本研究假設工作記憶訓練能夠提升慢性思覺失調症病人情緒處理的相關認知功能，進而改善負性症狀之喜樂不能。40位符合美國精神醫學會診斷統計手冊（DSM-IV-TR）診斷標準之精神分裂症（亦符合美國精神醫學會診斷統計手冊第五版診斷標準之思覺失調症）男性患者，年齡介於25-65歲之間，經設計分為21位為實驗組，19位為對照組，實驗組接受為期八周的工作記憶訓練，對照組則否，兩組皆於前後測接受基本認知功能、工作記憶測驗，並填寫社會性喜樂不能量表，觀看國際情緒圖片系統引發事件相關電位之晚期正向慢波，之後填寫情緒自評量表。研究結果發現：1. 實驗組與對照組於後測其工作記憶表現呈現顯著差異。2. 實驗組前後測比較，接受正向圖片刺激之LPP振幅明顯變小，而對照組則是接受負向圖片刺激之LPP振幅明顯變小。3. 實驗組接受負向圖片刺激後之情緒向度結果，前後測呈現顯著差異，從非常不愉快提升至有點不愉快。基於上述研究結果，發現工作記憶訓練能夠提升慢性思覺失調症病人的情緒處理表現，對情緒刺激能夠進行一定程度的調節，從而達到穩定情緒，然而對於工作記憶功能與情緒調節系統之相互影響仍需其他研究進一步探討。

This study hypothesized that working memory training can enhance the cognitive function about emotion processing and improve anhedonia of patients with chronic schizophrenia. Forty male patients of Han Chinese ethnicity with schizophrenia, aged 25-65, and diagnosed according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition （DSM-IV） participated in the present study. The study adopted the match group design. The twenty-one subjects were assigned to the experiment group and received an eight-week of the working memory computerized training by the modules of the CogniPlus system. The nineteen subjects were assigned to the control group and did not receive the same training. All subjects received twice same assessments. These included the Mini Mental Status Examination （MMSE）, Working Memory Index （WMI） of WAIS-III, Revised Social Anhedonia Scale （RSAS）, subjective rating to pictures of the International affective picture system （IAPS） by the Self-Assessment Manikin （SAM） and Late Positive Potentials （LPP） of event-related potentials at 1st week and 9th week. This study found that a computerized working memory training can improve working memory of patients with schizophrenia on the behavioral level. Second, we found that there was a significant decrease in the amplitude of the positive visual stimulus between pretest and post-test for the experimental group, but there was a substantial decrease in the amplitude of the negative visual stimulus between pretest and post-test for the control group. Third, we found that there was a considerable increase in the pleasure score of SAM of negative pictures between pretest and post-test for the experimental group. Based on the above findings, working memory training can improve the performance of emotion processing in patients with chronic schizophrenia, and strengthen emotion stimulation regulation to stay stable. However, the interaction between working memory and emotional regulations needs to be discussed further.

第一章 緒論 1
第一節 研究背景與動機 1
第二節 研究目的 2
第二章 文獻探討 3
第一節 慢性精神分裂症患者之特性 3
第二節 精神分裂症的病因與治療 3
第三節 精神分裂症之喜樂不能 4
第四節 情緒與大腦 6
第五節 認知功能缺損與情緒症狀之關聯 10
第六節 工作記憶與情緒之關聯 11
第七節 事件關聯電位 13
第八節 情緒ERPS研究回顧 13
第三章 研究方法 17
第一節 研究對象 17
第二節 研究工具 17
一、簡易智能狀態評估表（MMSE） 17
二、WAIS-III之工作記憶指標 18
三、國際情緒圖片系統（International affective picture system, IAPS） 18
四、事件相關電位 （ERPs: event-related potentials） 19
五、自陳問卷 21
六、認知能力訓練系統（CogniPlus） 22
第三節 研究設計 25
第四節 資料分析 28
一、行為資料分析 28
二、ERPs資料分析 28
第四章 研究結果 29
第一節 基本資料分析 29
第二節 基礎認知功能以及工作記憶之表現結果 29
第三節 實驗組與對照組之社會性喜樂不能量表以及情緒自評量表（SAM）結果比較 32
第四節 情緒刺激ERPS分析結果 35
第五節 針對全受試者、實驗組與對照組於接受情緒刺激圖片後引發LPP之振幅與情緒自評量表之激發程度進行比較 37
第六節 針對全受試者、實驗組與對照組在不同情緒刺激之LPP振幅與其工作記憶及喜樂不能量表評估結果的相關性分析 38
第五章 研究討論與建議 40
第一節 結果討論 40
一、精神分裂症病人接受工作記憶訓練前後的工作記憶能力有顯著差異？ 40
二、精神分裂症病人接受工作記憶訓練前後的喜樂不能量表有顯著差異？ 41
三、精神分裂症病人接受工作記憶訓練前後的情緒自評量表有顯著差異？ 41
四、精神分裂症病人接受工作記憶訓練前後的LPP振幅有顯著差異？ 42
五、綜合討論 43
第二節 研究建議 44

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