1. NCCU Academic Hub
  2. 學術產出
  3. 理學院
  4. 學位論文
  5. Item

學術產出-學位論文

文章檢視/開啟

書目匯出

Google ScholarTM

政大圖書館

引文資訊

TAIR相關學術產出

題名 慢性失眠者與情境性失眠高危險族群之壓力因應與失眠的關係
The Relationship of Coping and Insomnia in Chronic Insomniacs and Normal Sleepers Vulnerable to Stress-related Sleep Disturbance
作者 林詩淳
Lin, Shih Chun
貢獻者 楊建銘
Yang, Chien Ming
林詩淳
Lin, Shih Chun
關鍵詞 失眠
情境性失眠
壓力因應
睡眠相關安全行為
insomnia
adjustment insomnia
coping
sleep related safety behaviors
日期 2007
上傳時間 17-九月-2009 13:14:00 (UTC+8)
摘要 研究目的：失眠為國人常見的健康問題，造成患者夜間睡眠的痛苦，對白天生活品質也有明顯的影響，站在預防失眠慢性化的角度切入，找出情境性失眠高危險群的心理病理特性，應可為防治失眠疾患提供更積極的建議。本研究目的一即是想透過與好眠組的比較，討論壓力因應風格、持續失眠相關病因(對睡眠不適當認知、睡眠相關安全行為、身心激發程度)在失眠高危險族群及慢性失眠者的特性為何。第二個目的則想驗證失眠持續因素對失眠的影響路徑，並探討壓力因應風格在失眠持續模式中的影響性為何。

研究方法：本研究以橫斷式問卷調查法收集資料，蒐集有效問卷情境性失眠高風險群組74份、好眠組75份、與慢性失眠組62份，總共211份有效問卷。統計方法則根據不同研究目的分別採用單因子變異數分析及結構方程模型的路徑分析進行資料處理。

研究結果：慢性失眠者比好眠者與慢性失眠者有更高的睡眠不適當認知、更多睡眠相關安全行為更高的睡前激發程度。慢性失眠者與情境性失眠高危險族群在面對壓力時，也比好眠者使用較多的「社會支持、情緒調節與發洩的調解」、「逃避」、「問題解決、重釋與接受」等因應策略。此外，情境性失眠高危險族群也比好眠者用更多的睡眠相關安全行為來因應疲憊或睡不好的狀況。另外，本研究路徑分析結果發現睡眠不適當認知會透過安全行為及激發程度而影響失眠，且在考驗各個壓力因應風格對失眠持續模式之影響時，發現較一致的結果是逃避因應可能會增加個體使用更多睡眠相關安全行為而惡化失眠

研究討論：研究結果支持過去理論認為睡眠不適當認知、睡眠相關安全行為及睡前激發程度為失眠的持續因子。為預防情境性失眠高危險族群其失眠症狀慢性化，建議重點應放在睡眠的衛生教育，並且不只是教導適當因應失眠的行為，重要的是需包括增強對失眠處理的控制感、建立適當合理的藥物使用概念、矯正對失眠後果的災難化想法。最後，過去少有其他研究討論逃避因應風格與失眠的關係，建議對此有興趣的研究者可對逃避因應風格與失眠的關係做進一步的重覆驗證與探討。
OBJECTIVE: The goals of the study are to examine (1) the differences of coping, dysfunctional beliefs and attitudes about sleep, sleep related safety behaviors and pre-sleep arousals among chronic insomniacs, normal sleepers vulnerable to stress-related sleep disturbance and good sleepers (2) the interactions of coping with other etiological factors in the model of persistent insomnia.

METHOD: The sample was composed of 211 participants. Participants were asked to complete a set of questionnaires, including the Ford Insomnia Response to Stress Test (FIRST), the Insomnia Severity Index, the Pre-Sleep Arousal Scale, the Sleep-Related Behaviour Questionnaire, the Dysfunctional beliefs and attitudes about sleep questionnaire, COPE, the Center for Epidemiologic Studies Depression Scale, the Beck Anxiety Inventory and the Pittsburgh Sleep Quality Inventory. The participants were categorized into three subgroups, 75 good sleepers, 74 normal sleepers vulnerable to stress-related sleep disturbance, and 62 chronic insomniacs, according to clinical interview and/or their scores on the FIRST.

RESULT: The results showed that chronic insomniacs reported more dysfunctional beliefs and attitudes about sleep, sleep related safety behaviors and pre-sleep arousals than the other groups. In addition, chronic insomniacs and normal sleepers vulnerable to stress-related sleep disturbance used more coping styles of “problem solving, positive reinterpretation and acceptance”, “social support, focus on and venting of emotions”, and “avoidance” than good sleepers. Also, normal sleepers vulnerable to stress-related sleep disturbance reported more safety behaviors to cope insomnia than good sleepers. Furthermore, the path analysis showed that the safety behaviors and arousal play an important mediating role between dysfunctional beliefs and attitudes about sleep and insomnia in chronic insomniacs. Finally, data showed that avoidance coping could predict the frequency of sleep related safety behaviors.

CONCLUSION: The results imply that in order to prevent normal sleepers vulnerable to stress-related sleep disturbance from becoming chronic insomniacs, sleep hygiene education program should incorporate methods that are designed to reduce maladaptive sleep beliefs and sleep related safety behaviors. The relationship found between avoidance coping and insomnia is also of interest and require replication in future researches.
參考文獻 中文參考文獻
行政院主計處（2001）。台灣地區社會發展趨勢調查統計結果，行政院。
林一真（2000）。貝克焦慮量表中文版指導手冊。中國行為科學社。
台灣睡眠醫學學會（2007）。九十六年國人睡眠品質調查報告。台灣睡眠醫學學會。
孔繁鐘（1999）。精神疾病的診斷與統計。台北市：合計圖書出版社。
邱皓政（2006）。結構方程模式：LISREL的理論、技術與應用。台北市：雙葉。
健康心理學（蕭仁釗、林耀盛、鄭逸如譯）（1997）。臺北市：桂冠圖書。(原著出版年：1990/1994)
社會研究的後設分析程序（齊力譯）（1999）。臺北市：弘智文化。(原著出版年：1984)
邱兆宏（2004）。壓力與健康：整合分析與模式驗證之研究。高雄醫學大學行為科學研究所碩士班，未出版，高雄市。
林彥妤（1988）。生活事件，因應方式及社會支援對老人心理適應之影響。國立台灣大學心理學研究所碩士論文，未出版，台北市。
呂敏昌（1993）。國中學生的生活壓力、因應方式與心理社會幸福感之關係。私立中國文化大學兒童福利研究所碩士論文，未出版，台北市。
陳綱華（1995）。心臟移植後患者的壓力源、因應行為及生活滿意度之關係。國防醫學院護理學研究所碩士論文，未出版，台北市。
鄭幸宜（1998）。成人氣喘患者的壓力、因應策略與生活品質之關係。國立台灣大學醫學院護理學研究所碩士論文，未出版，台北市。
何家齊（1998）。大學生的樂觀傾向、壓力因應方式與生活適應的相關研究。國立彰化師範大學特殊教育研究所碩士論文，未出版，彰化市。
林詩維(2007)。失眠認知行為治療之療效與心理相關因素之改變。私立輔仁大學心理學系碩士論文，未出版，台北市。
林正修（1996）某醫學中心家庭醫學科門診病患憂鬱症之盛行率與相關因素的探討。國立台灣大學公共衛生學系碩士論文，未出版，台北市。
林美李 (2002)。台北市高中生憂鬱程度及其相關因素。國立台北護理學院護理研究所碩士論文，未出版，台北市。
許文耀（2003）。資源流失、因應、社會支持與九二一地震災民的心理症狀之關係。中華心理學刊，45(3)，263-277。
呂淑妤，林宗義(2000)南部社區老人憂鬱症狀盛行率及相關因素研究，中華公共衛生雜誌，19(1)，50-60。
車先蕙、盧孟良、陳錫中、張尚文、李宇宙（2006）。中文版貝克焦慮量表之信效度。台灣醫學，10(4)，447-454。
蘇東平（2000）。睡眠障礙之診斷分類及臨床評估。台灣醫學，4，665-672。
陳荻卿、張景媛（2007）。知識信念影響學習運作模式之驗證。教育心理學報，29(1)，23-43。
林詩淳、楊建銘、許世杰(2006年3月)。失眠嚴重度量表、睡前激發程度量表及睡眠失功能信念及態度量表中譯版之信效度研究。台灣睡眠醫學會壁報論文發表。台灣睡眠醫學學會第四屆研討會，台灣大學醫學院。
Reference
AASM. (2005). International Classification of Sleep Disorders (ICSD-2) (2nd edn ed.). Westchester, IL: AASM.
Aneshensel, C. S. (1999). Outcomes of the stress process. In A. V. Horwitz & T. L. Scheid (Eds.), A handbook for the study of mental health: Social contexts, theories and systems (pp. 211-227). Cambridge: UK: Cambridge University Press.
Bastien, C. H., Vallieres, A., & Morin, C. M. (2001). Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Medicine, 2(4), 297-307.
Bastien, C. H., Vallieres, A., & Morin, C. M. (2004). Precipitating factors of insomnia. Behavioral Sleep Medicine, 2(1), 50-62.
Billings, A. G., & Moos, R. H. (1981). The role of coping responses and social resources in attenuating the stress of life events. Journal of Behavioral Medicine, 4(2), 139-157.
Billings, A. G., & Moos, R. H. (1984). Coping, stress, and social resources among adults with unipolar depression. Journal of Personality and Social Psychology, 46(4), 877-891.
Bonnet, M. H., & Arand, D. L. (1997). Hyperarousal and insomnia. Sleep Medicine Reviews, 1(2), 97-108.
Borkovec, T. D. (1982). Insomnia. Journal of Consulting and Clinical Psychology, 50(6), 880-895.
Chou, C., Yang, C. M., & Chen, J. (2007). Dysfunctional sleep cognition and Vulnerability to stress related sleep disturbance. Sleep, 30 (suppl S), A380.
Clark, D. M., & Wells, A. (1995). A cognitive model of social phobia. In R. G. Heimberg, M. R. Liebowitz, D. A. Hope & F. R. Schneier (Eds.), Social phobia: Diagnosis, assessment, and treatment (Vol. 41-68). New York: Guilford Press.
Coren, S. (1988). Prediction of insomnia from arousability predisposition scores: scale development and cross-validation. Behaviour Research and Therapy, 26(5), 415-420.
Cosway, R., Endler, Norman S., Sadler Andrew J., & Deary, Ian J. . (2000). The Coping Inventory for Stressful Situations: Factorial Structure and Associations With Personality Traits and Psychological Health. Journal of Applied Biobehavioral Research, 5(2), 121-143.
Coyne, J. C., Aldwin, C., & Lazarus, R. S. (1981). Depression and coping in stressful episodes. Journal of Abnormal Psychology, 90(5), 439-447.
Drake, C., Richardson, G., Roehrs, T., Scofield, H., & Roth, T. (2004). Vulnerability to stress-related sleep disturbance and hyperarousal. Sleep, 27(2), 285-291.
Edinger, J. D., & Means, M. K. (2005). Cognitive-behavioral therapy for primary insomnia. Clinical Psychology Review, 25(5), 539-558.
Edinger, J. D., Stout, A. L., & Hoelscher, T. J. (1988). Cluster analysis of insomniacs` MMPI profiles: relation of subtypes to sleep history and treatment outcome. Psychosomatic Medicine, 50(1), 77-87.
Endler, N. S., & Parker, J. D. (1990). Multidimensional assessment of coping: a critical evaluation. Journal of Personality and Social Psychology, 58(5), 844-854.
Endler, N. S., & Parker, J. D. A. (1989). self-realization, success and adjustment. In Coping with frustrations to self-realization: Stress, anxiety, crises and adjustment (pp. 153-164). New York: Praeger.
Espie, C. A. (1991). The psychological treatment of insomnia: Chischester(UK): Wiley.
Espie, C. A., Inglis, S. J., Harvey, L., & Tessier, S. (2000). Insomniacs` attributions. psychometric properties of the Dysfunctional Beliefs and Attitudes about Sleep Scale and the Sleep Disturbance Questionnaire. Journal of Psychosomatic Research, 48(2), 141-148.
Folkman, S., & Moskowitz, J. T. (2004). Coping: pitfalls and promise. Annual Review of Psychology, 55, 745-774.
Freedman, R. R., & Sattler, H. L. (1982). Physiological and psychological factors in sleep-onset insomnia. Journal of Abnormal Psychology, 91(5), 380-389.
Gross, R. T., & Borkovec, T. D. (1982). Effects of a cognitive intrusion manipulation on the sleep-oneset latency of good sleepers. Behavior Therapy, 13, 112-116.
Harvey, A. G. (2002a). A cognitive model of insomnia. Behaviour Research and Therapy, 40(8), 869-893.
Harvey, A. G. (2002b). Identifying safety behaviors in insomnia. The Journal of Nervous and Mental Disease, 190(1), 16-21.
Harvey, A. G., Sharpley, A. L., Ree, M. J., Stinson, K., & Clark, D. M. (2007). An open trial of cognitive therapy for chronic insomnia. Behaviour Research and Therapy.
Holahan, C. J., & Moos, R. H. (1985). Life stress and health: personality, coping, and family support in stress resistance. Journal of Personality and Social Psychology, 49(3), 739-747.
Hu, L. T., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in convariance structural equation Analysis: Conventional Criteria Versus New Alternatives. Structural modeling, 6(1), 1-55.
Kales, A., Caldwell, A. B., Preston, T. A., Healey, S., & Kales, J. D. (1976). Personality patterns in insomnia. Theoretical implications. Archives of General Psychiatry, 33(9), 1128-1124.
Kales, A., Caldwell, A. B., Soldatos, C. R., Bixler, E. O., & Kales, J. D. (1983). Biopsychobehavioral correlates of insomnia. II. Pattern specificity and consistency with the Minnesota Multiphasic Personality Inventory. Psychosomatic Medicine, 45(4), 341-356.
Kuisk, L. A., Bertelson, A. D., & Walsh, J. K. (1989). Presleep cognitive hyperarousal and affect as factors in objective and subjective insomnia. Perceptual and Motor Skills, 69(3 Pt 2), 1219-1225.
Lavie, P., Carmeli, A., Mevorach, L., & Liberman, N. (1991). Sleeping under the threat of the Scud: war-related environmental insomnia. Israel Journal of Medical Sciences, 27(11-12), 681-686.
LeBlanc, M., Beaulieu-Bonneau, S., Merette, C., Savard, J., Ivers, H., & Morin, C. M. (2007). Psychological and health-related quality of life factors associated with insomnia in a population-based sample. Journal of Psychosomatic Research, 63(2), 157-166.
Lichstein, K. L., & Rosenthal, T. L. (1980). Insomniacs` perceptions of cognitive versus somatic determinants of sleep disturbance. Journal of Abnormal Psychology, 89(1), 105-107.
McCrae, R. R., & Costa, P. T. (1986). Personality, coping, and coping effectiveness in an adult sample. Journal of Personality, 54, 384-405.
Miller, S. M., Brody, D. S., & Summerton, J. (1988). Styles of coping with threat: implications for health. Journal of Personality and Social Psychology, 54(1), 142-148.
Monroe, L. J. (1967). Psychological and physiological differences between good and poor sleepers. Journal of Abnormal Psychology, 72(3), 255-264.
Monroe, L. J., & Marks, P. A. (1977). MMPI differences between adolescent poor and good sleepers. Journal of Consulting and Clinical Psychology, 45(1), 151-152.
Morin, C. M., & Espie, C. A. (1993). Insomnia: psychological assessment and management. New York: Kluwer Academic/ Plenum.
Morin, C. M., LeBlanc, M., Daley, M., Gregoire, J. P., & Merette, C. (2006). Epidemiology of insomnia: prevalence, self-help treatments, consultations, and determinants of help-seeking behaviors. Sleep Medicine, 7(2), 123-130.
Morin, C. M., Rodrigue, S., & Ivers, H. (2003). Role of stress, arousal, and coping skills in primary insomnia. Psychosomatic Medicine, 65(2), 259-267.
Morin, C. M., Stone, J., Trinkle, D., Mercer, J., & Remsberg, S. (1993). Dysfunctional beliefs and attitudes about sleep among older adults with and without insomnia complaints. Psychology and Aging, 8(3), 463-467.
Morin, C. M., Vallieres, A., & Ivers, H. (2007). Dysfunctional beliefs and attitudes about sleep (DBAS): validation of a brief version (DBAS-16). Sleep, 30(11), 1547-1554.
Nofzinger, E. A., Buysse, D. J., Germain, A., Price, J. C., Miewald, J. M., & Kupfer, D. J. (2004). Functional neuroimaging evidence for hyperarousal in insomnia. The American Journal of Psychiatry, 161(11), 2126-2128.
Nomura, K., Yamaoka, K., Nakao, M., & Yano, E. (2005). Impact of insomnia on individual health dissatisfaction in Japan, South Korea, and Taiwan. Sleep, 28(10), 1328-1332.
Ohayon, M. M. (2002). Epidemiology of insomnia: what we know and what we still need to learn. Sleep Medicine Reviews, 6(2), 97-111.
Pearlin, L. I., & Schooler, C. (1978). The structure of coping. Journal of Health and Social Behavior, 19(1), 2-21.
Perlis, M. L., Merica, H., Smith, M. T., & Giles, D. E. (2001). Beta EEG activity and insomnia. Sleep Medicine Reviews, 5(5), 363-374.
Radloff, L. S. (1977). The CES-D scale: a self-report depression scale for research in general population. Applied Psychological Measurement, 1, 385-401.
Ree, M. J., & Harvey, A. G. (2004). Investigating Safety Behaviours in Insomnia: The Development of the Sleep-related Behaviours Questionnaire (SRBQ). Behaviour Change, 21(1), 26-36.
Roehrs, T., Lineback, W., Zorick, F., & Roth, T. (1982). Relationship of psychopathology to insomnia in the elderly. Journal of the American Geriatrics Society 30, 312-315.
Sadeh, A., Keinan, G., & Daon, K. (2004). Effects of stress on sleep: the moderating role of coping style. Health Psychology, 23(5), 542-545.
Salkovskis, P. M. (1991). The importance of behaviour in the manitenance of anxiety and panic: A cognitive account. Behavioural Psychotherapy, 19, 6-19.
Schneider-Helmert, D. (1987). Twenty-four-hour sleep-wake function and personality patterns in chronic insomniacs and healthy controls. Sleep, 10(5), 452-462.
Semler, C. N., & Harvey, A. G. (2004). An investigation of monitoring for sleep-related threat in primary insomnia. Behaviour Research and Therapy, 42(12), 1403-1420.
Shealy, R. C., Lowe, J. D., & Ritzler, B. A. (1980). Sleep onset insomnia: personality characteristics and treatment outcome. Journal of Consulting and Clinical Psychology, 48(5), 659-661.
Spielman, A. J. (1986). Assessment of insomnia. Clinical Psychology Review, 6, 11-25.
Spielman, A. J., Caruso, L. S., & Glovinsky, P. B. (1987). A behavioral perspective on insomnia treatment. The Psychiatric Clinics of North America, 10(4), 541-553.
Spielman, A. J., & Glovinsky, P. B. (1991). The varied nature of insomnia. In Case studies in insomnia (In P. Hauri (ED.) ed., pp. 1-15). New York: Plenum Press.
Stepanski, E., Zorick, F., Roehrs, T., Young, D., & Roth, T. (1988). Daytime alertness in patients with chronic insomnia compared with asymptomatic control subjects. Sleep, 11(1), 54-60.
Stone, A. A., & Neale, J. M. (1984). New measure of daily coping: Development and preliminary results Journal of Personality and Social Psychology 46(4), 892-906.
Tsai, P. S., Wang, S. Y., Wang, M. Y., Su, C. T., Yang, T. T., Huang, C. J., et al. (2005). Psychometric evaluation of the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI) in primary insomnia and control subjects. Quality of Life Research, 14(8), 1943-1952.
Van Egeren, L., Haynes, S. N., Franzen, M., & Hamilton, J. (1983). Presleep cognitions and attributions in sleep-onset insomnia. Journal of Behavioral Medicine, 6(2), 217-232.
Vollrath, M., Wicki, W., & Angst, J. (1989). The Zurich study. VIII. Insomnia: association with depression, anxiety, somatic syndromes, and course of insomnia. European Archives of Psychiatry and Neurological Sciences, 239(2), 113-124.
Woodley, J., & Smith, S. (2006). Safety behaviors and dysfunctional beliefs about sleep: testing a cognitive model of the maintenance of insomnia. Journal of Psychosomatic Research, 60(6), 551-557.
Wright, H., Lack, L., Morin, C., & Edinger, J. (2000). Dysfunctional Beliefs and Attitudes about Sleep Questionnaire: preliminary factor analysis. Sleep, 23(Suppl 2), A381.
Yang, C. M., Spielman, A. J., & Glovinsky, P. (2006). Nonpharmacologic strategies in the management of insomnia. Psychiatr Clin North Am, 29(4), 895-919.
描述 碩士
國立政治大學
心理學研究所
93752004
96
資料來源 http://thesis.lib.nccu.edu.tw/record/#G0093752004
資料類型 thesis
dc.contributor.advisor 楊建銘zh_TW
dc.contributor.advisor Yang, Chien Mingen_US
dc.contributor.author (作者) 林詩淳zh_TW
dc.contributor.author (作者) Lin, Shih Chunen_US
dc.creator (作者) 林詩淳zh_TW
dc.creator (作者) Lin, Shih Chunen_US
dc.date (日期) 2007en_US
dc.date.accessioned 17-九月-2009 13:14:00 (UTC+8)-
dc.date.available 17-九月-2009 13:14:00 (UTC+8)-
dc.date.issued (上傳時間) 17-九月-2009 13:14:00 (UTC+8)-
dc.identifier (其他 識別碼) G0093752004en_US
dc.identifier.uri (URI) https://nccur.lib.nccu.edu.tw/handle/140.119/32485-
dc.description (描述) 碩士zh_TW
dc.description (描述) 國立政治大學zh_TW
dc.description (描述) 心理學研究所zh_TW
dc.description (描述) 93752004zh_TW
dc.description (描述) 96zh_TW
dc.description.abstract (摘要) 研究目的：失眠為國人常見的健康問題，造成患者夜間睡眠的痛苦，對白天生活品質也有明顯的影響，站在預防失眠慢性化的角度切入，找出情境性失眠高危險群的心理病理特性，應可為防治失眠疾患提供更積極的建議。本研究目的一即是想透過與好眠組的比較，討論壓力因應風格、持續失眠相關病因(對睡眠不適當認知、睡眠相關安全行為、身心激發程度)在失眠高危險族群及慢性失眠者的特性為何。第二個目的則想驗證失眠持續因素對失眠的影響路徑，並探討壓力因應風格在失眠持續模式中的影響性為何。

研究方法：本研究以橫斷式問卷調查法收集資料，蒐集有效問卷情境性失眠高風險群組74份、好眠組75份、與慢性失眠組62份，總共211份有效問卷。統計方法則根據不同研究目的分別採用單因子變異數分析及結構方程模型的路徑分析進行資料處理。

研究結果：慢性失眠者比好眠者與慢性失眠者有更高的睡眠不適當認知、更多睡眠相關安全行為更高的睡前激發程度。慢性失眠者與情境性失眠高危險族群在面對壓力時，也比好眠者使用較多的「社會支持、情緒調節與發洩的調解」、「逃避」、「問題解決、重釋與接受」等因應策略。此外，情境性失眠高危險族群也比好眠者用更多的睡眠相關安全行為來因應疲憊或睡不好的狀況。另外，本研究路徑分析結果發現睡眠不適當認知會透過安全行為及激發程度而影響失眠，且在考驗各個壓力因應風格對失眠持續模式之影響時，發現較一致的結果是逃避因應可能會增加個體使用更多睡眠相關安全行為而惡化失眠

研究討論：研究結果支持過去理論認為睡眠不適當認知、睡眠相關安全行為及睡前激發程度為失眠的持續因子。為預防情境性失眠高危險族群其失眠症狀慢性化，建議重點應放在睡眠的衛生教育，並且不只是教導適當因應失眠的行為，重要的是需包括增強對失眠處理的控制感、建立適當合理的藥物使用概念、矯正對失眠後果的災難化想法。最後，過去少有其他研究討論逃避因應風格與失眠的關係，建議對此有興趣的研究者可對逃避因應風格與失眠的關係做進一步的重覆驗證與探討。		zh_TW
dc.description.abstract (摘要) OBJECTIVE: The goals of the study are to examine (1) the differences of coping, dysfunctional beliefs and attitudes about sleep, sleep related safety behaviors and pre-sleep arousals among chronic insomniacs, normal sleepers vulnerable to stress-related sleep disturbance and good sleepers (2) the interactions of coping with other etiological factors in the model of persistent insomnia.

METHOD: The sample was composed of 211 participants. Participants were asked to complete a set of questionnaires, including the Ford Insomnia Response to Stress Test (FIRST), the Insomnia Severity Index, the Pre-Sleep Arousal Scale, the Sleep-Related Behaviour Questionnaire, the Dysfunctional beliefs and attitudes about sleep questionnaire, COPE, the Center for Epidemiologic Studies Depression Scale, the Beck Anxiety Inventory and the Pittsburgh Sleep Quality Inventory. The participants were categorized into three subgroups, 75 good sleepers, 74 normal sleepers vulnerable to stress-related sleep disturbance, and 62 chronic insomniacs, according to clinical interview and/or their scores on the FIRST.

RESULT: The results showed that chronic insomniacs reported more dysfunctional beliefs and attitudes about sleep, sleep related safety behaviors and pre-sleep arousals than the other groups. In addition, chronic insomniacs and normal sleepers vulnerable to stress-related sleep disturbance used more coping styles of “problem solving, positive reinterpretation and acceptance”, “social support, focus on and venting of emotions”, and “avoidance” than good sleepers. Also, normal sleepers vulnerable to stress-related sleep disturbance reported more safety behaviors to cope insomnia than good sleepers. Furthermore, the path analysis showed that the safety behaviors and arousal play an important mediating role between dysfunctional beliefs and attitudes about sleep and insomnia in chronic insomniacs. Finally, data showed that avoidance coping could predict the frequency of sleep related safety behaviors.

CONCLUSION: The results imply that in order to prevent normal sleepers vulnerable to stress-related sleep disturbance from becoming chronic insomniacs, sleep hygiene education program should incorporate methods that are designed to reduce maladaptive sleep beliefs and sleep related safety behaviors. The relationship found between avoidance coping and insomnia is also of interest and require replication in future researches.		en_US
dc.description.tableofcontents 第一章、緒論 6
第二章、文獻探討 8
第一節、失眠的定義與流行病學研究 8
第二節、慢性失眠的病因理論 9
第三節、慢性失眠者對一般壓力的因應 13
（一）壓力因應的定義及理論 13
（二）壓力因應傾向與失眠 15
第四節、慢性失眠的病因討論 16
（一）對睡眠不適當的認知、信念與失眠 17
（二）干擾睡眠的行為與失眠 18
（三）身心激發狀態與失眠 20
第五節、研究問題與假設 22
第三章、研究方法 26
第一節、研究對象 26
第二節、研究工具 27
第三節、研究程序與資料分析 36
(一)研究程序 36
(二)資料分析 37
第四章、研究結果 39
第一節、失眠高危險族群與慢性失眠者的心理病理特性 39
第二節、因應風格與持續失眠病因之路徑關係 45
(一) 基本統計資料分析 45
(二) 持續失眠的理論模式驗證 49
第五章、研究討論 64
第一節、情境失眠高危險族群、慢性失眠者於失眠的心理病理特性 64
第二節、失眠持續模式之驗證 70
第三節、壓力因應風格對失眠持續模式之影響 71
第四節、研究貢獻 74
第五節、研究限制與未來研究建議 75
中文參考文獻 77
REFERENCE 79
附錄 84
附錄一、受試者篩選問卷 84
附錄二、睡眠品質(PSQI) 85
附錄三、失眠易感程度(FIRST) 87
附錄四、自我狀態量表(CES-D) 88
附錄五、失眠困擾(ISI) 89
附錄六、睡眠身心狀態(PSAS) 90
附錄七、睡眠相關行為(SRBS) 91
附錄八、睡眠信念(DBAS-16) 93
附錄九、壓力因應風格(COPE) 95


表 目 次
表2-1.研究假設一之圖示…………………………………………………24
表3-1.壓力因應因素分析四因素與Caver等人(1989)的因素分析對照表……………………………………………………………………………36
表4-1.好眠組、情境性失眠高危險族群、慢性失眠組之人口學變項及臨床特徵……………………………………………………………………………40
表4-2.「因應風格」、「對睡眠不適當認知」、「睡眠相關安全行為」、與「睡前身心激發程度」於好眠組、情境性失眠高危險族群、及慢性失眠組三組的差異………………………………………………………………………44
表4-3.慢性失眠受試者之失眠嚴重度、睡前身心激發程度、睡眠相關安全行為、對睡眠不適當認知及壓力因應各因素之描述統計…………………46
表4-4.正常睡眠受試者之失眠嚴重度、睡前身心激發程度、睡眠相關安全行為、對睡眠不適當認知及壓力因應各因素之描述統計…………………47
表.4-5.慢性失眠組之失眠嚴重度、睡前身心激發程度、睡眠相關安全行為、對睡眠不適當認知及壓力因應風格之相關係數表………………………48
表.4-6.正常睡眠組之失眠嚴重度、睡前身心激發程度、睡眠相關安全行為、對睡眠不適當認知及壓力因應風格之相關係數表..……………………48
表4-7.直接效果模型(模型一)與調節效果模型(模型二)之適合度指標…51
表4-8.不同模型於兩樣本的SMC表………………………………………52
表4-9.兩樣本之持續失眠調節模型12個觀察指標之平均數、標準差與相關係數矩陣………………………………………………………………………54
表4-10.兩樣本之持續失眠病因調節模型的估計參數顯著性考驗及標準化係數值……………………………………………………………………………55
表5-1.研究假設一…………………………………………………………65
表5-2.研究結果一…………………………………………………………65

圖 目 次
圖2-1.Spielman 與Glovinsky的失眠三因素模式……………………10
圖2-2.心理/行為因素與神經心理系統交互影響睡眠模式………………12
圖2-3.研究假設二：壓力因應風格與失眠持續病因模式之關係………………………………………………………………………………25
圖3-1.受試者篩選過程與統計分析流程………………………………………………………………………………38
圖4-1.兩組樣本模型估計之標準化參數暨路徑分析圖………………………………………………………………………………53
圖4-2.慢性失眠者之持續失眠嚴重度相關病因模式的標準化路徑係數圖………………………………………………………………………………58
圖4-3.正常睡眠者之持續失眠嚴重度相關病因模式的標準化路徑係數圖………………………………………………………………………………62
圖5-1. 慢性失眠者與正常睡眠者壓力因應風格影響失眠持續模式之對照圖………………………………………………………………………………71		zh_TW
dc.format.extent 45160 bytes-
dc.format.extent 85739 bytes-
dc.format.extent 82160 bytes-
dc.format.extent 90205 bytes-
dc.format.extent 91482 bytes-
dc.format.extent 265255 bytes-
dc.format.extent 272988 bytes-
dc.format.extent 285762 bytes-
dc.format.extent 139938 bytes-
dc.format.extent 100625 bytes-
dc.format.extent 245326 bytes-
dc.format.mimetype application/pdf-
dc.format.mimetype application/pdf-
dc.format.mimetype application/pdf-
dc.format.mimetype application/pdf-
dc.format.mimetype application/pdf-
dc.format.mimetype application/pdf-
dc.format.mimetype application/pdf-
dc.format.mimetype application/pdf-
dc.format.mimetype application/pdf-
dc.format.mimetype application/pdf-
dc.format.mimetype application/pdf-
dc.language.iso en_US-
dc.source.uri (資料來源) http://thesis.lib.nccu.edu.tw/record/#G0093752004en_US
dc.subject (關鍵詞) 失眠zh_TW
dc.subject (關鍵詞) 情境性失眠zh_TW
dc.subject (關鍵詞) 壓力因應zh_TW
dc.subject (關鍵詞) 睡眠相關安全行為zh_TW
dc.subject (關鍵詞) insomniaen_US
dc.subject (關鍵詞) adjustment insomniaen_US
dc.subject (關鍵詞) copingen_US
dc.subject (關鍵詞) sleep related safety behaviorsen_US
dc.title (題名) 慢性失眠者與情境性失眠高危險族群之壓力因應與失眠的關係zh_TW
dc.title (題名) The Relationship of Coping and Insomnia in Chronic Insomniacs and Normal Sleepers Vulnerable to Stress-related Sleep Disturbanceen_US
dc.type (資料類型) thesisen
dc.relation.reference (參考文獻) 中文參考文獻zh_TW
dc.relation.reference (參考文獻) 行政院主計處（2001）。台灣地區社會發展趨勢調查統計結果，行政院。zh_TW
dc.relation.reference (參考文獻) 林一真（2000）。貝克焦慮量表中文版指導手冊。中國行為科學社。zh_TW
dc.relation.reference (參考文獻) 台灣睡眠醫學學會（2007）。九十六年國人睡眠品質調查報告。台灣睡眠醫學學會。zh_TW
dc.relation.reference (參考文獻) 孔繁鐘（1999）。精神疾病的診斷與統計。台北市：合計圖書出版社。zh_TW
dc.relation.reference (參考文獻) 邱皓政（2006）。結構方程模式：LISREL的理論、技術與應用。台北市：雙葉。zh_TW
dc.relation.reference (參考文獻) 健康心理學（蕭仁釗、林耀盛、鄭逸如譯）（1997）。臺北市：桂冠圖書。(原著出版年：1990/1994)zh_TW
dc.relation.reference (參考文獻) 社會研究的後設分析程序（齊力譯）（1999）。臺北市：弘智文化。(原著出版年：1984)zh_TW
dc.relation.reference (參考文獻) 邱兆宏（2004）。壓力與健康：整合分析與模式驗證之研究。高雄醫學大學行為科學研究所碩士班，未出版，高雄市。zh_TW
dc.relation.reference (參考文獻) 林彥妤（1988）。生活事件，因應方式及社會支援對老人心理適應之影響。國立台灣大學心理學研究所碩士論文，未出版，台北市。zh_TW
dc.relation.reference (參考文獻) 呂敏昌（1993）。國中學生的生活壓力、因應方式與心理社會幸福感之關係。私立中國文化大學兒童福利研究所碩士論文，未出版，台北市。zh_TW
dc.relation.reference (參考文獻) 陳綱華（1995）。心臟移植後患者的壓力源、因應行為及生活滿意度之關係。國防醫學院護理學研究所碩士論文，未出版，台北市。zh_TW
dc.relation.reference (參考文獻) 鄭幸宜（1998）。成人氣喘患者的壓力、因應策略與生活品質之關係。國立台灣大學醫學院護理學研究所碩士論文，未出版，台北市。zh_TW
dc.relation.reference (參考文獻) 何家齊（1998）。大學生的樂觀傾向、壓力因應方式與生活適應的相關研究。國立彰化師範大學特殊教育研究所碩士論文，未出版，彰化市。zh_TW
dc.relation.reference (參考文獻) 林詩維(2007)。失眠認知行為治療之療效與心理相關因素之改變。私立輔仁大學心理學系碩士論文，未出版，台北市。zh_TW
dc.relation.reference (參考文獻) 林正修（1996）某醫學中心家庭醫學科門診病患憂鬱症之盛行率與相關因素的探討。國立台灣大學公共衛生學系碩士論文，未出版，台北市。zh_TW
dc.relation.reference (參考文獻) 林美李 (2002)。台北市高中生憂鬱程度及其相關因素。國立台北護理學院護理研究所碩士論文，未出版，台北市。zh_TW
dc.relation.reference (參考文獻) 許文耀（2003）。資源流失、因應、社會支持與九二一地震災民的心理症狀之關係。中華心理學刊，45(3)，263-277。zh_TW
dc.relation.reference (參考文獻) 呂淑妤，林宗義(2000)南部社區老人憂鬱症狀盛行率及相關因素研究，中華公共衛生雜誌，19(1)，50-60。zh_TW
dc.relation.reference (參考文獻) 車先蕙、盧孟良、陳錫中、張尚文、李宇宙（2006）。中文版貝克焦慮量表之信效度。台灣醫學，10(4)，447-454。zh_TW
dc.relation.reference (參考文獻) 蘇東平（2000）。睡眠障礙之診斷分類及臨床評估。台灣醫學，4，665-672。zh_TW
dc.relation.reference (參考文獻) 陳荻卿、張景媛（2007）。知識信念影響學習運作模式之驗證。教育心理學報，29(1)，23-43。zh_TW
dc.relation.reference (參考文獻) 林詩淳、楊建銘、許世杰(2006年3月)。失眠嚴重度量表、睡前激發程度量表及睡眠失功能信念及態度量表中譯版之信效度研究。台灣睡眠醫學會壁報論文發表。台灣睡眠醫學學會第四屆研討會，台灣大學醫學院。zh_TW
dc.relation.reference (參考文獻) Referencezh_TW
dc.relation.reference (參考文獻) AASM. (2005). International Classification of Sleep Disorders (ICSD-2) (2nd edn ed.). Westchester, IL: AASM.zh_TW
dc.relation.reference (參考文獻) Aneshensel, C. S. (1999). Outcomes of the stress process. In A. V. Horwitz & T. L. Scheid (Eds.), A handbook for the study of mental health: Social contexts, theories and systems (pp. 211-227). Cambridge: UK: Cambridge University Press.zh_TW
dc.relation.reference (參考文獻) Bastien, C. H., Vallieres, A., & Morin, C. M. (2001). Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Medicine, 2(4), 297-307.zh_TW
dc.relation.reference (參考文獻) Bastien, C. H., Vallieres, A., & Morin, C. M. (2004). Precipitating factors of insomnia. Behavioral Sleep Medicine, 2(1), 50-62.zh_TW
dc.relation.reference (參考文獻) Billings, A. G., & Moos, R. H. (1981). The role of coping responses and social resources in attenuating the stress of life events. Journal of Behavioral Medicine, 4(2), 139-157.zh_TW
dc.relation.reference (參考文獻) Billings, A. G., & Moos, R. H. (1984). Coping, stress, and social resources among adults with unipolar depression. Journal of Personality and Social Psychology, 46(4), 877-891.zh_TW
dc.relation.reference (參考文獻) Bonnet, M. H., & Arand, D. L. (1997). Hyperarousal and insomnia. Sleep Medicine Reviews, 1(2), 97-108.zh_TW
dc.relation.reference (參考文獻) Borkovec, T. D. (1982). Insomnia. Journal of Consulting and Clinical Psychology, 50(6), 880-895.zh_TW
dc.relation.reference (參考文獻) Chou, C., Yang, C. M., & Chen, J. (2007). Dysfunctional sleep cognition and Vulnerability to stress related sleep disturbance. Sleep, 30 (suppl S), A380.zh_TW
dc.relation.reference (參考文獻) Clark, D. M., & Wells, A. (1995). A cognitive model of social phobia. In R. G. Heimberg, M. R. Liebowitz, D. A. Hope & F. R. Schneier (Eds.), Social phobia: Diagnosis, assessment, and treatment (Vol. 41-68). New York: Guilford Press.zh_TW
dc.relation.reference (參考文獻) Coren, S. (1988). Prediction of insomnia from arousability predisposition scores: scale development and cross-validation. Behaviour Research and Therapy, 26(5), 415-420.zh_TW
dc.relation.reference (參考文獻) Cosway, R., Endler, Norman S., Sadler Andrew J., & Deary, Ian J. . (2000). The Coping Inventory for Stressful Situations: Factorial Structure and Associations With Personality Traits and Psychological Health. Journal of Applied Biobehavioral Research, 5(2), 121-143.zh_TW
dc.relation.reference (參考文獻) Coyne, J. C., Aldwin, C., & Lazarus, R. S. (1981). Depression and coping in stressful episodes. Journal of Abnormal Psychology, 90(5), 439-447.zh_TW
dc.relation.reference (參考文獻) Drake, C., Richardson, G., Roehrs, T., Scofield, H., & Roth, T. (2004). Vulnerability to stress-related sleep disturbance and hyperarousal. Sleep, 27(2), 285-291.zh_TW
dc.relation.reference (參考文獻) Edinger, J. D., & Means, M. K. (2005). Cognitive-behavioral therapy for primary insomnia. Clinical Psychology Review, 25(5), 539-558.zh_TW
dc.relation.reference (參考文獻) Edinger, J. D., Stout, A. L., & Hoelscher, T. J. (1988). Cluster analysis of insomniacs` MMPI profiles: relation of subtypes to sleep history and treatment outcome. Psychosomatic Medicine, 50(1), 77-87.zh_TW
dc.relation.reference (參考文獻) Endler, N. S., & Parker, J. D. (1990). Multidimensional assessment of coping: a critical evaluation. Journal of Personality and Social Psychology, 58(5), 844-854.zh_TW
dc.relation.reference (參考文獻) Endler, N. S., & Parker, J. D. A. (1989). self-realization, success and adjustment. In Coping with frustrations to self-realization: Stress, anxiety, crises and adjustment (pp. 153-164). New York: Praeger.zh_TW
dc.relation.reference (參考文獻) Espie, C. A. (1991). The psychological treatment of insomnia: Chischester(UK): Wiley.zh_TW
dc.relation.reference (參考文獻) Espie, C. A., Inglis, S. J., Harvey, L., & Tessier, S. (2000). Insomniacs` attributions. psychometric properties of the Dysfunctional Beliefs and Attitudes about Sleep Scale and the Sleep Disturbance Questionnaire. Journal of Psychosomatic Research, 48(2), 141-148.zh_TW
dc.relation.reference (參考文獻) Folkman, S., & Moskowitz, J. T. (2004). Coping: pitfalls and promise. Annual Review of Psychology, 55, 745-774.zh_TW
dc.relation.reference (參考文獻) Freedman, R. R., & Sattler, H. L. (1982). Physiological and psychological factors in sleep-onset insomnia. Journal of Abnormal Psychology, 91(5), 380-389.zh_TW
dc.relation.reference (參考文獻) Gross, R. T., & Borkovec, T. D. (1982). Effects of a cognitive intrusion manipulation on the sleep-oneset latency of good sleepers. Behavior Therapy, 13, 112-116.zh_TW
dc.relation.reference (參考文獻) Harvey, A. G. (2002a). A cognitive model of insomnia. Behaviour Research and Therapy, 40(8), 869-893.zh_TW
dc.relation.reference (參考文獻) Harvey, A. G. (2002b). Identifying safety behaviors in insomnia. The Journal of Nervous and Mental Disease, 190(1), 16-21.zh_TW
dc.relation.reference (參考文獻) Harvey, A. G., Sharpley, A. L., Ree, M. J., Stinson, K., & Clark, D. M. (2007). An open trial of cognitive therapy for chronic insomnia. Behaviour Research and Therapy.zh_TW
dc.relation.reference (參考文獻) Holahan, C. J., & Moos, R. H. (1985). Life stress and health: personality, coping, and family support in stress resistance. Journal of Personality and Social Psychology, 49(3), 739-747.zh_TW
dc.relation.reference (參考文獻) Hu, L. T., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in convariance structural equation Analysis: Conventional Criteria Versus New Alternatives. Structural modeling, 6(1), 1-55.zh_TW
dc.relation.reference (參考文獻) Kales, A., Caldwell, A. B., Preston, T. A., Healey, S., & Kales, J. D. (1976). Personality patterns in insomnia. Theoretical implications. Archives of General Psychiatry, 33(9), 1128-1124.zh_TW
dc.relation.reference (參考文獻) Kales, A., Caldwell, A. B., Soldatos, C. R., Bixler, E. O., & Kales, J. D. (1983). Biopsychobehavioral correlates of insomnia. II. Pattern specificity and consistency with the Minnesota Multiphasic Personality Inventory. Psychosomatic Medicine, 45(4), 341-356.zh_TW
dc.relation.reference (參考文獻) Kuisk, L. A., Bertelson, A. D., & Walsh, J. K. (1989). Presleep cognitive hyperarousal and affect as factors in objective and subjective insomnia. Perceptual and Motor Skills, 69(3 Pt 2), 1219-1225.zh_TW
dc.relation.reference (參考文獻) Lavie, P., Carmeli, A., Mevorach, L., & Liberman, N. (1991). Sleeping under the threat of the Scud: war-related environmental insomnia. Israel Journal of Medical Sciences, 27(11-12), 681-686.zh_TW
dc.relation.reference (參考文獻) LeBlanc, M., Beaulieu-Bonneau, S., Merette, C., Savard, J., Ivers, H., & Morin, C. M. (2007). Psychological and health-related quality of life factors associated with insomnia in a population-based sample. Journal of Psychosomatic Research, 63(2), 157-166.zh_TW
dc.relation.reference (參考文獻) Lichstein, K. L., & Rosenthal, T. L. (1980). Insomniacs` perceptions of cognitive versus somatic determinants of sleep disturbance. Journal of Abnormal Psychology, 89(1), 105-107.zh_TW
dc.relation.reference (參考文獻) McCrae, R. R., & Costa, P. T. (1986). Personality, coping, and coping effectiveness in an adult sample. Journal of Personality, 54, 384-405.zh_TW
dc.relation.reference (參考文獻) Miller, S. M., Brody, D. S., & Summerton, J. (1988). Styles of coping with threat: implications for health. Journal of Personality and Social Psychology, 54(1), 142-148.zh_TW
dc.relation.reference (參考文獻) Monroe, L. J. (1967). Psychological and physiological differences between good and poor sleepers. Journal of Abnormal Psychology, 72(3), 255-264.zh_TW
dc.relation.reference (參考文獻) Monroe, L. J., & Marks, P. A. (1977). MMPI differences between adolescent poor and good sleepers. Journal of Consulting and Clinical Psychology, 45(1), 151-152.zh_TW
dc.relation.reference (參考文獻) Morin, C. M., & Espie, C. A. (1993). Insomnia: psychological assessment and management. New York: Kluwer Academic/ Plenum.zh_TW
dc.relation.reference (參考文獻) Morin, C. M., LeBlanc, M., Daley, M., Gregoire, J. P., & Merette, C. (2006). Epidemiology of insomnia: prevalence, self-help treatments, consultations, and determinants of help-seeking behaviors. Sleep Medicine, 7(2), 123-130.zh_TW
dc.relation.reference (參考文獻) Morin, C. M., Rodrigue, S., & Ivers, H. (2003). Role of stress, arousal, and coping skills in primary insomnia. Psychosomatic Medicine, 65(2), 259-267.zh_TW
dc.relation.reference (參考文獻) Morin, C. M., Stone, J., Trinkle, D., Mercer, J., & Remsberg, S. (1993). Dysfunctional beliefs and attitudes about sleep among older adults with and without insomnia complaints. Psychology and Aging, 8(3), 463-467.zh_TW
dc.relation.reference (參考文獻) Morin, C. M., Vallieres, A., & Ivers, H. (2007). Dysfunctional beliefs and attitudes about sleep (DBAS): validation of a brief version (DBAS-16). Sleep, 30(11), 1547-1554.zh_TW
dc.relation.reference (參考文獻) Nofzinger, E. A., Buysse, D. J., Germain, A., Price, J. C., Miewald, J. M., & Kupfer, D. J. (2004). Functional neuroimaging evidence for hyperarousal in insomnia. The American Journal of Psychiatry, 161(11), 2126-2128.zh_TW
dc.relation.reference (參考文獻) Nomura, K., Yamaoka, K., Nakao, M., & Yano, E. (2005). Impact of insomnia on individual health dissatisfaction in Japan, South Korea, and Taiwan. Sleep, 28(10), 1328-1332.zh_TW
dc.relation.reference (參考文獻) Ohayon, M. M. (2002). Epidemiology of insomnia: what we know and what we still need to learn. Sleep Medicine Reviews, 6(2), 97-111.zh_TW
dc.relation.reference (參考文獻) Pearlin, L. I., & Schooler, C. (1978). The structure of coping. Journal of Health and Social Behavior, 19(1), 2-21.zh_TW
dc.relation.reference (參考文獻) Perlis, M. L., Merica, H., Smith, M. T., & Giles, D. E. (2001). Beta EEG activity and insomnia. Sleep Medicine Reviews, 5(5), 363-374.zh_TW
dc.relation.reference (參考文獻) Radloff, L. S. (1977). The CES-D scale: a self-report depression scale for research in general population. Applied Psychological Measurement, 1, 385-401.zh_TW
dc.relation.reference (參考文獻) Ree, M. J., & Harvey, A. G. (2004). Investigating Safety Behaviours in Insomnia: The Development of the Sleep-related Behaviours Questionnaire (SRBQ). Behaviour Change, 21(1), 26-36.zh_TW
dc.relation.reference (參考文獻) Roehrs, T., Lineback, W., Zorick, F., & Roth, T. (1982). Relationship of psychopathology to insomnia in the elderly. Journal of the American Geriatrics Society 30, 312-315.zh_TW
dc.relation.reference (參考文獻) Sadeh, A., Keinan, G., & Daon, K. (2004). Effects of stress on sleep: the moderating role of coping style. Health Psychology, 23(5), 542-545.zh_TW
dc.relation.reference (參考文獻) Salkovskis, P. M. (1991). The importance of behaviour in the manitenance of anxiety and panic: A cognitive account. Behavioural Psychotherapy, 19, 6-19.zh_TW
dc.relation.reference (參考文獻) Schneider-Helmert, D. (1987). Twenty-four-hour sleep-wake function and personality patterns in chronic insomniacs and healthy controls. Sleep, 10(5), 452-462.zh_TW
dc.relation.reference (參考文獻) Semler, C. N., & Harvey, A. G. (2004). An investigation of monitoring for sleep-related threat in primary insomnia. Behaviour Research and Therapy, 42(12), 1403-1420.zh_TW
dc.relation.reference (參考文獻) Shealy, R. C., Lowe, J. D., & Ritzler, B. A. (1980). Sleep onset insomnia: personality characteristics and treatment outcome. Journal of Consulting and Clinical Psychology, 48(5), 659-661.zh_TW
dc.relation.reference (參考文獻) Spielman, A. J. (1986). Assessment of insomnia. Clinical Psychology Review, 6, 11-25.zh_TW
dc.relation.reference (參考文獻) Spielman, A. J., Caruso, L. S., & Glovinsky, P. B. (1987). A behavioral perspective on insomnia treatment. The Psychiatric Clinics of North America, 10(4), 541-553.zh_TW
dc.relation.reference (參考文獻) Spielman, A. J., & Glovinsky, P. B. (1991). The varied nature of insomnia. In Case studies in insomnia (In P. Hauri (ED.) ed., pp. 1-15). New York: Plenum Press.zh_TW
dc.relation.reference (參考文獻) Stepanski, E., Zorick, F., Roehrs, T., Young, D., & Roth, T. (1988). Daytime alertness in patients with chronic insomnia compared with asymptomatic control subjects. Sleep, 11(1), 54-60.zh_TW
dc.relation.reference (參考文獻) Stone, A. A., & Neale, J. M. (1984). New measure of daily coping: Development and preliminary results Journal of Personality and Social Psychology 46(4), 892-906.zh_TW
dc.relation.reference (參考文獻) Tsai, P. S., Wang, S. Y., Wang, M. Y., Su, C. T., Yang, T. T., Huang, C. J., et al. (2005). Psychometric evaluation of the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI) in primary insomnia and control subjects. Quality of Life Research, 14(8), 1943-1952.zh_TW
dc.relation.reference (參考文獻) Van Egeren, L., Haynes, S. N., Franzen, M., & Hamilton, J. (1983). Presleep cognitions and attributions in sleep-onset insomnia. Journal of Behavioral Medicine, 6(2), 217-232.zh_TW
dc.relation.reference (參考文獻) Vollrath, M., Wicki, W., & Angst, J. (1989). The Zurich study. VIII. Insomnia: association with depression, anxiety, somatic syndromes, and course of insomnia. European Archives of Psychiatry and Neurological Sciences, 239(2), 113-124.zh_TW
dc.relation.reference (參考文獻) Woodley, J., & Smith, S. (2006). Safety behaviors and dysfunctional beliefs about sleep: testing a cognitive model of the maintenance of insomnia. Journal of Psychosomatic Research, 60(6), 551-557.zh_TW
dc.relation.reference (參考文獻) Wright, H., Lack, L., Morin, C., & Edinger, J. (2000). Dysfunctional Beliefs and Attitudes about Sleep Questionnaire: preliminary factor analysis. Sleep, 23(Suppl 2), A381.zh_TW
dc.relation.reference (參考文獻) Yang, C. M., Spielman, A. J., & Glovinsky, P. (2006). Nonpharmacologic strategies in the management of insomnia. Psychiatr Clin North Am, 29(4), 895-919.zh_TW