東吳大學博碩士論文 etd-0130108-095541 詳細資訊
姓名 王淳慧 (Chun-hui Wang)
系所名稱 心理學系 (Department of Psychology)
學位 碩士 (Master) 學年度／學期 96 學年度第 1 學期
論文名稱 廣泛性焦慮疾患的病因機制：「無法忍受不確定性」、「對擔心的負向信念」與「廣泛性焦慮疾患」間關係的探討
論文名稱(英) The Pathological Mechanism of Generalized Anxiety Disorder: The Exploration of Relations among ‘Intolerance of Uncertainty’, ‘Negative Beliefs about Worry’, and ‘Generalized Anxiety Disorder’
論文名稱(其他) none
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關鍵字(中) 病因 對擔心的負向信念 無法忍受不確定性 廣泛性焦慮疾患 擔心
關鍵字(英)
etiology
negative believe about worry
intolerance of uncertainty
GAD
worry
摘要(中) 研究目的： Dugas等人所提出的廣泛性焦慮疾患（GAD）之成因理論及實證研究都支持「無法認受不確定性」會導致GAD。但此理論仍有兩個問題有待釐清：第一、過去相關研究都是以賓州憂慮問卷（PSWQ）來測量GAD，而PSWQ只能測得「過多或過度擔心」，並不能等同於GAD。第二、Dugas並未探討「無法認受不確定性」導致GAD的機制。因此，本研究目的有二：第一、以測量GAD的廣泛焦慮疾患問卷（GADQ-IV）取代PSWQ，以檢驗「無法忍受不確定性」是否可顯著預測「類GAD」。第二，探討「對擔心的負向的信念」是否為「無法忍受不確定性」到GAD的中介必須變項，以確認「無法忍受不確定性」至GAD的機制。
研究方法：本研究採橫斷式研究，以「無法忍受不確定性」量表、監控認知問卷及廣泛焦慮疾患問卷收集資料，研究對象為大學生，有效樣本共333位，資料分析方法以簡單線性及階層式多元回歸分析為主。
結果與討論：（1）「無法忍受不確定性」可顯著預測GAD。（2）「對擔心的負向信念」在「無法忍受不確定性」到GAD的歷程中的確扮演著中介必須變項角色，且以「無法控制的負向思考」為「對擔心的負向信念」中最具關鍵性的因素。
貢獻：此結果除了釐清GAD的病因機制外，有助於GAD之預防、治療的衡鑑及治療方式。也就是更著重於GAD的「無法忍受不確定性」及「對擔心的負向信念」之衡鑑及處遇。
摘要(英) Purpose: The GAD etiology proposed by Dugas and the research result had confirmed that the “intolerance of uncertainty” (IU) is a cause of GAD. There are, however, two remaining issues required to clarify. First, all previous studies used PSWQ to measure the level of worry, but PSWQ was intended to measure “excessive worry”, not GAD itself. Second, the mechanism from IU to GAD is still waited to be explored. There are two purposes of this research. First, to measure GAD by GADQ-IV, which concept fit GAD better, instead of PSWQ and to test if “analogous GAD” significantly predicted by IU. Second, to investigate if “negative believe about worry” (NBW) is the mediator between IU and GAD, thus confirms the mechanism from IU to GAD.
Methodology: Three hundred and thirty-three College students were recruited to fill out Intolerance of Uncertainty Scale, Meta-cognitions Questionnaire, and Generalized Anxiety Disorder Questionnaire. Simple regression and stepwise multiple regression were used to analyze data in accordance to Baron and Kenny’s mediator formula.
Conclusion and discussion: (1) IU can be used to predict GAD significantly. (2) NBW plays a mediator between IU and GAD. The most important factor of NBW is “uncontrollable negative thought”.
論文目次 摘要
第一章 緒論 …………………………………………………………… 1
第一節 研究動機與目的 …………………………………………… 1
第二節 解釋名詞 …………………………………………………… 4
第二章 文獻探討 ……………………………………………………… 6
第一節 GAD特殊性及構成要素……………………………………… 6
第二節 「無法忍受不確定性」與GAD的關係……………………… 9
第三節 GAD病因機制的中介必須變項：「對擔心的負向信念」… 17
第三章 研究目的與假設 ……………………………………………… 23
第四章 研究方法 ……………………………………………………… 24
第一節 研究對象…………………………………………………… 24
第二節 研究工具…………………………………………………… 26
第三節 研究設計及程序…………………………………………… 32
第四節 資料分析方法……………………………………………… 32
第五章 研究結果……………………………………………………… 34
第一節 研究之描述統計結果……………………………………… 34
第二節 研究之推論統計結果……………………………………… 37
第六章 討論與建議…………………………………………………… 40
第一節 討論………………………………………………………… 40
第二節 研究限制及未來發展……………………………………… 45
第三節 結論………………………………………………………… 46
參考文獻……………………………………………………………… 47
附錄一 廣泛焦慮疾患問卷…………………………………………… 57
附錄二 「無法忍受不確定性」量表………………………………… 58
附錄三 監控認知問卷………………………………………………… 59
圖目錄
圖一 研究架構圖 ……………………………………………………… 3
圖二 研究程序圖……………………………………………………… 32
表目錄
表4-1-1 性別及系別分佈表………………………………………… 25
表4-2-1 「對擔心的負向信念」因素分析表……………………… 29
表5-1-1 各變項平均數及標準差摘要……………………………… 35
表5-1-2 各變項間相關之相關矩陣………………………………… 36
表5-2-1 驗證「對擔心的負向信念」是否為中介必須變項之迴歸分析表……… 39
表5-2-2 驗證「無法控制的負向思考」是否為中介必須變項之迴歸分析表…… 39
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鄧閔弘、翁嘉英、李毅達（民92）。憂慮的正向預期與憂慮程度之間的關係。中華心理衛生學刊，十六卷，第三期，頁61-78。
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Wells, A. (2007). Cognition about cognition: metacognitive therapy and change in Generalized Anxiety Disorder and Social Phobia. Cognitive and Behavioral Practice, 14, 18-25.
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Wells, A., & Carter, K. (2001). Further tests of a cognitive model of generalized anxiety disorder: Metacognitions and worry in GAD, panic disorder, social phobia, depression, and non-patients. Behavior Therapy, 32, 85-102.
Wells, A., & Cartwright-Hatton, S. (2004). A short form of the metacognitions questionnaire: properties of the MCQ-30. Behaviour Research and Therapy, 42, 385-396.
Wells, A., & Davies,M. (1994). The Thought ControlQuestionnaire: Ameasure of individual differences in the control of unwanted thoughts. Behaviour Research and Therapy, 32, 871–878.
Wells, A., & Papageorgiou, C. (1999). Relationships between worry, obsessive-compulsive symptoms and meta-cognitive beliefs. Behaviour Research and Therapy, 36, 899-913.
Wetherell, J. L., Le Roux, H., & Gatz, M. (2003). DSM-IV Criteria for generalized anxiety disorder in older adults: Distinguishing the worried from the well. Psychology and Aging, 18, 622-627.
Wetherella, J. L., Thorp, S. R., Patterson, T. L., Golshana, S., Jeste, D. V., & Gatzb, M. (2004). Quality of life in geriatric generalized anxiety disorder: A preliminary investigation. Journal of Psychiatric Research, 38, 305-312.
指導教授/口試委員 * 依職稱與姓名排序
張本聖 - 指導教授
王叢桂 - 口試委員
楊建銘 - 口試委員
繳交日期 2008-01-30
