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題名:日常生活的偏離與歸返:反芻思考在憂鬱失能經驗中的角色
書刊名:中華心理衛生學刊
作者:王家齊李錦虹 引用關係張盛堂
作者(外文):Wang, Chia-chiLee, Gin-hongChang, Shang-tang
出版日期:2014
卷期:27:2
頁次:頁223-251
主題關鍵詞:憂鬱症憂鬱反芻反覆思考質性研究現象學DepressionDepressive ruminationRepetitive thoughtQualitative researchPhenomenology
原始連結:連回原系統網址new window
相關次數:
  • 被引用次數被引用次數:期刊(2) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:2
  • 共同引用共同引用:113
  • 點閱點閱:16
研究目的:本研究以現象學方法重返憂鬱者主觀經驗,了解憂鬱反芻的經驗意涵。研究方法:本研究共計5名受訪者(4女1男),皆符合重鬱症診斷,並有憂鬱後反覆思考的經驗。受訪者填寫貝克憂鬱量表第二版(Beck Depression Inventory-II, BDI-II)並接受約1.5小時的訪談。訪談全程錄音謄為逐字稿,並依照李維倫、賴憶嫺(2009)建議的步驟進行現象學分析。研究結果:本研究以「日常生活-病人生活-受苦生活」的普遍結構說明憂鬱失能的經驗,是在:(1)失能、失控感,(2)與他人、自我的比較中「偏離」日常生活,並掉落受苦生活的處境。此時受訪者意欲歸返日常生活,也就是和「他人」、「病前自我」表現地一樣好。然而,「變好」的過程艱難且充滿挫折,受訪者常對自己留在受苦生活而「無法變好」的處境進行自我批判。對於接受精神醫療協助的擔心,則使受訪者感到衝突而拒絕成為「病人」,也就是進入病人生活。當其無法回歸日常,又不願進入病人生活-則留在無以命名的受苦,並以反芻意義化其所在。當意義化將受訪者帶往不利處境,則使其經驗次發性受苦,並再次以意義化命名其處境,形成憂鬱反芻的迴圈。研究結論:本研究以「處境意義化」解釋受苦、反芻的迴圈,及其難以中止的可能原因。助人工作者應協助憂鬱者探索受苦經驗的多元可能,共同找出有利的意義化。
Purpose: This study examines the subjective experience of depressive rumination, to descript an experiential structure of this phenomenon. Methods: A total of 5 patients (1 male, 4 female) diagnosed with a major depressive disorder and referred by a psychiatrist participated in this study. They all had the experience of thinking repetitively when feeling depressed. All completed the Beck Depression Inventory-II (BDI-II) and were interviewed by the researcher 1-2 times, for about 1.5 hours each time. Interviews were transcribed verbatim. Phenomenological analysis was used to analyze the text. Results: Our results indicated a general structure of perceived experience: "Daily life-Patient’s life-Suffering life". People with depression and disability experience themselves as existentially apart from their daily life. They experience a "suffering life" through: (1) a sense of disability and lack of control, and (2) comparing their suffering to daily life/other people’s lives. When people are suffering, they want to go back to daily life, to have life be as good as before. However, the process of "being good" is hard and full of frustration. Participants criticized themselves for living a suffering life. When they asked for medical service, they rejected the label of "patient", which to them means they would live a "patient’s life." When people can’t return to a normal daily life, they feel conflict. They remain in a suffering state that is nameless. The experience of depressive rumination is the effort to make sense of this nameless suffering. However, this effort to make sense of things may cause them to live with much more distress and experience secondary suffering. After that, people make sense of their secondary suffering again. This creates the circle of depressive rumination and suffering. Conclusions: This article indicates that the effort to "make sense of my suffering" may explain the reason depressive rumination and suffering are sustained. Psychotherapists should help depressive patients explore their suffering and find a more adaptive way of making sense of their situation.
期刊論文
1.Nolen-Hoeksema, Susan、Wisco, Blair E.、Lyubomirsky, Sonja(2008)。Rethinking rumination。Perspectives on Psychological Science: A Journal of the Association for Psychological Science,3(5),400-424。  new window
2.Joormann, J.、Dkane, M.、Gotlib, I. H.(2006)。Adaptive and maladaptive components of rumination? Diagnostic specificity and relation to depressive biases。Behavior Therapy,37(3),269-280。  new window
3.Beck, A. T.(1991)。Cognitive therapy: A 30-year retrospective。American Psychologist,46(4),368-375。  new window
4.Lara, M. E.、Klein, D. N.、Kasch, K. L.(2000)。Psychosocial predictors of the short-term course and outcome of major depression: A longitudinal study of a nonclinical sample with recent-onset episodes。Journal of Abnormal Psychology,109(4),644-650。  new window
5.Morrow, J.、Nolen-Hoeksema, S.(1990)。Effects of responses to depression on the remediation of depressive affect。Journal of Personality and Social Psychology,58(3),519-527。  new window
6.Segerstrom, S. C.、Stanton, A. L.、Alden, L. E.、Shortridge, B. E.(2003)。A Multidimensional Structure for Repetitive Thought: What’s on Your Mind, and How, and How Much?。Journal of Personality and Social Psychology,85(5),909-921。  new window
7.Whitmer, A. J.、Gotlib, I. H.(2011)。Brooding and reflection reconsidered: A factor analytic examination of rumination in currently depressed, formerly depressed, and never depressed individuals。Cognitive Therapy and Research,35(2),99-107。  new window
8.Nolen-Hoeksema, S.、Morrow, J.、Fredrickson, B. L.(1993)。Response styles and the duration of episodes of depressed mood。Journal of Abnormal Psychology,102(1),20-28。  new window
9.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
10.DeRubeis, R. J.、Hollon, S. D.、Amsterdam, J. D.、Shelton, R. C.、Young, P. R.、Salomon, R. M.、Gallop, R.(2005)。Cognitive Therapy vs Medications in the Treatment of Moderate to Severe Depression。Archives of General Psychiatry,62(4),409-416。  new window
11.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
12.Treynor, W.、Gonzalez, R.、Nolen-Hoeksema, S.(2003)。Rumination Reconsidered: A Psychometric Analysis。Cognitive Therapy and Research,27(3),247-259。  new window
13.李維倫、賴憶嫺(20090300)。現象學方法論:存在行動的投入。中華輔導與諮商學報,25,275-321。new window  延伸查詢new window
14.Garnefski, N.、Kraaij, V.、Spinhoven, P.(2001)。Negative life events, cognitive emotion regulation and emotional problems。Personality and Individual Differences,30(8),1311-1327。  new window
15.Keng, S. L.、Smoski, M. J.、Robins, C. J.(2011)。Effects of mindfulness on psychological health: A review of empirical studies。Clinical Psychology Review,31(6),1041-1056。  new window
16.Aldao, Amelia、Nolen-Hoeksema, Susan、Schweizer, Susanne(2010)。Emotion-regulation strategies across psychopathology: A meta-analytic review。Clinical Psychology Review,30(2),217-237。  new window
17.余德慧、李維倫、林耀盛、余安邦、陳淑惠、許敏桃、謝碧玲、石世明(20041200)。倫理療癒作為建構臨床心理學本土化的起點。本土心理學研究,22,253-325。new window  延伸查詢new window
18.Nolen-Hoeksema, S.(2000)。The role of rumination in depressive disorders and mixed anxiety/depressive symptoms。Journal of Abnormal Psychology,109,504-511。  new window
19.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
20.Robinson, M. S.、Alloy, L. B.(2003)。Negative cognitive styles and stress-reactive rumination interact to predict depression: A prospective study。Cognitive Therapy and Research,27,275-291。  new window
學位論文
1.周嘉娸(2008)。憂鬱反芻對工作記憶容量的影響之初探(碩士論文)。國立臺灣大學。  延伸查詢new window
圖書
1.McLeod, J.、連廷嘉、徐西森(2001)。諮商與心理治療質性研究。台北:心理出版社。  延伸查詢new window
2.Williams, M.、Teasdale, J.、Segal, Z.、andKabat-Zinn, J、劉乃誌(2007)。是情緒糟,不是你很糟:穿透憂鬱的內觀力量。台北:心靈工坊。  延伸查詢new window
3.Beck, A. T.、Alford, B. A.(2009)。Depression: causes and treatments。Philadelphia:University of Pennsylvania Press。  new window
4.孔繁鐘、孔繁錦(2000)。DSM-ΙV精神疾病診斷準則手冊。臺北:合記。  延伸查詢new window
5.Giorgi, A.(2009)。The descriptive phenomenological method in psychology: A modified Husserlian approach。Pittsburgh, PA:Duquesne University Press。  new window
6.Becker, C.(1992)。Living and Relating: An Introduction to Phenomenology。Newbury Park:Sage。  new window
其他
1.Adichie, C.(2009)。The danger of a single story,http:// www.ted.com/talks/chimamanda_adichie_the_danger_of_a_single_story.html, 2010/10/10。  new window
圖書論文
1.Martin, L. L.、Tesser, A.、McIntosh, W. D.(1993)。Wanting but not having: The effects of unattained goals on thoughts and feelings。Handbook of Mental Control。Englewood Cliffs, New Jersey:Prentice Hall。  new window
2.Wertz, Frederick J.(1985)。Method and findings in a phenomenological psychological study of a complex life-event: Being criminally victimized。Phenomenology and psychological research。Duquesne University Press。  new window
3.Churchill, S. D.、Lowery, J. E.、McNally, O.、Rao, A.(1998)。The question of reliability in interpretive psychological research: A comparison of three phenomenologically based protocol。Phenomenological inquiry in psychology: Existential and transpersonal dimensions。New York, NY:Plenum Press。  new window
 
 
 
 
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