第五章 討論
第二節 研究結果在臨床實務的意涵
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害怕正向評價機制可能同時包含對於杏仁核過低的調節與正向訊息的處理不 足。
而與原先預期較不同的發現則是在排除社會焦慮傾向的影響後，仍可觀察到 左側眶額葉皮質-左側眶額葉皮質內聯結與 FPE 量表分數達顯著負相關，顯示腦 部功能聯結網絡可能具有與社會焦慮傾向無關的正向評價處理機制。
第二節、研究結果在臨床實務的意涵
Wang 等人(2012)的模式的各個因子在本研究中被發現具有對應的腦部功能 聯結，顯示此模式具有其生理實質性，未來在探討心理疾患的共病關係時，可採 用階層模式中共同因子與獨特因子，透過這樣的模式可以更好地釐清心理疾患間 的關係。
而本研究發現的腦部功能聯結或可在未來的診斷或治療效果評估中作為參 考指標，然各個因子是否還有更多可能的對應聯結，仍須更進一步的研究，以更 加確立模式中的因子與腦部功能聯結的關係，始可更有效地被應用在臨床與研究 實務中。
第三節、研究限制與未來研究方向
本研究雖重覆驗證過去研究發現的部分聯結，但也如同後設分析的發現，本 研究發現的聯結與過去並非完全一致(Brühl et al, 2014)，而本研究與過去研究主 要的差異點在於種子位置的選擇與參與者的選擇，本研究為了探討 Wang 等人 (2012)提出的模式之生理佐證，在種子區域的選擇以模式中的負向情感、正向情 感、害怕負向評價與害怕正向評價因子作為選擇的標準，故在部分種子區域的選 擇與過去研究的選擇不同，是可能造成發現不一致的原因之一。另一方面，主要
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的研究參與者為高社會焦慮傾向與低社會焦慮傾向的大學生，並非過去研究選擇 使用的社會焦慮疾患患者，也可能是造成發現不一致的原因之一。
而本研究在左右側腦的發現不一致，過去亦有大量研究在探討大腦側化現象，
然本研究旨在進行心理病理因子在腦部功能聯結的初探，在此次研究發現的側化 狀況仍需要更進一步的研究，以利進一步瞭解其臨床意涵。
本研究雖發現可與 Wang 等人(2012)的模式各個因子對應的腦部功能聯結，
但無法呈現該模式中的因子間的關係，未如預期的在正向感受功能聯結發現同時 和 SADS 與 BDI 量表相關達顯著之聯結，然目前腦造影分析技術已發展出眾多 方法，未來或可在較複雜模式分析方法中驗證 Wang 等人(2012)的模式，以進一 步確立腦部功能聯結與該模式因子間的關聯性。
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