本研究主要的研究目的有二：其一，探討高社會焦慮者對不同情緒臉孔的注意力時間歷程；其二，探討自動化階段與控制式階段所進行的注意力訓練，對於降低注意力偏誤以及改善社會焦慮的效果。基於上述兩項研究目的，分為研究一與研究二進行。研究一中，共有60名參與者完成眼動作業，其中高、低社會焦慮組 (HSA組/ LSA組) 各30名。在眼動作業中，生氣、難過、快樂與中性四類情緒臉孔同時呈現於螢幕上，參與者被指示自由觀賞螢幕上的圖片，直到圖片消失。研究一的結果發現，HSA組對生氣臉的初始注視時間 (initial gaze duration; IGD) 明顯高於LSA組，且高於其它三類情緒臉孔，LSA組對四類情緒臉孔的IGD則沒有差異；其次，LSA組對快樂臉的整體凝視時間比例 (proportion of total viewing time; PTVT) 明顯高於HSA組。時間歷程分析的結果發現，HSA組在751-1000 ms 對生氣臉的凝視可能性高於LSA組，以及在7-8 s對難過臉的凝視可能性高於LSA組；LSA組在9-10 s對快樂臉的凝視可能性高於HSA組。研究一結果指向，高社會焦慮者對威脅刺激可能有注意力脫離困難，同時可能缺少對正向刺激的注意。研究二共有72名高社會焦慮者參與，本研究將注意力訓練的刺激呈現時間操弄為100 ms或500 ms兩種，每一種刺激呈現時間的注意力訓練可分為注意力改變組 (AMP組) 與注意力控制組 (ACC組) 兩種情境，因此共有AMP-100、ACC-100、AMP-500與ACC-500四種訓練情境。所有參與者被隨機分派至四種訓練情境中，並完成八次 (每週兩次，為期四週) 的注意力訓練作業。參與者在注意力訓練的前、後分別完成量表填寫、修改版Posner作業與眼動作業的評估，並且在注意力訓練結束至少一個月後，接受追蹤階段的評估。研究二的結果發現，100 ms的注意力訓練可以增進AMP-100組在修改版Posner作業上對所有無效嘗試次的反應時間；降低其在眼動作業上對生氣臉的IGD；同時改善AMP-100組參與者的負向評價恐懼、互動焦慮以及演講前的預期焦慮。500 ms的注意力訓練可以降低AMP-500組的參與者在修改版Posner作業上對社會威脅詞無效嘗試次的反應時間；減少其在眼動作業上對負向情緒臉孔的注意力維持時間，並增加對正向情緒臉孔的注意力維持時間；同時降低AMP-500組的負向評價恐懼與社會互動焦慮。研究二結果顯示，自動化階段與控制式階段所進行的注意力訓練，均可促進高社會焦慮者對威脅刺激的注意力脫離速度，並且改善社會焦慮。本研究於討論中，針對本研究結果在理論與臨床應用上的意涵進行探討，並提出本研究的限制與對未來研究的建議。 / The purpose of the present study was twofold. First, it aimed to investigate the attentional processing of emotional faces in social anxiety using the eye-tracking technique. Second, it tried to examine the effects of attentional training in reducing attentional bias and in decreasing social anxiety symptoms in high socially anxious individuals. In study 1, a total of 30 high socially anxious (HSA) and 30 low socially anxious (LSA) participants completed the eye-movement task. In the eye-movement task, participants were instructed to view the slides on the monitor naturally. Each slide contained 4 emotional faces (one angry, one sad, one happy and one neutral face). The results showed that the HSA participants had longer initial gaze duration (IGD) on angry faces than the LSA participants did. Further, the LSA participants had higher proportion of total viewing time (PTVT) on happy faces than the HSA participants did. Time-course of attention to emotional faces was also examined. The results showed that the HSA group had higher fixation probabilities to angry faces than the LSA group did in the 751-1000 ms time window. The HSA group exhibited higher fixation probability to sad faces than the LSA group did in the 7-8 s time window. Further, compared with the HSA group, the LSA group had higher fixation probability on happy faces in the 9-10 s time window. The results of study 1 indicate that individuals with high socially anxiety may have difficulty in disengagement form social threatening information and may demonstrate decreased attention to positive information. In study 2, seventy-two high socially anxious participants completed the experiments. In the attention training task, stimuli were presented at two durations: 100 ms and 500 ms. Participants were randomly assigned to four different attentional training conditions, including the AMP-100 (attention modification program; presentation duration = 100 ms), the ACC-100 (attention control condition; presentation duration = 100 ms), the AMP-500 and the ACC-500 group. All participants completed eight attentional training sessions delivered over four weeks (i.e., twice weekly sessions). Participants were also required to complete preassessments, postassessments and follow-up assessments. The results demonstrated that the 100 ms attention modification program facilitated attention disengagement in the Modified Version of Posner task and decreased attentional maintenance to angry faces in the eye-movement task for participants in the AMP-100 group. Furthermore, it reduced the fear of negative evaluation, interaction anxiety and anticipated anxiety for public-speaking situation in the AMP-100 group. The 500 ms attention modification program facilitated the disengagement from social threat words in the Modified Version of Posner task in participants of the AMP-500 group. It also decreased the attentional maintenance to negative faces and increased the attentional maintenance to happy faces in participants of the AMP-500 group. Further, it reduced the fear of negative evaluation and social interaction anxiety in the AMP-500 group. The results of study 2 suggest that attention modofication programs may decrease difficulty in disengagement from threat and reduce some aspects of social anxiety symptoms in individuals with high socially anxiety. Theoretical and clinical implications of these results were discussed.

本研究主要的研究目的在探討青少年自我概念是否能在父母控制（父母心理控制、及父母行為控制）與青少年情緒困擾（焦慮、憂鬱、及憤怒）及偏差行為之間扮演中介的角色。以國中生與高中生共967人為研究對象，以父母心理控制量表、父母監控量表、自我概念量表、貝氏焦慮量表、青少年憂鬱量表、特質生氣量表、偏差行為量表等做為研究工具，再以描述統計、T檢定、皮爾遜積差相關、結構方程模式等統計方法進行分析，結果發現： (一)、 青少年知覺中等程度之父母心理控制與父母行為控制、中上程度之自我概念、低程度之情緒困擾與偏差行為。 (二)、 男、女生所知覺之父母心理控制、焦慮、及偏差行為，存在顯著差異。 (三)、 國、高中生所知覺之父母行為控制、自我概念、焦慮、憂鬱、憤怒、及偏差行為，存在顯著差異。 (四)、 青少年知覺之父母心理控制與其自我概念之間存在顯著負相關、父母行為控制與其自我概念之間存在顯著正相關；父母心理控制與父母行為控制之間存在顯著正相關。 (五)、 青少年自我概念與其焦慮、憂鬱、憤怒、及偏差行為之間，皆存在顯著負相關。 (六)、 青少年知覺之父母心理控制與其焦慮、憂鬱、憤怒、及偏差行為之間，皆存在顯著正相關。 (七)、 青少年知覺之父母行為控制與其焦慮、憂鬱、及憤怒之間，皆不存在顯著相關；青少年知覺之父母行為控制與其偏差行為之間，存在顯著負相關。 (八)、 「父母控制、青少年自我概念、與其情緒困擾及偏差行為間關係」理論模式，與由研究對象為觀察樣本所估計之模式達到適配。亦即將青少年自我概念納入模式後，青少年知覺之父母心理控制對其情緒困擾（焦慮、憂鬱、及憤怒）不再存在直接影響，僅透過青少年自我概念間接負向影響其情緒困擾與偏差行為；父母行為控制除了直接負向影響偏差行為之外，還透過青少年自我概念間接負向影響其情緒困擾與偏差行為。 本研究根據上述研究結果逕行討論，並提出建議，供後續相關研究與實務工作之參考。 / The main purpose of this study is to investigate whether adolescent’s self concept is able to mediate between parental control and adolescent’s emotional disturbance as well as disruptive behavior. Parental control includes psychological control and behavioral control. Emotional disturbance is composed of anxiety, depression and anger. A total of 967 secondary school students from grade 7 to grade 12 responded to the Parental Psychological Control Scale, Parental Monitoring Scale, Self Concept Scale, Anxiety Scale, Adolescent’s Depressive Scale, Anger Temperament Scale and Disruptive Behavior Scale to measure the parental psychological control, parental behavioral control, adolescent’s self concept, anxiety, depression, anger and disruptive behavior respectively. The data were conducted by descriptive statistics, T test, Pearson correlation, structural equation modeling. The major findings are as follows: 1. Adolescents perceived middle level of parental psychological control and behavioral control, upper middle level of self concept, and low level of emotional disturbance as well as disruptive behavior. 2. The parental psychological control, anxiety and disruptive behavior perceived by the male adolescents are significantly different from those perceived by the female adolescents. 3. The parental behavioral control, self concept, anxiety, depression, anger and disruptive behavior perceived by the junior high school students are significantly different from those perceived by the senior high school students. 4. Parental psychological control and behavioral control have the significantly negative and positive correlation with self concept respectively. Parental psychological control is positively correlated with behavioral control significantly. 5. Self concept is negatively correlated with emotional disturbance and disruptive behavior. 6. Parental psychological control is positively correlated with emotional disturbance and disruptive behavior. 7. Parental behavioral control is negatively correlated with disruptive behavior, however, have no significant correlation with emotional disturbance. 8. The SEM results showed that the proposed “model of relations among parental control and adolescents' self concept, emotional disturbance and disruptive behavior” fit the collected data well. That means when considering self concept in model, parental psychological control no longer affects emotional disturbance directly, but, negatively influences emotional disturbance and disruptive behavior via self concept indirectly. Parental behavior control owns the similar indirect influence like psychological control, besides, affects disruptive behavior directly. In accordance with the findings, researcher raised several advices for parents and school for the sake of parental practices and education. Suggestions were also made for further research.

本研究的主要目的在於運用靜息態功能性磁振造影技術來探討高社會焦慮的自我參照處理腦區的功能聯結。根據Clark和Wells(1995)的模型，高社會焦慮者的負向自我心象只透過自我相關的在線索來建構；然而根據Rapee和Heimberg(1997)的模型則假設高社會焦慮者還會納入他人外在訊息，做自我與他人參照訊息的處理。本研究企圖透過神經影像的發現來檢測上述兩個模型。 本研究篩選出四十名大學生分為高社會焦慮組與低社會焦慮組，所有受試者都會進行靜息態功能性磁振造影的掃描，並使用MPFC、PCC、ACC、VMPFC、DMPFC作為種子進行全腦的功能聯結分析並獲得功能聯結圖譜做比較。 研究結果發現高社會焦慮者的MPFC、PCC、ACC都有增加的功能聯結，顯示他們比一般人更容易做自我參照處理，而VMPFC、DMPFC同時有增加的功能聯結，代表高社會焦慮者的自我參照處理除了自我內在的相關訊息外，還會包含他人外在相關訊息的處理，研究結果較支持Rapee和Heimberg(1997)的說法。最後並提出本論文研究限制，與對社會焦慮症的臨床理論與實務上之建議。 / The purpose of the present study was to utilize the resting-state functional magnetic resonance imaging(RS-fMRI) technique to investigate the brain regions in functional connectivity of self-referential processing in socially anxious individuals. According to Clark and Wells’ (1995) view, socially anxious individuals were hypothesized to construct their negative self-image with self-related internal information. However, according to Repee and Heimberg’ s (1997) model, they supposed that socially anxious individuals also brought other-related external information to make other-related external information self-referential and other-referential be processed. The present study was designed to use finding of neuroimaging to examine the two models Forty undergraduate students were assigned to either high or low social-anxiety group. All subjects were asked to be scanned with RS-fMRI. MPFC, PCC, ACC, VMPFC, DMPFC were used as seeds to proceed the whole-brain functional connectivity analysis and acquired functional connectivity maps for comparison. The results revealed that functional connectivity of MPFC, PCC, ACC of high social anxiety group increased, it displayed that they were more easily to do self-referential processing. Besides, functional connectivity of VMPFC and DMPFC also increased simultaneously, which means that the self-referential processing of high social anxiety group not only included self-related internal information but also included other-related external information. The result supported Repee and Heimberg’ s model. The limitations of this study and the suggestions for the theories and clinical treatment of social anxiety disorder were advanced in the end.

本研究的目的是初步探索Wang等人(2012)的模式中各因子的生理基礎，在該模式當中，社會焦慮疾患與憂鬱疾患間的結構關係，可透過高負向情感因子、低正向情感因子、害怕負向評價因子與害怕正向評價因子良好說明，然目前主要研究發現多來自問卷法研究，本研究以靜息態磁振造影做為生理方面的初探工具，以功能聯結網絡找出與因子對應的生理佐證。本研究邀請共邀請50位大學生，其中有25位是高社會焦慮傾向者，另外25位則是低社會焦慮傾向者，每位參與者都須填寫問卷與接受約15分鐘的磁振造影掃描。本研究分別以杏仁核、腦島、依核與眶額葉皮質為種子區域形成的功能聯結網絡，結果發現高社會焦慮傾向組與低社會焦慮傾向組在四組功能聯結網絡均有顯著差異；進一步分析具差異的功能聯結與量表的關係，可觀察到與負向情感因子有關的聯結同時和社會焦慮傾向及憂鬱傾向達顯著正相關，與正向情感因子有關的聯結則同時和社會焦慮傾向及憂鬱傾向達顯著負相關；分別排除社會焦慮傾向與憂鬱傾向的影響後，仍可發現和害怕正向評價因子與害怕負向評價因子具顯著相關的功能聯結。本研究的發現顯示Wang等人(2012)的模式中各因子的確有對應的腦部功能聯結，可見該模式具有生理實質性，且可良好論述與釐清心理疾患間關係，然本研究受限於種子與參與者的選擇，無法呈現該模式中因子間的關係，未來可進一步採用作業態等方法，以利更加確立腦部功能聯結與模式中各因子的關係。

本研究主要目的是以文獻分析、問卷調查、潛在成長模式等方法探討數學焦慮、數學學習動機與數學學業成就等三個變項的縱貫模式及因果結構模式。根據五百二十九位國三學生所填的五波調查問卷資料，進行兩部分研究。 研究一乃在估算數學焦慮、數學學習動機、數學學業成就的潛在改變量模式及 數學焦慮、數學學習動機、數學學業成就兩兩之間的因果結構模式。結果發現1.數學焦慮縱貫模式上，符合「焦慮遞增理論」；2.數學學習動機縱貫模式上，符合「動機先升後降理論」；3.數學學業成就縱貫模式上，符合「成就先升後降理論」； 4.數學焦慮與數學學習動機因果結構模式上，符合「動機焦慮交互激發效果理論」；5.數學焦慮與數學學業成就因果結構模式上，符合「焦慮成就交互抑制效果理論」；6.數學學習動機與數學學業成就因果結構模式上，符合「動機成就交互激發效果理論」。 研究二則依據研究一二變項因果結構統計驗證成立的三套理論，建構出三變項因果結構六模式，並驗證有無中介效果。結果顯示，1.前焦慮、中動機、後學業成就因果模式上，符合「動機未完全中介前焦慮、後學業成就理論」；2. 前動機、中焦慮、後學業成就因果模式上，符合「焦慮未完全中介前動機、後學業成就理論」；3.前焦慮、中學業成就、後動機因果模式上，符合「學業成就未完全中介前焦慮、後動機理論」；4.前學業成就、中焦慮、後動機因果模式上，符合「焦慮未完全中介前學業成就、後動機理論」；5. 前動機、中學業成就、後焦慮因果模式上，符合「學業成就未完全中介前動機、後焦慮理論」；6.前學業成就、中動機、後焦慮因果模式上，符合「動機未完全中介前學業成就、後焦慮理論」。 除了上述結果外，研究也對數學焦慮、數學學習動機與數學學業成就縱貫模式的趨勢與時間效果量，國三學生轉折點界定，數學焦慮、數學學習動機與數學學業成就適當模式產出及個別中介角色剖析有深入探討。 / This study, using literature review, questionnaire survey, and latent growth model, investigated the longitudinal model and causal model among math anxiety, learning motivation, and academic achievement. After collecting 529 students with 5 waves, I conducted two studies. The purpose of study 1 was to estimate the latent change model and the causal model of math anxiety, learning motivation, and academic achievement. Results showed that 1. The anxiety increasing theory was supported by the math anxiety longitudinal model. 2. The first increasing then decreasing theory was supported by the math learning motivation longitudinal model. 3. The first increasing then decreasing theory was supported by the math academic achievement longitudinal model. 4. The reciprocal activated effect theory was supported by the math anxiety and learning motivation causal models. 5. The reciprocal inhibitive effect theory was supported by the math anxiety and academic achievement causal models. 6. The reciprocal activated effect theory was supported by the math learning motivation and academic achievement causal models. According to the final three theories stated above and proved by study 1, I constructed the six causal models in order to verify the mediated effects of math anxiety, math learning motivation, and math academic achievement. I found that 1. Math learning motivation did not mediate fully the effects on early math anxiety and late math academic achievement. 2. Math anxiety did not mediate fully the effects on early math learning motivation and late math academic achievement. 3. Math academic achievement did not mediate fully the effects on early math anxiety and late math learning motivation. 4. Math anxiety did not mediate fully the effects on early math academic achievement and late math learning motivation. 5. Math academic achievement did not mediate fully the effects on early math learning motivation math and late math anxiety. 6. Math learning motivation did not mediate fully the effects on early math academic achievement and late math anxiety. In addition, the research also explored the longitudinal model trend and effect, the key period for 3rd year junior high school students, the proper models, and the mediated roles among math anxiety, learning motivation, and academic achievement.

本研究目的在於探討與女性領導者有關的刻板印象與偏見是否會產生刻板印象威脅效果而影響女性的領導表現，以及是否可以消除或減少它對於個人表現的影響。本研究也探討「對特定領域的認同」及「對所屬團體的認同」在女性領導能力的範疇中，是否會使得刻板印象威脅對於個人表現有不同程度的影響效果。另外，本研究為了要更加確認威脅感的產生，故增加行為觀察的方式來測量焦慮的產生，以彌補自陳焦慮方法的不足。 本研究以60位國立政治大學女學生為研究對象，隨機分派至「激發刻板印象威脅」、「不激發刻板印象威脅」、及「減除刻板印象威脅」等三個情境。每位女性受試者另搭配一男一女成為一小組，每組由此位女性受試者擔任領導者，帶領小組討論並解決一新車分配問題。女性受試者的領導表現由自己、小組中的二位成員、以及不知道本研究目的與假設的評估者來予以衡量。另外，本研究除了由受試者及小組成員以情境焦慮量表來評估受試者的焦慮程度之外，也請不知道本研究目的與假設的評估者，以情境焦慮量表來評估受試者的焦慮程度，並觀察其焦慮行為，評量受試者在活動過程中顯出不舒服或不自然的程度及頻率。 研究結果顯示，「激發刻板印象威脅」情境與「不激發刻板印象威脅」情境的受試者在大部分領導表現變項上均無顯著差異；「激發刻板印象威脅」情境中的受試者在部分領導表現變項上的平均得分顯著低於「減除刻板印象威脅」情境中的受試者。在本研究中，性別認同程度及領域認同程度並不會影響刻板印象威脅與領導表現之間的關係。此外，三個實驗情境中受試者的情境焦慮程度及非語言焦慮並沒有顯著差異。 本文也針對研究結果進行整體性的討論，並提出可能的研究限制，及對於後續研究的建議。

本研究結合Clark與Watson（1991）的三角模式（Tripartite Model）以及Brown、Chorpita和Barlow（1998）提出的階層性概念，結構正向情感、負向情感、焦慮、憂鬱、無望感、自傷、自殺的關係，建立自傷與自殺的階層預測模式，說明自傷與自殺的同異處。研究對象為487位大學生，325位女性與162位男性，採取自陳式問卷的方式施測，包含自我傷害行為量表、自殺危險程度量表、貝克無望感量表、正負向情感量表、症狀檢核表-90-修正版（摘錄測量焦慮與憂鬱的題目）、相關背景變項的測量，並以描述性統計、相關性考驗、階層迴歸分析、結構方程模式等統計方式對資料進行處理。主要的研究結果為：（1）負向情感能預測與解釋焦慮和憂鬱，且能透過焦慮預測自傷與自殺，唯焦慮對自傷的解釋力較高；負向情感亦能透過憂鬱預測自殺，但無法透過憂鬱預測自傷。（2）正向情感能預測與解釋憂鬱，且能透過憂鬱預測自殺。（3）加入無望感分析後，發現憂鬱能透過無望感預測自殺，憂鬱也能直接預測自殺，顯示無望感為憂鬱與自殺的部分中介變項。最後，結果發現有15.81%的自傷比例、24.64%的自殺意念比例、8.01%的自殺企圖比例。 / This study combined Clark & Watson’s (1991) tripartite model with Brown, Chorpita, and Barlow’s (1998) hierarchical model to structure the relationship of positive affect (PA), negative affect (NA), anxiety, depression, hopelessness, non-suicidal self-injury (NSSI), and suicide. This study attempted to establish hierarchical predictor model of NSSI and suicide, and explain the relationship of NSSI and suicide. The participants were 487 university students, 325 females and 162 males, who were participating in a study of test of deliberate self-harm inventory, suicide risk inventory, Beck hopelessness scale, positive and negative affect schedule, symptom checklist-90-R, and background variables. The data were examined by descriptive statistics, correlation, hierarchical analysis, and structural equation modeling. The main results were : (1) NA could predict anxiety and depression ; anxiety could not only mediate the relationship of NSSI and NA, but also mediate the relationship of NA and suicide ; anxiety accounted for more of the variance in NSSI than in suicide ; depression could mediate the relationship of NA and suicide, but could not mediate the relationship of NSSI and NA. (2) PA could predict depression, and depression could mediate the relationship of PA and suicide. (3) the role of hopelessness was partial mediator of depression and suicide. Finally, the result found 15.81% NSSI, 24.64% suicidal ideation, and 8.01% suicidal attempt.

本研究主要目的為，運用點偵測作業探討高社交焦慮者面對環境中的社會威脅訊息的注意力處理歷程，並釐清在實驗中加入誘發社交焦慮情緒程序對高社交焦慮者的注意力處理是否造成影響。由於過往研究對高社交焦慮者對社會威脅訊息的注意力處理意見分歧，學者們分別提出過度警覺－逃避假設與過度警覺－難以轉移假設，兩假設皆有相關理論與研究支持，本研究企圖檢驗這兩個假設的合理性。 　　本研究篩選出高社交焦慮組30人與低社交焦慮組30人參與實驗，受試者在接受所分派的情緒誘發程序後，進行以生氣臉與嫌惡臉所組成的威脅臉為實驗刺激的點偵測作業，以評估個體對威脅的注意力。 　　研究結果發現，接受社交威脅誘發程序的高社交焦慮者對社會威脅訊息的注意力處理，傾向為過度警覺－逃避假設的歷程，對威脅產生警覺後，便逃避對威脅的處理；而接受中性情緒誘發程序的高社交焦慮者對社會威脅訊息的注意力處理，傾向為過度警覺－難以轉移假設的歷程，對威脅產生警覺後，便無法將注意力自威脅轉移。 　　高社交焦慮者對社會威脅訊息，有明顯的注意力偏誤，且此偏誤會隨個體所處的情境與接觸威脅的時間而有所變化。由於這些偏誤扮演著維持個體的社交焦慮的重要角色，故在釐清高社交焦慮者在不同情境下對威脅的注意力處理後，有助於選擇適當的治療策略，協助高社交焦慮者因應環境中的威脅。 / The purpose of the present study was to utilize the dot-probe task to investigate the attention processing for social threat in high social anxiety, and to know what under conditions of social threat influence. Owing to the conflicts of the past studies, there are hypervigilance-avoidance hypothesis and hypervigilance-difficult to disengagement hypothesis for the attention processing. This study attempt tests the rationality of the two hypotheses. Performance on a face-probe task was assessed in high (n=30) and low (n=30) social anxiety. After participants were assigned the mood induction procedure randomly, they were presented the task. The results revealed that under conditions of social threat high social anxiety are at first vigilant of threat faces, and avoid them. And under conditions of neutral high social anxiety are at first vigilant of threat faces, and difficult to disengage them. These results suggest that the attention bias for social threat in high social anxiety would be changed by the context and how long the individual face the threat. Know that the attention processing for social threat in the different context in high social anxiety would help the psychologists to choice the applicable therapy for high social anxiety.

Clark與Watson（1991）焦慮與憂鬱的三元模式及後續相關理論（Mineka, Watson, & Clark, 1998）對焦慮疾患與憂鬱疾患的高共病率現象提出了解釋：兩疾患高共病率之因乃共同擁有負向情感共同因子，而憂鬱疾患因擁有低正向情感特殊因子使之與焦慮疾患有所區辨。然而透過文獻回顧已知社交互動焦慮疾患與憂鬱疾患皆擁有高負向情感與低正向情感兩類因子（Hughes, Heimberg, Coles, Gibb, Liebowitz, & Schneier, 2006），故目前依三元模式及其相關文獻的架構（Brown, Chorpita, & Barlow, 1998; Hughes et al., 2006; Kashdan, 2002），尚未找出得以區辨社交互動焦慮、憂鬱兩疾患不同之因子。本研究即以三元模式裡已架構的一般因子負向情感、特殊因子正向情感，再加入特殊因子害怕負向評價、以及獨特因子害怕正向評價，來建構社交互動焦慮與憂鬱的階層特徵預測模式：負向情感與正向情感屬於高階因子，為影響著社交互動焦慮與憂鬱的脆弱因子；害怕負向評價與害怕正向評價屬為低階因子，是受到社交互動焦慮與憂鬱影響的症狀向度，其中害怕正向評價即具有能區分社交互動焦慮與憂鬱兩疾患不同之區分因子概念，屬於社交互動焦慮的獨特因子。本研究主要以大學部學生為樣本，共計收取566份問卷，再進行結構方程模式統計分析。結果支持社交互動焦慮與憂鬱的階層特徵預測模式之架構，害怕正向評價為社交互動焦慮的獨特因子，能作為社交互動焦慮、憂鬱間的區分因子。然而本研究假設之一：兩疾患對害怕負向評價此特徵的預測力不同，則在統計分析中未達顯著。最後，提出本研究貢獻與其在臨床上的應用，並進一步探討本研究可能的限制，以及未來研究方向。 / Clark and Watson’s (1991) tripartitle model of anxiety and depression and Mineka, Watson, and Clark’s (1998) an integrative hierarchical model of mood and anxiety disorders explain why the comorbility of anxiety and depression (unipolar mood disorders) is high: the reason of high comorbility of anxiety and depression is these two kinds of disorders contain commom factor—negative affect. Besides low positive affect can differentiates depression from anxiety,that is depression contains low positive affect, but anxiety doesn’t. But from research review, both social interaction anxiety and depression associate with negative affect and low positive affect (Hughes, Heimberg, Coles, Gibb, Liebowitz, & Schneier, 2006). Given this finding, on the structure of tripartite model and other relevant studies (Brown, Chorpita, & Barlow, 1998; Hughes et al., 2006; Kashdan, 2002 ), until now the differential factor of social interaction anxiety and depression is not found. In this study, the factors of tripartite model: a general factor—negative affect, and a specific factor—positive affect, are included. Besides, a specific factor—fear of negative evaluation, and a unique factor—fear of positive evaluation, also are added to our research to build the hierarchical characteristic predictor model of social interaction anxiety and depression. In the hierarchical characteristic predictor model, negative affect and positive affect are higher order factors that influence and could be vulnerabilities to social interaction anxiety and depression; fear of negative evaluation and fear of positive evaluation are lower order factors that are influenced by social interaction anxiety and depression and are dimension of symptoms. Fear of positive evaluation is a unique factor of social interaction anxiety, it accounts for the diversity of these two kinds of disorders and is a differentiable key factor. The participants were college students, and the sample consisted of 566 individuals. The data were examined by structural equation modeling. The results were that most of the hypotheses of the hierarchical characteristic predictor model of social interaction anxiety and depression were supported by data analysis. One of the hypotheses: fear of positive evaluation is a unique factor of social interaction anxiety and is a key factor that can distinct social interaction anxiety from depression , was also proved. But one of the other hypotheses: fear of negative evaluation containing amounts of variance attributable to social interaction anxiety and to depression are different; social interaction anxiety contains a more component of fear of negative evaluation than depression does, in this study, the difference was not significant different. Finally, discussing this study’s contribution, practical application in treatment, and the limitations, we give some directions and suggestions for the future research.

應屆畢業護生雖然經過多次臨床實習的學習過程，但對即將成為臨床護士的角色，感到壓力及焦慮。某技術學院基於增加護生能力及培育產業人才所須，實施臨床選習制度，但臨床選習壓力過大，會影響護生職涯抉擇，產生不當因應策略，有憂鬱與焦慮情緒。因此，本研究目的主要有二：（1）瞭解臨床選習壓力、因應策略、輔導需求的現況與關係；（2）設計及實施認知行為團體輔導方案，探討方案對護專學生臨床選習壓力、因應策略、輔導需求與壓力反應之成效，作為未來選習壓力輔導方案的參考。 於臨床選習結束後1週內，選取327位五專五年級護生，以自編「臨床選習壓力、因應策略、輔導需求等量表」進行資料蒐集，運用單因子多變量變異數分析、皮爾森積差相關、多元逐步迴歸分析等，結果顯示如下： 1、五專選習護生有輕度臨床選習壓力，以「專業知識與技能」壓力最高，「有時」會使用因應策略，以「情緒抒發或認知調適」頻率最多，「有些」需要臨床選習輔導需求，最需要「行政與專業技能協助」。 2、在「重急症與特殊單位」選習護生，在「實際護理病人」或「專業知識與技能」的壓力，比「一般內外科病房」及「產兒與精神科」單位高。 3、畢業前計畫為「不確定」的選習護生臨床選習壓力，高於計畫「工作」或「就學」者。 4、「問題逃避或轉移」因應策略運用愈多及「教師與作業協助」輔導需求愈高，「整體臨床選習壓力」愈高；「情緒抒發或認知調適」因應策略運用愈多，「整體臨床選習壓力」愈低。 5、「問題逃避或轉移」、「情緒抒發或認知調適」策略、「教師與作業協助」輔導需求能有效聯合預測「整體臨床選習壓力」，聯合預測力為32％（F(4, 322) = 40.92, p < .001），其中以「問題逃避或轉移」策略最具預測力，單獨解釋量為28％，故實施認知行為團體方案有助於改善臨床選習壓力，增加因應策略。 在驗證認知行為輔導方案成效上，採實驗研究法，分實驗與控制組兩班，各30位，於臨床選習前兩個月對五專五年級實驗組班級護生實施8次，每次90分鐘單元活動，以「臨床選習壓力、因應策略、輔導需求、貝克憂鬱、貝克焦慮等量表」來資料收集，進行GEE分析、成對樣本t檢定及 McNemar-Bowker test、獨立樣本T檢定等檢定分析差異，結果顯示如下： 1、臨床選習前護生呈現輕度憂鬱與焦慮，實施認知行為團體輔導方案後，實驗組護生整體憂鬱有越來越低趨勢，焦慮也下降。 2、實施認知行為團體輔導方案，可提升臨床選習護生對「護理工作的喜好程度」，不影響畢業規劃，無法改善臨床選習壓力及臨床選習輔導需求程度，但可增加「情緒抒發或認知調適」及「整體選習壓力因應策略」，具立即及延宕成效；可改善憂鬱情緒，具立即及延宕成效；可降低焦慮的「主觀感受」，具延宕成效。 根據上述的研究結果，提出相關的建議。 / Although the graduates of the nursing major have taken various clinical practicum courses along the five years during their college study, they still feel a huge amount of stress and anxiety when they are going to work as nurses. Due to the great stress from the preceptorship clinical practicum, the nursing students of one technical college have developed improper adjustment strategies which induce more anxiety and depression and, moreover, have impact upon their career choices. This study aims to (1) understand the relationship among the stress of the preceptorship clinical practicum, the adjustment strategies and the need for counseling; and (2) design and implement the cognitive-behavioral group counseling model to investigate its effectiveness for developing certain adjustment strategies and the need for counseling among the students facing the stress of the preceptorship clinical practicum. After the nursing students of the fifth grade from one five-year technical college finished the practicum, 327 were selected to fill out “the stress of the preceptorship clinical practicum, the adjustment strategies, the need for counseling questionnaire” within 1 weeks. Through One-way MANOVA, Pearson product-moment correlation and Multiple Step Regression, data analysis shows: 1. The subjects listed “the professional knowledge and skills” the highest stressful, “sometimes” adopted certain adjustment strategies among which “venting emotions and cognitive adjustment” were used most frequently. “Some” subjects expressed the need for counseling. “The administrative and the professional assistance” was most needed. 2. The subjects proceeding the practicum at the emergency or critical care units felt more stressful about “clinical nursing” and “professional knowledge and skills” than those at the medical, surgical, obstetrical, psychiatric units. 3. The subjects whose plans after graduation were uncertain showed higher stressful levels than those who planned to work or continue the formal education. 4. The more the coping strategies of “avoiding problems” were adopted and the need for “the instructor and the assignment assistance” was demanded, the higher the overall stress level of the preceptorship clinical practicum was. The more the coping strategies of “venting emotions and cognitive adjustment” were adopted, the lower the overall stress level of the preceptorship clinical practicum was. 5. “The avoiding problems strategies”, “the venting emotions and cognitive adjustment strategies” and “the need for the instructor and the assignment assistance” could be combined to predict the stress level of the preceptorship clinical practicum. The joint predictability is 32％（F(4, 322) = 40.92, p < .001）. “The avoiding problems strategies” had the most predictability. It is anticipated that the cognitive-behavioral intervention model would reduce the stress and promote the coping strategies. To prove the effectiveness of the cognitive-behavioral intervention model, the experiment group and the control group were composed of thirty nursing students separately. Before the experiment group students went to the preceptorship clinical practicum, they were requested to participate in a 90-minute activity section eight times. The data was evaluated through the preceptorship clinical practicum stress questionnaire, Beck depression inventory, Beck anxiety inventory, and was analyzed through Generalized Estimatig Equations, paired-samples T test, McNemar-Bowker test and Independent Sample t-test. The outcome was as following： 1. After the cognitive-behavioral intervention model was exercised, the anxiety level and depression level was reduced. 2. After the cognitive-behavioral intervention model was exercised, the interest in nursing is increased. Moreover, the immediate and delayed effectiveness of “venting emotions and cognitive adjustment” and “the coping strategies for the preceptorship clinical practicum”was increased. The depressive emotions were improved. The subjective feelings of anxiety were reduced.