探究人際創傷經驗、情緒辨識能力及臉部情緒性肌肉模仿活動之關聯：以受暴婦女為例

Abstract

目的：相較於一般創傷事件，過去的研究發現遭逢人際創傷事件的個體呈現的創傷症狀可能更為嚴重，罹患創傷後壓力症（Posttraumatic stress disorder, PTSD）的風險亦較高。並且，不少國內外創傷相關研究曾聚焦探討創傷個體臉部情緒辨識能力的改變，聲音情緒辨識能力之研究則相對闕如。此外，創傷個體對於情緒刺激的自動化回應狀況亦較少有研究探討，亦即臉部情緒性肌肉模仿活動（Facial Mimicry）。因此，本研究將探討人際創傷經驗對個體情緒訊息處理能力之影響，亦納入憂鬱焦慮及壓力、述情障礙等變項與創傷症狀嚴重度的關聯，並探究有無人際創傷經驗的個體在各變項是否存在差異。研究方法：以國內年滿20歲以上女性為研究對象，依照其是否具人際創傷經驗分為人際創傷組（44人）及健康控制組（38人），採用量表、情緒辨識作業與臉部生理回饋儀器搜集資料。研究結果：（一）約有34％的人際創傷個體PTSD症狀達PDS-5的切截分數（28分），且憂鬱焦慮及壓力、述情障礙皆顯著高於健康控制組。（二）人際創傷組於部分情緒辨識準確率顯著較健康控制組差，且部分情緒辨識的反應時間顯著較健康控制組慢。（三）人際創傷組的臉部性情緒模仿活動變化量與健康控制組未有顯著差異。（四）PTSD症狀與部分聲音情緒辨識準確率具顯著負相關，且述情障礙於PTSD症狀與「聲音-弱刺激」間扮演中介效果。討論：本研究期望能讓社會大眾對於人際創傷個體在非語言情緒辨識能力和臉部情緒性肌肉模仿活動可能存在的缺損狀況有更多了解，並擴展臨床實務工作者在協助個體面臨人際創傷議題時可關注之面向，最後為未來研究方向之建議。

Background：Compared with general traumatic events, previous studies have found that individuals who have experienced interpersonal traumatic events may have more severe traumatic symptoms and a higher risk of developing posttraumatic stress disorder (PTSD). Moreover, many trauma-related studies have focused on the changes of facial emotion recognition ability in traumatized individuals, but the research on voice emotion recognition ability is relatively lacking. Facial Mimicry, an automatic response to emotional stimuli in traumatic individuals, has been less studied. The current study thus explored the impact of interpersonal trauma experience on the ability of emotional information processing as well as the associations among traumatic symptoms, depression, anxiety, stress and alexithymia. Furthermore, this study examined whether there are differences in each variable between individuals with and without interpersonal trauma. Methods: Participants were females over 20 years old and with or without history of interpersonal trauma, i.e., interpersonal trauma group (IPT, n = 44) and healthy control group (HC, n = 38). Data were collected by self-report scales, emotion recognition tasks, and facial physiological feedback instruments. Results: (1) With a cutoff score of 28 for the PDS-5, approximately 34% of participants in IPT group suffered from serious PTSD symptoms. The IPT group displayed significantly higher scores in depression, anxiety, and stress as well as in alexithymia than HC group. (2) The IPT group showed lower recognition accuracy of some emotions and slower reaction of some emotion recognition as compared to the HC group. (3) No significant difference was found in the amount of facial emotional imitation activity between IPT group and HC group. (4) PTSD symptoms were significantly negatively correlated with the accuracy of some voice emotion recognition, and alexithymia mediated the relationship between PTSD symptoms and weak-voice emotion recognition accuracy. Discussion: This study hopes to better understand the potential deficits in nonverbal emotion recognition and facial emotional imitation activity resulted from interpersonal trauma. Accordingly, it may broaden the perspectives of clinical professionals when helping the individuals experiencing interpersonal trauma issues. Finally, directions for future research will be suggested.