不同靜坐方式對高強迫傾向者之效果：情緒、正念狀態及利他動機

Abstract

正念是指以一種特定的方式專注：有目地的（注意在特定位置）、著重當下、與不評價的方式專注（Kabat-Zinn, 2001）。近幾年來，第三波心理治療盛行，強調以更擴展視野看待心理健康與治療結果，例如正念、生活價值、脈絡與經驗，易言之，第二序的改變。其中，一種以正念為基礎的心理治療被應用在強迫症患者，並被證實能有效降低經驗迴避及改善焦慮（Fairfax, Easey, Fletcher, & Barfield, 2014），提升正念程度與生活品質（Sguazzin, 2017）。本研究目的在探討不同靜坐方式對高、低強迫傾向者在不同層面的改善效果。本研究參與者共 108位，其中，男性 41 位，女性 67 位，高強迫傾向組（莫斯利強迫量表MOCI得分12分以上）54位，低強迫傾向組（莫斯利強迫量表得分8分以下）54位。年齡全距為 18 至 31歲。高、低強迫傾向組皆分別被隨機分派至不同靜坐方式的組別（正念靜坐、慈愛靜坐或專注意象控制組），進行練習時間約 20 分鐘。在第一序改變的層面方面，本研究以視覺化類比量尺評估參與者的正向情緒、負向情緒與欲壓抑強迫衝動評估；在第二序改變的層面方面，以南安普敦止觀量表（SMQ）與自陳式利他量表（SRA-scale）分別評估正念狀態與利他動機。評估時間點為基線期、情緒誘發後及不同靜坐方式。本研究結果顯示，在正向情緒的改善程度方面，正念、慈愛靜坐二組的提升效果相當，且提升效果在高、低強迫傾向二組無差異。在負向情緒方面，雖然正念及慈愛靜坐的降低效果皆相當，但是相較於低強迫傾向組，高強迫傾向組的降低效果較大。在欲壓抑強迫衝動方面，正念、慈愛靜坐二組的降低效果相當，且降低效果在高、低強迫傾向二組無差異。在正念狀態方面，對高強迫傾向組而言，正念靜坐的提升效果較慈愛靜坐為大；對低強迫傾向組而言，正念與慈愛靜坐二者的提升效果相當；對正念靜坐練習而言，相較於低強迫傾向組，高強迫傾向組提升的效果較大；對慈愛靜坐練習而言，高、低強迫傾向二組的提升效果相當。在利他動機方面，雖然正念及慈愛靜坐的提升的效果皆相當，但是相較於低強迫傾向組，高強迫傾向組的降低效果較大。在臨床應用方面，本研究結果可提供情緒相關疾患的心理治療方針，採用以第二序改變的觀點，透過培養個體正念相關的能力，像是覺察與專注，作為一種更深遠與長效的情緒調節方法。

Mindfulness means paying attention in a particular way: on purpose, in the present moment and non-judgmentally (Kabat-Zinn, 2001). In recent years, the third wave of psychotherapies has been considerably growing, emphasizing a broader vision of mental health and treatment results, such as mindfulness, life value, context and experience, that is, the second-order change; one of which was mindfulness-based psychotherapy, when applied to OCD patients, has been proved to effectively reduce experiential avoidance and anxiety (Fairfax, Easey, Fletcher & Barfield, 2014), and improve mindfulness and quality of life (Sguazzin, 2017). The purpose of this study was to compare the differential improvement effects of different types of meditations on high- vs. low-compulsive tendency individuals. There were 108 participants enrolled into in this study, with 41 males and 67 females, 54 high-compulsive tendency individuals (score on the MOCI was above 12) and 54 low-compulsive tendency individuals (score on the MOCI was below 8). Ages ranged from 18 to 31 years. High- and low-compulsive tendency individuals were randomly assigned to one of the three 20-minute excercises (mindfulness meditation, loving-kindness meditation or image focus excersise control group), respectively. Participants were measured the first-order of changes (positive emotions, negative emotions, and desire to suppress compulsive impulse) with VAS, and the second-order of changes (mindfulness state and altruistic motivation) with SMQ and SRA-scale. The measuring time points were baseline period, after negative mood induction, and after meditation excersise. The results of this study showed that in terms of positive emotion, the promotion effects of mindfulness meditation and loving-kindness meditation were equivalent, and the effects were comparable between high- and low- compulsive tendency groups. In terms of negative emotion, though the reduction effects of mindfulness meditation and loving-kindness meditation were equivalent, compared to the low-compulsive tendency group, the reduction effect of the high-compulsive tendency group was greater. In terms of desire to suppress compulsive impulse, the reduction effects of mindfulness meditation and loving-kindness meditation were equivalent, and the effects were comparable between high- and low- compulsive tendency groups. In terms of mindfulness state, for the high-compulsive tendency group, the promotion effect was greater for mindfulness meditation compared to loving-kindness meditation; for the low-compulsive tendency group, the promotion effects of mindfulness meditation and loving-kindness meditation were equivalent; for the mindfulness meditation, compared to the low-compulsive group, the improvement effect of the high-compulsive tendency group was larger; for loving-kindness meditation, the promotion effects of the high- and low- compulsive tendency groups were equivalent. In terms of altruistic motivation, though the promotion effects of mindfulness meditation and loving-kindness meditation were equivalent, compared to the low-compulsive tendency group, the promotion effect of the high-compulsive tendency group was greater. The results of this study provides a psychological treatment strategy for clinical patients with affective-related disorders, suggesting a second-order change perspective, with cultivating individuals’ mindfulness-related abilities, such as awareness and focus, as a more profound and long-lasting method of emotional regulation.