A Prospective Study of Cognitive Interpersonal Model of Depression: Recognition, Judgment, and Schematic Response of Facial Emotions

以憂鬱的人際認知整合取向為背景觀點，本研究的主要目的為探討個體對非語言人際訊息—臉部情緒表情的辨識、判斷及認知基模反應與憂鬱狀態之關連。本研究依循Coyne（1976b）的憂鬱人際論述與Beck（1967）的憂鬱認知理論，推測憂鬱傾向個體能敏感、準確辨識出負向臉部情緒，並對此負向訊息展現負向的認知基模反應傾向；而此負向認知基模反應模式應為穩定認知特質，能與非語言人際壓力共同預測個體的憂鬱狀態。本研究以54位本地大學／研究所學生為樣本，在資料蒐集的第一階段，進行同時間點憂鬱症狀與臉部情緒之辨識、判斷與認知基模反應等變項表現的測量；七週後，完成其中47位受試者的追蹤評估。研究結果顯示，相較於非憂鬱個體，憂鬱傾向個體在臉部情緒的辨識與判斷表現上並無顯著錯誤／偏誤傾向；憂鬱傾向個體亦能精準辨識出正、負向臉部情緒訊息。而在同等臉部情緒之辨識與判斷表現的基準上，憂鬱傾向個體在面對負向、甚至所有非正向之臉部情緒訊息時，明顯展現認知概念與情緒向度上的負向認知基模反應傾向。綜合兩階段資料之分析結果顯示，個體對負向臉部情緒表情所展現之認知概念基模反應傾向，呈現獨立於憂鬱狀態變化、並具跨時間穩定的特性，確立其特質地位。進一步探討發現，個體與實驗作業中臉部情緒刺激互動後，其負向認知概念基模反應傾向可預測當下負向情緒的發生。而人際環境中負向臉部情緒訊息之經驗與負向認知概念基模反應傾向的交互作用，能預測個體當時的憂鬱症狀，但無法預測長時間後續的憂鬱變化。本研究以認知歷程層次與特性觀點、認知特異質—壓力模式統整上述結果，並加入憂鬱的人際行為危險因子，共同討論憂鬱發展、維持或惡化的可能脈絡。最後，提出本研究的貢獻與臨床應用價值，討論可能的研究限制並延伸未來研究方向。Within the framework of the integrated cognitive-interpersonal model of depression, this study aimed to investigate the associations between depression and recognition, judgment, and schematic response of nonverbal interpersonal cues--facial emotions. Based on Coyne’s (1976b) interpersonal model and Beck’s (1967) cognitive theory of depression, the present study proposed that the depressed individuals recognize the negative facial emotions accurately, and respond to negative cues in the negative schematic tendency. This negative schematic set would be a stable cognitive factor; in addition, the interaction of the negative schematic set and nonverbal interpersonal stress would predict depression. Participants were 54 undergraduate/graduate students. The measurement included depressive symptoms, recognition of facial emotions, judgment of facial emotions, and schematic response to facial emotions. Forty-seven participants were repetitively measured after seven weeks. The results showed that, the accuracy of emotional recognition and preference for emotional judgment did not differ between the dysphoric and nondysphoric individuals. However, the dysphoric individuals tended to respond to non-positive facial emotions with negative cognitive-conceptual and affective schemas. In addition, the cognitive-conceptual schematic response tendency to negative facial emotions was depressed state-independent and did not change over time, and therefore may have trait-like quality. Moreover, after the interacting with the experimental facial stimuli, the increase of individuals’ negative affect could be predicted by their negative cognitive-conceptual schematic response. It was also found that the interaction of this negative schematic response set and the negative facial emotion experiences in the interpersonal environment could predict the individuals’ concurrent depressive symptoms. Contrarily, it could not predict the change of individuals’ depression over time. In conclusion, the levels and features of cognitive processing as well as the diathesis-stress model were discussed as a synthesis framework. We also combined the results and the interpersonal-behavioral risk factor to discuss the possible context of depression. Finally, we discussed the contributions and clinical applications of the present study, addressed the possible limitations, and provided some suggestions for future researches.第一章 緒論…………………………………………………… 1 研究動機……………………………………………………… 1 第一節 人際認知取向憂鬱模式…………………………… 3 第二節 憂鬱與非語言人際認知—臉部情緒之認知表現… 9 第三節 研究目的、架構與假設……………………………17 第二章 研究方法………………………………………………22 第一節 研究對象……………………………………………22 第二節 研究工具……………………………………………24 第三節 研究程序……………………………………………30 第四節 統計分析方法………………………………………30 第三章 研究結果………………………………………………32 第一節 憂鬱狀態與臉部情緒之認知經驗反應……………32 第二節 憂鬱相關臉部情緒認知反應傾向之穩定性………52 第三節 負向認知反應傾向與憂鬱狀態……………………55 第四節 總結…………………………………………………61 第四章 討論……………………………………………………62 第一節 憂鬱與臉部情緒之認知反應………………………62 第二節 從臉部情緒之認知反應傾向的憂鬱危險因子角色 討論憂鬱脈絡………………………………………67 第五章 研究貢獻、限制與未來研究方向……………………71 第一節 研究貢獻……………………………………………71 第二節 研究限制……………………………………………73 第三節 未來研究方向………………………………………75 參考文獻…………………………………………………………78 附錄………………………………………………………………86 附錄一：情緒狀態評估………………………………………86 附錄二：中文版尋求再保證量表……………………………87 附錄三：研究參與同意書……………………………………8