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系統識別號 U0026-2001201621534700
論文名稱(中文) 神經心理取向之團體治療於增強抑制控制與情緒調節之成效研究─以高憤怒情緒青少年為例
論文名稱(英文) The Efficacy of Neuropsychological Group Therapy on Enhancing Inhibitory Control and Emotion Regulation for Adolescent with Anger Problems
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 104
學期 1
出版年 105
研究生(中文) 林源欽
研究生(英文) Yuan-Chin Lin
學號 S86011019
學位類別 碩士
語文別 中文
論文頁數 105頁
口試委員 指導教授-郭乃文
口試委員-董旭英
口試委員-謝碧玲
中文關鍵字 抑制控制  神經心理治療  情緒調節  團體情境  憤怒情緒 
英文關鍵字 Anger  Emotion Regulation  In Group  Inhibitory Control  Neuropsychotherapy 
學科別分類
中文摘要 目的:研究指出憤怒情緒問題與大腦功能有關,特別是以情緒調節或抑制能力為主軸的研究,也有新近心理治療研究以大腦功能訓練為策略。本研究欲以神經心理取向建構一套強化高憤怒情緒青少年情緒調控能力之團體治療方案。

方法:受試者來自台灣南部某兩所國中之一年級學生,共801名。所有學生於一年內完成三次情緒篩檢系列測驗做為情緒狀態之評估。研究者根據首次情緒篩檢系列測驗成績,邀請符合青少年情緒調節量表得分後25%或短式華人敵意量表得分前25%其中之一者參與本研究團體治療,共邀請275名。其中26名同意參與本研究之團體治療,研究者依其意願參與時間,隨機選取16名為介入組,其餘249名為未介入組。介入組進入三個不同時間開始的治療團體;團體治療共進行八次、16小時。介入組共有15人完成自我監控系列測驗和廣泛式非語文注意力測驗之前後測;未介入組共有91人於上述相同時間點完成自我監控系列測驗之前後測。

結果:介入組經團體治療後,多種情緒狀態、情緒調節與抑制控制指標達顯著進步,多種情緒狀態與情緒調節指標於半年後追蹤亦發現有進步情形產生。此治療後的進步與未介入組或全體學生之自然成長相比,交互作用亦達顯著。

討論:本研究證實依據神經心理學理論所設計之團體治療方案,對於高憤怒情緒青少年之抑制功能與情緒調節能力,產生了具實徵性的改變效益。未來可持續研究此治療模式於其他不同年齡層之高憤怒情緒個案之效益。
英文摘要 SUMMARY
The aim of this study was to develop a group therapy program based on neuropsychological principle that enhances emotion regulation abilities in adolescent with anger problems. Participants were 801 7th-grade students recruited from two junior high schools in southern Taiwan. We identified 264 of them whose score of Inventory of Adolescent Emotion Regulation was either below 25% or whose score of Chinese Hostility Inventory: Short Form was above 75%. Sixteen of such 7th graders that agreed to participate the program were randomly selected as the intervention group. The remaining 249 students served as non-intervention group. Except the sixteen students of the intervention group, all the other students served as norm group. The intervention group was divided into three subgroups that the three subgroups received the same interventions but started at three different times. Each intervention subgroup received 8 sessions, 16 hours, of treatment. Fifteen members of intervention group completed the evaluation of self-monitoring ability tests and Comprehensive Non-verbal Attention Test Battery before and after treatment. Ninety one members of non-intervention group completed the evaluation of self-monitoring ability tests before intervention group recived treatment and after treatment. The results revealed that the intervention group significantly improved their performance in emotion regulation and inhibitory control after treatment. These improvements were significantly better than the non-intervention group. In conclusion, the program of present study has the potential to enhance inhibitory control and emotion regulation for adolescent with anger problems.

Key words: Anger, Emotion Regulation, In Group, Inhibitory Control, Neuropsychotherapy

INTRODUCTION
Anger problems are related to cardiovascular disease, smoking, alcohol abuse, aggression, and social disturbance. Studies have demonstrated that anger problems are related to frontal lobe functions, especially in line with emotion regulation, executive function, and inhibitory control. Neuropsychological psychopathology studies suggest that several regions in the brain are the key of anger problems including medial preoptic area, lateral septum, anterior and ventromedial hypothalamus, bed nucleus of the stria terminalis, periaqueductal gray, amygdala, anterior medial prefrontal cortex, lateral prefrontal regions, orbital prefrontal cortex, ventrolateral prefrontal cortex, dorsolateral prefrontal cortex, and dorsal anterior cingulate cortex. These brain areas are the physiological basis of mental abilities such as socio-emotional information processing, decision-making, impulse control, and emotion regulation. Conventional psychotherapy techniques to anger problems are proven effective, but recent researches suggest that brain function training techniques can be helpful such as executive function training. To date, there is no study adopt latest findings of brain research to develop new therapy technique. Therefore, this study aims to develop a group therapy program based on neuropsychological principle that enhances emotion regulation abilities in adolescent with anger problems.

MATERIALS AND METHODS
In present study, there were 801 7th-grade students recruited from two junior high schools in southern Taiwan. These 801 7th-grade students completed the evaluation of emotional ability tests three times in a year. Emotional ability tests included Inventory of Adolescent Emotion Regulation, Chinese Hostility Inventory: Short Form, and Anger Inventory. At the first evaluation, we identified 264 of them whose score of Inventory of Adolescent Emotion Regulation was either below 25% or whose score of Chinese Hostility Inventory: Short Form was above 75%. After giving informed consent by the teachers in school, sixteen of such 7th graders that agreed to participate the program were randomly selected as the intervention group. The remaining 249 students served as non-intervention group. Except the sixteen students of the intervention group, all the other students served as norm group. The intervention group was divided into three subgroups that the three subgroups received the same interventions but started at three different times. Each intervention subgroup received 8 sessions, 16 hours, of treatment. Both intervention subgroup and non-intervention group completed the evaluation of emotional ability tests after treatment and a half year later. Fifteen members of intervention group completed the evaluation of self-monitoring ability tests and Comprehensive Non-verbal Attention Test Battery before and after treatment. Ninety one members of non-intervention group completed the evaluation of self-monitoring ability tests before intervention group recived treatment and after treatment. Self-monitoring ability tests included Impulsivity Scale: Short Form, Adolescent Executive Function Scale, and Inventory of Everyday Life Self-attention.

RESULTS AND DISCUSSION
There were three levels of evidence. At the first level, the intervention group significantly improved their performance in most indices of emotion abilities and Self-monitoring ability after treatment including emotion regulation, hostility, anger, executive function, and inhibitory control. The improvements in emotion abilities lasted for a half year including emotion regulation, hostility, and anger. At the second level, the improvements of intervention group were significantly better than the non-intervention group in several indices including hostility and executive function. After a half year, the improvements of intervention group were significantly better than the non-intervention group in most emotion abilities indices including emotion regulation, hostility, and anger. At the third level, the improvements of intervention group were significantly better than norm group in every emotion abilities index. After a half year, performance of intervention group was better than norm group in every emotion abilities index. Overall, results revealed that the program of present study is effective.

CONCLUSION
The group therapy program of present study is based on neuropsychological theories. There are four possible mechanisms why the program works. First, inhibitory control training enhances the control of negative prepotent cognitive processing and impulsive behavior. These improvements make individuals able to acess more cognitive resource for problem solving as to cease the rising anger in provocative situation. Second, the training activities activate the frontal lobe. Individuals with activating frontal lobe use more top-down processing. It makes the progression generalize to other aspects. Third, the training focuses on the specific mental function. Focusing on inhibitory control training makes individuals have more opportunities to practice such function. Fourth, the neuroplasticity principles suggest that brain is affected by genes and experience. Studies have shown that brain function training can change the connection between neurons. Hence inhibitory control training may adjust related circuits in the brain. Although the results indicate that this program has potential to enhance inhibitory control and emotion regulation for adolescent with anger problems, there are four limitations due to the methodology problem. First, the sample of intervention group was few. It may affect statistical inference. Second, the study didn’t apply waiting group design. Therefore, we can’t examine whether the self-monitoring ability of third subgroup of intervention group is different from the other two. Third, there is lack of third evaluation of self-monitoring ability test. So we can’t examine the lasting effect of the program. Fourth, all the participants were 7th grader. The effectiveness could be different when apllying to other age group.
論文目次 中文摘要I
英文摘要II
誌謝VI
目錄VII
表目錄IX
圖目錄X
第壹章 緒論1
第一節 高憤怒情緒之探討1
一、憤怒情緒的定義與理論1
二、高憤怒情緒的臨床議題4
三、高憤怒情緒之成因探討5
第二節 執行功能對情緒功能的調控9
一、執行功能與情緒調節的定義9
二、執行功能與情緒調節的關係14
三、高憤怒情緒者的執行功能15
第三節 高憤怒情緒的介入與治療17
一、傳統心理治療17
二、神經心理治療之可能性20
第四節 研究動機與問題假設23
一、研究動機與目的23
二、問題假設23
第貳章 研究方法24
第一節 研究設計與流程24
第二節 研究對象28
一、受試者篩選與招募28
二、受試者分派28
第三節 研究工具28
一、療效評估工具28
二、治療工具:憤怒情緒調節團體方案34
第四節 統計分析38
第參章 研究結果40
第一節 受試者基本資料分析40
第二節 團體神經心理治療成效分析43
一、介入組前測與後測之比較43
二、介入組與未介入組比較49
三、介入組與常模組比較65
第肆章 討論72
第一節 憤怒情緒調節團體治療方案之療效探討72
第二節 本研究方案之特色與可能的療效機制74
第四節 研究限制76
第五節 研究貢獻與未來展望76
參考文獻78
中文部份78
英文部份79
附錄105
附錄一 憤怒情緒量尺105
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