憂鬱症患者之非語言情緒辨識表現初探

Abstract

本研究目的在於以實徵研究方式探討憂鬱與非語言情緒辨識之關聯性，檢驗處於憂鬱發作之憂鬱患者在臉部表情、聲音語調與雙重管道上之非語言情緒辨識表現。在文獻回顧中，皆發現憂鬱個體在非語言情緒辨識上有異於正常個體之表現，但其差異內容因研究對象、研究工具、及研究設計之差異，而在不同研究之間存在歧異性。是故，本研究改善研究設計與方法，並以本土性憂鬱患者檢驗憂鬱症與非語言情緒辨識之關聯性，期望能進一步釐清其可能的關連性。本研究假設：相較於正常個體，憂鬱個體在單一管道（包括臉部表情和聲音語調）的非語言情緒辨識上，傾向呈現負向偏誤與正向偏誤；在雙重管道（包括一致情緒和不一致情緒）的非語言情緒辨識上，則傾向呈現負向辨識與敏感辨識。本研究的樣本為30名憂鬱患者與 39名社區居民。研究過程中先以結構式訪談問卷篩選出適宜受試者，其後以自填式量表衡鑑其憂鬱情緒狀態，以電腦化非語言情緒辨識工具測量受試者在臉部表情、聲音語調、及雙重管道之非語言情緒辨識能力，並以短版魏氏成人智力測驗第三版評估智商。研究結果顯示，在排除智商的影響後，憂鬱患者相較於正常者在單一管道的非語言情緒辨識上有負向偏誤，對悲傷負向情緒的辨識較為正確，以及易將其他非語言情緒錯誤辨識成悲傷與憤怒等負向情緒，但在高興正向情緒上則和正常者無顯著差異。換言之，本研究結果支持憂鬱患者具有情緒一致傾向的假設，憂鬱患者傾向增強與情緒一致之負向情緒刺激的處理，對負向情緒具有高敏感辨識度。在雙重管道上，憂鬱患者相較於正常者，對一致情緒訊息與不一致情緒訊息的正確辨識度與正常者無顯著差異；然而，在表情語音雙重管道一致的高興或悲傷情緒之辨識正確率上優於正常組，在一致的憤怒或恐懼情緒之辨識正確率則低於正常組；此外，憂鬱患者在表情語音雙重管道一致的情緒辨識錯誤特性上，較容易出現高興正向情緒之辨識傾向，而在表情語音雙重管道不一致情緒的辨識錯誤特性，則容易出現恐懼負向情緒之辨識傾向。最後，本研究以認知理論、人際理論、及特質壓力模式等角度討論憂鬱可能之維持機制，並且討論研究結果在臨床應用之意涵，以及可供未來後續研究參考之方向。

This study aimed to empirically investigate the association between depression and nonverbal emotional recognition, and examine the possible deficits of nonverbal emotion recognition abilities in facial, paralanguage, and dual-channel expression in depressed patients. Literature review shows that there exists difference of nonverbal emotion recognition between depressed patients and normal controls. However, the results are inconclusive yet. Such inconsistent results probably arise from diverse samples, various tools, and different research designs of existent studies. Thus, through bettering the research design and assessment tools, the present study used clinically depressed patients and normal controls to examine two hypotheses: a) clinically depressed patients might display negative and positive biases in various emotion recognition of both facial and paralanguage expression; b) clinically depressed patients might show negative and sensitive tendency in dual-channel nonverbal emotion recognition task. The subjects consisted of 30 clinically depressed patients and 39 normal controls. The study used structured diagnostic interview for screening purpose, self-report symptom scale for assessing depressive tendency, computerized Diagnostic Analysis of Nonverbal Accuracy 2-Taiwan version（DANVA2-TW）for assessing ability of nonverbal emotional recognition, and short form of WAIS-III for assessing IQ. Results revealed that, after controlling for IQ, there existed negative bias in nonverbal emotional recognition of facial and paralanguage expression in depressed patients. Specifically, depressed patients recognized sad emotions more accurately. They tended to misperceive nonverbal emotions as negative ones including sad and angry, whereas there was no difference in positive emotions. The results suggested that depressed individuals tended to correctly recognize negative emotions and negatively perceive other’s emotions in a mood-congruent manner. Besides, results revealed that, in dual-channel nonverbal emotion recognition, there was no difference in accuracy between depressed patients and normal controls. But, depressed patients tended to be more accurate in recognizing congruent sad and happy emotions and less accurate in congruent angry and fear emotions. In terms of their error pattern, depressed patients tended to misperceive congruent emotions as happy ones, and misperceive incongruent emotions as fear ones. Finally, some possible explanations about maintenance of depression were discussed from viewpoints of cognitive, interpersonal, and diathesis-stress models. Clinical applications as well as future research directions were also addressed.