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系統識別號 U0026-1507201823591700
論文名稱(中文) 強化情緒調節之神經心理功能團體-以高身心症狀抱怨青少女為例
論文名稱(英文) The Efficacy of Neuropsychological Group Therapy on Enhancing Emotion Regulation for Girl Adolescents with High Subjective Health Complaints
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 106
學期 2
出版年 107
研究生(中文) 李婕寧
研究生(英文) Chieh-Ning, Li
學號 s86041048
學位類別 碩士
語文別 中文
論文頁數 156頁
口試委員 指導教授-郭乃文
口試委員-董旭英
口試委員-詹雅雯
中文關鍵字 身心症狀抱怨  執行功能  團體神經心理治療 
英文關鍵字 subjective health complaints  executive function  Neuropsychological Group 
學科別分類
中文摘要 目的:青少女身心症狀抱怨有相當高的盛行率,且影響其整體身心適應。個體生活習慣與其壓力因應的方式影響個體神經、心理及社會等各方面的身心適應狀況。實徵證據已指出執行功能於生活習慣建立與壓力因應的重要性,本研究欲進一步探討身心症狀抱怨與執行功能之關聯性,並進一步探討以團體神經心理治療訓練高身心症狀抱怨青少女執行功能之成效。
方法:研究一採用大樣本資料分析共2311筆台南市某高級中學女生104至106學年度期間該校所進行的身心適應狀態篩檢資料,以統計方法分析與驗證身心健康狀態、生活適應及執行功能等指標間的相關性,並分析三級預防各級別青少女之差異性。研究二分析團體神經心理治療的介入組共14位104和105學年度被篩檢為二級群體之青少女,於接受共八週、每週一次、每次90分鐘的執行功能訓練後之成效,療效以神經生理層次、日常生活行為功能層次及日常適應功能層次等進行檢驗。
結果:研究一資料分析結果顯示多項身心健康狀態指標與生活適應指標皆與執行功能呈現高度相關。ANOVA結果顯示不同身心症狀水準之青少女,其各項身心適應狀態之差異性,事後比較則指出二級群體於生活適應和執行功能皆表現得比一級或三級群體來得差,顯示相對於生理條件可能比較不好的三級群體,二級群體之心理適應狀態更與其本身之行為習慣、壓力因應等心理變項相關聯。研究二團體療效探討方面,介入組身心症狀抱怨數顯著下降、自我效能則有顯著的提升,並且情緒調節與執行功能在介入後皆有顯著的進步,然而在情緒引發情境之設計,生理指標皆未有顯著的變化。
結論:青少女之執行功能與各項身心適應狀態有顯著相關,二級群體之身心適應應有積極介入之必要性,並可藉由訓練執行功能來協助二級群體,以提升各項身心適應狀態。訓練執行功能以調整情緒之團體神經心理治療療效指出可有效改善二級青少女之日常行功能層次,並促使日常適應功能層次之提升,然療效並未反映於神經生理層次,原因可能與實驗情境的操弄有效性、青少女本身生理變動性較大,以及白袍高血壓相關症候群有關,未來待更多的研究加以驗證。
英文摘要 SUMMARY
The aim of this study is to investigate the relationships between the health complaints and the executive functions among girl adolescents, and to evaluate the efficacy of a group-based neuro-psychotherapy on enhancing their self-regulation. The research was composed of two studies. Study 1: 2311 female adolescents’ data was attained by the senior high school’s yearly screen, and was grouped into three level by the concept of the tertiary prevention. The indicators of the study included physical and mental health status, life adaptation and executive function. Study 2: The intervention group(n=14) was intervened with group-based neuro-psychotherapy that was designed 1.5 hours a week for 8 weeks, while compared with the non-intervention group(n=111). The study used indexes from three level evidences to discuss the curative effects, including neurophysiological assessment, behavioral questionnaires , and adaptive functions. Most physical and mental health indicators and life adaptation indicators are highly correlated with executive functions. The ANOVA results showed that the girls with different levels of health complaints, their physical and mental adaptability were significantly different. Post-hoc indicates that the secondary group’s overall performance was the worst. Intervention group significantly improved their performance on behavioral questionnaires and adaptive functions, including the improve on health complaints and the elevate of the emotion regulation, executive function, and self-efficacy. But the effect on neurophysiological assessment wasn’t significant. The executive function of young girls has a significant correlation with the physical and mental adaptability. The secondary groups should have the necessity of active intervention. Subjects can benefit from the group-based neuro-psychotherapy that improving the girl adolescents’ behavioral questionnaires and adaptive functions. However, Future studies should further investigate the neurophysiological assessment.

Key words: subjective health complaints, executive function, Neuropsychotherapy group.
論文目次 目錄
第壹章 緒論………..…………………………...………………………….………………1
第一節 青少女之身心症狀探討……………………………….....………………..….1
一、高身心症狀抱怨青少女之盛行率…………………..………….…………….1
二、身心症狀之成因探討………………………………..………………………..3
第二節 身心症狀抱怨與執行功能………………………..……….……………...…..8
一、前額葉皮質與執行功能…………………………….………….……………..8
二、執行功能與其相關之生理心理病理機制……………………..……………11
三、前額葉皮質與執行功能…………………………….………….……………21
四、高身心症狀抱怨青少女之執行功能…………………………..……………23
第三節 對高身心症狀抱怨青少女的心理功能介入…………….………..……...…26
一、傳統心理治療……………………………………….………….……………26
二、神經心理治療…………………………………………………..……………26
第貳章 研究目標與問題假設………………...………………………….………………30
第一節 研究目標……………………………………………….....………………….30
第二節 研究假設與問題……………………………………….....………………….31
第參章 研究方法……………………………...………………………….………………35
第一節 研究設計與流程……………………………………….....………………….35
第二節 研究對象……………………………………….....………………………….40
第三節 研究工具……………………………………….....………………………….42
一、療效評估工具……………………………………….………….……………48
二、治療工具:強化情緒調節之團體神經心理治療訓練方案…..……………57
第四節 結果分析……………………………………….....………………………….64
第肆章 研究結果……………………………...………………………….………………67
第一節 青少女身心適應狀態分析…………………………….....………………….67
第二節 二級群體之自然變動………………………….....………………………….71
一、三級預防人數比例於一年間之自然變動………….………….……………71
二、二級母群體之身心適應指標在一年間的自然變動…………..……………72
第三節 團體神經心理治療療效結果………………….....………………………….74
一、研究參與者基本資料……………………………….………….……………74
二、團體神經心理治療療效探討──比較介入組與非介入組…..……………77
三、團體神經心理治療療效探討──介入組療效分析.………….……………82
四、團體神經心理治療療效探討──個別療效分析……………..……………96
第伍章 討論……..……………………………...………………………….……………122
第一節 青少女高身心症狀抱怨、生活適應及執行功能…….....………………...122
第二節 二級群體之自然變動與其身心適應狀態…….....………………………...125
第三節 二級青少女日常生活適應的改善與進步.………………………………...127
第四節 團體神經心理治療之組別療效探討….…………………………………...128
第五節 團體神經心理治療之個別療效探討….…………………………………...131
第六節 研究限制………………………….....……………………………………...135
第七節 研究貢獻與未來展望…………….....……………………………………...137
參考文獻……..……………………………...………………………….……..…………138
中文文獻……………………………………………………..….....………………...138
西文文獻……………………………………………………..….....………………...141

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