思覺失調症之人臉情緒辨識及其與神經認知及心智推理之關係

Facial Emotion Recognition and Its Relationships with Neurocognition and Theory of Mind in Schizophrenia

本研究目的為澄清思覺失調症患者之人臉情緒辨識及其與神經認知（注意力／警覺、工作記憶、推理與問題解決）和心智推理之間關係。本研究受試者為106位來自臺灣北部兩所醫療機構之思覺失調症患者，他們完成了簡式中文版魏氏成人智力量表第三版、Conners連續性表現作業第二版、中文版魏氏記憶量表第三版工作記憶指數分測驗、威斯康辛卡片分類測驗，日本人與白種人臉部情緒表情測驗以及中文版心智推理作業，包括失態偵測、弦外之音及非語言圖片心智推理作業。結構方程模式之路徑分析指出在控制住年齡與智力之下，除了魏氏記憶量表所測量的工作記憶之外，Conners連續性表現作業所測量的注意力／警覺和威斯康辛卡片分類測驗所測量的推理與問題解決分別影響日本人與白種人臉部情緒表情測驗所測量的人臉情緒辨識，其接著影響三項心智推理作業，這些結果可被解釋為提供證據支持本研究之假設，本研究結論為注意力／警覺和推理與問題解決是人臉情緒辨識的重要成分，又人臉情緒辨識是心智推理的重要成分，本研究發現在臨床工作上的實務意涵將一併於文中討論。

The present study aimed at clarifying the relationships among neurocognition (attention/vigilance, working memory, reasoning and problem solving), facial emotion recognition and theory of mind in patients with schizophrenia. Participants were 106 patients with schizophrenia recruited from two medical institutes in north Taiwan. Participants completed the Short Version of Chinese Wechsler Adult Intelligence Scale-III, Conners' Continuous Performance Task- II (CPT-II), the Chinese Wechsler Memory Scale-III, Working Memory Index subtests (WMI), the Wisconsin Card Sorting Test (WCST), the Japanese and Caucasian Facial Expression of Emotion (JACFEE), and the Chinese Theory of Mind Tasks, including Faux Pas, implication stories, and non-verbal task. Structural equation modeling technique with path analyses indicated that, under the control of age and the general intelligence, except for working memory from the WMI, attention/vigilance from the CPT-II and reasoning and problem solving from the WCST respectively influenced facial emotion recognition from the JACFEE, which in turn influenced three tasks of theory of mind. These results can be interpreted as providing evidences to support the hypotheses of this study. The conclusions of this study are attention/ vigilance and reasoning and problem solving are important ingredients of facial emotion recognition. In addition, facial emotion recognition is an important ingredient of theory of mind. The practical implication for clinical working is discussed.