任感皆作為完美主義影響無法忍受不確定性的部分中介變項。本研究之研究結果可增加對強迫症及強迫檢查行為之認知機制之了解，並作為臨床工作者在介入治療時之參考。

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