論文報告練習

1. Emotional Reactivity to
Social Rejection Versus a Frustration Induction
Among Persons With Borderline Personality Features
Sean M. Butler and Kristy N. Walters, Simon Fraser University
Alexander L. Chapman, Simon Fraser University
Katherine L. Dixon-Gordon, University of Massachusetts Amherst
報告者：醫學三 柯皓禎

2. Central：
Emotional
Reactivity
American Psychiatric Association, 2013
Gunderson, Zanarini, & Kisiel, 1996
Lieb et al., 2004; Linehan, 1993
Introduction │ Method│ Laboratory Procedures│ Result │ Discussion
─Review 1
Physiological
reactivity
Self-report
Jacob et al., 2009
Herpertz et al., 2001
Herpertz & Koetting, 2005
Vitale & Newman, 2012
一些過去關於BPD患者的研究顯示
與控制組(一般人)
具顯著差異
不管是 self-report
或 physiological reactivity，
其呈現反應都較一般人高
(Gratz, Rosenthal, Tull, Lejuez, & Gunderson, 2010)
(Dixon-Gordon, Chapman, Lovasz, & Walters, 2011;
Ebner-Priemer et al., 2005; see Cavazzi & Becerra,
2014; Rosenthal et al., 2008 for a review)
所謂的顯著差異在於
Higher negative
affect intensity
Cheavens et al., 2005
Levine, Marziali, & Hood, 1997
(詳細相關研究少)

3. Introduction │ Method │ Laboratory Procedures │ Result │ Discussion
─Review 2
Social
Rejection
對拒絕性刺激
出現認知障礙
Gunderson & Lyons-Ruth, 2008
對任何事會有
焦慮性預設
容易感知 造成強烈反應
Anxiously
expect
Readily
perceive
Intensely
react
Ayduk, Gyurak, & Luerssen, 2008
在以下情境
Social rejection in daily life
Rejection scenarios(拒絕情境)
Social ostracism tasks(社會排斥任務)
如何將Emotional Reactivity量化→ Social rejection
(Self-report)
Meyer, Ajchenbrenner, & Bowles, 2005; Tragesser, Lippman, Trull, & Barrett, 2008
Renneberg et al., 2012
BPD患者中，
會在此情境出現
higher negative
emotional intensity
Lawrence, Chanen, & Allen, 2011
來自於BPD患者
人際/情緒處理
困難之經驗 Korfine & Hooley, 2000
Berenson, Downey, Rafaeli, Coifman, & Paquin, 2011; Sadikaj, Russell, Moskowitz, & Paris, 2010
(Self-report)

4. Introduction │ Method │ Laboratory Procedures │ Result │ Discussion
─Review 3
Delayed
(人際衝突後，
其濃度恢復時間較一般人長)
Greater Activation
(專指處理情緒反應的區域)
Walter et al., 2008 Dixon-Gordon et al., 2011 Domsalla et al., 2013
壓力賀爾蒙
血壓↑
血糖水平↑
免疫抑制作用↑
腺體
(皮質醇)
ANS
(交感神經)
CNS
(大腦)
如何將Emotional Reactivity量化→ Social rejection
(Physiological reactivity)

5. Introduction │ Method │ Laboratory Procedures │ Result │ Discussion
─Review 4
Greater
Dixon-Gordon et al., 2011
ANS
(交感神經)
就交感反應性而言
Abandonment
stimuli
Survival
threat
stimuli
>
1. 對BPD患者本身來說，Abandonment
stimuli相較於 Survival threat stimuli
並不會給他們更為不悅的感受
2. 此研究並無明確為情緒反應性進行定義
(e.g., anger, hostility, shame)
(有待討論)

6. Rejection stressor
(比起PASAT-C)
可呈現出他們較為顯著的
emotional reactivity
(不論是在自我評估方面或
是生理反應方面)
Introduction │ Method │ Laboratory Procedures │ Result │ Discussion
─Review
─Hypothesis 1
相較於 low-BP控制組，high-BP受試者
(生理反應上呈現)
副交感神經反應↓
交感神經反應↑
顯著情緒反應

7. Introduction │ Method │ Laboratory Procedures │ Result │ Discussion
─Review
─Hypothesis 2
相較於 low-BP控制組，high-BP受試者
對於敵意以及
易怒情緒反應
Rejection stressor
(比起PASAT-C)
可呈現出他們較為顯著的
shame and anger
reactivity

8. Introduction │ Method │ Laboratory Procedures │ Result │ Discussion
─Participants
University students
(N=938)
High BP features
(N=43)
Low BP features
(N=67)
透過PAI-BOR問卷分類、篩選出合格者(N=530)
分數≥38 分數<23
全程參與研究(N=110)
隨機分配到
Social
rejection
PASAT-C
High-BP(N=23)
Low-BP(N=33)
High-BP(N=20)
Low-BP(N=34)
Diverse (39% East Asian, 35% White/Caucasian)
Mostly female (84%)
Average age of 21(SD=4.07)

9. Introduction │ Method │ Laboratory Procedures │ Result │ Discussion
─Participants

10. Introduction │ Method │ Laboratory Procedures │ Result │ Discussion
─Participants
─Questionnaires

11. Introduction │ Method │ Laboratory Procedures │ Result │ Discussion
─Procedures
PASAT-C (n=54)
Social rejection stressor (n=56)
療程前24小時避免服用任何非處方藥物或物質（咖啡因和酒精）
療程前1小時戒除尼古丁
5-min neutral computer task,
involving counting
Both conditions then viewed a graph
showing that they were rated in the lowest 10% for 5 min
Underwent a Social rejection stressor/ PASAT-C
消除生理影響因子
Baseline mood
Negative
emotion induction
Sat in front of a blank screen for 5 min Recovery
Self-reported emotional state
Psychophysiological measurements

12. Introduction │ Method │ Laboratory Procedures │ Result │ Discussion
─Procedures
─Data Analysis
Repeated measures ANOVAs
Group
• high-BP
• low-BP
Time
• Baseline
• Emotion induction
• Recovery
Condition
• PASAT-C
• Social rejection

13. Introduction │ Method │ Laboratory Procedures │ Result │ Discussion
─Preliminary Analyses

14. Introduction │ Method │ Laboratory Procedures │ Result │ Discussion
─Preliminary Analyses
─Hypothesis 1
Overall Emotional Reactivity to Social Rejection
High-BP 受試者在PASAT-C以及 social rejection情境中
其情緒階層皆出現顯著上升(baseline→postemotion induction)

15. Introduction │ Method │ Laboratory Procedures │ Result │ Discussion
─Preliminary Analyses
─Hypothesis 1
Overall Emotional Reactivity to Social Rejection
Low-BP 受試者僅在PASAT-C情境中
情緒階層出現顯著上升(baseline→postemotion induction)

16. Introduction │ Method │ Laboratory Procedures │ Result │ Discussion
─Preliminary Analyses
─Hypothesis 1
─Hypothesis 2
High-BP 受試者在PASAT-C 出現顯著 shame response，而後回復
(Baseline→ Postemotion induction→Recovery)
Specific Reactivity of Shame and Anger

17. Introduction │ Method │ Laboratory Procedures │ Result │ Discussion
─Preliminary Analyses
─Hypothesis 1
─Hypothesis 2
Low-BP 受試者在social rejection情境出現顯著 shame response
(Baseline→ Postemotion induction)
Specific Reactivity of Shame and Anger

18. Introduction │ Method │ Laboratory Procedures │ Result │ Discussion
─Preliminary Analyses
─Hypothesis 1
─Hypothesis 2
Specific Reactivity of Shame and Anger
High-BP 受試者特別在
social rejection情境
出現顯著 hostility response
High-BP 受試者特別在
social rejection情境
出現顯著 irritability response

19. • High BP 受試者對於social 以及 nonsocial stressors皆會
出現顯著負面情緒；Low BP 受試者僅對於 nonsocial
stressors易出現顯著負面情緒
• 程度上而言， social stressors相較於 nonsocial stressors
更會引起 High BP 受試者的負面情緒反應
→顯示出High BP 面對人際關係處理的挑戰
• 負面情緒中，又以 hostility response(敵意)最為顯著
Introduction │ Method │ Laboratory Procedures │ Result │ Discussion
─Conclusion

20. Introduction │ Method │ Laboratory Procedures │ Result │ Discussion
─Conclusion
─Limitation
• 透過不同實驗程序得出的結果可否加以比較有待討論
• High BP 受試者非經由臨床衡鑑所篩選(僅透過問卷)
• PAI-BOR於臨床診斷上的效用尚未獲得確認
• 沒有臨床對照組→不確定其結論與BP有關還是有其他的精
神官能症相關因子介入
[加強實驗可信度的部分]
• SSGS量表的介入
• 樣本數多