| Abstract: | 憂鬱者對負向刺激有注意力偏誤（attentional bias, AB），尤其對環境中悲傷刺激（如悲傷臉孔）難以移開注意力。以視覺偵測作業（visual probe task）訓練注意力遠離悲傷刺激，證實能降低憂鬱症狀（Wells & Beevers, 2010）。然而注意力訓練（Attentional bias modification, ABM）的療效機制未明。本研究假設一般或情緒特定的執行控制（特別是抑制和轉移功能）可能是ABM降低AB和憂鬱症狀的機制。 研究對象為有輕度以上憂鬱症狀（BDI-Ⅱ≧14）的大學生，被雙盲且隨機分派為ABM組和控制組兩組，接受為期兩週的ABM和情緒自評。以視覺偵測作業訓練ABM組注意力遠離負向刺激，並在訓練前後以情緒轉移作業（Affective Shift Task, De Lissnyder, Koster, Derakshan, & De Raedt, 2010）檢測ABM是否影響一般和情緒特定的執行控制。訓練結束後兩週會追蹤訓練效果的維持（含AB、情緒症狀和執行控制）。研究在訓練前亦記錄參與者的反芻程度和反芻類型（自責、brooding，或反省、reflection），分析其與ABM效果的關聯。 研究結果顯示，接受ABM的憂鬱者在訓練後測注意力偏誤較低，但訓練並未緩解情緒症狀。ABM介入可預測憂鬱者在後測一般抑制功能較差，在追蹤階段一般轉移和特定抑制功能較佳。執行控制雖未中介ABM對AB的影響，但會調節ABM對追蹤時憂鬱程度的影響。訓練前的憂鬱程度和反省反芻程度，會影響注意力和情緒的降低幅度。研究支持執行控制在ABM機制扮演重要角色，助於發展臨床運用之注意力訓練工具，並建議此注意力訓練工具的適用對象。
Individuals with depressive symptoms have attentional bias (AB) toward dysphoric stimuli. Wells and Beevers (2010) proved that training attention away from dysphoric stimuli in visual probe task can reduce depressive symptoms. However, the mechanism underlying attentional bias training (namely, ABM) remains unclear. The current study hypothesized that general or emotion-specific executive control (particularly, inhibition and shifting) may be the critical mechanism underlying ABM. Participants were college students with depressive symptoms (BDI-Ⅱ score ≧ 14) but with no psychiatric history. We adopted the double-blind design and randomly assign participants to ABM and control groups. The visual probe task was used for training attention away from dysphoric stimuli. Affective Shifting Task (AST; De Lissnyder, Koster, Derakshan, & De Raedt, 2010) was used to examine whether ABM affected general or emotion-specific executive control. Executive control, AB, and emotion were recorded at follow-up 2-week after ABM. Rumination tendency and its subtypes (brooding and reflection) were also recorded. Results revealed that ABM could alleviate AB but not the depressive symptoms. ABM predicted a decrease in general inhibition at posttest, and an increase in general shifting and specific inhibition at follow-up. Although executive control failed to mediate ABM and AB, it moderated the correlation between ABM and depressive symptoms at follow-up. Dysphoric mood and reflection at pretest affected the way AB and depressive symptoms changed. The present study suggested that executive control plays an important role in ABM. |
