尋求再保證於網路：憂鬱與網路成癮的形成路徑之前瞻性探索

Abstract

目的：在網路成癮之研究領域中，憂鬱為最常被報告的共病問題，然而過去研究多為橫斷性研究，而未能釐清兩者的病理前後關係。因此，本研究欲以相隔四週之前瞻性研究設計，檢驗憂鬱先於網路成癮之病理路徑的可能性。考量現今網路人際溝通隨科技進展而越趨重要，本研究將以人際取向探討之。基於Coyne（1976b）憂鬱人際模式之論述，Joiner、Alfano及Metalsky（1992）認為尋求再保證乃惡化憂鬱之關鍵人際行為，本研究則進一步檢驗尋求再保證風格能否作為憂鬱與網路成癮之共同危險因子，並檢驗個體是否透過了現實/網路尋求再保證後果，而惡化了後續憂鬱與網路成癮。方法：研究參與者為網路招募之成年人，有效樣本共181名（43.1%男性，56.9%女性，年齡範圍為20至39歲）。參與者以匿名方式作答，於初始時間點填答貝氏憂鬱量表第二版（BDI-II）、陳氏網路成癮量表（CIAS）、及中文版尋求再保證量表（CRSS），並於四週後填答BDI-II、CIAS、及現實/網路尋求再保證量表。結果：（1）控制初始網路成癮傾向後，初始憂鬱仍能顯著預測後續網路成癮。（2）尋求再保證風格能顯著預測網路成癮，且此一關係受到初始憂鬱之調節。（3）初始網路成癮能調節尋求再保證風格與現實/網路尋求再保證後果之關係，然而初始憂鬱並無調節效果。（4）現實/網路尋求再保證後果皆能中介尋求再保證風格與後續症狀之關係。（5）憂鬱與網路成癮形成模式僅獲部分支持，考量初始症狀後，現實/網路尋求再保證後果無法顯著預測後續症狀。討論：本研究將依據結果探討尋求再保證於憂鬱與網路成癮之形成路徑中所扮演的可能人際歷程，接著針對不符合原先假設的研究結果提出可能解釋，並依序闡述本研究結果之貢獻、臨床意涵、限制以及未來研究方向。

OBJECTIVE: Previous studies have demonstrated that depression is the most frequently reported psychiatric symptom comorbid with Internet addiction. However, these studies were mostly with cross-sectional design and insufficient to clarify the temporal sequence of the psychopathology of these two problems. Hence, the current study aimed to examine the path from depression to Internet addiction with a prospective design. With respect to progress in technology science, interpersonal activities in Internet become more popular and indispensable in people’s lives. An alternative interpersonal approach is necessary to understand the development of depression and Internet addiction in this digital era. The current study explored whether reassurance-seeking style, an interpersonal tendency for eliciting other’s rejection and deteriorating depressive symptoms proposed by Joiner, Alfano, and Metalsky (1992) conjoining Coyne’s (1976b) interpersonal model of depression, may serve as a common risk factor for the development of depression and Internet addiction. Moreover, this study further tested the mediation role of offline/online reassurance-seeking outcomes in the path to depression and Internet addiction. METHOD: We recruited a valid sample of 181 adults (43.1% Male, 56.9% Female, age range = 20-39 years old) via web advertisement. At Time 1 (T1), participants were asked to fill out the Chen Internet Addiction Scale (CIAS), Beck Depression Inventory-II (BDI-II), and Chinese Reassurance-Seeking Scale (CRSS). At Time2 (T2, 4 weeks later), the CIAS, BDI-II, and Offline/online Reassurance-Seeking Scale were assessed. RESULTS: 1) After controlling T1 Internet addiction symptoms, T1 depressive symptoms still significantly predicted T2 Internet addiction symptoms. 2) Reassurance-seeking style significantly predicted T2 Internet addiction symptoms, and such correlation was moderated by T1 depressive symptoms. 3) T1 Internet addiction symptoms moderated the relationship between reassurance-seeking style and offline/online reassurance-seeking outcomes respectively, while T1 depressive symptoms did not serve as a moderator. 4) Offline/online reassurance-seeking outcomes mediated the relationship of reassurance-seeking style and T2 depressive as well as Internet addiction symptoms. 5) The model of path to depression and Internet addiction was partially supported. In specific, offline/online reassurance-seeking outcomes could not predict the followed-up symptoms while taking initial symptoms into account. DISCUSSION: Based on the above findings, the interpersonal process of reassurance seeking was discussed to elucidate the development of depression and Internet addiction. Finally, applications, clinical implications, limitations and future directions of the study were further addressed.