再評估策略對注意力不足過動症高風險成人生氣誘發情境的情緒調控效果探討

The Emotion Regulation Effect of Reappraisal of Anger-provoking Events in High-risk adults with Attention Deficit/hyperactivity Disorder

約有34%到70%的注意力不足過動症（attention-deficit/hyperactivity disorder, ADHD）成人有情緒失調問題，尤其是生氣情緒失控，容易引發人際衝突、親密關係惡化、危險駕駛等嚴重問題。再評估被認為是調控生氣情緒的有效策略，但較少研究探討ADHD成人運用此策略調控生氣的效果，且ADHD成人自評情緒調控能力差，平日多採用逃避或壓抑策略，因此本研究將以實驗法探討ADHD高風險成人執行再評估策略調控生氣情緒的效果。研究對象為平均年齡23歲的31位ADHD高風險成人及31位控制組成人，透過較具生態效度且貼近真實生活的自傳式回憶法誘發生氣情緒，參與者需回想最近發生與他人互動的生氣事件，進而教導再評估策略調控生氣情緒，寫下生氣與再評估階段的內容，以語文探索與字詞計算詞典分析其文本，並請參與者自評基礎期、誘發期與調控期的情緒反應。結果發現ADHD高風險成人在整個實驗過程的生氣、負向情緒反應皆較控制組成人強烈，且回想生氣事件時，會伴隨明顯的罪惡、羞恥等內化情緒。當教導ADHD高風險成人使用再評估策略，他們可有效執行此策略並調降生氣與負向情緒，因此，於臨床實務中教導ADHD高風險成人辨識自己的生氣情緒，並練習再評估策略調控生氣情緒是重要的，此外也要幫助他們敏銳覺察並探索生氣情緒伴隨的羞恥與罪惡情緒。

Emotion dysregulation (especially anger dysregulation) occurs in approximately 34%-70% of adults with attention deficit hyperactivity disorder (ADHD). This results in several problems (e.g., interpersonal conflict, intimate relationship deterioration, and dangerous driving). Reappraisal is considered an adaptive strategy for regulating anger. However, studies on anger control that apply reappraisal to adults with ADHD are rare. They have reported that their competence in emotion regulation is deficient, and that suppression and avoidance strategies are used more often in everyday life. The present study aimed to investigate the regulatory effect of reappraisal on anger in high-risk adults with ADHD; accordingly, 31 high-risk adults with ADHD and 31 healthy control adults, all aged 23 years, participated in the current study. The autobiographical recall method, which has more ecological validity, was utilized to induce anger. The participants were asked to recall an anger-provoking episode and were then instructed to engage in cognitive reappraisal and write down their content about the anger-provoking and reappraisal regulation stages, respectively. Their written transcripts were analyzed using the Linguistic Inquiry Word Count. They were also required to self-rate their emotions at the baseline, anger, and regulation stages, respectively. The results indicated that the high-risk ADHD group experienced more intense anger and negative emotions throughout the experimental stages. When recalling anger episodes, they also reported more shame and guilt emotions. If the reappraisal strategy is taught to the high-risk ADHD group, they will be able to effectively execute it to reduce their anger and negative emotions. Therefore, it is important to educate high-risk adults with ADHD to recognize their anger and to regulate it using a reappraisal strategy. Clinical interventions regarding high-risk ADHD adults should include awareness and exploration of shame and guilt emotions as well as anger.