生氣壓抑之自主神經與心血管反應

Autonomic and Cardiovascular Responses to Anger Suppression

目的：在情緒調節策略中，壓抑是一種反應調節，亦是心血管疾病重要的心理危險因子。然而，過去實證研究並未明確區分情緒激發和壓抑調節的階段，且混淆了陌生刺激的干擾，難以釐清壓抑調節之心理生理反應，特別是自主神經反應。因此，本研究在研究設計上加以修正，來探討生氣壓抑調節下之自主神經反應，以歷程分析來進行理論驗證。
方法：本研究資料經網路公告招募志願參與的研究對象，經篩選最終納入63人進入資料分析（男性占比66.7%；平均20.29歲）。研究參與者先完成基本資料問卷後，進入實驗室參與生氣情緒激發與壓抑調節作業，包含基準期、生氣回憶期、壓抑調節期與恢復期，同時蒐集自主神經反應與心血管反應之資料，以期進行各階段的歷程分析。
結果：結果顯示，在生氣回憶、壓抑調節與恢復期下，研究對象的迷走神經反應均比基準期有顯著的下降（HF%下降），而交感神經則無顯著改變（PEP不變），但生氣回憶的交感神經仍具有上升的趨勢。此外，在生氣回憶後進行壓抑調節時發現，研究對象的迷走神經反應並無顯著的改變，而交感神經則有顯著的下降。最後，在壓抑調節後的恢復狀態下，研究對象的迷走神經反應並無顯著的改變，而交感神經則持續有顯著的下降。
結論：本研究區分「生氣激發」和「壓抑調節」兩個階段，並去除對陌生刺激的警覺反應干擾，闡明情緒激發和壓抑調節的自主神經反應之變化歷程樣貌。結果發現「生氣激發」下：迷走神經活性降低、交感神經活性上升趨勢，主觀生氣情緒提高。生氣激發後的「壓抑調節」下：迷走神經不調節（活性無顯著差異）、交感神經活性下降，主觀生氣情緒更為降低。在理論層次，將Brosschot與Thayer（1998）提出的情緒壓抑所造成的未竟行動趨勢理論，進一步區分出兩個階段，來呈現迷走神經與主觀生氣情緒的變化歷程。壓抑調節下，迷走神經不調節，主觀生氣情緒降低。壓抑後的恢復期，主觀生氣情緒雖更為降低，迷走神經卻呈現延宕恢復的樣貌。此外，藉由消除陌生刺激所造成的警覺反應（交感神經活性上升）的干擾，研究結果說明Mauss和Gross（2004）所提出的，「壓抑調節」下交感神經反應上升，可能是混淆了情境威脅刺激之結果。

Objective: Suppressive regulation is an emotional modulation strategy that could increase the risk of cardiovascular disease, particularly through autonomic imbalance. However, in previous research, emotion inducing stage and threat stimulus may confound the manipulation of suppressive regulation, especially autonomic response. Therefore, revised research design is adopted, with anger recall task that exclude confounders, to study the change of vagal and sympathetic reactivities during suppressive regulation following anger inducing, and perform theoretical verification by process analysis.
Methods: Participants are recruited from online bulletin board, sixty-three participants were recruited after screening (age = 20.29±1.88, 66.7% male). They completed demographic questionnaires first, then were brought into laboratory to perform experimental task consisting the following stages: baseline, anger recall, suppressive regulation, and recovery, while vagal and sympathetic reactivities were assessed.
Results: During anger recall, suppressive regulation, and recovery stage, even so the vagal (HF%) has significant withdrawal and sympathetic activity (PEP) has no significant change from baseline, there is still the tendency of the increase for sympathetic activity during anger recall. Furthermore, during the suppressive regulation stage following anger recall stage, sympathetic activity decreased while vagal activity did not show significant change. Moreover, during the recovery stage following the suppressive regulation stage, sympathetic activity continued to decrease while vagal activity remains to show no significant change.
Conclusion: This study distinguished anger recall and suppressive regulation into two stages, and removed the confounding response to threat stimulus, in order to present the process of autonomic response to emotional arousal and repression regulation. The result indicated, (i) under anger arousal, vagal activity decreased, sympathetic activity showed increased tendency, and subjective anger emotion elevates; (ii) under suppression regulation, vagal activity showed no significant difference, sympathetic activity decreased, and subjective anger emotion decreased. At theoretic level, this study extended Brosschot and Thayer’s (1998) vagal withdrawal model. Under suppressive regulation, vagal nerve does not function, just like be frozen, even subjective anger emotion decreased. Under recovery stage, though subjective anger emotion decreased continually, but vagal nerve still showed delayed recovery. Besides, by removing threat stimulus, this study failed to validate Mauss and Gross’s (2004) model of sympathetic nervous inducing under suppressive regulation.