如何擺脫擔憂？比較專注在呼吸、正向回憶與中性概念三種注意力轉移策略對於減少擔憂思緒與情緒調節的效果

Abstract

過度的擔憂（worry）會使個體維持高負向情緒以及高生理激發的狀態中，對於長期的身心健康有不良後果，因此如何有效減擔憂思緒、跳脫負向的情緒回圈對身心健康的維持是重要的。注意力轉移是一般人常用來幫助自己減少憂慮思緒的策略，但目前的研究並不多，且所採用的分心物與成效也不一致。不同分心物可能因其性質相異而有不同面向的成效，然而過去少有研究系統性地比較使用不同分心物的注意力轉移策略在處理擔憂思緒上的效果。本論文首次比較三種可能有效的分心物—專注於呼吸、正向分心物（個人正向經驗的回憶）與中性分心物（個人無涉的中性概念）—對擔憂控制在四個不同面向上的成效，包括在使用策略時擔憂思緒出現的頻率、策略運用仰賴認知資源（工作記憶廣度）的程度、對負面情緒的調節效果，以及擔憂出現能否不累加負面情緒（亦即擔憂思緒入侵頻率與隨後的情緒狀態脫鉤）。101位落在輕度憂鬱以下的實驗參與者被隨機分派到三種注意力轉移策略組，在短暫的策略練習後，參與者被要求回想近期最惱人的擔憂，接著在五分鐘的思緒控制階段，以所教導的策略控制擔憂思緒。其間的擔憂入侵頻率以經驗取樣方法中的自我報告方式測量，並在思緒控制階段前後測量參與者的情緒狀態。參與者的工作記憶廣度與憂鬱程度也予以控制以減少可能的混淆。本論文有四個主要發現：一、在思緒控制階段中，相較於專注在中性分心物，專注呼吸與專注正向回憶皆能有效減少擔憂思緒的入侵。二、使用專注呼吸與專注正向分心物策略時，擔憂思緒出現的頻率與個體工作記憶廣度無關，顯示這兩種策略的使用較不仰賴需要認知資源的執行控制歷程。相反地，在專注中性分心物組中，其擔憂思緒入侵頻率與工作記憶廣度有負向的相關。三、各組在使用策略後負向情緒皆有顯著下降，並無組間差異。四、在正向分心物組中，在思緒控制階段想到擔憂的頻率越高，隨後的情緒狀態越負面，然而專注呼吸組以及中性分心物組中擔憂思緒入侵次數與之後的情緒狀態無關，亦即擔憂思緒的出現與負面情緒的產生兩者有脫鉤現象。本論文首次顯示專注於不同分心物的注意力轉移策略在處理擔憂上有不同的效用或優勢。綜合比較所有面向，專注呼吸策略不但能以較少的認知資源減少擔憂思緒的入侵，且當擔憂出現時亦能避免負向情緒的累積，整體而言是較佳的策略。最後，本論文也討論不同策略背後可能牽涉的認知機制，以及未來對一般人或臨床病患的適用性。

Excessive worry keeps individuals in a state of high negative emotions and high physiological arousal, which has adverse consequences for long-term physical and mental health. Therefore, effectively reducing worrying thoughts and breaking the negative emotional cycle is essential for maintaining physical and psychological health. Attention distraction is a common strategy people use to deal with their daily worries. However, there is little research about attention distraction strategy on reducing worrisome thoughts. Moreover, the effectiveness of this strategy is inconsistent in extant studies, probably due to various distractors used. Distractors with distinct properties may be helpful for worry control in different aspects through different mechanisms. However, few studies systematically compared the effectiveness of attention distraction strategies adopting various distractors on worry control comprehensively. In this thesis, for the first time, three types of attention distraction strategies adopting different but potentially effective distractors—focusing on breathing, a positive distractor such as a happy memory, and a neutral distractor such as a self-irrelevant concept （respectively named as FBS, FPS, and FNS）were compared to each other regarding their effects on reducing worry intrusion, emotional regulation, decoupling of emotional state from worrying intrusion, and their dependency of cognitive resources （working memory capacity, WMC）. One hundred one university students whose depression levels fell below mild depression (BDI-II<20) were randomly assigned to one of the three strategy groups. Each group was taught one of the strategies above to prevent thoughts regarding a worrying event occupying their minds recently during a 5-min thought control session. The number of worry intrusions was measured online with the self-caught method. Participants rated their emotional states before and after the thought control session. Their WMCs and the tendency of depression were also assessed and controlled across groups. There are four major findings. First, compared to FNS, using FBS and FPS resulted in fewer worry intrusions during the thought control session. Second, the number of worry intrusions was negatively related to WMC for the FNS group but independent to WMC for the FBS and FPS groups. This indicates that using the latter two strategies involves less executive control processing which exerts cognitive resources. Third, significant mitigation of negative emotions was found for all the groups after the thought control session. Fourth, emotion states decoupled from worry intrusions for the FBS and FNS groups. In contrast, for the FPS group, the more worry intrusions experienced, the worse the following emotion became. In sum, this study demonstrated that the attention-distraction strategy with different types of distractors is effective in various aspects of dealing with worry. FBS is superior to the other two because it can effectively reduce worry intrusions with less effort and prevent increasing negative emotion while the worrying thoughts occur. The theoretical and practical implications for general and clinical populations were discussed.