本研究在探討年輕成人與老年人之資源流失、控制策略使用對於憂鬱情緒之影響；主要希望了解資源流失對憂鬱具有直接之影響性，或者需透過控制策略間接影響憂鬱；同時，透過年輕成人與老年人之比較，了解各種資源流失的影響途徑以及各種控制策略對憂鬱的影響是否會受到個體所處發展階段的影響。 本研究採用問卷調查法，以台灣地區260名成人為對象，年輕成人組共132人(30-46歲，M=37.2歲)，老人組共128人(60-86歲，M=68.7歲)。施以「資源流失調查表」、「控制策略量表」及「貝氏憂鬱量表」，調查所得資料以描述性統計、單因子變異數分析、皮爾森積差相關及路徑分析等方法進行資料分析。 本研究之主要發現如下： 一、 物質資源流失不論在年輕成人或老年人，對於憂鬱均不具顯著預測力。 二、 在年輕成人組，家庭支持資源流失對憂鬱具最強的預測力，且透過直接的路徑影響憂鬱；能量資源流失則透過積極因應策略間接影響憂鬱，即能量資源流失越多者越少使用積極因應的策略，而增加了個人的憂鬱程度。 三、 在老人組，家庭支持資源流失會透過直接與間接兩種路徑影響憂鬱，即家庭支持資源流失越多者越少使用積極因應與降低要求兩種策略，進而影響個人的憂鬱程度；能量資源流失則是對憂鬱具直接的預測力。 四、 在控制策略對憂鬱的影響部分，積極因應策略不論在年輕成人與老人組均對憂鬱具顯著的預測力，使用越多積極因應策略則憂鬱程度越低；但降低要求策略僅在老人組才對憂鬱具顯著的預測力，且使用越多降低要求策略的老年人，憂鬱程度越高。 本文最後根據研究結果進行討論，並根據研究結果對年輕成人與老年人之心理衛生工作以及未來之研究方向提出建議。 / The purposes of this study were: (1) to investigate the influence of lost resources and control strategies for depression in young adult and old adult. Furthermore, to explore that the relation between lost resources and depression was direct or mediated by control strategies. (2) to find out whether the way that different kinds of lost resources and control strategies influence depression will be varied from different developmental stages or not. Subjects of 260 Adults in Taiwan (132 young adults and 128 old adults) were evaluated by the instruments, including resources evaluation scale, control strategy scale, and Beck Depression Items (BDI). The data were analyzed by descriptive statistics, one-way ANOVA, Pearson product-moment correlation, and path analysis. The main findings were as follows: 1. Losses of material resources could not predict depression in both age groups. 2. In young adults, losses of family support resources predict depression directly; but the relation between energy resources and depression was mediated by active coping strategy, which means the more energy resources lose, the less active coping strategies were used, and the more depression were reported. 3. In old adults, losses of family support resources predict depression directly and indirectly, which means the more family support resources lose, the less active coping and lowering aspiration strategies were used, and the more depression were reported. 4. As to the relation between control strategies and depression, active coping strategies could predict depression in both age groups, which means the subjects using more active coping strategies had less depression. Lowering aspiration strategies could predict depression only in old adults. In other words, the old adults using more lowering aspiration strategies had more depression. According to the findings, some suggestions for the mental health of young adults and old adults, as well as for further study were provided.

本研究主要採用資源保存理論的壓力模式來檢驗921地震發生兩年半後，災區居民的資源流失與因應行為對身心症狀的影響，並比較不同社區組織與族群在資源流失、因應行為及身心症狀上的差異本研究主要採用問卷調查法，研究對象為南投埔里鎮居民，有效樣本共354份。受測樣本的設計分為目前住在組合屋和目前住在自己家中以及原住民和非原住民。研究工具包括「創傷後壓力反應指標問卷」、「資源流失調查表」及「因應量表」。資料的處理以相關分析、路徑分析、階層回歸分析和單因子共變數分析為主。本研究結果發現如下：（1）資源流失與逃避式的因應均能預測災區居民的身心症狀，但資源流失對身心症狀的預測要大於逃避式因應，且在四種類型的資源中，以個人資源流失的預測力最強。（2）在不同社區組織的比較中，組合屋居民出現較多身心症狀和資源的流失，且個人資源的流失和逃避式因應均是預測其身心症狀的最強變項。（2）在不同族群的比較中，原住民族群與非原住民族群在身心症狀和資源流失上沒有明顯差異，但原住民族群報告較多逃避式的因應，且逃避式的因應是預測其身心症狀的最強變項。根據研究結果，本研究對地震後的復建提出以下幾點建議：（1）減緩災難後資源的流失並增加資源的獲得。（2）社區組織的介入。（3）增強原住民族群的因應行為。 關鍵字：921地震、資源流失、因應行為、組合屋、原住民 / This study used the Conservation of Resources stress model to examine the effects of resources loss and coping behavior on psychological/physical symptoms after the 921 earthquake. And compared with the differences of resources loss, coping behavior and psychological/physical symptoms in different community organizations and races. This study was conducted by questionnaire investigation. 354 participants living in Pu-Li Town completed the questionnaires. The design of samples was distinguished between living in Temporal houses and living in own houses, and aborigines and non-aborigines. The measurements applied in this study included "Posttraumatic Stress Reaction Index Questionnaire", "Resources Loss Inventory" and "Coping Scale". The obtained data was analyzed by Pearson product-moment correlation, path analysis, hierarchical multiple regression analysis and one-way ANCOVA. The results of this study included: (1) resources loss and avoidant coping could predict psychological/physical symptoms, but resource loss predicted psychological symptoms better than avoidant coping. Personal resources were the strongest predictor among four kinds of resources. (2) In different community organizations. Temporal house's residents reported more resources loss and psychological/physical symptoms. And personal resources and avoidant coping were the strongest predictors. (3) In different races, the level of resources loss and psychological/physical symptoms were no significant differences between aborigines and non-aborigines. But aborigines revealed more avoidant coping and avoidant coping was the strongest predictor. Based on the results, some suggestions to post-earthquake rehabilitation were included: (1) Acting to limit resources loss after disaster and increase resources gain. (2) Considering the intervention of community organization. (3) Enhancing aborigine's coping behavior. Keywords: 921 earthquake, resource loss, coping behavior. Temporal houses, aborigines

目的：基於初診斷乳癌患者的心理沮喪反應存在個別差異性之假設，本研究旨在探討乳癌患者的心理沮喪發展軌跡及其與資源變化、因應風格之間的關係，並採用動態性的壓力調適觀點來說明影響個體間發展差異與個人內變化之因素。三個主要的目的為（1）初診斷乳癌患者是否具有不同的心理沮喪發展軌跡？（2）隨時序變化的資源變化與因應風格可否區辨不同的軌跡組別；以及（3）不同軌跡組別的資源變化與因應風格對其心理沮喪之影響是否不同？ 方法： 本研究採用貫時性的研究設計，共收錄200名初診斷乳癌患者。患者於診斷後的手術前一天進行評估，並於術後一個月、術後四個月、術後七個月及術後一年進行後續的追蹤。每一點的心理沮喪分數採用中文的醫院版焦慮與憂鬱量表（HADS）來測量，追蹤時間點的資源變化與癌症因應風格之分數，分別是以修編的資源改變量表（資源流失與資源獲得）與台灣版癌症心理調適量表（Mini-MAC）進行評估。 結果：潛在類別成長模式的結果顯示，相較於過去的研究，心理沮喪的變化軌跡可區辨出「韌性組」、「復原組」、「晚發組」及「慢性組」。潛在成長曲線模式的分析顯示，相較於其他三組，「韌性組」的壓力因應特性為：診斷之後維持在低資源流失、較低的初始AP，以及較低的CA成長率；相較於「韌性組」，「復原組」還具有下降較慢的FS；「晚發組」與「慢性組」又比前兩組具有更高的初始HH與較高的AP成長率，而「慢性組」比起其他三組在診斷初期具有最高的資源流失、最高的HH以及最低的FS。階層線性模式的分析顯示，四組之中的資源流失與因應風格皆可預測心理沮喪，作用的差異之處主要出現在「慢性組」的資源獲得與CA具有減緩心理沮喪之效果，以及各組之內的預測因子不同。 結論：本研究支持罹癌後的壓力反應具有個別差異性，並且指出乳癌患者的心理沮喪反應具有四種不同的發展型態。本研究也強調於連續變化的向度中考量不同的心理沮喪發展軌跡及其相關的壓力調適因子亦具有時序變化之重要性。有關的理論與實務意涵將於後作進一步地討論。 / Objectives: This study assumed the psychological distress of newly-diagnosed breast cancer (BC) patients existed the entities of the individual difference, so this study examined distinct development trajectories of psychological distress amongst BC patients and their relationship with resource changes and coping styles, and adopted a dynamic stress-coping perspective to shed light on the factors that contribute to the diversity of inter-individual development and intra-individual change. The three major purposes were (1) to determine if there are distinct development trajectories of psychological distress amongst newly-diagnosis BC patients; (2) to test whether time-varying resource changes and coping styles can distinguish the trajectory groups; (3) to explore whether the effect of time-varying resource changes and coping styles on psychological distress differ within each trajectories group. Methods: A longitudinal reasarch study of 200 newly-diagnosed BC patients was recruited and participants were assessed at the day before surgery, and again at the 1-month, 4-month, 7-month and 1-year post-surgery follow-ups. Psychological distress was measured at the five time-points using the Chinese version of Hospital Anxiety and Depression Scale (HADS). Resource changes and cancer-specific coping were assessed at all follow-ups using the revised Resource Change Scale and the the Chinese version of Mini-MAC Scale, respectively. Results: Latent Class Growth Analysis (LCGA) identified four latent classes of BC patients with distinct developmental trajectories of psychological distress - resilience, recovery, late onset and chronic dysfunction. Latent Growth Curve Model (LGM) revealed that the stress-coping properties of the resilience group featured a stabilized lower level of resource loss after diagnosis, a lower level of initial AP-coping and a lower growth rate of CA-coping when compared with the others. The recovery group was more likely to have a lower decrease of FS-coping than the resilience group. Moreover, the late onset group and the chronic dysfunction group were more likely to have a higher level of initial HH-coping and a higher increase in AP-coping, and the chronic dysfunction group was characterized by the highest level of initial resource loss and HH-coping, and the lowest level of initial FS-coping compared with the other groups. The Hierarchical Linear Model (HLM) indicated that resource loss and use of coping styles could significantly predict levels of psychological distress in each trajectory group. The major differences that appeared were in the positive effect of resource gain and use of CA-coping on decreasing distress symptoms amongst people in the chronic dysfunction group, as well as in the different predictors that were found in each trajectory group. Conclusions: The present study shows that there are individual differences in cancer-specific stress responses and outlines four different developmental patterns of psychological distress amongst newly-diagnosed Taiwanese BC patients. This study also stressed the importance of considering time-serial continuity of distinct developmental trajectories with regards to psychological distress as well as the related stress-coping factors which also varies with time. Further theoretical and practical implications are discussed in depth in the content of the study.