政大機構典藏-National Chengchi University Institutional Repository(NCCUR):Item 140.119/58970
English  |  正體中文  |  简体中文  |  Post-Print筆數 : 27 |  全文筆數/總筆數 : 113303/144284 (79%)
造訪人次 : 50828446      線上人數 : 903
RC Version 6.0 © Powered By DSPACE, MIT. Enhanced by NTU Library IR team.
搜尋範圍 查詢小技巧：
  • 您可在西文檢索詞彙前後加上"雙引號"，以獲取較精準的檢索結果
  • 若欲以作者姓名搜尋，建議至進階搜尋限定作者欄位，可獲得較完整資料
    •  進階搜尋
    政大機構典藏 > 理學院 > 心理學系 > 學位論文 >  Item 140.119/58970


    請使用永久網址來引用或連結此文件: https://nccur.lib.nccu.edu.tw/handle/140.119/58970


    題名: 以失眠的認知模型探討失眠患者每日睡眠與情緒狀態的關聯性
    The day-to-day association of sleep and mood state in insomnia patients：From the perspective of cognitive model of insomnia.
    作者: 陳琬渝
    Chen, Wan Yu
    貢獻者: 楊建銘
    Yang, Chien Ming
    陳琬渝
    Chen, Wan Yu
    關鍵詞: 失眠
    情緒狀態
    失眠的認知模型
    insomnia
    mood state
    cognitive model of insomnia
    日期: 2012
    上傳時間: 2013-07-22 17:16:51 (UTC+8)
    摘要: 研究背景與目的：在失眠患者上，除了夜間睡眠症狀外，白天功能缺損亦是常見
    的問題。過去研究較少去探討可能影響失眠患者產生白天功能缺損的相關因素，
    特別在情緒困擾此一面向上，研究更為缺乏。而根據 Harvey (2002)失眠的認知模型，假定失眠患者在早晨醒來時，思考的內容便會聚焦在睡眠困擾上，這些過度的負向認知活動會為失眠患者帶來高度激發的狀況，使得患者會在一整天當中不斷地自我監測睡不好所帶來的影響，而對於睡眠的不適應信念則會加劇負向認知活動，上述這些認知歷程的過度活動，可能為造成失眠患者白天功能缺損的相關因素，並為患者帶來痛苦的感受。因此本研究的目的為探討失眠患者其每日睡眠狀況對於隔天情緒狀態的影響，並以失眠的認知模型為框架，進一步澄清睡眠相關失功能信念及對睡眠相關訊息自我監測的傾向對於失眠患者其睡眠與情緒狀態間的關係的影響，以期有助於增加對失眠病理的瞭解。

    研究方法：本研究運用生態瞬間評估法，在每天的四個隨機時間點，請40名失眠受試者（10名男性、30名女性，平均年齡43歲）進行情緒狀態的評估，並即時的回覆評估結果，同時請受試者配戴活動記錄儀及填寫睡眠日誌，進行連續一週的睡眠狀態測量，此外並請受試者填寫睡眠相關失功能信念與睡眠相關監測指標等兩份問卷。研究結果以階層線性模式進行分析，階層一分析個人內的主客觀睡眠指標是否能預測隔天的情緒狀態，階層二則分析個人間的睡眠相關失功能信念及自我監測行為是否會調節夜間睡眠及白天情緒狀態間的關係。

    研究結果：本研究發現在失眠受試者上，其主客觀睡眠指標間有所不一致，多數
    的主觀睡眠指標可以預測隔天的正負向情緒，其中以主觀的總睡眠時數為最能預
    測失眠患者的負向情緒；在客觀睡眠指標上，僅有客觀總睡眠時間的增加，能預測隔天會有較少的負向情緒，而多數客觀睡眠指標則未能預測隔天的情緒狀態。
    另外，睡眠相關失功能信念以及睡眠相關監測行為並非扮演調節變項的角色，而
    是能顯著地預測失眠受試者的負向情緒。

    結論：相較於實際的睡眠狀況，失眠患者對於睡眠的主觀知覺，可能是影響失眠
    患者產生情緒困擾的相關因素，而失眠患者其實際睡眠量的減少，可能會有近似
    部份睡眠剝奪的效果，影響隔天的情緒；此外，在失眠患者上，當擁有更多對於
    睡眠的不當認知時，以及愈傾向去監測睡眠相關訊息時，失眠患者會在一天當中
    有較多的情緒困擾。因此，調整失眠患者對於睡眠的不當認知，以及減少患者在
    一天當中不斷自我監測睡眠相關訊息的行為，並在後續研究中探討影響失眠患者
    其主客觀睡眠指標有所不一致的因素，可望能減少失眠患者的白天情緒困擾，增
    加生活品質。
    OBJECTIVE：In addition to the nocturnal symptoms, daytime dysfunction is a common problem in insomnia patients. There are only limited number of studies to explore the factors that may influence daytime function in insomnia patients,
    particularly in mood disturbance. The Cognitive Model of Insomnia by Harvey (2004) suggests that the patients with insomnia tend to think about their sleep disturbance in
    the morning and throughout the day. These excessive negatively toned cognitive activity will enhance the patients’ level of arousal, and make them monitoring the
    impacts of sleep disturbances on daytime functioning throughout the day. The dysfunctional belief about sleep may further exacerbate the negatively toned cognitive activity. Such excessive daytime cognitive activities may be more the cause of their daytime dysfunction than their sleep disturbances, and may bring the distress of the patients. Therefore, the aim of this study is to explore the day-to-day association of sleep and mood state in insomnia patient, and to use the Cognitive Model of Insomnia as a framework to clarify the influence of dysfunctional beliefs and attitudes about sleep and the self-monitoring tendency of sleep-associated threat on the association between sleep and mood state, in order to further the understanding of pathological of insomnia.

    METHOD：Forty insomnia patients (10 male and 30 female, mean age 43) participated in the study. Their daytime emotion function were measured using the ecological momentary assessment, by asking them to rate their mood state and to
    submit the ratings immediately through text messages four times a day for a week. They were also asked to wear the actigraphy and to fill the sleep diary during the week. Moreover, participates were required to complete the Dysfunctional Beliefs and Attitude about Sleep Scale-16-item version and the Sleep-Associated Monitoring Index. Hieratical linear model was conducted for data analyses. Mood state ratings and subjective/objective sleep indicators were the variables for within-individual level analysis (level one), to examine whether the subjective/objective sleep indicators can predict the next day’s mood state; dysfunctional belief and self-monitoring of sleep-related threat included the variables for between individual level (level two), to examine whether these variables moderate the relationship of sleep and mood state.

    RESULT：The data showed inconsistency results between the subjective and objective sleep indicators. Most of the subjective sleep indicators can predict the next day’s
    mood state, particularly the amount of sleep time they subjectively experienced. On the other hand, only the total sleep time among the objective sleep indicators can predict negative mood the next day. Most objective sleep indicators failed to predict daytime emotion the next day`s. In addition, the dysfunctional beliefs about sleep and the self-monitoring tendency for sleep-related threat can significantly predicted the negative affect, but do not play a role as moderators for the relationship of sleep indicators and mood state.

    CONCLUSION：In patients with insomnia, the subjective experience rather than the objective measure of nighttime sleep is the major factor that determine their mood state the next day. The reduction of the actual amount of sleep may have negative impact on their mood through partial sleep deprivation. Also, when they have more dysfunctional beliefs about sleep, and the tendency for monitoring sleep-related threat, during the day, they may have more emotional disturbance during the day.The findings of the current study suggests that adjust the dysfunctional beliefs about
    sleep and reduce the tendency for monitoring the sleep-related threat, and explore the factors that may influence the inconsistent of objective and subjective sleep index in
    insomnia patients in subsequent studies, is expect to reduce emotional distress during the day, and increase the quality of life in insomnia patients
    參考文獻: 中文部份：

    林一真（2000）。貝克焦慮量表中文版指導手冊。台北市：中國行為科學社。
    李宇宙、曾美智、陳映燁、謝明憲、許森彥、李信謙等人（1999）。MINI 台灣版：台灣精神醫學會。
    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。
    陳心怡（2000）。貝克憂鬱量表第二版（BDI-II）中文版。台北市：中國行為科學社。
    陳昌偉、詹雅雯、楊建銘、林詩淳（2009）。中文版睡眠失功能信念及態度量表之信度探討。臨床心理學刊，4（1），59-67。
    溫福星、邱皓政（2009）。多層次模型方法論：階層線性模式的關鍵議題與試解。台大管理論叢，19（2），263-294。
    鄧閔鴻、張素凰（民 95）。廣泛性焦慮疾患與憂鬱疾患共病現象的階層病理模式。中華心理學刊，48（2），203-218。
    盧孟良、車先蕙、張尚文、沈武典（民 91）。中文版貝克憂鬱量表第二版之信度和效度。臺灣精神醫學，16（4），301-310。

    英文部份：

    Arroll, B., Fernando, A., 3rd, Falloon, K., Warman, G., & Goodyear-Smith, F. (2011). Development, validation (diagnostic accuracy) and audit of the Auckland Sleep Questionnaire: a new tool for diagnosing causes of sleep disorders in primary care. Journal of Primary Health Care, 3(2), 107-113.
    Bonnet, M. H., & Arand, D. L. (1995). 24-Hour metabolic rate in insomniacs and matched normal sleepers. Sleep, 18(7), 581-588.
    Berkman, E. T., Dickenson, J., Falk, E. B., & Lieberman, D. (2011). Using SMS text messaging to assess moderators of smoking reduction: Validating a new tool for ecological measurement of health behaviors. Health Psychology, 30(2),
    186-194.
    Bolge, S. C., Doan, J. F., Kannan, H., & Baran, R. W. (2009). Association of insomnia with quality of life, work productivity, and activity impairment. Quality of Life
    Research, 18(4), 415-422.
    Buysse, D. J., Thompson, W., Scott, J., Franzen, P. L., Germain, A., Hall, M., . . . Kupfer, D. J. (2007). Daytime symptoms in primary insomnia: a prospective analysis using ecological momentary assessment. Sleep Medicine, 8(3),
    198-208.
    Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.).Hillsdale, NJ: Lawrence Erlbaum.
    Chan, S. F., Chen, T. H., Liao, Y. M., Chou, K. R., & Tsai, P. S. (2011). Development and preliminary validation of the Chinese version of the Sleep-Associated Monitoring Index. International Journal of Nursing Studies.
    Carney, C. E., Edinger, J. D., Manber, R., Garson, C., & Segal, Z. V. (2007). Beliefs about sleep in disorders characterized by sleep and mood disturbance. Journal
    of Psychosomatic Research, 62(2), 179-188.
    Coates, T. J., Killen, J. D., George, J., Marchini, E., Silverman, S., & Thoresen, C.(1982). Estimating sleep parameters: A multitrait-multimethod analysis. Journal of Consulting and Clinical Psychology, 50(3), 345-352.
    Clark, L. A., & Watson, D. (1991). Tripartite model of anxiety and depression:psychometric evidence and taxonomic implications. Journal of Abnormal Psychology, 100(3), 316-336.
    Daley, M., Morin, C. M., LeBlanc, M., Gregoire, J. P., Savard, J., & Baillargeon, L.(2009). Insomnia and its relationship to health-care utilization, work absenteeism, productivity and accidents. Sleep Medicine, 10(4), 427-438.
    Dinges, D. F., Pack, F., Williams, K., Gillen, K. A., Powell, J. W., Ott, G. E., . . . Pack, A. I. (1997). Cumulative sleepiness, mood disturbance, and psychomotor
    vigilance performance decrements during a week of sleep restricted to 4-5 hours per night. Sleep, 20(4), 267-277.
    Edinger, J. D., Fins, A. I., Glenn, D. M., Sullivan, R. J., Jr., Bastian, L. A., Marsh, G.R., . . . Vasilas, D. (2000). Insomnia and the eye of the beholder: are there clinical markers of objective sleep disturbances among adults with and without insomnia complaints? Journal of Consulting and Clinical Psychology, 68(4), 586-593.
    Edinger, J. D., Means, M. K., Carney, C. E., & Krystal, A. D. (2008). Psychomotor performance deficits and their relation to prior nights` sleep among individuals with primary insomnia. Sleep, 31(5), 599-607.
    Ellis, J., Mitchell, K., & Hogh, H. (2007). Sleep preoccupation in poor sleepers:psychometric properties of the Sleep Preoccupation Scale. Journal of Psychosomatic Research, 63(6), 579-585.
    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.
    Eysenck, M. W., Derakshan, N., Santos, R., & Calvo, M. G. (2007). Anxiety and cognitive performance: attentional control theory. Emotion, 7(2), 336-353.
    Franzen, P. L., Siegle, G. J., & Buysse, D. J. (2008). Relationships between affect,vigilance, and sleepiness following sleep deprivation. Journal of Sleep Research, 17(1), 34-41.
    Harvey, A. G. (2002). A cognitive model of insomnia. Behaviour Research and Therapy , 40(8), 869-893.
    Hayes, S., Hirsch, C. R., & Mathews, A. (2010). Facilitating a benign attentional bias reduces negative thought intrusions. Journal of Abnormal Psychology, 119(1), 235-240.
    Hart, R. P., Morin, C. M., & Best, A. M. (2007). Neuropsychological performance in elderly insomnia patients. Aging, Neuropsychology, and Cognition, 2(4),268-278.
    Jansson-Fröjmark, M., Harvey, A. G., Norell-Clarke, A., & Linton, S. J.(2013).Associations between psychological factors and nighttime/daytime symptomatology in insomnia. Cognitive Behaviour Therapy, 41(4), 273-287.
    Koffel, E., & Watson, D. (2009). The two-factor structure of sleep complaints and its relation to depression and anxiety. Journal of Abnormal Psychology, 118(1), 183-194.
    Kyle, S. D., Morgan, K., Spiegelhalder, K., & Espie, C. A. (2011). No pain, no gain:an exploratory within-subjects mixed-methods evaluation of the patient experience of sleep restriction therapy (SRT) for insomnia. Sleep Medicine,
    12(8), 735-747.
    Littner, M., Kushida, C. A., Anderson, W. M., Bailey, D., Berry, R. B., Davila, D.G., . . . Johnson, S. F. (2003). Practice Parameters for the Role of Actigraphy in
    the Study of Sleep and Circadian Rhythms: An Update for 2002. Sleep, 26(3),337-341.
    Lichstein, K. L., Stone, K. C., Donaldson, J., Nau, S. D., Soeffing, J. P., Murray, D., . . . Aguillard, R. N. (2006). Actigraphy validation with insomnia. Sleep, 29(2), 232-239.
    Mathews, A. (1990). Why worry? The cognitive function of anxiety. Behavior Research and Therapy, 28(6), 455-468.
    Mai, E., & Buysse, D. J. (2008). Insomnia: Prevalence, Impact, Pathogenesis, Differential Diagnosis, and Evaluation. Sleep Medicine Clinics, 3(2), 167-174.
    Murray, G., Allen , N. B., & Trinder, J. (2002). Mood and the circadian system: investigation of a circadian component in positive affect. Chronobiology International, 19(6), 1151-1169.
    Montserrat Sanchez-Ortuno, M., & Edinger, J. D. (2009). A penny for your thoughts:Patterns of sleep-related beliefs, insomnia symptoms and treatment outcome. Behaviour Research and Therapy, 48, 125-133.
    Means, M. K., Edinger, J. D., Glenn, D. M., & Fins, A. I. (2003). Accuracy of sleep perceptions among insomnia sufferers and normal sleepers. Sleep Medicine,4(4), 285-296.
    Morin, C. M., LeBlanc, M., Belanger, L., Ivers, H., Merette, C., & Savard, J. (2011).Prevalence of insomnia and its treatment in Canada. Canadian Journal of Psychiatry, 56(9), 540-548.
    McCrae, C. S., McNamara, J. P., Rowe, M. A., Dzierzewski, J. M., Dirk, J., Marsiske, M., & Craggs, J. G. (2008). Sleep and affect in older adults: using multilevel modeling to examine daily associations. Journal of Sleep Research, 17(1),42-53.
    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.
    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., & Hong, S. C. (2002). Prevalence of insomnia and associated factors in South Korea. Journal of Psychosomatic Research, 53(1), 593-600.
    Riedel, B. W., & Lichstein, K. L. (2000). Insomnia and daytime functioning. Sleep Medicine Reviews, 4(3), 277-298.
    Semler, C. N., & Harvey, A. G. (2004a). An investigation of monitoring for sleep-related threat in primary insomnia. Behaviour Research and Therapy, 42(12), 1403-1420.
    Semler, C. N., & Harvey, A. G. (2004b). Monitoring for sleep-related threat: a pilot study of the Sleep Associated Monitoring Index (SAMI). Psychosomatic Medicine, 66(2), 242-250.
    Semler, C. N., & Harvey, A. G. (2006). Daytime functioning in primary insomnia:does attentional focus contribute to real or perceived impairment? Behavioral Sleep Medicine, 4(2), 85-103.
    Shekleton, J. A., Rogers, N. L., & Rajaratnam, S. M. (2010). Searching for the daytime impairments of primary insomnia. Sleep Medicine Reviews, 14(1),47-60.
    Stepanski, E., Koshorek, G., Zorick, F., Glinn, M., Roehrs, T., & Roth, T. (1989). Characteristics of individuals who do or do not seek treatment for chronic insomnia. Psychosomatics, 30(4), 421-427.
    Steptoe, A., O`Donnell, K., Marmot, M., & Wardle, J. (2008). Positive affect, psychological well-being, and good sleep. Journal of Psychosomatic Research, 64(4), 409-415. Shiffman, S., Stone, A. A., & Hufford, M. R. (2008). Ecological Momentary Assessment. Annual Review of Clinical Psychology, 4, 1-32.
    Vallieres, A., & Morin, C. M. (2003). Actigraphy in the assessment of insomnia. Sleep, 26(7), 902-906.
    Van Dongen, H. P., Maislin, G., Mullington, J. M., & Dinges, D. F. (2003). The cumulative cost of additional wakefulness: dose-response effects on neurobehavioral functions and sleep physiology from chronic sleep restriction and total sleep deprivation. Sleep, 26(2), 117-126.
    Varkevisser, M., Van Dongen, H. P., & Kerkhof, G. A. (2005). Physiologic indexes in chronic insomnia during a constant routine: evidence for general hyperarousal? Sleep, 28(12), 1588-1596.
    Varkevisser, M., Van Dongen, H. P., Van Amsterdam, J. G., & Kerkhof, G. A. (2007). Chronic insomnia and daytime functioning: an ambulatory assessment. Behavioral Sleep Medicine, 5(4), 279-296.
    Walker, M. P. (2009). The role of sleep in cognition and emotion. Annals of the New York Academy of Sciences, 1156, 168-197.
    Watson, D., & Clark, L. A. (1984). Negative Affectivity: The disposition to experience aversive emotional states. Psychological Bulletin, 96,465-490.
    Watson, D., Clark, L. A., & Tellegen, A.(1988). Development and validation of brief measures of positive and negative affect: the PANAS scales. Journal of Personality and Social Psychology, 54(6), 1063-1070.
    Yoo, S. S., Gujar, N., Hu, P., Jolesz, F. A., & Walker, M. P. (2007). The human emotional brain without sleep--a prefrontal amygdala disconnect. Current Biology, 17(20), R877-878.
    描述: 碩士
    國立政治大學
    心理學研究所
    97752017
    101
    資料來源: http://thesis.lib.nccu.edu.tw/record/#G0097752017
    資料類型: thesis
    顯示於類別:[心理學系] 學位論文

    文件中的檔案:

    檔案 大小格式瀏覽次數
    201701.pdf1427KbAdobe PDF21166檢視/開啟


    在政大典藏中所有的資料項目都受到原著作權保護.


    社群 sharing

    著作權政策宣告 Copyright Announcement
    1.本網站之數位內容為國立政治大學所收錄之機構典藏，無償提供學術研究與公眾教育等公益性使用，惟仍請適度，合理使用本網站之內容，以尊重著作權人之權益。商業上之利用，則請先取得著作權人之授權。
    The digital content of this website is part of National Chengchi University Institutional Repository. It provides free access to academic research and public education for non-commercial use. Please utilize it in a proper and reasonable manner and respect the rights of copyright owners. For commercial use, please obtain authorization from the copyright owner in advance.

    2.本網站之製作，已盡力防止侵害著作權人之權益，如仍發現本網站之數位內容有侵害著作權人權益情事者，請權利人通知本網站維護人員(nccur@nccu.edu.tw)，維護人員將立即採取移除該數位著作等補救措施。
    NCCU Institutional Repository is made to protect the interests of copyright owners. If you believe that any material on the website infringes copyright, please contact our staff(nccur@nccu.edu.tw). We will remove the work from the repository and investigate your claim.
    DSpace Software Copyright © 2002-2004  MIT &  Hewlett-Packard  /   Enhanced by   NTU Library IR team Copyright ©   - 回饋