強迫症的記憶力偏向：責任感與負面情緒所扮演的角色

Abstract

本研究旨在探討認知與情緒變項的交互作用對於強迫症狀的影響，具體言之，探討「責任感」、「情緒情境」與「刺激詞類型」的交互作用，對於「記憶力表現」、「記憶力信心」的影響。過去的研究認為「誇大的責任感」在強迫症狀上扮演很重要的角色 （Salkovskis, 1989）；而當個人擁有誇大的責任感，且處在負面情緒狀態下時，會加強強迫檢查行為的產生（MacDonald & Davey, 2005）。Radomsky，Rachman與 Hammond（2001）亦發現責任感的提升，會減少個人的記憶力信心。由於過去的研究並沒有同時探討責任感、負向情緒與刺激詞類型的交互作用對強迫症狀的影響，故本研究假設高責任感者在負向情緒情境下會有較多和強迫症狀有關的記憶力偏向。本研究參與者為84名台灣大學在學生。研究設計為2 × 2 × 3因子的實驗設計。第一因子為「責任感」，分為高責任感與低責任感；第二因子為「情緒情境」，分為正向情緒情境與負向情緒情境；第三因子為「刺激詞類型」，分為中性詞（neutral）、檢查詞（checking）與汙染詞（contamination）。第一與第二因子為受試者間設計，第三因子為受試者內設計。經由責任感分組和情緒情境操弄後，參與者被告知完成文字記憶力的作業，並填寫「知感判斷量表」（Feeling of Knowing, FOK）作為評估記憶力信心的依據。雖然在記憶力表現方面，研究結果並未完全符合預期假設，但本研究顯示責任感會增強參與者對於汙染詞的正向記憶力偏向；而在記憶力信心方面，研究結果符合預期假設，顯示高責任感的參與者在負向情緒情境中的記憶力信心顯著降低，而單獨考慮責任感和情緒情境變項，都不會影響參與者的記憶力信心。本研究於臨床應用上亦有其啟示，最後針對研究限制與未來方向加以討論。

The present study explored the interaction effects of cognitive and mood factors on the strength of memory confidence and memory performance of the obsessive-compulsive symptoms. It has been proposed inflated responsibility plays an important role in OCD (Salkovskis, 1989), inflated responsibility would facilitate checking for people in a negative mood condition (MacDonald & Davey, 2005), and decrease memory confidence (Radomsly, Rachman, & Hammond, 2001). However, the interaction of responsibility, negative mood, and word types in OC remains to be investigated. It was hypothesized that negative mood will facilitate more OC relevant memory bias in people with high sense of responsibility. The participants were 84 college students. The design was a 2 × 2 × 3 mixed factorial design, with responsibility (high vs. low), mood condition (positive vs. negative) being between-subjects variables and word type (neutral, contamination, vs. checking) being within-subjects variable. After mood manipulation, participants were asked to perform a memory test and feeling of knowing (FOK) judgments for their memory confidence. The results revealed that responsibility facilitated memory bias. Besides, negative mood with high responsibility generated less memory confidence. Neither high responsibility nor negative mood alone is a sufficient condition for low memory confidence. The implications of the results in terms of acquisition, maintenance, and cognitive behavior therapy for OCD are discussed and future research possibilities are proposed.