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系統識別號 U0026-0812200911414897
論文名稱(中文) 男性單純焦慮症與焦慮酒癮共病患者在性格向度與酒精效果預期上之差異
論文名稱(英文) Personality Dimensions and Alcohol Outcome Expectancy in male Patients with Pure Anxiety Disorder and Mixed Anxiety-Alcoholism
校院名稱 成功大學
系所名稱(中) 行為醫學研究所
系所名稱(英) Institute of Behavioral Medicine
學年度 93
學期 2
出版年 94
研究生(中文) 翁茹萍
研究生(英文) Ju-Ping Weng
學號 s8691404
學位類別 碩士
語文別 中文
論文頁數 94頁
口試委員 召集委員-程炳林
指導教授-陸汝斌
指導教授-柯慧貞
中文關鍵字 焦慮酒癮共病  單純焦慮  正向酒精效果預期  尋求刺激  逃避傷害 
英文關鍵字 none 
學科別分類
中文摘要 一、研究背景:
  臨床與流行病學研究已證實酒癮與焦慮症具有高共病性,但兩者共病的機制仍無一致的結論,其中一個最常被提出的解釋為「自我醫療假設」 (self-medication),此假設認為若焦慮個案藉由使用酒精來降低其焦慮症狀,將會提高發展出酒精依賴的高危險性;不過,已有研究修正自我醫療假設,提出焦慮個案中僅有某一群特質的個案會藉由使用酒精來因應其焦慮症狀。另外,以往研究指出性格與酒精效果預期都是酒癮的重要致病因子,因此本研究取樣單純焦慮患者、焦慮合併酒癮患者、控制組個案,檢驗三組在逃避傷害、尋求刺激、藉酒消除負向情緒預期、藉酒尋求正向情緒預期上的差異,以驗證自我醫療假設;並探討性格、酒精效果預期與飲酒行為的關係。其中焦慮合併酒癮組特別收集先發作焦慮再發作酒癮的個案,以進一步釐清先焦慮後發展出酒癮的共病現象。

二、研究目的:
本研究之主要目的為:(一) 探討性格與單純焦慮、酒癮合併焦慮的關係;(二) 探討酒精效果預期與單純焦慮、酒癮合併焦慮的關係;(三) 探討性格與酒精效果預期對於飲酒行為的影響。

三、研究方法:
(一) 受試者:本研究使用個案對照研究設計,分別至精神科門診收集27名男性單純焦慮症患者、27名男性焦慮合併酒癮患者、與至社區收集48名正常控制組男性個案。(二) 研究工具:分別以最近飲酒量與飲酒頻率問卷評估個案收案前三個月的飲酒量與飲酒頻率、三向度性格量表評估性格變項、以及酒精效果預期量表評估酒精使用預期變項。(三) 研究流程:所有參與者均在完整、詳細的說明與填寫同意書後,才開始接受資料之收集。三組參與者均先接受精神疾病診斷晤談以確定終生診斷,確定診斷並符合各組之篩選條件後正式收案。所有參與者自填最近飲酒量與飲酒頻率問卷、三向度性格量表與酒精效果預期量表。(四) 統計分析:以卡方檢定、t檢定與單因子變異數分析分別比較各組人口學資料的差異;以單因子變異數分析分別比較各組在性格量表、酒精效果預期的總分與分量表分數上的差異;使用階層迴歸分析,探討逃避傷害、藉酒消除負向情緒預期、尋求刺激、藉酒尋求正向情緒預期與飲酒行為的關係。

四、研究結果:
(一) 在性格方面,結果發現焦慮組與焦慮合併酒癮組此兩組個案,相較於控制組有較高的逃避傷害得分;且焦慮合併酒癮組個案比焦慮組個案或控制組有較高的尋求刺激得分;(二) 在酒精效果預期方面,結果發現焦慮合併酒癮組個案比焦慮組個案或控制組有較高的正向酒精效果預期、藉酒消除負向情緒預期分量表、藉酒尋求正向情緒預期分量表的得分;(三) 在預測飲酒行為方面,結果發現逃避傷害、尋求刺激、藉酒消除負向情緒預期、藉酒尋求正向情緒預期均可以單獨的預測飲酒量或飲酒頻率。研究結果也發現逃避傷害主要透過尋求刺激的中介效果來影響飲酒量與飲酒頻率;藉酒消除負向情緒預期主要透過藉酒尋求正向情緒預期的中介效果來影響飲酒量與飲酒頻率。另外,尋求刺激可直接預測飲酒量與飲酒頻率,但部分透過藉酒尋求正向情緒預期預測飲酒量與飲酒頻率。

五、結論:
本研究發現焦慮合併酒癮患者不僅具有高逃避傷害、高藉酒消除負向情緒預期,同樣也具有高尋求刺激、高藉酒尋求正向情緒預期;因此本研究祇部分支持自我醫療假設,本研究結果顯示焦慮合併酒癮患者除了降低焦慮或緊張而飲酒,也會為了尋求刺激而有飲酒並隨後發展出酒癮。此外,本研究支持若男性個體具有逃避傷害的性格特質,則較容易發展出焦慮症;而男性焦慮症個體若有越高的尋求刺激性格特質與正向酒精效果預期,則越提高發展出酒精依賴的危險性。
英文摘要 none
論文目次 第一章 緒論 ………………………………………………1
 第一節 酒癮問題的重要性………………………………1
  一、 酒癮的定義………………………………………1
  二、 國內酒癮的盛行率………………………………2
  三、 小結………………………………………………3
 第二節 酒癮與焦慮症共病現象的重要性………………5
  一、 酒癮與焦慮症共病的定義………………………5
  二、 酒癮與焦慮症共病的盛行率……………………5
  三、 酒癮與焦慮症共病機制的解釋…………………9
 第三節 三向度性格與酒癮、焦慮的關係 ……………15
  一、 三向度性格的內涵與測量方法 ………………15
  二、 與酒癮相關之三向度性格研究 ………………16
  三、 與焦慮相關之三向度性格研究 ………………19
  四、 以三向度性格探討焦慮酒癮共病之關係 ……20
 第四節 酒精效果預期與酒癮、焦慮的關係 …………22
  一、 酒精效果預期的內涵與測量方法 ……………22
  二、 與酒癮相關之酒精效果預期研究 ……………24
  三、 與焦慮相關之酒精效果預期研究 ……………27
  四、 以酒精效果預期探討焦慮酒癮共病之關係 …27
 第五節 性格與酒精效果預期對飲酒行為的影響模型…28
 第六節 研究目的與假設…………………………………29
  一、 研究目的…………………………………………29
  二、 研究假設…………………………………………30

第二章 研究方法 …………………………………………31
 第一節 研究設計…………………………………………31
 第二節 研究對象…………………………………………31
  一、 焦慮合併酒癮個案………………………………31
  二、 單純焦慮個案……………………………………32
  三、 正常控制組………………………………………33
 第三節 研究工具…………………………………………34
  一、 中文版精神疾病終生診斷晤談手冊……………34
  二、 中文版最近飲酒量與飲酒頻率問卷……………35
  三、 中文版三向度性格量表…………………………35
  四、 中文版酒精預期量表……………………………36
 第四節 研究程序…………………………………………37
 第五節 統計方法…………………………………………37

第三章 研究結果 …………………………………………40
 第一節 人口學變項與臨床特性的資料分析……………40
 第二節 探討焦慮合併酒癮、單純焦慮與性格特質的
     關係 ……………………………………………42
  一、 焦慮合併酒癮、單純焦慮患者在逃避傷害性格
     向度上之比較 …………………………………42
  二、 焦慮合併酒癮、單純焦慮患者在尋求刺激性格
     向度上之比較 …………………………………42
 第三節 探討焦慮合併酒癮、單純焦慮與酒精效果預期
     的關係 …………………………………………43
  一、 焦慮合併酒癮、單純焦慮患者在正向酒精效果
     預期上之比較 …………………………………43
  二、 焦慮合併酒癮、單純焦慮患者在藉酒消除負向
     情緒預期上之比較 ……………………………43
  三、 焦慮合併酒癮、單純焦慮患者在藉酒尋求正向
     情緒預期上之比較 ……………………………43
 第四節 探討性格特質、酒精效果預期與飲酒行為間的
     關係 ……………………………………………44
  一、 人口學資料、性格特質、酒精效果預期、飲酒
     行為以及疾病診斷間之相關分析 ……………44
  二、 探討性格特質、酒精效果預期和飲酒量之間的
     關係 ……………………………………………45
  三、 探討性格特質、酒精效果預期和飲酒頻率之間
     的關係 …………………………………………49

第四章 討論 …………………………………………………53
 第一節 本研究之主要發現與解釋 ………………………53
  一、 焦慮合併酒癮組、焦慮組以及正常控制組在基本
     人口學資料與臨床特性之差異 ………………53
  二、 焦慮合併酒癮組、焦慮組及正常控制組在性格
     特質與酒精效果預期之差異 …………………54
  三、 性格特質、酒精效果預期與飲酒行為間的
     關係 ……………………………………………57
 第二節 本研究之限制與未來研究方向…………………60
  一、 研究樣本的限制…………………………………60
  二、 研究設計的限制…………………………………61
 第三節 本研究之理論貢獻與應用價值…………………62
  一、 理論貢獻…………………………………………62
  二、 應用價值…………………………………………63

參考文獻 ……………………………………………………65

附錄一 最近飲酒量與飲酒頻率問卷………………………84
附錄二 性格問卷(含逃避傷害與尋求刺激分量表)………86
附錄三 酒精預期量表………………………………………90
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