Beck憂鬱認知模式中不同認知因子關係之檢驗

Test of the Relationships among Different Cognitive Factors in Beck's Cognitive Model of Depression

本研究檢驗Beck憂鬱認知理論中的失功能態度、認知三元素及憂鬱症狀之間的關係，Beck認為具有失功能態度的人當其遇見壓力事件時會產生認知三元素，進而導致憂鬱症狀的出現，但過去的實徵研究相當缺乏且結果不一致，有鑑於此，本研究根據Beck的理論建立一個交互作用模式，並利用結構方程模式技術對此交互作用模式進行檢驗。本研究受試者為162位來自台灣南、北部三所醫院之重鬱症病人，他們完成了威脅經驗檢核表、失功能態度量表、認知三元素量表、Beck憂鬱量表。統計分析指出此模式中的負向生活事件與失功能態度的交互作用在認知三元素及憂鬱症狀上不顯著，此結果表示Beck的理論假設不被支持，但此模式中的其它變項之間的路徑係數仍然達顯著，經過模式修改後，本研究再度假設一個中介模式，統計分析指出此模式中所有路徑皆達顯著水準，此模式揭露負向生活事件影響失功能態度，其再影響認知三元素，其最後導致憂鬱症狀，本研究發現對臨床治療的實務意涵將一併於文中討論。

This research tested the relationships among dysfunctional attitudes, the cognitive triad and depressive symptoms derived from Beck's cognitive theory of depression. Beck proposed that when encountering stressful events, the people with dysfunctional attitudes may develop cognitive triad, and then become depressed. However, earlier empirical research on Beck's theory has been limited and generated inconsistent findings. Therefore, this study formulated an interactional model based on Beck's theory. The model was tested by structural equation modeling technique. Participants were 162 patients with major depressive disorder recruited from south and north Taiwan. Participants completed the List of Threatening Experiences, the Short-version of the Dysfunctional Attitude Scale, the Cognitive Triad Inventory and the Chinese version of the Beck Depression Inventory. Statistical analyses indicated that the effect of the interaction between negative life events and dysfunctional attitudes on depressed symptoms in the interactional model was not significant. This indicated that Beck's theory was not supported. However, the path coefficients among the other variables in the model were still significant. After model modification, this study again formulated a mediational model. Statistical analyses indicated that all path coefficients in the mediational model were significant. The model revealed that negative life events affected dysfunctional attitudes, which in turn influenced the cognitive triad, which in turn led to depressive symptoms. The practical implication for clinical treatment is discussed.