情緒調節困難在童年逆境經驗與成癮物質使用行為之中介效果研究

Abstract

本研究旨在探討情緒調節困難於童年逆境經驗與成癮物質使用行為之間的中介效果。隨著成癮物質使用率逐年攀升，及童年逆境經驗對成年心理健康與行為的深遠影響，了解其內在機制對預防與治療策略具重要意義。本研究採用國際童年逆境經驗問卷（ACE-IQ）、情緒調節困難量表（DERS）及成癮物質使用行為問卷，以便利抽樣方式，透過線上問卷回收臺灣地區18歲以上成人有效樣本共1,187份，依據所收集資料進行描述性統計、獨立樣本t檢定、單因子變異數、皮爾森積差相關進行資料分析，最後透過拔靴法（bootstrapping）檢驗中介效果的顯著性。研究結果如下：首先，背景變項的部分，童年逆境經驗、情緒調節困難與成癮物質使用行為皆有部分向度在性別、教育程度與經濟狀況上呈顯著差異。相關分析發現，童年逆境經驗與飲酒頻率、飲酒問題、抽菸頻率及抽菸量均呈顯著正相關，且與情緒調節困難中的「不接納且無助」、「衝動失控」及「無法執行目標」等構面顯著正相關。同時，「不接納且無助」、「衝動失控」及「無法執行目標」也與成癮物質使用行為中的飲酒問題呈顯著正相關。中介效果分析顯示，情緒調節困難在童年逆境經驗與飲酒問題之間具有部分中介作用，其中「衝動失控」構念為對飲酒問題唯一達顯著中介效果的因子。本研究結果支持童年逆境經驗透過影響情緒調節能力，進而促成成癮物質使用的理論架構，強調情緒調節困難尤其是衝動控制的能力，是介於童年逆境與成癮行為間的重要心理機制。建議未來預防與干預策略應著重提升情緒調節能力，特別是衝動控制的調節技巧，以及針對童年逆境經驗較多的高風險族群，加強早期識別與介入支持，以降低成年後的成癮物質使用行為。

This study aimed to examine the mediating effect of emotion regulation difficulties on the relationship between adverse childhood experiences (ACEs) and addictive substance use behaviors. Given the rising prevalence of substance use disorders and the profound impact of childhood adversity on adult mental health and behavior, understanding the underlying mechanisms is of critical importance for prevention and treatment strategies. The study employed the International ACE Questionnaire (ACE-IQ), the Difficulties in Emotion Regulation Scale (DERS), and a substance use behavior questionnaire. Using convenience sampling, data were collected via online surveys from 1,187 adults aged 18 and above in Taiwan. Data analyses included descriptive statistics, independent samples t-tests, one-way ANOVA, Pearson correlation, and mediation analysis using bootstrapping to test the significance of indirect effects.The results are as follows: Regarding demographic variables, certain dimensions of ACEs, emotion regulation difficulties, and substance use behaviors showed significant differences across gender, education level, and socioeconomic status. Correlational analyses revealed significant positive associations between ACEs and frequency of alcohol consumption, alcohol-related problems, smoking frequency, and smoking quantity. ACEs were also significantly positively correlated with DERS dimensions including Nonacceptance and Helplessness, Impulse Control Difficulties, and Difficulties Engaging in Goal-Directed Behavior. Furthermore, these DERS dimensions were significantly positively correlated with alcohol-related problems. Mediation analysis indicated that emotion regulation difficulties partially mediated the relationship between ACEs and alcohol-related problems, with the Impulse Control dimension being the only significant mediator of alcohol problems.These findings support the theoretical framework that ACEs influence addictive substance use through impairments in emotion regulation, emphasizing that difficulties in emotion regulation, particularly deficits in impulse control, serve as key psychological mechanisms linking childhood adversity to addiction. It is recommended that future prevention and intervention strategies focus on enhancing emotion regulation abilities, especially impulse control skills, and strengthen early identification and intervention efforts targeting high-risk individuals with extensive childhood adversity, in order to reduce the risk of addictive substance use in adulthood.