青少年之精神分裂病質、衝動性、與物質使用的相關

Abstract

中文摘要 目的：本研究的目的是評估衝動性(impulsivity)在精神分裂病質(schizotypy)與物質濫用的關係中所扮演的角色，以社區青少年為樣本。 方法：從台北市國民中學分層隨機取樣後，共有905名國中學生，完成施測量表，包含物質使用經驗、知覺偏差量表，與精神分裂性人格量表。其中六分之一的學生，經由系統化選取後，進行連續注意力測驗。精神分裂病質的指標包含知覺偏差，以及精神分裂性人格與其三個因子(認知知覺因子，人際因子，以及失序因子)。而衝動指標包含連續注意力測驗中的漏判率(omission error rate)，誤判率 (commission error rate)、快速反應次數(total number of very fast response)，及平均反應時間(mean reaction time)。 結果：結果顯示物質使用(包含香煙或酒精)與較高的正性精神病質相關，特別是知覺偏差，但與負性精神分裂病質或失序病質(disorganization)無關。而連續注意力測驗中，較高的誤判率不只與物質使用相關，也與較高的知覺偏差相關。再者，當控制了連續注意力測驗中的誤判率之後，知覺偏差對物質使用的回歸係數下降了55.8%，並且變得不再顯著。 結論：我們的結果顯示衝動性在正性精神病質與物質使用之間，可能扮演了一個中介因子的角色，也可能成為預防精神分裂病質或精神分裂症病患使用物質的治療目標。

Abstract Objective: The aim of this study was to evaluate the role of impulsivity on the relationship between schizotypy and substance use in non-referred adolescents. Methods: A total of 905 middle school students randomly selected from Taipei completed a questionnaire consisting of substance use experience, the Perceptual Aberration Scale (PAS), and the Schizotypal Personality Questionnaire (SPQ), and one of every 6 students systematically selected completed the Continuous Performance Test (CPT) as well. Indexes for schizotypy included the PAS as well as the SPQ and its three factors (Cognitive-Perceptual factor, Interpersonal factor, and Disorganization factor), while indexes for impulsivity included omission error rate, commission error rate, total number of very fast response, and mean reaction time on the CPT. Results: The results revealed that substance use of either alcohol or tobacco was correlated with higher level in positive schizotypy, particularly the PAS, but not negative schizotypy or disorganization. Higher commission error rates on the CPT were associated with not only substance use but also higher scores on the PAS. Furthermore, the regression coefficient of the PAS score for substance use decreased 55.8% and became non-significant when commission error rate was controlled for. Conclusion: Our results suggest that impulsivity might act as a mediator on the relations of positive schizotypy to substance use and might be a target for the prevention for substance use in persons with schizotypy or schizophrenia.