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系統識別號 U0026-0812200912110049
論文名稱(中文) 社會依賴性格與自主性格,人際事件與自主事件對更年期婦女的憂鬱及心理症狀的影響
論文名稱(英文) The effects of sociotropy-autonomy personality, interpersonal-autonomous events on depressive and psychological symptoms among climacteric women
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 94
學期 2
出版年 95
研究生(中文) 莊淑屏
研究生(英文) SHU-PING CHUANG
電子信箱 xota51@yahoo.com.tw
學號 s8692403
學位類別 碩士
語文別 中文
論文頁數 58頁
口試委員 口試委員-鄭中平
指導教授-柯慧貞
口試委員-張峰銘
中文關鍵字 自主性格  社會依賴性格  人際事件  心理症狀  停經階段  憂鬱症狀  自主事件 
英文關鍵字 Sociotropy personality  Autonomy personality  Autonomous events  Interpersonal events  Depressive symptoms  Psychological symptoms  Menopausal status 
學科別分類
中文摘要 研究背景與目的:

婦女在中年階段可能會歷經許多生理、心理及社會方面的轉變。婦女在面臨停經的改變時,會經歷到一些身心症狀,包括身體症狀、性功能障礙、血管舒縮症狀及心理症狀。而根據過去文獻指出婦女在停經的轉變並未發現與憂鬱有顯著關連,此外,也有文獻發現血管舒縮症狀與荷爾蒙的改變有關係,而心理症狀則與心理社會因素有關,因此從心理社會因素的角度去探討婦女的心理健康比起從生理因素的角度更顯得重要。過去也甚少從素質壓力模式探討在特定的壓力事件之下,婦女具備有哪些心理脆弱因子會更容易使其心理產生不適應或出現憂鬱。另過去文獻也指出過去的憂鬱病史,月經前心情惡劣疾患是影響婦女之後的憂鬱症狀或憂鬱症的危險因子,因此本研究在控制了這些混淆變項後,本研究目的探討社會依賴性格與自主性格,人際事件與自主事件對更年期婦女憂鬱症狀及心理症狀的影響,本研究假設包括:假設1:社會依賴性格與人際事件對於更年期婦女的憂鬱症狀是否有交互作用的效果。假設2:社會依賴性格與人際事件對於更年期婦女的心理症狀是否有交互作用的效果。假設3:自主性格與自主事件對於更年期婦女的憂鬱症狀是否有交互作用的效果。假設4:自主性格與自主事件對於更年期婦女的心理症狀是否有交互作用的效果。

研究方法:
於民國92年9月開始進行研究,受試者來自台南市東區、西區、北區三區的40-60歲的婦女。排除手術停經者及不識字者,依經期分為停經前期、停經中期、停經後期。以社會依賴-自主性格量表、生活壓力事件量表、憂鬱症診斷(SADS-L)、柯氏憂鬱量表、身心症狀量表進行資料收集。橫斷式研究總共有191位婦女參加,於兩年半後再以相同的量表進行施測,總共有115位婦女參加,反應率達60.2%。統計方法使用多元階層回歸分析檢驗社會依賴性格與自主性格,人際事件與自主事件對更年期婦女的憂鬱症狀及心理症狀的影響。

研究結果:
一、憂鬱症狀方面:(1)橫斷式結果方面,社會依賴性格與人際事件並無交互作用,但社會依賴性格對憂鬱症狀的主要效果達顯著;自主性格對憂鬱症狀的主要效果未達顯著且與自主事件的交互作用未達顯著;人際事件及自主事件對於憂鬱症狀的主要效果達顯著。(2)縱貫式結果方面:社會依賴性格對於第二次的憂鬱症狀的預測力消失,僅自主事件可預測第二次的憂鬱症狀。
二、心理症狀方面:橫斷式結果方面,社會依賴性格與人際事件的交互作用未達顯著,但社會依賴性格對心理症狀的主要效果達顯著;自主性格對心理症狀的主要效果未達顯著且與自主事件的交互作用未達顯著。縱貫式結果方面,社會依賴性格與人際事件的交互作用未達顯著,但社會依賴性格仍舊可顯著地預測第二次的心理症狀;自主性格仍舊無法預測第二次的心理症狀且與自主事件的交互作用未達顯著,但自主事件可預測第二次的心理症狀。

結論:
一、在橫斷式結果方面,控制了混淆變項後,研究顯示社會依賴性格對於憂鬱及心理症狀的主要效果達顯著,而自主性格對於憂鬱及心理症狀並無主要效果且與自主事件的交互作用未達顯著。
二、在縱貫式結果方面,控制了混淆變項及第一次的心理症狀後,社會依賴性格對於第二次的心理症狀仍舊有顯著的預測力,而自主性格對於第二次的心理症狀並無預測力。另自主事件可預測第二次的憂鬱及心理症狀。


英文摘要 Background and purpose:
Women experience transitions in many aspects of biological, psychological and social changes in midlife. During this period, women may experience menopausal symptoms which include aspects of somatic symptoms, sexual dysfunction, psychological symptoms and vasomotor symptoms during the menopausal transition. Based on
previous literature; the transition of menopause was not related with depression or psychological distress. Recent findings indicated that vasomotor symptoms were related with the menopausal status; however, psychological symptoms were associated with psychosocial factors. Therefore, it is more important to investigate mental health from psychosocial perspective than biological perspective. However, few studies focused on the types of vulnerabilities that may exacerbate the psychological distress of climacteric women who are under stress from diathesis-stress model, such as the role of soicotropy-autonomy personality and interpersonal-autonomous events on the depression of climacteric women. Previous studies suggested that previous depression, PMDD were risk factors for women’s mental health, so the study also controls these confounding variables. The purpose in this study investigated the effects of sociotropy-autonomy personality, interpersonal-autonomous events on depressive and psychological symptoms of climacteric women .The hypotheses were:1. Whether the interaction between sociotropy personality and interpersonal events would predict increases in depressive symptoms of women during menopausal transition. 2. Whether the interaction between sociotropy personality and interpersonal events would predict increases in psychological symptoms of women during menopausal transition. 3. Whether the interaction between autonomy personality and autonomous events would predict increases in depressive symptoms of women during menopausal transition. 4. Whether the interaction between autonomy personality and autonomous events would predict increases in psychological symptoms of women during menopausal transition.

Methods:
The study was a longitudinal design, composed of participants between the ages of 40 to 60 year-old living in Tainan, Southern of Taiwan. The participants were recruited from three districts: East District, North District, and West District. Illiterate women and women who have undergone surgical procedures leading to menopause were excluded from the study. Among them, a total of 191 women participated in the second screening, including Sociotropy-Autonomy Personality Scale, Life Events Questionnaire,
Ko-Depression Inventory and psychological symptoms and a semi-interview to assess if they had previous depression, dysthymia and PMDD .The 191 women were followed-up after two and half years and were asked to complete the same questionnaires. 115 women completed the follow-up questionnaires, giving a response rate of 60.2%. Using hierarchical multiple regression analyses to investigate sociotropy-autonomy personality, interpersonal-autonomous events on depressive and psychological symptoms of menopausal women.

Results:
In the results of cross-sectional study, the interaction between sociotropy personality and interpersonal events was not significant on depressive and psychological symptoms, but sociotropy personality had a significant main effect on depressive and psychological symptoms; Autonomy personality had no main effect on depressive and psychological symptoms and the interaction between autonomy personality and autonomous events on depressive and psychological symptoms was not significant; Interpersonal and autonomous events had a significant main effect on depressive symptoms. In the results of longitudinal study, the interaction between sociotropy personality and interpersonal events was not significant on time 2 depressive and psychological symptoms, but sociotropy personality predicted time 2 psychological symptoms; however, sociotropy personality could not predict time 2 depressive symptoms; Autonomy personality could not predict time 2 depressive and psychological symptoms, but autonomous events had a significant main effect on time 2 depressive and psychological symptoms.

Conclusion:
In the results of cross-sectional study, controlling for confounding variables, it revealed that sociotropy personality had a significant main effect on depressive and psychological symptoms, and autonomy personality had no main effect or interaction with autonomous events on depressive and psychological symptoms. Interpersonal and autonomous events had a significant main effect on depressive symptoms. In the results of longitudinal study, controlling for confounding variables, it revealed that sociotropy personality predicted time 2 psychological symptoms, and autonomy personality could not predict time 2 depressive and psychological symptoms; however, autonomous events predicted time 2 depressive and psychological symptoms.


論文目次 主 目 錄
摘要......................................................................Ⅰ.
誌謝......................................................................Ⅶ
主目錄....................................................................Ⅷ
表目錄....................................................................Ⅹ
第一章 緒論...............................................................1
第一節 更年期婦女與憂鬱症或憂鬱症狀的相關研究.............................1
第二節 社會依賴性格,自主性格與憂鬱症或憂鬱症狀的關係.....................2
一、社會依賴性格與自主性格..............................................2
二、社會依賴性格及自主性格與憂鬱症或憂鬱症狀的相關研究..................2
第三節 生活事件與憂鬱症或憂鬱症狀的關係...................................3
一、生活事件與憂鬱症或憂鬱症狀的相關研究................................4
二、小結................................................................4
第四節 社會依賴性格與自主性格,人際事件與自主事件和憂鬱症
或憂鬱症狀的關係...................................................5
一、社會依賴性格與自主性格,人際事件與自主事件和憂鬱症或
憂鬱症狀的相關研究..................................................5
二、小結................................................................7
第五節 其他與憂鬱症或憂鬱症狀相關之混淆變項...............................8
一、過去憂鬱病史........................................................8
二、月經前心情惡劣疾患..................................................9
第六節 研究目的與假設.....................................................9
第二章 研究方法...........................................................10
第一節 研究程序與研究對象.................................................10
第二節 研究工具...........................................................11
第三節 統計方法...........................................................13
第三章 研究結果...........................................................15
第一節 有參加與未參加婦女之社會人口學變項之差異...........................15
第二節 過去憂鬱病史,月經前心情惡劣疾患,第一次及第二次的社會人口
學變項,憂鬱症狀及心理症狀的相關...................................15
第三節 第一次及第二次的憂鬱症狀,心理症狀,社會依賴性格,自主性格,
人際事件及自主事件的平均數,標準差及相關.............................15
第四節 以第一次的憂鬱症狀為依變項之單次多元階層回歸模式:橫斷式............17
第五節 以第二次的憂鬱症狀為依變項之單次多元階層回歸模式:縱貫式............18
第六節 以第一次的心理症狀為依變項之單次多元階層回歸模式:橫斷式............18
第七節 以第二次的心理症狀為依變項之單次多元階層回歸:縱貫式................19
第四章 結論與討論.........................................................20
第一節 本研究的主要發現與解釋.............................................20
第二節 本研究的研究貢獻...................................................23
第三節 研究限制與未來研究方向.............................................24
第五章 參考文獻...........................................................25
附錄......................................................................41
自述......................................................................58



表 目 錄
表3-1 有參加與未參加婦女在社會人口學變項上之差異..........................32
表3-2 過去憂鬱病史,月經前心情惡劣疾患,第一次及第二次的社會人口
學變項,憂鬱症狀及心理症狀的相關係數摘要表.........................33
表3-3 第一次及第二次的憂鬱症狀,心理症狀,社會依賴性格,自主性格,
人際事件及自主事件的平均數,標準差及相關係數摘要表..................34
表3-4 社會依賴性格,自主性格,人際事件,自主事件
與憂鬱症狀之多元階層回歸模式-橫斷式................................35
表3-5 社會依賴性格,自主性格,人際事件,自主事件
與憂鬱症狀之多元階層回歸模式-縱貫式................................36
表3-6 社會依賴性格,自主性格,人際事件,自主事件
與心理症狀之多元階層回歸模式-橫斷式................................38
表3-7 社會依賴性格,自主性格,人際事件,自主事件
與心理症狀之多元階層回歸模式-縱貫式.................................39

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