強化執行功能之團體神經心理治療的成效研究——以高身體症狀青少女為例

The Effects of Group–Based Neuropsychotherapy on Executive Function for Adolescent Girls with Somatic Symptoms

研究目的：本研究建構一個運用在團體情境中的神經心理功能訓練計畫，以強化執行功能為核心，討論其對高身體症狀抱怨青少女之症狀抱怨改善與自我調控功能增進之成效。研究方法：受試者來自南部某女中經電腦化身心適應量表組合篩選，符合身體症狀抱怨數多於母樣本平均數且健康自評不佳者，共134名。其中47名自願參與本研究並取得家長同意書。研究者依其意願參與時間，從中隨機選取17名為實驗組，另30名為控制組。以身體症狀與健康自評調查表、身體覺察能力量表、執行功能行為量表、一般性自我效能量表進行前後測，比較症狀抱怨與自我調控功能之結果。以二因子變異數分析與相依樣本t 檢定檢驗之。研究結果：症狀抱怨方面，實驗組與控制組在身體症狀數在後測均顯著下降，但只有實驗組的健康自評有顯著進步。自我調控功能方面，實驗組的身體覺察、執行功能及自我效能之三項指標皆較控制組進步，交互作用亦達顯著。實驗組的各項進步指標皆達中等至高強度之進步效果量（.06≦η2≦.27）。研究結論：本研究之神經心理治療方案，透過功能拆解以增加訓練之深化，一方面有效地緩解受試者之身體抱怨與低健康自評，另一方面提升其自我身心調控功能。未來應持續探討此治療模式之療效穩定度與應用於其他對象之效果。

Purpose: This study develops a neuropsychotherapy training program based on executive training to be used in group context with the goal of evaluating the effect of training programs on symptoms relief and self-regulation ability enhancement in adolescent girls with somatic symptoms. Methods: Participants were recruited from a girls’ senior high school. There were 134 students had physical complaints higher than sample means and their subjective health ratings were poor on the Computerized Adjustment Check List. After obtaining informed consent from 47 of them, they were randomly allocated to either experimental group (n =17) or a control arm (n =30). Both experimental and control groups completed the pre- and post-test questionnaires. The data were collected using the Computerized Adjustment Check List, the Executive Function Scale, the Body Awareness Ability Inventory, and the General Self-Efficacy Scale. A two-way ANOVA and paired t-test was used. Results: Both groups demonstrated a significant decrease in somatization symptoms on the pre-post comparison. Health self-report improvement was significantly greater in the experimental group than in the control group. The experimental group significantly improved their performance on body awareness, executive function and self-efficacy compared with those in the control group. The effect size on each index of experimental group was medium to large (.06≦η2≦.27). Conclusions: Participants can benefit from a neuropsychotherapy training program that helps release physical symptoms and improve subjective feelings of health and self-regulation ability. We plan to explore the stability of this therapeutic effect and the application for other kinds of participants in a future study.