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題名 美沙冬使用者抑制缺損初探
Inhibitory deficits of methadone users作者 郭綺苑
Kuo,Chi Yuan貢獻者 許文耀
郭綺苑
Kuo,Chi Yuan關鍵詞 美沙冬
注意力偏誤
彈性認知轉換
海洛因
抑制缺損
Go/No-Go
cognition flexibility
methadone
heroin
attentional bias
inhibitory deficits
Go/No-Go日期 2011 上傳時間 30-Oct-2012 11:45:53 (UTC+8) 摘要 本研究的主要目的在於探討美沙冬的使用者是否具有抑制控制能力缺損、對海洛因相關刺激是否具有注意力偏誤，以及是否有彈性認知轉換能力上的問題。研究使用的是Noel等人（2005,2007）發展出來的Go/No-Go作業，並使用海洛因圖片與中性圖片為作業刺激，分別測量受試者在作業中的反應正確率、反應遺漏數、反應犯錯數、平均反應時間、決定偏誤與區辨度，並且使用依賴嚴重度量表，以了解受試者對海洛因的依賴嚴重度與Go/No-Go作業各指標之間的相關。 美沙冬組樣本選取自八里療養院土城門診部之接受美沙冬治療者，共17人，經由網路招募之健康控制組十九人，受試者一共三十六人。共變數分析之結果顯示在Go/No-Go作業的正確率、遺漏數、區辨度和決定偏誤等指標上，發現組別與情境轉換之交互作用，顯示使用美沙冬之受試者具有彈性認知能力上的缺損，因此在有轉換的區段之中，無法快速地適應新的作答規則。此外，Go/No-Go作業結果未發現美沙冬使用者之抑制缺損與對海洛因相關圖片之注意力偏誤之現象。 依賴嚴重度與Go/No-Go作業的指標相關研究則發現，其依賴嚴重度越高，其在非轉換情境中對海洛圖片的犯錯數越低、決定偏誤越高，顯示美沙冬使用者似乎在沒有情境轉換的區段中，會將其注意力資源分配在海洛因圖片上，忽略非海洛因圖片，顯示其注意力較具選擇性。
The goal of this study is to explore the inhibitory deficits、attentional bias towards heroin-related cues and cognition flexibility of current methadone users. The Go/No-go task used here was previously developed by Noel et al. (2005, 2007). Heroin-related pictures and neural pictures were presented as targets or non-targets. Accuracy rate、omission、commission、average reaction time、decision bias(C) and discrimination (d’) were being measured individually. The relation between the severity of heroin dependence and task performance was also investigated.The 17 subjects in methadone group were currently methadone maintenance treatment patients from Bali psychiatric center, and the 19 control group subjects without a drug using history were recruited by internet advertisement. The covariance analysis revealed interactions of group and shift/non-shift condition on accuracy rate、omission、decision bias(C) and discrimination (d’), indicating a cognitive flexibility deficits in methadone users. They had difficulty adapting to new rules in shifting conditions. No inhibitory deficits or attentional bias were found so far in this study. The relation between heroin dependence and Go/No-go task performance revealed that the more dependent the methadone subjects were, the less commission errors they made, the higher decision bias score they got towards heroin pictures in non-shifting conditions. 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國立政治大學
心理學研究所
95752018
100資料來源 http://thesis.lib.nccu.edu.tw/record/#G0095752018 資料類型 thesis dc.contributor.advisor 許文耀 zh_TW dc.contributor.author (Authors) 郭綺苑 zh_TW dc.contributor.author (Authors) Kuo,Chi Yuan en_US dc.creator (作者) 郭綺苑 zh_TW dc.creator (作者) Kuo,Chi Yuan en_US dc.date (日期) 2011 en_US dc.date.accessioned 30-Oct-2012 11:45:53 (UTC+8) - dc.date.available 30-Oct-2012 11:45:53 (UTC+8) - dc.date.issued (上傳時間) 30-Oct-2012 11:45:53 (UTC+8) - dc.identifier (Other Identifiers) G0095752018 en_US dc.identifier.uri (URI) http://nccur.lib.nccu.edu.tw/handle/140.119/54794 - 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) 95752018 zh_TW dc.description (描述) 100 zh_TW dc.description.abstract (摘要) 本研究的主要目的在於探討美沙冬的使用者是否具有抑制控制能力缺損、對海洛因相關刺激是否具有注意力偏誤，以及是否有彈性認知轉換能力上的問題。研究使用的是Noel等人（2005,2007）發展出來的Go/No-Go作業，並使用海洛因圖片與中性圖片為作業刺激，分別測量受試者在作業中的反應正確率、反應遺漏數、反應犯錯數、平均反應時間、決定偏誤與區辨度，並且使用依賴嚴重度量表，以了解受試者對海洛因的依賴嚴重度與Go/No-Go作業各指標之間的相關。 美沙冬組樣本選取自八里療養院土城門診部之接受美沙冬治療者，共17人，經由網路招募之健康控制組十九人，受試者一共三十六人。共變數分析之結果顯示在Go/No-Go作業的正確率、遺漏數、區辨度和決定偏誤等指標上，發現組別與情境轉換之交互作用，顯示使用美沙冬之受試者具有彈性認知能力上的缺損，因此在有轉換的區段之中，無法快速地適應新的作答規則。此外，Go/No-Go作業結果未發現美沙冬使用者之抑制缺損與對海洛因相關圖片之注意力偏誤之現象。 依賴嚴重度與Go/No-Go作業的指標相關研究則發現，其依賴嚴重度越高，其在非轉換情境中對海洛圖片的犯錯數越低、決定偏誤越高，顯示美沙冬使用者似乎在沒有情境轉換的區段中，會將其注意力資源分配在海洛因圖片上，忽略非海洛因圖片，顯示其注意力較具選擇性。 zh_TW dc.description.abstract (摘要) The goal of this study is to explore the inhibitory deficits、attentional bias towards heroin-related cues and cognition flexibility of current methadone users. The Go/No-go task used here was previously developed by Noel et al. (2005, 2007). Heroin-related pictures and neural pictures were presented as targets or non-targets. Accuracy rate、omission、commission、average reaction time、decision bias(C) and discrimination (d’) were being measured individually. The relation between the severity of heroin dependence and task performance was also investigated.The 17 subjects in methadone group were currently methadone maintenance treatment patients from Bali psychiatric center, and the 19 control group subjects without a drug using history were recruited by internet advertisement. The covariance analysis revealed interactions of group and shift/non-shift condition on accuracy rate、omission、decision bias(C) and discrimination (d’), indicating a cognitive flexibility deficits in methadone users. They had difficulty adapting to new rules in shifting conditions. No inhibitory deficits or attentional bias were found so far in this study. The relation between heroin dependence and Go/No-go task performance revealed that the more dependent the methadone subjects were, the less commission errors they made, the higher decision bias score they got towards heroin pictures in non-shifting conditions. It seemed that the methadone users were prone to allocate more attention resource to heroin-related pictures in non-shifting conditions, suggesting a more selective attention process. en_US dc.description.tableofcontents 第一章 緒論………………………………………………………………… 1 第一節 研究背景與動機………………………………………………… 1第二章 文獻探討…………………………………………………………… 6 第一節 抑制缺損與物質使用疾患的關聯……………………………… 6 第二節 抑制缺損與成癮機制…………………………………………… 10 第三節 鴉片劑使用者的抑制缺相關研究……………………………… 18 第四節 Go/No-Go作業及其相關理論…………………………………… 23 第五節 研究目的………………………………………………………… 29 第六節 研究問題與假設………………………………………………… 31第三章 研究方法…………………………………………………………… 33 第一節 研究對象………………………………………………………… 33 第二節 實驗程序………………………………………………………… 36 第三節 研究工具………………………………………………………… 37第四章 研究結果…………………………………………………………… 41 第一節 受試者基本資料描述…………………………………………… 41 第二節 美沙冬組與控制組之神經心理作業表現比較………………… 45 第三節 Go/NoGo作業表現與其他臨床變項之相關…………………… 57第五章 綜合討論…………………………………………………………… 60 第一節 美沙冬使用者的控制抑制功能探討…………………………… 60 第二節 研究限制……………………………………………………… 65 第三節 未來研究方向…………………………………………………… 67參考文獻……………………………………………………………………… 69附件一 海洛因刺激圖片選取程序………………………………………… 76附件二 美沙冬組資本資料問卷與依賴嚴重度量表……………………… 78附件三 控制組基本資料問卷……………………………………………… 80附件四 依賴嚴重度量表、中文年級認字量表與瑞文氏標準圖形推理測驗之信效度……………………………………………………………………… 81附件五 Go/No-Go作業依變項計算方式…………………………………… 83 zh_TW dc.language.iso en_US - dc.source.uri (資料來源) http://thesis.lib.nccu.edu.tw/record/#G0095752018 en_US dc.subject (關鍵詞) 美沙冬 zh_TW dc.subject (關鍵詞) 注意力偏誤 zh_TW dc.subject (關鍵詞) 彈性認知轉換 zh_TW dc.subject (關鍵詞) 海洛因 zh_TW dc.subject (關鍵詞) 抑制缺損 zh_TW dc.subject (關鍵詞) Go/No-Go zh_TW dc.subject (關鍵詞) cognition flexibility en_US dc.subject (關鍵詞) methadone en_US dc.subject (關鍵詞) heroin en_US dc.subject (關鍵詞) attentional bias en_US dc.subject (關鍵詞) inhibitory deficits en_US dc.subject (關鍵詞) Go/No-Go en_US dc.title (題名) 美沙冬使用者抑制缺損初探 zh_TW dc.title (題名) Inhibitory deficits of methadone users en_US dc.type (資料類型) thesis en dc.relation.reference (參考文獻) 中文部份行政院衛生署管制藥品管理局（2011）。100年藥物濫用案件暨檢驗統計資料。台北市，行政院衛生署。行政院衛生署疾病管制局（2011）。替代治療月報。台北市，行政院衛生署。行政院衛生署疾病管制局（2008）。HIV/AIDS統計月報表。台北市，行政院衛生署。法務部（2011）。毒品案件摘要統計分析。台北市，法務部。美國疾病控制及預防中心（Centers for Disease Control and Prevention）及教育發展學院（Academy for Educational Development）www.cdc.gov/idu www.healthstrategies.org/pubs/pubications.htm 陳乃釧、楊延壽、李之徽。美沙冬替代療法。基層醫學，24(2)，61-65。陳光輝、林自強、諶立中(2007）。海洛因成癮者之美沙酮代替療法。台灣醫學， 11(3)。李思賢（2005）。藥癮再犯罪成因與心理治療介入的可行性：出監毒癮者之回溯性與前瞻性追蹤研究(一)。行政院衛生署管制藥品管理局科技研究發展計畫成果報告。 李思賢（2006）。藥癮再犯罪成因與心理治療介入的可行性：出監毒癮者之回溯性與前瞻性追蹤研究(二)。行政院衛生署管制藥品管理局科技研究發展計畫成果報告。 李思賢、王榮德、王博恩、王永衛、方啟泰、任全鈞、武維馨、陳耀謙、游錦雲、鄭保志、劉宜廉（2008）。台灣北部地區美沙冬替代療法實施背景、成效及成本效益：三年期追蹤研究（一）。行政院衛生署管制藥品管理局科技研究發展計畫成果報告。 李思賢（2009）。美沙冬替代療法的實施背景與現況。管制藥品簡訊，39。俞筱鈞（1994）。瑞文氏標準圖形推理測驗指導手冊。台北市：中國行為科學社。黃秀霜（2001）。中文年級認字量表：指導手冊。台北市：心理出版社。黃華妮（民99）。利用神經心理作業初探台灣地區海洛因戒治者之認知功能研究。國立政治大學心理系碩士論文。傅雅懌（民99）。海洛因藥癮者抑制歷程初探。國立中正大學臨床心理研究所碩士論文。英文部份American Psychiatric Association, 2000. 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