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題名：乳癌患者之反芻反應風格對其術後憂鬱與創傷後壓力症狀之預測
書刊名：中華心理學刊
作者：游勝翔／陳淑惠 引用關係／張金堅
作者(外文)：Yu, Sheng-hsiang／Chen, Sue-huei／Chang, King-jen
出版日期：2008
卷期：50:3
頁次：頁289-302
主題關鍵詞：反芻反應風格；反應風格；乳癌；創傷後壓力症候群；憂鬱；Breast cancer；Depression；PTSD；Response style；Rumination
原始連結：連回原系統網址new window
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  • 被引用次數被引用次數:期刊(5) 博士論文(3) 專書(0) 專書論文(0)
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獲知罹患威脅生命重大疾病（如癌症）的診斷及接受醫療的歷程可視為一創傷事件。過去研究指出，反芻反應風格與壓力事件後的憂鬱與創傷後壓力症狀有關。然而，對反芻反應風格與癌症患者身心症狀之關聯性的瞭解仍相當有限。因此，本研究目的在於檢驗反芻反應風格對接受手術後的乳癌患者之憂鬱與創傷後壓力症狀的預測力。本研究之研究對象為244位乳癌術後患者，由醫師轉介自願參與本研究。簽署同意書後，參與者填寫包括中文反應風格量表短版、中文症狀檢劾量表短版及創傷後心理症狀指標量表短版等量表。研究結果顯示，反應風格分別能顯著預測乳癌術後病人之憂鬱與創傷後壓力症狀，其中反芻反應風格與憂鬱和創傷後壓力症狀之增加有關；而分心反應風格則與憂鬱和創傷後壓力症狀之減輕有關。反芻反應風格對創傷後壓力症狀具獨特之預測力。最後，本文討論反芻反應風格影響創傷後壓力症狀病程之可能機制與臨床應用。
Life-threatening illness (e.g. cancer) is recognized as a traumatic stressful event. Cancer patients who receive medical treatment may present some notable psychological complaints, such as depressive and posttraumatic stress symptoms. Thus, factors associated with these psychiatric symptoms may play an important role in the adjustment and recovery of the postoperative cancer patients. Empirical researches suggest rumination as a powerful predictor of the maintenance of depressive and PTSD symptoms in response to stress. However, the relationship between rumination and PTSD symptoms in cancer patients has been little understood in the western literature or examined in Taiwan. Therefore, the first purpose of the present study was to investigate the relationship among rumination, depression, and PTSD symptoms in postoperative breast cancer patients. This study also sought to examine the ability of rumination in predicting depression and PTSD symptoms. Specifically, ruminative response style was hypothesized to predict depressive and PTSD severity in postoperative cancer patients. In addition, rumination was assumed to have a unique contribution to the prediction of PTSD severity, controlling for current level of depressive severity. Two hundred and forty four postoperative breast cancer female outpatients recruited from National Taiwan University Hospital volunteered to participate in this study. The measures included the Symptom CheckList-90-Revised short form, Post Traumatic Stress Reaction Index-short form, and Chinese Response Style Questionnaire-short form. The results showed that, as predicted, response style could both significantly predict depression and PTSD severity in postoperative breast cancer patients. Hierarchical regression analysis revealed that, after demographical variables and depression severity were controlled, ruminative response style had a unique contribution to the prediction of PTSD severity. The findings of this study suggest that rumination may play an important role in the development and maintenance of PTSD symptoms in cancer patients. It is speculated that ruminating traumatic experiences may trigger intrusive traumatic memories and affect the cognitive reconstruction of traumatic events. Ruminative responses may also interfere with instrumental behaviors such as seeking care and reducing problem solving ability thus so to result in exacerbation of PTSD. Finally, it will be helpful to replicate this study in patients with different types of cancers. Moreover, future studies can adopt different research paradigms, such as prospective design, to establish the causal relationship of rumination and PTSD symptoms.
期刊論文
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2.Nolen-Hoeksema, Susan(1991)。Responses to depression and their effects on the duration of depressive episodes。Journal of Abnormal Psychology，100(4)，569-582。  new window
3.McCann, I. Lisa、Pearlman, Laurie A.(1990)。Vicarious traumatization: A framework for understanding the psychological effects of working with victims。Journal of Traumatic Stress，3(1)，131-149。  new window
4.Lyubomirsky, S.、Caldwell, N. D.、Nolen-Hoeksema, S.(1998)。Effects of ruminative and distracting responses to depressed mood on retrieval of autobiographical memories。Journal of Personality and Social Psychology，75，166-177。  new window
5.Just, N.、Alloy, L. B.(1997)。The response styles theory of depression: Tests and an extension of the theory。Journal of Abnormal Psychology，106(2)，221-229。  new window
6.Alter, C. L.、Pelcovitz, D.、Axelrod, A.、Goldenberg, B.、Meyers, B. S.(1996)。Identification of PTSD in Cancer Survivors。Psychosomatics，37，137-143。  new window
7.Green, B. L.、Rowland, J. H.、Krupnick, J. L.、Epstein, S. A.、Stockton, P.、Stern, N. M.(1998)。Prevalence of Posttraumatic Stress Disorder in Women with Breast Cancer。Psychosomatics，39，102-111。  new window
8.Hegel, M. T.、Moore, C. P.、Collins, E. D.、Kearing, S.、Gillock, K. L.、Riggs, R. L.(2006)。Distress, Psychiatric Syndromes, and Impairment of Function in Women with Newly Diagnosed Breast Cancer。Cancer，107(12)，2924-2931。  new window
9.Kornblith, A. B.、Herndon, J. E.、Weiss, R. B.、Zhang, C.、Zuckerman, E. L.、Rosenberg, S.(2003)。Long-term Adjustment of Survivors of Earlystage Breast Carcinoma, 20 Years after Adjuvant Chemotherapy。Cancer，98，679-689。  new window
10.Matsuoka, Y.、Nakano, T.、Inagaki, M.、Sugawara, Y.、Akechi, T.、Imoto, S.(2002)。Cancer-related Intrusive Thoughts as an Indicator of Poor Psychological Adjustment at 3 or More Years after Breast Surgery: A Preliminary Study。Breast Cancer Research and Treatment，76，117-124。  new window
11.Spasojevic, J.、Alloy, L. B.(2001)。Rumination as a Common Mechanism Relating Depressive Risk Factors to Depression。Emotion，1，25-37。  new window
12.Filipp, S. H.、Klauer, T.、Freudenberg, E.、Ferring, D.(1990)。The Regulation of Subjective Well-being in Cancer Patients: An Analysis of Coping Effectiveness。Psychology and Health，4，305-317。  new window
13.Smith, M. Y.、Redd, W. H.、Peyser, C.、Vogl, D.(1999)。Post-traumatic Stress Disorder in Cancer: A Review。Psycho-Oncology，8(6)，521-537。  new window
14.Cordova, M. J.、Andrykowski, M. A.(2003)。Responses to Cancer Diagnosis and Treatment: Posttraumatic Stress and Posttraumatic Growth。Seminars in Clinical Neuropsychiatry，8，286-296。  new window
15.Wells, A.、Sembi, S.(2004)。Metacognitive Therapy for PTSD: A Core Treatment Manual。Cognitive and Behavioral Practice，11，365-377。  new window
16.Alfano, C. M.、Rowland, J. H.(2006)。Recovery Issue in Cancer Survivorship: A New Challenge for Supportive Care。Cancer Journal，12，432-443。  new window
17.Street, H.(2003)。The Psychosocial Impact of Cancer: Exploring Relationships between Conditional Goal Setting and Depression。Psycho-oncology，12，580-589。  new window
18.Petersen, S.、Heesacker, M.、Schwartz, R. C.、Marsh, R. D.(2000)。Predictors of Decision-making Style among Cancer Patients: An Empirical Test of Theory。Psychology and Health，15，663-675。  new window
19.McWilliams, L. A.、Cox, B. J.、Asmundson, G. J.(2005)。Symptom Structure of Posttraumatic Stress Disorder in a Nationally Representative Sample。Journal of Anxiety Disorders，19，626-641。  new window
20.Kangas, M.、Henry, J. L.、Bryant, R. A.(2002)。Posttraumatic Stress Disorder Following Cancer: A Conceptual and Empirical Review。Clinical Psychology Review，22，499-524。  new window
21.Ehlers, A.、Steil, R.(1995)。Maintenance of Intrusive Memories in Posttraumatic Stress Disorder: A Cognitive Approach。Behavioural and Cognitive Psychotherapy，23，217-249。  new window
22.Tedstone, J. E.、Tarrier, N.(2003)。Posttraumatic Stress Disorder Following Medical Illness and Treatment。Clinical Psychology Review，23，409-448。  new window
23.Davis, R. N.、Nolen-Hoeksema, S.(2000)。Cognitive Inflexibility among Ruminators and Nonruminators。Cognitive Therapy and Research，24，699-711。  new window
24.Michael, T.、Halligan, S. L.、Clark, D. M.、Ehlers, A.(2007)。Rumination in Posttraumatic Stress Disorder。Depression and Anxiety，24，307-317。  new window
25.Stanton, A. L.(2006)。Psychosocial Concerns and Intervention for Cancer Survivors。Journal of Clinical Oncology，24，5132-5137。  new window
26.Lyubomirsky, S.、Kasri, F.、Chang, O.、Chung, I.(2006)。Ruminative Response Styles and Delay of Seeking Diagnosis for Breast Cancer Symptoms。Journal of Social and Clinical Psychology，25，276-304。  new window
27.Treynor, W.、Gonzalez, R.、Nolen-Hoeksema, S.(2003)。Rumination Reconsideration: A Psychometric Analysis。Cognitive Therapy and Research，27，247-259。  new window
28.Kuehner, C.、Weber, I.(1999)。Responses to Depression in Unipolar Depressed Patients: An Investigation of Nolen-Hoeksema's Response Styles Theory。Psychological Medicine，29，1323-1333。  new window
29.Kornblith, A. B.、Ligibel, J.(2003)。Psychosocial and Sexual Functioning of Survivors of breast Cancer。Seminars in Oncology，30，799-813。  new window
30.Ehlers, A.、Mayou, R. A.、Bryant, B.(2003)。Cognitive Predictors of Posttraumatic Stress Disorder in Children: Results of a Prospective Longitudinal Study。Behaviour Research and Therapy，41，1-10。  new window
31.Gurevich, M.、Devins, G. M.、Rodin, G. M.(2002)。Stress Response Syndromes and Cancer: Conceptual and Assessment Issues。Psychosomatics，43，259-281。  new window
32.Tjemsland, L.、Søreide, J. A.、Malt, U. F.(1998)。Posttraumatic Distress Symptoms in Operable Breast Cancer III。Breast Cancer Research and Treatment，47，141-151。  new window
33.Ehlers, A.、Clark, D. M.(2003)。Early Psychological Interventions for Adult Survivors of Trauma: A Review。Biological Psychiatry，53，817-826。  new window
34.Nolen-Hoeksema, S.、Morrow, J.(1991)。A Prospective Study of Depression and Posttraumatic Stress Symptoms after a Natural Disaster: The 1989 Loma Prieta Earthquake。Journal of Personality and Social Psychology，61，115-121。  new window
35.Cordova, M. J.、Andrykowski, M. A.、Kenady, D. E.、McGrath, P. C.、Sloan, D. A.、Redd, W. H.(1995)。Frequency and Correlates of poPsttraumatic Stress Disorder - Like Symptoms after Treatment for Breast Cancer。Journal of Consulting and Clinical Psychology，63，981-986。  new window
36.Palmer, S. C.、Kagee, A.、Coyne, J. C.、DeMichele, A.(2004)。Experience of Trauma, Distress, and Posttraumatic Stress Disorder among Breast Cancer Patients。Psychosomatic Medicine，66，258-264。  new window
37.Lyubomirsky, S.、Nolen-Hoeksema, S.(1995)。Effects of Self-focused Rumination on Negative Thinking and Interpersonal Problem Solving。Journal of Personality and Social Psychology，69，176-190。  new window
38.Kangas, M.、Henry, J. L.、Bryant, R. A.(2005)。The Course of Psychological Disorders in the 1st Year after Cancer Diagnosis。Journal of Consulting and Clinical Psychology，73，763-768。  new window
39.Lyubomirsky, S.、Tucker, K. L.、Caldwell, N. D.、Berg, K.(1999)。Why Ruminators are Poor Problem Solvers: Clues from the Phenomenology of Dysphoric Rumination。Journal of Personality and Social Psychology，77，1041-1060。  new window
40.Ehlers, A.、Mayou, R. A.、Bryant, B.(1998)。Psychological Predictors of Chronic Posttraumatic Stress Disorder after Motor Vehicle Accidents。Journal of Abnormal Psychology，107，508-519。  new window
41.陳淑惠、洪福建、林耀盛、曾旭民(2002)。高低受災成人之創傷後心理症狀與社會心理變動：九二一集集地震三個月後的比較研究。中華心理學刊，44(2)，167-188。  延伸查詢new window
學位論文
1.蕭仁釗(1989)。疾病壓力與一般壓力下社會支持運作歷程的探討(碩士論文)。國立台灣大學。  延伸查詢new window
2.游勝翔(2004)。反芻反應風格、自傳式記憶與憂鬱之關聯性探討，0。  延伸查詢new window
3.蘇逸人(2002)。疾病覺知、疾病控制信念與社會污名：精神分裂症患者疾病心理適應之心理社會因應模式，0。  延伸查詢new window
圖書
1.Tedeschi, R. G.、Calhoun, L. G.(1995)。Trauma and transformation: Growing in the aftermath of suffering。Thousand Oak, CA：Sage Publications, Inc.。  new window
2.American Psychiatric Association(2000)。Diagnostic and Statistical manual of mental disorders。Washington, DC：Book Promotion & Service LTD。  new window
3.Segal, Z. V.、Williams, J. M. G.、Teasdale, J. D.(2002)。Mindfulness-based cognitive therapy for depression: A new approach to preventing relapse。New York, NY：Guilford Press。  new window
4.(1999)。Essential Papers on Posttraumatic Stress Disorder。Essential Papers on Posttraumatic Stress Disorder。New York, NY。  new window
5.Horowitz, M. J.(1997)。Stress Response Syndromes--PTSD, Grief, and Adjustment Disorders。Northvale, NJ：Jason Aronson Inc.。  new window
6.American Psychiatric Association(1996)。Diagnostic and Statistical Manual of Mental Disorders。Diagnostic and Statistical Manual of Mental Disorders。Washington, DC。  new window
7.Green, B. L.、Epstein, S. A.、Krupnick, J. L.、Rowland, J. H.(1997)。Trauma and Medical Illness: Assessing Trauma-related Disorders in Medical Settings。Assessing Psychological Trauma and PTSD。New York, NY。  new window
8.Clark, D. M.、Ehlers, A.(2004)。Posttraumatic Stress Disorder: From Cognitive Theory to Therapy。Contemporary Cognitive therapy: Theory, Research, and Practice。New York, NY。  new window
9.Lyubomirsky, S.、Tkach, C.(2004)。The Consequences of Dysphoric Rumination。Depressive Rumination: Nature, Theory, and Treatment。Chichester, UK。  new window
10.Derogatis, L. R.、Lazarus, L.(1994)。SCL-90-R, Brief Symptom Inventory, and Matching Clinical Rating Scales。The Use of Psychological Testing for Treatment Planning and Outcome Assessment。Hillsdale, NJ/ London, UK。  new window
 
 
 
 
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