政大機構典藏-National Chengchi University Institutional Repository(NCCUR):Item 140.119/117435

政大典藏 > College of Social Science > Graduate Institute of Social Administration and Social Work > Theses > Item 140.119/117435

Please use this identifier to cite or link to this item: https://nccur.lib.nccu.edu.tw/handle/140.119/117435

Title:	青少年時期發病之躁鬱症患者的主觀經驗回溯 People with adolescence-onset bipolar disorder: Personal stories in retrospect
Authors:	邱思語 Chiu, Ssu Yu
Contributors:	楊佩榮 Yang, Pei Jung 邱思語 Chiu, Ssu Yu
Keywords:	躁鬱症青少年主觀經驗汙名詮釋現象學 Adolescents with bipolar disorder Personal stories Stigma Hermeneutic phenomenology
Date:	2018
Issue Date:	2018-06-01 15:53:27 (UTC+8)
Abstract:	現今的社會對於躁鬱症認識有限，躁鬱症患者的經驗仍然不被重視，甚至遭受到負面的偏見與責難。青少年時期正處於生理心理社會蓬勃發展的階段，若是遭逢躁鬱症初次發病，很可能會影響到青少年時期各面向的發展進程。本研究運用詮釋現象學研究方法，深度訪談三位從青少年時期發病並且已進入成人早期的躁鬱症患者，透過他們主觀地回溯過往的經驗，看見他們在青春期發病以來在日常生活、人際互動上的經驗，並且探究在青春期遭遇躁鬱症發病，將會對他們的發展帶來什麼樣的衝擊和影響，他們在適應的過程中又是如何看待這段生病的經歷。最後，從受訪者的角度出發，給予實際的建議幫助他人可以適切地與正經歷躁鬱症的青少年相處。研究發現，三位受訪者在青少年階段發病都經歷到生理心理社會層面的衝擊與轉變，尤其面臨到兩大方面的困擾，第一方面的困擾是疾病本身的生理症狀、藥物副作用帶來的失能狀態，影響到他們日常生活的運作和人際關係的品質。第二方面的困擾來自於大環境的價值觀和結構，包括社會普遍對於躁鬱症經驗缺乏認知而帶來的社會汙名，以及社會制度的缺失帶來的結構性汙名，進而使得他們內化這些汙名而形成自我汙名的感受。然而，三位受訪者在與躁鬱症和環境抗衡的過程中，都透過思索生病意義和重新塑造自己，找到與躁鬱症的共存之道。 In today’s society, there is limited understanding of bipolar disorder (BD). The life experience of BD patients is not yet being fully heard and understood. Furthermore, some even face accusation and negative bias in their surroundings. Adolescence is a period in life when young people flourish socially, physiologically and psychologically. Adolescence-onset BD might affect the progress of their development in various aspects. This thesis used the method of hermeneutic phenomenology. In-depth interviews were conducted with three young adults with adolescence-onset BD. The interviewees described their personal experience with BD during their adolescent years. The significance of such retrospection is as follows: 1) understanding of their daily and social experience since the onset of BD in adolescence; 2) understanding of the effects of adolescence-onset BD on their development; 3) understanding of their views being a patient and the way they adapted to BD; and 4) from their standpoints, proposing recommendations for practice on ways to appropriately interact with adolescents experiencing BD. This investigation discovered that the three interviewees, since the onset of BD in their adolescence, had encountered changes and challenges in social, physiological and psychological aspects. There were two types of difficulties in particular. First, physiological symptoms of BD and side-effects of medication disempowered them, and adversely affected their daily functioning and quality of social life. Second, the difficulty they experienced traced back to the values and institutions of society as a whole. For instance, social and structural stigma, originating from a lack of understanding of BD and deficiencies in the social institutions, led to internalization of social stigma. While wrestling with BD and the social world, the three interviewees had managed to reflect on the meaning of being ill, reframed their perspective of lives and found ways to live with BD.
Reference:	壹、中文部分丁凡譯（2006）。躁鬱症完全手冊（原作者：E.F. Torrey & M.B. Knable）。臺北：心靈工坊。（原著出版年：2002）丁凡譯（2010）。是躁鬱，不是叛逆：青少年躁鬱症完全手冊（原作者：D.J. Miklowitz & E.L. George）。臺北：心靈工坊。（原著出版年：2008）人權公約施行監督聯盟（2017月8月20日）。什麼是障礙？誰是障礙者？上篇。人權公約施行監督聯盟【CRPD星期天】專欄。2018年2月15日，取自：http://covenantswatch.org.tw /crpd/crpd-sunday/ 王仕圖、吳慧敏（2003）。深度訪談與案例演練。載於齊力、林本炫（主編），質性研究方法與資料分析（頁95-113）。嘉義：南華大學社會教育學研究所。王育瑜、謝儒賢（2015）。需求評估的假象，社會控制的事實：身心障礙鑑定評估新制的批判。社區發展季刊，150，頁123-133。王國羽（2015年1月23日）。臺灣障礙者的需求是什麼？從ICF談起。巷口仔社會學。2018年2月15日，取自： www.lea-test.fi/en/assessme/imp_vis/images/ big/2.jpg 包凡一、王湲譯（1992）。人類本性與社會秩序（原作者：C. H. Cooley）。臺北：桂冠。（原著出版年：1902）周月清、張恆豪、李慶真、詹穆彥（2015）。聯合國國際衛生組織ICF緣起與精神：文獻檢視。社區發展季刊，150，頁17-39。周月清、張恆豪（2017）。新制身心障礙鑑定與需求評估（ICF）執行之探討：身心障礙服務使用者觀點。東吳社會工作學報，32，頁1-34。周祝瑛、劉豫敏、胡祝惠（2013）。兩岸大學生交流之回顧：1992-2012。教育資料與研究，110，113-151。林哲立、邱曉君、顏菲麗譯（2007）。人類行為與社會環境（二版）（原作者：B.J. Ashford, C.W. LeCroy, & K.L. Lortie）。臺北：雙葉。（原著出版年：2001）林憲（1994）。精神醫學史。臺北：水牛。胡幼慧、姚美華（2008）。一些質性方法上的思考：信度與效度？如何抽樣？如何收集資料、登錄與分析。載於胡幼慧（主編），質性研究：理論、方法及本土女性研究實例（二版）（117-132頁）。臺北：巨流。胡榮、王小章譯（1995）。心靈、自我與社會（原作者：G. H. Mead）。臺北：桂冠。（原著出版年：1934）高淑清（2008a）。質性研究的18堂課：首航初探之旅。高雄：麗文。高淑清（2008b）。質性研究的18堂課：揚帆再訪之旅。高雄：麗文。孫淑強、金筑雲譯（1994）。癲狂與文明─理性時代的精神病史（原作者：M. Foucault）。臺北：淑馨。（原著出版年：1961）陳向明（2002）。社會科學質的研究。臺北：五南。陳毓文（2000）。他們想說什麼？─青少年自傷行為之初探。社會政策與社會工作學刊，2，頁127-178。畢恆達（1998）。社會研究的研究者與倫理。載於嚴祥鸞（主編），危險與秘密─研究倫理（31-91頁）。臺北：三民。畢恆達（2008）。詮釋學與質性研究。載於胡幼慧（主編），質性研究：理論、方法及本土女性研究實例（二版）（21-36頁）。臺北：巨流。張葦譯（2003）。不要叫我瘋子：還給精神障礙者人權（原作者：P. Corrigan & R. Lundin）。臺北：心靈工坊。（原著出版年：2001）喬潔瓊（2017）。從繪畫團體到展覽行動：精神障礙者的主體經驗（未出版之碩士論文）。政治大學社會工作研究所，臺北。曾凡慈譯（2010）。汙名（原作者：E. Goffman）。臺北：群學。（原著出版年：1963）黃雅雪（2007）。躁鬱症主要照顧者因照顧患者所引發需要之探討（未出版之碩士論文）。亞洲大學健康管理研究所，臺中。黃德祥（2000）。青少年發展與輔導（二版）。臺北：五南。廖小雯、程景琳（2011）。成年初顯期的自我認同狀態、自我定義記憶之解釋歷程與心理幸福感之關係探討。應用心理研究，51，79-110 潘淑滿（2003）。質性研究：理論與應用。臺北：心理。潘德榮（1999）。詮釋學導論。臺北：五南。蔡鎮戎（2008）。從「洪大俠」事件看社會大眾對精神病友的迷思。社區發展季刊，121，291-302。鄭諺鴻（2012年10月21日）。破除污名─精障族首度上街。台灣立報。2018年3月9日，取自：https://tw.news.yahoo.com/破除污名-精障族首度上街-142353693.html 衛生福利部（2017年11月22日）。身心障礙者權利公約初次國家報告國際審查會議結論性意見。2018年3月10日，取自：https://crpd.sfaa.gov.tw/BulletinCtrl?func=getBulletin&p=b_2&c=A&bulletinId=161 蘇峰山（2010）。障礙與多元文化公民身分。南臺灣社區發展學術研討會。屏東科技大學。頁499-513。貳、英文部分 American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5. Arlington, VA: American Psychiatric Association. Bearden, C.E., Soares, J.C., Klunder, A.D., Nicoletti, M., Dierschke, N., Hayashi, K.M., Narr, K.L., Brambilla, P., Sassi, R.B., Axelson, D., Ryan, N., Birmaher, B., & Thompson, P.M. (2008). Three-dimensional mapping of hippocampal anatomy in adolescents with bipolar disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 47(5), 515-525. Bih, S.H., Chien, I.C., Chou, Y.J., Lin, C.H., Lee, C.H., & Chou, P. (2008). The treated prevalence and incidence of bipolar disorder among national health insurance enrollees in Taiwan, 1996–2003. Social Psychiatry and Psychiatric Epidemiology, 43(11), 860-865. Bitter, S.M., Mills, N.P., Adler, C.M., Strakowski, S.M., & DelBello, M.P. (2011). Progression of amygdala volumetric abnormalities in adolescents after their first manic episode. Journal of the American Academy of Child and Adolescent Psychiatry, 50(10), 1017-1026. Bonnington, O., & Rose, D. (2014). Exploring stigmatisation among people diagnosed with either bipolar disorder or borderline personality disorder: A critical realist analysis. Social Science & Medicine, 123, 7-17. Brohan, E., Elgie, R., Sartorius, N., & Thornicroft, G. (2010). Self-stigma, empowerment and perceived discrimination among people with schizophrenia in 14 European countries: The GAMIAN-Europe study. Schizophrenia Research, 122(1-3), 232-238. Brohan, E., Gauci, D., Sartorius, N., Thornicroft, G., & For the GAMIAN–Europe Study Group (2011). Self-stigma, empowerment and perceived discrimination among people with bipolar disorder or depression in 13 European countries: The GAMIAN–Europe study. Journal of Affective Disorders, 129(1-3), 56-63. Cerit, C., Filizer, A., Tural, Ü., & Tufan, A.E. (2012). Stigma: a core factor on predicting functionality in bipolar disorder. Comprehensive Psychiatry, 53(5), 484-489. Corrigan, P.W., & Penn, D.L. (1999). Lessons from social psychology on discrediting psychiatric stigma. American Psychologist, 54(9), 765-776. Corrigan, P.W. (2000). Mental health stigma as social attribution: implications for research methods and attitude change. Clinical Psychology: Science and Practice, 7, 48-67. Corrigan, P.W., & Watson, A.C. (2002). Understanding the impact of stigma on people with mental illness. World Psychiatry, 1, 16-20. Corrigan, P.W., Kerr, A., & Knudsen, L. (2005). The stigma of mental illness: explanatory models and methods for change. Applied and Preventive Psychology, 11(3), 179-190. Corrigan, P.W., Rafacz, J., & Rüsch, N. (2011). Examining a progressive model of self-stigma and its impact on people with serious mental illness. Psychiatry Research, 189(3), 339-343. Durand-Zaleski, I., Scott, J., Rouillon, F., & Leboyer, M. (2012). A first national survey of knowledge, attitudes and behaviours towards schizophrenia, bipolar disorders and autism in France. BMC Psychiatry, 12, 128. Ellis, A.J., Portnoff, L.C., Axelson, D.A., Kowatch, R.A., Walshaw, P., & Miklowitz, D.J. (2014). Parental expressed emotion and suicidal ideation in adolescents with bipolar disorder. Psychiatry Research, 216(2), 213-216. Ellison, N., Mason, O., & Scior, K. (2015). Public beliefs about and attitudes towards bipolar disorder: testing theory based models of stigma. Journal of Affective Disorders, 175, 116-123. Fagiolini, A., Forgione, R., Maccari, M., Cuomo, A., Morana, B., Dell’Osso M.C., Pellegrini, F., & Rossi, A. (2013). Prevalence, chronicity, burden and borders of bipolar disorder. Journal of Affective Disorders, 148(2-3), 161-169. Fredman, S.J., Baucom, D.H., Boeding, S.E., & Miklowitz, D.J. (2015). Relatives’ emotional involvement moderates the effects of family therapy for bipolar disorder. Journal of Consulting and Clinical Psychology, 83(1), 81-91. Garrett, A., & Chang, K. (2008). The role of the amygdala in bipolar disorder development. Development and Psychopathology, 20(4), 1285-1296. Harter, S. (2012). The construction of the self(2nd ed). New York: Guilford. Hartman, L.I., Michel, N.M., Winter, A., Young, R.E., Flett, G.L., & Goldberg, J.O. (2013). Self-stigma of mental illness in high school youth. Canadian Journal of School Psychology, 28(1), 28-42. Hawke, L.D., Parikh, S.V., & Michalak, E.E. (2015). Stigma and bipolar disorder: A review of the literature. Journal of Affective Disorders, 150(2), 181-191. Keenan-Miller, D., & Miklowitz, D.J. (2011).Interpersonal functioning in pediatric bipolar disorder. Clinical Psychology-Science and Practice, 18(4), 342-356. Konradi, C., Zimmerman, E.I., Yang, C.K., Lohmann, K.M., Gresch, P., Pantazopoulos, H., Berretta, S., & Heckers, S. (2011). Hippocampal interneurons in bipolar disorder. Archives of General Psychiatry, 68(4), 340-350. Lan, W.H., Bai, Y.M., Hsu, J.W., Huang, K.L., Su, T.P., Li, C.T., Yang, A.C., Tsai, S.J., & Chen, M.H. (2015). Comorbidity of ADHD and suicide attempts among adolescents and young adults with bipolar disorder: A nationwide longitudinal study. Journal of Affective Disorders, 176, 171-175. Latalova, K., Ociskova, M., Prasko, J., Kamaradova, D., Jelenova, D., & Sedlackova, Z. (2013). Self-stigmatization in patients with bipolar disorder. Neuroendocrinology Letters, 34(4), 265-272. Lee, J., Altshuler, L., Glahn, D.C., Miklowitz, D.J., Ochsner, K. & Green, M.F. (2013). Social and nonsocial cognition in bipolar disorder and schizophrenia: relative levels of impairment. American Journal of Psychiatry, 170(3), 334-341. Lee, W.H., & Chang S.S. (2009). Monitoring the seizure efficacy during electroconvulsive therapy. Taiwanese Journal of Psychiatry, 23(1), 4-13. Li, S.H., & Ho, C.Y. (2009). Contact Theory and Social Distance in Schizophrenia.Taiwanese Journal of Psychiatry, 23(3), 223-229. Masi, G., Mucci, M., Pfanner, C., Berloffa, S., Magazu, A., & Perugi, G. (2012). Developmental pathways for different subtypes of early-onset bipolarity in youths. Journal of Clinical Psychiatry, 73(10), 1335-1341. Miklowitz, D.J. (2006). A review of evidence-based psychosocial interventions for bipolar disorder. Journal of Clinical Psychiatry, 67, 28-33. Miklowitz, D.J., & Johnson, S.L. (2006). The psychopathology and treatment of bipolar disorder. Annual Review of Clinical Psychology, 2, 199-235. Miklowitz, D.J. (2007). The role of the family in the course and treatment of bipolar disorder. Current Directions in Psychological Science, 16(4), 192-196. Perlis, R.H., Miyahara, S., Marangell, L.B., Wisniewski, S.R., Ostacher, M., DelBello, M.P., Bowden, C.L., Sachs, G.S., & Nierenberg, A.A. (2004). Long-term implications of early onset in bipolar disorder: data from the first 1000 participants in the systematic treatment enhancement program for bipolar disorder (STEP-BD). Biological Psychiatry, 55(9), 875-881. Rosso, I.M., Killgore,W.D.S., Cintron, C.M., Gruber, S.A., Tohen, M., & Yurgelun-Todd, D.A. (2007). Reduced amygdala volumes in first-episode bipolar disorder and correlation with cerebral white matter. Biological Psychiatry, 61(6), 743-749. Sala, R., Axelson, D.A., Castro-Fornieles, J., Goldstein, T.R., Ha, W., Liao, F.Z., Gill, M.K., Iyengar, S., Strober, M.A., Goldstein, B.I., Yen, S., Hower, H., Hunt, J., Ryan, N.D., Dickstein, D., Keller, M.B., & Birmaher, B. (2010). Comorbid anxiety in children and adolescents with bipolar spectrum disorders: prevalence and clinical correlates. Journal of Clinical Psychiatry, 71(10), 1344-1350. Sameroff, A. (2010). A unified theory of development: a dialectic integration of nature and nurture. Child Development, 81(1), 6-22. Schenkel, L.S., Chamberlain, T.F., & Towne, T.L. (2014). Impaired theory of mind and psychosocial functioning among pediatric patients with type I versus type II bipolar disorder. Psychiatry Research, 215(3), 740-746. Sullivan, A.E., & Miklowitz, D.J. (2010). Family Functioning Among Adolescents With Bipolar Disorder. Journal of Family Psychology, 24(1), 60-67. Sullivan, A.E., Judd, C.M., Axelson, D.A., & Miklowitz, D.J. (2012). Family functioning and the course of adolescent bipolar disorder. Behavior Therapy, 43(4), 837-847. Vargas-Huicochea, I., Huicochea, L., Berlanga, C., & Fresan, A. (2014). Taking or not taking medications: psychiatric treatment perceptions in patients diagnosed with bipolar disorder. Journal of Clinical Pharmacy and Therapeutics, 39(6), 673-679. Vázquez, G.H., Kapczinski, F., Magalhaes, P.V., Córdoba, R., Lopez Jaramillo, C., Rosa, A.R., & The Ibero-American Network on Bipolar Disorders (IAN-BD) group (2011). Stigma and functioning in patients with bipolar disorder. Journal of Affective Disorders, 130(1-2), 323-327. Wolkenstein, L., & Meyer, T.D. (2009). What factors influence attitudes towards people with current depression and current mania? International Journal of Social Psychiatry, 55, 124-140.
Description:	碩士國立政治大學社會工作研究所 101264014
Source URI:	http://thesis.lib.nccu.edu.tw/record/#G1012640141
Data Type:	thesis
Appears in Collections:	[Graduate Institute of Social Administration and Social Work] Theses

Files in This Item:

File	Size	Format
014101.pdf	2728Kb	Adobe PDF2	143	View/Open

社群 sharing

Loading...