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題名：憂鬱、認知及社會影響對臺灣南部大學生檳榔使用之解釋
書刊名：中華心理衛生學刊
作者：陳筱茜／柯慧貞 引用關係／李昆樺／林旻沛 引用關係
作者(外文)：Chen, Hsiao-chien／Ko, Huei-chen／Lee, Kun-hua／Lin, Min-pei
出版日期：2010
卷期：23:4
頁次：頁587-612
主題關鍵詞：檳榔；自我效能；結果預期；社會影響；憂鬱；Betel nut chewing；Self-efficacy；Outcome-expectancy；Social influence；Depression
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研究目的：過去文獻已證實ASE模式(Attitude-Social Influence-Efficacy model)可解釋國人檳榔使用的行為，指出檳榔使用結果預期透過自我效能影響嚼檳榔的意圖與行為，社會影響則直接影響意圖與行為。本研究擬修正ASE模式，假設憂鬱可以直接影響嚼檳榔的行為，或透過認知因素間接影響檳榔的使用。研究方法：由南區大學生依分層叢集抽樣出3246名有效樣本，施測檳榔使用意圖與行為量表、檳榔結果預期量表、社會影響量表、拒用檳榔自我效能量表及柯氏憂鬱量表；資料以結構性方程式驗證心理社會因子之模式適配度。研究結果：指出檳榔使用之高正向結果預期需透過低拒用自我效能影響嚼檳榔的意圖與行為；高度社會影響與低拒用自我效能直接影響檳榔使用行為；而憂鬱則透過高正向結果預期和低拒用自我效能，預測嚼檳榔之意圖與行為。研究結論：本研究建議可透過教育與諮商輔導增加大學生學習情緒調控知能，減少檳榔的正向結果預期以及強化拒用自我效能，以預防檳榔的使用。
Purpose: Around Asia, betel nuts, the seed of the Areca palm, are often wrapped in a leaf along with flavorings and chewed for a mild euphoric effect. The harmful aspects of betel nut chewing as a possible cause of oral cancer have been well documented. Given the prevalence of the practice, it is important to understand the psychosocial process. A previous study found that the chewer's outcome expectancy predicted the intention and behavior of betel nut chewing via refusal self-efficacy. Social influence directly predicted intention and behavior, supporting the attitude social-influence efficacy (ASE) model. Although research has consistently indicated an association between substance abuse disorders and depression, few studies have examined the relation between depression and chewing betel nut. The purpose of this study is to explore whether depression affects the behavior of betel nut chewing directly or indirectly through cognitive factors. We examine a modified ASE model with 2 hypotheses: 1) high positive outcome expectancy, low negative outcome expectancy, high social influence factor, low refusal self-efficacy and high depressed mood affect betel chewing intention and behavior; and 2) refusal self-efficacy and social influence factors influence betel chewing intention and behavior, while outcome expectancy and depression indirectly affect betel chewing intention and behavior via refusal self-efficacy. Methods: Using stratified and cluster sampling, 3, 246 valid responses were obtained from students age 18 to 22 (1,498 males and 1, 748 females) from 14 colleges in Southern Taiwan in 2003. Measurements included demographic data, betel nut outcome expectancy, social influence, betel nut refusal self-efficacy, betel nut chewing intention, betel nut chewing behavior, and the Ko depression inventory (KDI). U We compared the 2 competing models and examined the relationship among the variables through structural equation modeling (SEM). Results: The second hypothesis model had a better fit than the first one. Outcome expectancy predicted behavior by way of refusal self-efficacy. Low refusal self-efficacy and high social influence directly influenced betel nut chewing intention and behavior. Furthermore, depression via cognitive variables (low refusal self-efficacy and high positive outcome expectancy) predicted intention and behavior. Conclusions: The results indicate that social, cognitive, and emotional factors are the main determinants of betel nut chewing among college students. Also, emotion can affect behavior via cognition. The results of the study serve educational and counseling purposes and illuminate the importance of coping with depression, reduction of positive outcome expectancy, and reinforcement of refusal self-efficacy in preventing the use of betel nut.
期刊論文
1.Chu, Nai-shin(20010500)。Effects of Betel Chewing on the Central and Autonomic Nervous Systems。Journal of Biomedical Science，8(3)，229-236。  new window
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3.Chang, C. H.、Ko, H. C.、Wu, J. Y. W.、Cheng, C. P.(2007)。Social cognitive determinants of betel quid chewing among college students in southern Taiwan: A revised attitudes-social influence-efficacy model。Addictive Behaviors，32(10)，2345-2350。  new window
4.Chien, L. L.、Ko, H. C.、Wu, J. Y. W.(2007)。The five-factor of personality and depressive symptoms: One-year follow-up。Personality and. Individual Differences，43，1013-1023。  new window
5.Chiu, S. H.、Ko, H. C.、Wu, J. Y. W.(2007)。Depression moderated the effect of exposure to suicide news on suicidality among college students in Taiwan。Suicide and Life-Threatening Behavior，37(5)，585-592。  new window
6.De Weert-Van Oene, G. H.、Breteler, M. H. M.、Schippers, G. M.、Schrijvers, A. J. P.(2000)。The validity of the self-efficacy list for drug users (SELD)。Addictive Behaviors，25(4)，599-605。  new window
7.Epstein, J. A.、Williams, C.、Botvin, G. J.(2002)。How universal are social influences to drink and problem behaviors for alcohol use? A test comparing urban African-American and Caribbean-American adolescents。Addictive Behaviors，27(1)，75-86。  new window
8.Tate, S. R.、Brown, S. A.、Unrod, M.、Ramo, D. E.(2004)。Context of relapse for sub-stance-dependent adults with and without comorbid psychiatric disorders。Addictive Behaviors，29，1707-1724。  new window
9.楊奕馨、陳鴻榮、曾筑瑄、謝天渝(20021000)。臺灣地區各縣市檳榔嚼食率調查報告。臺灣口腔醫學衛生科學雜誌，18(1)，1-16。  延伸查詢new window
10.Jenkins, J. E.、Zunguze, S. T.(1998)。The relationship of family structure to adolescent drug use, peer affiliation and perception of peer acceptance of drug use。Adolescence，33(132)，811-822。  new window
11.Oei, T. P. S.、Burrow, T.(2000)。Alcohol expectancy and drinking refusal self-efficacy: A test of specificity theory。Addictive Behaviors，25，499-507。  new window
12.Christiansen, B. A.、Roehling, P. V.、Smith, G. T.、Goldman, M. S.(1989)。Using Alcohol Expectancies to Predict Adolescent Drinking Behavior after One Year。Journal of Consulting and Clinical Psychology，57(1)，93-99。  new window
13.陳富莉、李蘭(19991000)。臺灣地區成年人之吸菸與嚼檳榔行為的組合及其相關因子探討。中華公共衛生雜誌，18(5)，341-348。new window  延伸查詢new window
14.柯慧貞、孫苑庭、林木芬、葉宗烈、陸汝斌(20000300)。由行為抑制探討婦女焦慮與憂鬱之共病機制。臺灣精神醫學，14(1)，13-21。new window  延伸查詢new window
15.Bandura, Albert(1989)。Human agency in social cognitive theory。American Psychologist，44(9)，1175-1184。  new window
16.Maassen, I. T.、Kremers, S. P.、Mudde, A. N.、Joof, B. M.(2004)。Smoking Initiation among Gambian Adolescents: Social Cognitive Influences and the Effect of Cigarette Sampling。Health Education Research，19(5)，551-560。  new window
17.Li, S. M.、Rwei-Ling, Y.、Hu, H. C.、Huang, J. S.(2003)。Areca Quid Chewing by Taiwanese Adolescents: Application of the Attitudes Social Influence Self-efficacy (ASE) Model。Addiction，98(12)，1723-1729。  new window
18.Demmel, T. R.、Nicolai, J.、Gregorzik, S.(2006)。Alcohol expectancies and current mood state in social drinkers。Addictive Behaviors，31，859-867。  new window
19.Dill, P. L.、Wells-Parker, E.、Cross, G. W.、Williams, M.、Mann, R. E.、Stoduto, G.(2007)。The relationship between depressed mood, self-efficacy and affective states during the drinking driving sequence。Addictive Behaviors，32，1714-1718。  new window
20.Khantzian, E. J.(1997)。The self-medication hypothesis of substance use disorders： A reconsideration and recent applications。Harvard Review of Psychiatry，4(5)，231-244。  new window
21.Klavs, I.、Bufon-Lužnik, T.、Škerl, M.、Grgič-Vitek, M.、Lejko-Zupanc, T.、Dolinšek, M.(2003)。Prevalance of and risk factors for hospital-acquired infections in Slovenia: Results of the first national survey, 2001。Journal of Hospital Infection，54(2)，149-157。  new window
22.Kuo. P. H.、Yang. H. J.、Soong. W. T.、Chen. W. J.(2002)。Substance use among adolescents in Taiwan: Associated personality traits, incompetence, and behavioral/emotional problems。Drug and Alcohol Dependence，67(1)，27-39。  new window
23.Lee, N. K.、Greely, J.、Oei, T. P. S.(1999)。The relationship of positive and negative alcohol expectancies to patterns of consumption of alcohol in social drinkers。Addictive Behaviors，24(3)，359-369。  new window
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25.Willemsen, M. C.、de-Vries, H.、van Breukelen, G.、Oldenburg, B.(1996)。Determinants of intention to quit smoking among Dutch employees： The influence of the social environment。Preventive Medicine，25(2)，195-202。  new window
26.Yu, R. L.,、Ko, H. C.(2006)。Cognitive determinants of MDMA use among college students in southern Taiwan。Addictive Behaviors，31(12)，2199-2211。  new window
研究報告
1.柯慧貞(2002)。比較單純酒癮、單純焦慮、併有焦慮之酒癮及正常組在氣質、酒精效果預期、及抗酒自我效能評估上之差異 (計畫編號：NSC91-2413-H-006-005-SSS)。臺北市：行政院國家科學委員會。  延伸查詢new window
2.謝天渝、楊奕馨、曾筑瑄(2001)。台灣地區檳榔嚼食率、吸菸率及對檳榔健康危害意識調查 (計畫編號：DOH90-TD-1135)。  延伸查詢new window
3.李景美、賴香如、李碧霞、張鳳琴、陳雯昭(2000)。台北縣市高職學生物質濫用之危險因子與保護因子研究 (計畫編號：DOH89-TD-1115)。  延伸查詢new window
4.李蘭、蕭朱杏、陸玓玲(1996)。臺灣地區青少年與成人有關嚼檳榔危害之認知與行為調查 (計畫編號：DOH84-HP-042)。  延伸查詢new window
5.徐達光(2000)。檳榔族對嚼食檳榔及戒食檳榔之知識和行為與影響戒食之原因調查 (計畫編號：DOH89-TD-1176)。  延伸查詢new window
6.唐子俊、戴谷霖、廖秀娟、蘇薇如(2007)。高雄地區青少年嚼食檳榔行為習慣形成歷程及影響因素之質性研究 (計畫編號：DOH96-HP-1503)。  延伸查詢new window
7.郭憲文、李玫姿(2004)。台灣地區在學國中、高中生藥物濫用之調查 (計畫編號：DOH93-NNB-1009)。  延伸查詢new window
8.顏正芳、唐子俊、柯志鴻、羅文君(2005)。憂鬱對於青少年物質使用和其他危險行為之問關聯性的影響研究 (計畫編號：NSC93-2413-H-037-005-SSS)。  延伸查詢new window
9.嚴道、黃松元、馬藹屏、蕭惠文、周曉惠(1995)。台灣地區青少年對吸菸、飲酒、嚼檳榔汁認知、態度、行為與其心理特質調查研究 (計畫編號：DOH83-HP-119-3M27)。  延伸查詢new window
學位論文
1.盧俊泰(1995)。口腔癌流行病學研究(博士論文)。高雄醫學大學。  延伸查詢new window
2.柯慧貞(1989)。內因性憂鬱症與非內因性憂鬱症在腎上腺皮質素抑制反應、認知偏差及生活壓力上之比較(博士論文)。國立台灣大學。new window  延伸查詢new window
3.莊文寬(2002)。台中縣國中生嚼食檳榔相關因素之研究(碩士論文)。逢甲大學。  延伸查詢new window
圖書
1.U.S. Department of Health and Human Services(1997)。Ninth special report to U.S. Congress on alcohol and health。Rockville, MD：National Institute on Alcohol Abuse and Alcoholism。  new window
2.吳明隆、涂金堂(2007)。SPSS與統計應用分析。五南。  延伸查詢new window
3.Bandura, Albert(1977)。Social Learning Theory。Prentice-Hall, Inc.。  new window
4.Khantzian, E. J.(1999)。Treating addiction as a human process。Lanham, MD：Jason Aronson。  new window
其他
1.行政院衛生署(2008)。歷年死因統計：表6歷年癌症主要死亡原因死亡人數--按性別區分，http://www.doh.gov.tw/CHT2006/DM/DM2_2H.aspx?now_fod_list_no＝10327&class_no＝440&level_no＝4， 2008/11/18。  延伸查詢new window
2.中華民國教育統計指標(2002)。高等教育－九十學年度大專院校學生數分析，臺北市：教育部。  延伸查詢new window
 
 
 
 
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