0
一零八 學年度
休假研究報告書
休假研究計畫名稱：
腦心智科學對心理健康促進與腦心理疾患療育之貢獻
單位：醫學院行為醫學所(主聘)
姓名：郭乃文教授
中華民國 109 年 10 月 31 日
研究休假期間:
107 學年度上學期與 108 學年度下學期
1
目錄:
一、
休假研究申請表與計畫名稱 2
二、
休假研究計畫摘要 3
三、
休假研究計畫內容 4
四、
休假期間預期成果與實際成果 6
五、
附件
附件 A 休假期間主持計畫列表 10
附件 B 近五年發表之學術性著作 12
附件 C 近三年研究成果於國際與國內研討會摘要發表 22
附件 D 近三年受委託計畫之主題與成果報告摘要 52
附件 E 近三年之參與國際學術活動與成果報告 74
2
國立成功大學教授、副教授休假研究申請表
單位 醫學院 行為醫學研究所 申請日期 107.02.08 姓名 郭乃文 聯絡電話 (略) 職稱 V 教 授 (任職日期： 1 年 月 ) V 副教授 (任職日期： 9 年 月 ) 識別證號 (略) e-mail [email protected] 休 假 研 究 計 畫 名 稱 腦心智科學對心理健康促進與腦心理疾患療育之貢獻 休 假 研 究計 畫地 點 國內：_成大__行為醫學研究所與健康照護科學研究所 休假研究起訖期間 第1 段：_107_學年度第__上_學期 第2 段：__108__學年度第___下______學期 ※休假研究辦法第3 條：「申請休假研究一學年，可分段申請休假研究兩個學期。 惟分段休假研究應同時申請，並於第一段休假研究開始之日起二學年內完成。 是否併科技部或其 他機關補助之研究 V 否 任職本校教授（副教授） 期間曾以留職方式在國 內外進修、研究、講學 V 否 ※目前有無兼任行政主管職務(休假研究如獲核定，依規定須卸除主管職務) V 無 ※休假研究期間有無擔任其他專兼職務： V 無 以上所填資料，確實屬實，並願遵守本校「教授、副教授休假研究辦法」之規定。 申請人： 郭乃文 （簽章） 日期： 年 月 日 申請人年資及資格符合本校「教授、副教授休假研究辦法」規定，且通過最近一次評量，並檢附 系教評會審查通過之會議紀錄乙份。 單位主管： （簽章） 日期： 年 月 日 業經院教評會審議通過，並檢附院教評會紀錄乙份。 一級單位主管： （簽章） 日期： 年 月 日3
國立成功大學教授休假研究與學生教育規劃
一、
計畫
名稱
腦心智科學
對心理健康促進與腦心理疾患療育之貢獻
二、
計畫
摘要
二十一世紀的腦心智科學在基礎研究上已有相當成
果，但是對於實務上與臨床上之應用，卻依然不足。
尤其是對不同年齡層個體之心理健康促進之運用，以及對
腦部功能不足心理疾患患者之貢獻。本次休假研究目的將
致力於此。
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三 、 計 畫 內 容 個人之教學與研究規劃 受聘人以推動復健心理與神經心理領域之臨床心理專業發展與培育為 終生職志，也以此學術專長受聘於健康照護科學研究所。 復健心理領域於 1955 年美國心理學會即已成立分會 (Division of Rehabilitation Psychology，為第 21 分會)，神經心理學為第 40 個分會 (Division of Neuropsychology)，而結合兩者 Division of Neuropsychology and Rehabilitation Psychology 是常見的大學發展趨勢，比如設於 The University of Pittsburgh 內之 The Department of Physical Medicine & Rehabilitation。反 觀台灣地區，一方面由於文化與民情對心理健康較不重視，另一方面復健 醫學領域的全人醫療發展也較晚，因此受聘人雖從民國 74 年即在復健科 心理領域工作，長年發展神經心理學，但一直到 97 民受聘至成大行醫所， 且於98 年合聘健康照護科學研究所臨床心理學組後，以成大為濫觴，全 國才開始有復健與神經領域之結合。其規劃與推動是很長的一段路，包括 專業服務對象的特質與需求定位、合宜的心理衡鑑和治療的項目、恰當的 治療技術等，都必須經過實徵性、本土適應性、效益性之考驗，是受聘人 研究之主要方向。 (一). 規劃全人照護課程，並結合復健與神經心理領域的博士層級訓練。 受聘人從98 年加入健康照護科學研究所，99 年起替已領有臨床心理師執照 者規劃督導課程，也替健照所跨組博士學程(護理、物理治療以及職能治療 組)規劃正向心理學類之課程。此次所申請之研究休假分為兩段，第 1 段於 107 學年度第一學期，第 2 段於 108 學年度第二學期，而研究休假期間，持 續指導獨立研究與專題研究課程，至108 學年度為止，已持續指導十位博士 班學生，其中四位已取得博士學位畢業，一位已獲得博士候選人資格。 (二). 建構神經復健心理學之臨床教育督導課程:呼應心理師法之第二 條臨床心理師之養成要求，須「經實習至少一年實習及格」，91 年起於成功 大學附設教學醫院復健科籌備臨床心理實習生之半年全職實習計畫(全國首 創)，每學年指導五至六位實習生與三至四位 PGY 學員，實習生必須安排臨 床教師(督導)，因此受聘人於 103 年起開始在健照所發展完整督導系統並帶5
領健康照護科學研究所臨床心理學組博士班高年級學生擔任督導，並指導進 行相關臨床教學研究且發展完善的復健督導內容與督導制度。已發表架構層 面的「臨床神經心理學復健領域的專業服務與督導」與實徵層面的「從督導 實務談神經心理復健之督導倫理與督導建構專業內容之反思」之報告。此次 休假過程中將不停止對博士班與碩士班學生之臨床督導訓練。比如目前健照 所博士生黃文怡(博二)、沈慶華(博一)、王亭力(博一)三位，每周二中午都持 續參與受聘人所主持之跨校督導課程。 (三) 推動宣導正向神經心理學之社會教育:受聘人每周帶領碩士班與博 士班學生參與發展專業之社會投入。目前承辦衛生福利部心理健康資源平台 計劃(心快活https://wellbeing.mohw.gov.tw/)，持續帶領健照所博士班同學一 齊參與經營此心理健康平台。受聘人108 年申請科技部神經心理學學術平台 方案，109 年正式進行，也帶領博士班同學參與加入規劃與品質維護，藉以 學習專業發展於社會之定位與貢獻。6
四、 (原申 請書) 休假 期間 預期 成果 (一)、論文撰寫: 五篇之論文稿件送出投稿。 (二)、出版一般社會人適用之工具書: 書名為「㊣人日誌」 (三)、推廣衛福部「心快活」心理健康平台之運用，達二十萬人次。 (四)、完成勞動部系統運用神經心理衡鑑與介入模式。 (五)、協助臨床心理師進入台灣長照服務系統進行正向心理素質之專業服 務。 四-1、 (休假 結束) 休假期 間實際 成果 (註)、因 109-2 休假受到疫情影響，部分預期成果修改成與疫情心理有關 之工作內涵。 (一)、學術部分之計畫主持與論文撰寫: (1)這三年主持之計畫共 13 件，總 計25,283,000 元，如附件(A)。(2)截至 202010 底為止，2019 與 2020 已發表七篇論文，含四篇SCI、兩篇 TSSCI，如附件(B)。此外共於 國內外學術性會議發表研究論文摘要，共 41 篇，請參考附件(C)。 另有投稿進行中之論文三篇。 (二)、關於一般社會人之神經心理學參考書目，已修改成與疫情心理有關 之專業工作內涵，包括:社會宣導、大眾刊物以及學術性刊物。學術 性刊物發 表 於醫策 會之 《 醫療品質雜誌 》(Journal of Healthcare Quality) ，主題為:新冠肺炎期間醫事人員壓力因應與心理情緒調適 (第 14 卷第 3 期，16-20 頁 (2020 年 05 月刊)；大眾刊物發表於成大 校刊，主題為:自由腦的心理抗疫(266 期，22-25 頁)。 (三)、因應疫情之心理防疫，已完成十份宣導資料推廣放置於衛福部「心 快活」心理健康平台之運用，從109 年 1 月至 10 月，該平台已增加 達四十萬人次點閱。近三年受委託計畫之主題與成果報告摘要。請 參考附件(D) (四)、於勞動部系統完成運用神經心理衡鑑與介入模式之介紹。已將「談身 心障礙者神經認知功能與就業準備」發表於勞動部勞動力發展署負 責之就業安全半年刊(17（1），72-78 頁)。此外，也正式將運用神經 心理衡鑑與介入模式成功的案例發表於學術性期刊《復健諮商》，主 題為:應用認知功能訓練模組提升思覺失調症個案就業準備度之案 例報告(9，45-58 頁)。請參考附件(B)。 (五)、主導中華民國臨床心理師公會全國聯會辦理臨床心理師進入台灣長 照服務系統之分級課程，和增進正向心理素質之課程。目前，從107 年底時全國沒有臨床心理師完成二級與三級課程，推廣到目前全國 至少分別有600 位和 300 位臨床心理師完成長照二級與三級課程。7
並協助開辦臨床心理師 PAC 系統中的中風與創傷性腦傷之養成課 程。 (六)其他多於預期之成果: 1、 國際成果: (1)爭取國際會議到台灣主辦: 受聘人藉著兩次休假之半學期期 間，兩度至國際神經心理學會(The International Neuropsychological Society, INS)之年會(丹佛)與年中會(巴西)會場，擺宣傳攤位和拜訪 理監事，爭取在臺灣舉辦2023 國際神經心理學年中會(INS 2023)。 INS 為世界上最重要也最具應響力的神經心理學會，從 1967 年即開 始運作(見下面照片所附)，每年在北美地區召開年會，並選定世界其 他地點召開年中會。受聘人於休假期間並兩度接待國際神經心理學 會之國際教育委員會主席與學會執行長抵達台北與成大訪問，並參 觀國際會議地點、拜訪政府相關之衛生署與衛生局長官，以及舉辦 學術性會議與座談。請見附件(E)參與國際學術活動與成果報告。2020 年 4 月 INS 之官方網站正式公布「2023 Taiwan meeting」 (見下頁照片所附)。這是 INS 第一次在亞洲舉辦年中會。
8
https://www.the-ins.org/meetings/ https://www.the-ins.org/meetings/future-ins-meetings/ (2)爭取國際學會報導台灣心理防疫狀況: 受聘人於今年 4 月投稿台 灣心 理防 疫現 況報 導於 INS 學會，獲得刊登於其官方網站。當時 (04/08/2020)全球有 9 個國家獲得報導，目前(06/05/2020)有 12 個國家獲 得報導。台灣兩度都以Taiwan 為名被刊登。9
報導內文，如下:
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2、國內成果: 受聘人已經完成國內腦心智發展與心理復健學會對神經心 理專科之臨床心理師(Clinical Neuropsychologist)之認證系統。從 2018 到 2020 已進行 專科認證達 12 位(美 國至2014 年為止，大 約 已 經 認 證 2000 位)。附件(A) 休假期間主持計畫列表：共 13 件
年度 單 位 系 所 主 持 人 計畫名稱 計畫編號 補助經費 執行期限 補 助 或 委 託 單 位 109 行 為 醫 學 研 究 所 郭 乃 文 神經心理治療於伴 隨注意力缺損的網 路成癮青少年之療 效研究-從精準醫療 觀念反思 MOST 109- 2410-H-006-036 - 1,109,000 109/08/01 ~10/07/31 科技部 109 腦 心 智 健 康 與 發 展 研 究中心 郭 乃 文 【《臨床神經心理學 學術研究網》學術研 究網站】 MOST107- 2420-H002- 007-MY3-W10903 230,000 109/01/01~109/12/31 科 技 部 人 文 社 會 科 學 中心 109 腦 心 智 健 康 與 發 展 研 究中心 郭 乃 文 107-109 年度[建置 整合性藥癮醫療示 範中心先期試辦計 畫] 420,000 109/01/01~09/12/31 衛 生 福 利 部 嘉 南 療 養 院 109 腦 心 智 健 康 與 發 展 研 究中心 郭 乃 文 109 年度雲嘉南區身 心障礙者職業重建 服務資源中心計畫 3,500,000 109/01/01~109/12/31 勞 動 部 勞 動 力 發展署 109 腦 心 智 健 康 與 發 展 研 郭 乃 文 109 年度『心快活』 -心理健康學習平台 維運 2,100,000 109/01/30~109/12/31 衛 生 福 利部11
究中心 109 腦 心 智 健 康 與 發 展 研 究中心 郭 乃 文 109 年度『心快活』 -心理健康學習平台 維運 2,100,000 109/01/30~109/12/31 衛 生 福 利部 108 行 為 醫 學 研 究 所 郭 乃 文 融合業師與多元課 程培育模式進行臨 床心理師衡鑑與治 療技術實作之教學 成效研究 258,750 108/08/01~109/07/31 教育部 108 腦 心 智 健 康 與 發 展 研 究中心 郭 乃 文 108 年度「『心快活』 -心理健康學習平台 維運」 2,100,000 108/05/09~108/12/31 衛 生 福 利部 108 行 為 醫 學 研 究 所 郭 乃 文 國際智障運動員審 認制度研究 600,000 108/03/01~108/10/31 教 育 部 體育署 108 腦 心 智 健 康 與 發 展 研 究中心 郭 乃 文 108 年度雲嘉南區身 心障礙者職業重建 服務資源中心計畫 2,933,210 108/02/18~108/12/31 勞 動 部 勞 動 力 發展署 107 行 為 醫 學 研 究 所 郭 乃 文 神經心理治療於伴 隨注意力缺損的網 路成癮青少年之療 效研究(第二年) MOST107- 2410-H-006-051 1,236,000 107/08/01~108/07/31 科技部 107 行 為 醫 學 研 究 所 郭 乃 文 107 年度「『心快活』 -心理健康學習平台 維運」 2,320,000 107/01/23~107/12/31 衛 生 福 利部 107 行 為 醫 學 研 究 所 郭 乃 文 (後續擴充)106 年度 雲嘉南區身心障礙 者職業重建服務資 源中心 6,376,040 107/01/01~107/12/31 勞 動 部 勞 動 力 發展署12
附件(B): 近五年發表之學術性著作
受聘人最近五年著作目錄(指導學生發表，黃底為行醫所碩班生或健照所博士班生) 1. Meng-Ting Chen , Yen-Ping Chang , Marisa E. Marraccini , Miao-Chun Cho &
Nai-Wen Guo(corresponding) (2020): Comprehensive attention training system (CATS): A computerized executive functioning training for school-aged children with autism spectrum disorder, International Journal of Developmental Disabilities, DOI:
10.1080/20473869.2020.1827673 (SCI)
2. 李婕寧、許立港、郭乃文* (2020) 青少女高身心症狀抱怨、生活適應與執行功
能之關聯探討。臨床心理學刊, Archives of Clinical Psychology Vol. 12 No. 1/2 pp. 1-14 (2018)。(投稿日期：2018 年 6 月 接受日期：2020 年 6
DOI:10.6550/ACP.201812)
The Relationship between Subjective Health Complaints, Life Adjustment with Executive Function among Adolescent Girls. Archives of Clinical Psychology Vol. 12 No. 1/2 pp. 1-14 (2018)
3. Liao, Y.-C., Guo, N.-W. (corresponding), Su, B.-Y., Chen, S.-J., Tsai, H.-F., & Lee, K.-Y. (2020) Frontal Beta Activity in the Meta-Intention of Children with Attention Deficit Hyperactivity Disorder. Clinical EEG and Neuroscience. Clinical EEG and Neuroscience 1-8 (SCI)( accepted: May 11, 2020.)
4. 吳英璋、林耀盛*、花茂棽、許文耀、郭乃文、楊建銘、姜忠信、林宜美、詹
雅雯、王韋婷、廖御圻（2019）科學家與實務者：臺灣臨床心理學回顧與展 望。中華心理學刊，61(4)，359-390。(TSSCI)
En-Chang Wu, Yaw-Sheng Lin, Mau-Sun Hua, Wen-Yau Hsu, Nai-Wen Guo, Chien-Ming Yang, Chung-Hsin Chiang, I-Mei Lin, Ya-Wen Jan, Wei-Ting Wang, and Yu-Chi Liao (2019). Scientists and Practitioners: Thematic Reviews and Reflective Perspectives in the Development of Clinical Psychology in Taiwan. Chinese Journal of Psychology 2019, 61(4), 359-390.] (TSSCI)
5. Yeh, PY., Yu, Lifa., Guo, NW. (corresponding), Lin, WC., Wu, CK.(2019) Observation and Imitation of Social Emotions Are Essential for Improving
Cognitive and Affective Theory of Mind in Schizophrenia: A Meta-analysis. Journal of Nervous and Mental Disease. 207(6), 474-481. (SCI&SSCI)
6. Chang, H.Y., & Guo, N.W (corresponding). (2019), A Chinese Scale Measuring the Perceptions of People with Disability Regarding Family Support: Scale
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Development and Education. 1-13. (Published online: 20 Oct 2019). DOI:10.1080/1034912X.2019.1679354 (SCI)
7. 蘇純瑩、邱毓賢、鄭駿樺、郭乃文、陳明德(2019)。「電腦化日常注意力測
驗」於思覺失調症患者的信效度研究。職能治療學會雜誌，37(2)，211-234。 (通訊作者)
Chwen-Yng Sua , Yu-Hsien Chiub , Chun-Hua Chengc , Nai-Wen Guod, Ming-De Chena. (2019) Reliability and Validity of the Computerized Everyday Attention Test for Patients With Schizophrenia. Journal of Taiwan Occupational Therapy Association, 2019, 37(2), 211-234.
8. Liao, Y.-C., Guo, N.-W (corresponding),., Chen, S.-J., Tsai, H.-F., Fang, J.-H., Chen, J.J., & Su, B.-Y. (2018). The Significance of Impulsive Error in Children With ADHD. Clinical EEG and Neuroscience, 49(5), 295–301.
https://doi.org/10.1177/1550059417742297(SCI) 9. 張瀚云、郭乃文、張哲豪、邱美珍、吳雅玲、傅馨瑩、林修如（2018）。談身 心障礙者神經認知功能與就業準備。就業安全半年刊，17（1）， 72-78。(通 訊作者) 10. 張瀚云、郭乃文、傅馨瑩、何曉婷（2018）。應用認知功能訓練模組提升思覺 失調症個案就業準備度之案例報告。復健諮商，9，45-58。(通訊作者)
11. Tai-Ling Liu, Nai-Wen Guo(共同第一作者), Ray C. Hsiao , Huei-Fan Hue, Cheng-Fang Yen*. (2017). Relationships of bullying involvement with intelligence, attention, and executive function in children and adolescents with attention-deficit/hyperactivity disorder. Research in Developmental Disabilities, 70, 59–66. (SSCI)
12. Li-Fan Liu, Nai-Wen Guo, Pei-Fang Su, Jia-Jen Chen (2017). A follow-up study observing health outcomes of the care recipients in the home and community-based service of the long-term care system of Taiwan, Health and Primary Care. 1(3): 1-7. (SCI)
13. Su BY, Guo NW, Chen NC, Lin SS, Chuang MT, Liao YC, Kuo CM, Lin CW, Chou W, Kuo JR, Yen SY (2017, Mar). Brain Contusion as the Main Risk Factor of Memory or Emotional Complaints in Chronic Complicated Mild Traumatic Brain Injury. Brain
Injury, 31(5),601-606. 本人為通訊作者.(SCI)
14. Jyong-Huei Su, Yu-Hsin Wu, Nai-Wen Guo, Ching-Fen Huang, Cyuan-Fong Li, Chia-Hsin Chen, Mao-Hsiung Huang. (2017, Apr). The effect of cranioplasty in cognitive and functional improvement: Experience of posttraumatic brain injury
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inpatient rehabilitation. Kaohsiung Journal of Medical Sciences., 33,344-350.(SCI) 15. Nai-Wen Guo, Chii-Jeng Lin, Ming Tung Huang, Cheng-Li Lin, Cheng-Wei Lin,
Tsung-Hsueh Lu, Fu-Wen Liang, Min-Fang Tsai, Shi-Liang Wu (2016). Fracture Risk and Correlating factors of Pediatric Population with Attention Deficit Hyperactivity Disorder: A Nationwide Matched Study, Journal of Pediatric
Orthopaedics B,25(4) , 369-374 (SCI) JPOB-07-1686R2
16. 王鼎嘉、吳玉欣、郭乃文*、黃茂雄、蘇炯輝。應用中文簡短式智能評估(MMSE-C)與盧-尼神經心理測驗組篩檢測驗(LNNB-S)於腦中風患者之篩檢比較。臺灣 復健醫誌，2016;44(1):19-27). 17. 何曉婷、劉立凡、郭乃文*(2016/3)。台灣南部地區老年憂鬱情緒之影響因子探 討。台灣家醫誌 2016; 26: 100 -108。 18. 廖御圻、林育岑、郭乃文*、黃冠堂、蘇倍儀. (2016). 運用神經回饋訓練之神經 心理治療模組於重度腦傷患者改善執行功能效果分析—個案報告. 臨床心理學 刊, 10(2), 31–49.
期刊論文摘要
: (神經心理學之研究與運用)
1.Liao, Y.-C., Guo, N.-W.*, Su, B.-Y., Chen, S.-J., Tsai, H.-F., & Lee, K.-Y. (2020) Frontal Beta Activity in the Meta-Intention of Children with Attention Deficit Hyperactivity Disorder. Clinical EEG and Neuroscience https://doi.org/10.1177/1550059420933142. (SCI) MOST 98-2410-H-006-020-MY3. MOST 106-2410-H-006-030-SSS. MOST 107-2410-H-006-051
Children with attention deficit hyperactivity disorder (ADHD) have high theta and low beta activity in the frontal lobe. The higher the theta/beta ratio, the lower the level of central nervous system (CNS) cortical arousal. However, there is seldom evidence between electroencephalograms (EEGs) and the patient’s intentionality to regulate the cortical activity of executive attention tasks. We investigated whether children with ADHD intended to improve their performance in executive attention tasks and whether that increased their brain activity. Fifty-one children with ADHD (ADHD) and 51 typical developing (TD) children were investigated using focused attention (FA) and search attention (SA) tasks and a simultaneous EEG. The children were then regrouped as faster (ADHD-F, TD-F) and slower (ADHD-S, TD-S) depending on reaction time (RT). Quantitative EEGs of frontal lobe theta and beta activity at frontal F3, F4, and Fz were used. Twenty-eight (54.9%) ADHD children were regrouped as ADHD-S and 14 (27.5%) as TD-S. The ADHD-S group, however, had poorer FA and SA performance than the other 3 groups did: fewer correct answers, more frequent
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impulsive and missing errors, and higher RT variations. There were no significant differences in theta activity, but the TD-S group had higher beta activity than the ADHD-S group did. We conclude that the ADHD-F and ADHD-S groups had different attention processes. beta activity did not increase in the ADHD-S group, and their executive attention performance in the FA and SA tests was poor. It seems ADHD-S had poor meta-intention function. The frontal beta activity might be a feasible training target of neurofeedback in ADHD-S patients.
2.Chen, M.-T., Chang, Y.-P., Marraccini, M. E., Cho, M.-C., & Guo, N.-W. (2020). Comprehensive attention training system (CATS): A computerized executive-functioning training for school-aged children with autism spectrum disorder. International Journal of Developmental Disabilities, 1–10. https://doi.org/10.1080/20473869.2020.1827673
Objective: Theory suggests that impaired executive functioning (EF) might explain several symptoms of autism spectrum disorder (ASD) in children. However, only a few studies have examined the efficacy of EF training for the children using randomized control trial designs, and only two of them found significant benefits of the training.
Method: We designed Comprehensive Attention Training System (CATS), and tested this new EF intervention for children with ASD in a small-sampled randomized controlled trial. Twenty-five children with ASD aged six to twelve were randomly assigned to either the CATS or the control training and were assessed pre- and post-training.
Results: Relative to the control group, the CATS group improved on EF as measured by the trail-making test, avoiding perseverative errors, and forming conceptual responses in the Wisconsin Card Sorting Task. There were also indications that CATS contributed to long-term communication skills as measured by the Vineland adaptive behavior scales.
Conclusions: We report preliminary evidence that the CATS intervention may improve the EF of school-aged children with ASD compared to a control intervention. We discuss the results in terms of their generalizability to other developmental disorders.
3. Chang, H.-Y., & Guo, N.-W. (2019). A Chinese Scale Measuring the Perceptions of People with Disability regarding Family Support: Scale Development, Reliability, and Validity. International Journal of Disability, Development and Education, 1–13. https://doi.org/10.1080/1034912X.2019.1679354
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The People with Disability’s Perception of Family Support Scale was developed in the Chinese language to enable career counsellors, educators, researchers, and policymakers to assess the perceptions of people with a disability regarding their family support for developing vocational rehabilitation services. This study analysed 515 valid questionnaires. An exploratory factor analysis was conducted in the pilot study with data from 124 participants; confirmatory factor and Rasch analyses were conducted in the main study with data from 391 participants. The six-factor structure had a favourable fit to the observed data and excellent internal consistency (Cronbach’s α = 0.92) and test–retest reliability (0.97), indicating that the scale is a brief yet psychometrically sound measure for evaluating perceptions of family support among people with disability in Chinese populations.
4. Yeh, P. Y., Yu, L., Guo, N. W., Lin, W. C., & Wu, C. K. (2019). Observation and Imitation of Social Emotions Are Essential for Improving Cognitive and Affective Theory of Mind in Schizophrenia: A Meta-Analysis. Journal of Nervous and Mental Disease, 207(6), 474– 481. https://doi.org/10.1097/NMD.0000000000000996
People with schizophrenia often demonstrate deficits in theory of mind (ToM), which may be addressed via social cognition training that includes observation and imitation of social emotions. We examined the effect of observation and imitation on ToM and whether computerized cognitive training (CCT) can improve ToM. Among 14 controlled trials, 264 of 494 people with schizophrenia received treatment. Observation and imitation of social emotions improved cognitive (g = 0.53; 95% confidence interval [CI], 0.29–0.76) and affective ToM (g = 0.54; 95% CI, 0.34–0.73), versus treatment as usual or cognitive rehabilitation alone. CCT did not significantly enhance affective ToM (p = 0.42); however, cognitive ToM improvements without CCT (g = 1.20; 95% CI, 0.78–1.61) were superior to those with CCT (g = 0.33; 95% CI, 0.02–0.64; p < 0.01). Observation and imitation of social emotions are essential for improving ToM in schizophrenia, but CCT may not improve ToM.
5. Liao, Y.-C., Guo, N.-W*., Chen, S.-J., Tsai, H.-F., Fang, J.-H., Chen, J.-J., & Su, B.-Y. (2018). The Significance of Impulsive Error in Children With ADHD. Clinical EEG and Neuroscience, 49(5), 295–301. https://doi.org/10.1177/1550059417742297 (SCI) MOST 98-2410-H-006-020-MY3.
A deficit of inhibition ability is a neuropsychological problem in children with attention deficit hyperactivity disorder (ADHD). We investigated whether in children who made impulsive error (IE), less error-related negativity (ERN) would correlate
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with poorer executive attention functions (EAFs). Ninety children (49 with ADHD and 41 without ADHD) were investigated by a 4-minute simple reaction time task and simultaneous electroencephalogram. When they made IE, the ERN in response-locked event-related potential (ERP) was defined as error awareness. The average area under curve of ERN in the control group with IEs was used as the proper criterion for regrouping the children with ADHD into 2 groups: ADHD children with enough ERN (ADHD-enough ERN) and those with less ERN (ADHD-less ERN). EAFs from Comprehensive Nonverbal Attention Test were used as objective indices, and behavioral questionnaires were used as subjective indices and statistically analyzed within ADHD groups. Forty-eight percent of the children made IEs. ADHD(n = 31, 63%) was significantly more than in the control group (n = 12, 29%; P < .001). The ADHD group had significantly less ERN than did the control group while making IE, especially at frontal and central electrodes (P < .01). Both ADHD-less ERN and ADHD-enough ERN groups had poorer subjective EAFs on questionnaires. Only the ADHD-less ERN group had significant poorer objective EAFs on the Comprehensive Nonverbal Attention Test than did the ADHD without IE. We conclude that investigating the IE and ERN of IE in children with ADHD might help to differentiate subtypes of ADHD with different neuropsychological abilities, and the possibility that ADHD-less ERN children might be confirmed a meaningful subgroup that needs close follow-up, treatments different from standard, or both.
6. Su BY, Guo NW*, Chen NC, Lin SS, Chuang MT, Liao YC, Kuo CM, Lin CW, Chou W, Kuo JR, Yen SY (2017, Mar). Brain Contusion as the Main Risk Factor of Memory or Emotional Complaints in Chronic Complicated Mild Traumatic Brain Injury. Brain Injury, 31(5), 601-606. https://doi.org/10.1080/02699052.2016.1267800 (SCI, 11/70, Rehabilitation(Ss)). MOST 104-2314-B-006-033.
Objective: To investigate the risk factors for memory or emotional complaints in patients with complicated mild traumatic brain injury (mTBI).
Methods: Retrospective analysis of medical records was conducted by physicians in a teaching hospital in Southern Taiwan, and complicated mTBI had been identified by means of computed tomography. Psychological complaints, including problems with memory and emotions, were collected by structured telephone interviews, 10–15 minutes long, and were held with subjects who agreed to participate in our study. Among 327 patients who were injured for more than two years, 190 agreed to join this study (mean age: 41.6 years; male: 60.5%; stably employed: 50.0%). We used
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demographic data and neurological factors to predict memory or emotional complaints without muscle power or response speed (MEMR) complaints.
Results: Only the presence or absence of cerebral contusions predicted memory or emotional complaints without MEMR complaints in different employed status, and the odds ratio was 4.82–13.50 times higher for those with cerebral contusions than for those without.
Conclusions: Cerebral contusions were the primary risk factor for MEMR complaints in chronic complicated mTBI. Early preventive psychological intervention might be necessary for patients with complicated mTBI and cerebral contusions.
7. Tai-Ling Liu, Nai-Wen Guo(共同第一作者), Ray C. Hsiao , Huei-Fan Hue, Cheng-Fang Yen*. (2017) Relationships of bullying involvement with intelligence, attention, and executive function in children and adolescents with attention-deficit/hyperactivity disorder. Research in Developmental Disabilities,70,59–66.(SSCI)
This study investigated the relationship of bullying victimization and perpetration with the levels of intelligence, attention, and executive function in children who had received a diagnosis of attention-deficit/hyperactivity disorder (ADHD). The experiences of bullying involvement in 105 children with ADHD were assessed using the Chinese version of the School Bullying Experience Questionnaire. Their scores for four intelligence indexes on the Wechsler Intelligence Scale for Children 4th Edition-Chinese version were determined. Their levels of attention and executive function were assessed using the Comprehensive Nonverbal Attention Test Battery. The results of logistic regression analyses indicated that a high Perceptual Reasoning Index was significantly associated with a decreased risk of being victims of bullying. A high level of executive function was significantly associated with a decreased risk of being victims and perpetrators of bullying. Bullying victimization and perpetration in children with ADHD having a low PRI and low executive function should be routinely surveyed.
8. Jyong-Huei Su, Yu-Hsin Wu, Nai-Wen Guo, Ching-Fen Huang ,Cyuan-Fong Li ,Chia-Hsin Chen ,Mao-Hsiung Huang. (2017, Apr). The effect of cranioplasty in cognitive and functional improvement: Experience of posttraumatic brain injury inpatient rehabilitation. Kaohsiung Journal of Medical Sciences., 33,344-350.(SCI)
To investigate the effect of cranioplasty on rehabilitation of post-traumatic brain injury (TBI) patients, 37 patients with TBI were arranged by retrospectively assessment study. Those TBI patients receiving in-hospital rehabilitation in the
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Department of Rehabilitation in a medical center of South Taiwan from 2010 to 2015 were assigned into two groups: A and B. All patients entered the multidisciplinary holistic in-patient rehabilitation training for about 1 month. Patients in Group A received decompressive craniectomy (DC), patients in Group B received DC and cranioplasty. All assessments were arranged right on admission and before discharge. The functional activity evaluation included muscle power and Barthel index (BI), and cognitive function evaluation, including the Rancho Los Amigo Scale, Mini Mental State Examination (MMSE), Community Mental State Examination (CMSE), and the Luria-Nebraska Neuropsychological Battery-Screening Test Short Form (LNNBS). The results showed that there were synergetic effects of cranioplasty on post-TBI patients with rehabilitation training, especially in the BI score, and cognitive improvement in CMSE and LNNBS.
9. Li-Fan Liu; Nai-Wen Guo; Pei-Fang Su; Jia-Jen Chen (2017) A follow-up study observing health outcomes of the care recipients in the home and community-based service of the long-term care system of Taiwan, Health and Primary Care. 1(3): 1-7.
Background: In planning for the country’s long-term care provision, the Taiwanese government launched the long-term care policy since 2007. There is a need to observe the follow-up health outcomes of care recipients and provide feedback to policy and practice.Purpose: This study explored the health outcomes of LTC recipients in the home and community-based service by following the changes in outcomes for two years, and examined the factors associated with.Methods: The data came from the long-term care dataset (LTC-CM) of one southern city in Taiwan for people with LTC needs. In total, 1,338 care recipients who were reassessed by care managers from the baseline to two years (T0-T4) in the dataset were analyzed. The descriptive and inferential analyses were conducted. Generalized Estimating Equations (GEE) were used to analyze four universal outcome measures, including the activities of daily living (ADLs), the instrumental activities of daily living (IADLs), the Short Portable Mental Status Questionnaire (SPMSQ), and the short version of the Centre for Epidemiologic Studies Depression Scale (CESD).Results: Different patterns were found with regard to the changes in outcomes of the care recipients and their characteristics that influenced these changes. The ADL scores increased from T1 to T3 (OR from T1-T3=1.27 to 1.21, p < 0.01) when compared with T0. The IADL scores fell from T1 to T4 (OR from T1-T4=0.75
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to 0.66, p < 0.001). The average cognitive status decreased in T4 compared with T0 (OR = 0.85, p < 0.001). In contrast, the CESD outcomes increased (OR from T1-T4=0.73 to 0.55, p < 0.001). Age, gender, living status, educational level, social welfare status and the dependency level at baseline (T0) significantly influenced the change of health outcomes. Conclusions/Implications for practice: This research found that the patterns of changes in outcomes moved in different directions. The tendency of depression among care recipients had changed more positively. Exact monitoring and feedback of the health outcomes of care recipients are needed to effect improvements in policy and long-term care service practice.
10. 吳英璋、林耀盛*、花茂棽、許文耀、郭乃文、楊建銘、姜忠信、林宜美、詹雅 雯、王韋婷、廖御圻（2019）科學家與實務者：臺灣臨床心理學回顧與展望。中華 心理學刊，61(4)，361-392。(TSSCI) 回顧台灣心理學的發展，可從三個向度回顧各領域的進展。一個是以普遍性與 特定性向度，如透過整體性概 念或是特定性議題的向度探討。一個是時間性向 度，如以回顧與展望為軸，進行歷史性的鋪陳與未來性的指引。另 一個是空間 性向度，如心理學各領域進展涉及的國際化與本土化辯證立場。回到臨床心理 學的進展，更重視理論與 實踐的連結。本文對於台灣臨床心理學的探討，不以 歷時性面向回顧，而是綜合特定與普遍主題，以及本土研究的 特色，以取樣取 向與徵候取向兩個面向為軸進行探究。首先，是以取樣取向，涵蓋心理病理、 心理衡鑑和心理治療 三個層次高度連結的取樣特定的研究主題進行論述，包 括自閉症、睡眠心理學、乳癌患者心理成長，以及心臟心理 學研究成果。其次， 是以徵候取向，呈現已發展成熟的神經與復健心理學，以及正在發展的人文臨 床心理學特色， 進行相關討論。透過取樣與徵候兩個面向，顯示台灣臨床心理 學研究發展，是蘊含在科學家與實務者兼備的訓練實 踐進程。最後，本文在回 顧成果與闡述論點下，提出透過研究發展回到臨床實踐的反思，從深度化、在 地化和倫理 化的層次，邁向未來另一個時空處境尚待深化的臨床心理學議程。 11. 黃文怡、郭乃文（2019）。運用神經心理治療模式於受虐兒童的認知與心理復健 計劃。兒虐議題之資訊整合與政策建言（民109 年出版）。台北市：財團法人國家衛 生研究院 12.張瀚云、郭乃文、張哲豪、邱美珍、吳雅玲、傅馨瑩、林修如（2018）。談身心障 礙者神經認知功能與就業準備。就業安全半年刊，17（1）， 72-78。(通訊作者) 13.張瀚云、郭乃文、傅馨瑩、何曉婷（2018）。應用認知功能訓練模組提升思覺失調
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症個案就業準備度之案例報告。復健諮商，9，45-58。(通訊作者) 研究目的：本研究主要運用強化認知功能之訓練介入模組，以探討是否能增加 個案的就業準備度與就業穩定度。研究方法：結合注意力訓練與目標管理之神 經心理功能訓練，對就業不穩定之思覺失調症個案進行為期10 週、每週 1 小時 之神經認知功能訓練，並由神經心理衡鑑結果、日常生活行為及職業適應功能 三個層次分析訓練介入對提升個案就業準備度之成效。研究結果：神經心理衡 鑑結果發現個案注意力容量增加與活動轉換時的自我監控能力提升。日常行為 結果顯示個案自覺整體憤怒及不耐煩情緒的頻率下降、情緒監控的能力進步及 日常生活執行功能困難降低。職業適應功能結果顯示個案於訓後2 週內自行就 業，已穩定就業超過12 個月，並持續就業中。訓練後 3 個月追蹤，神經心理衡 鑑結果發現個案的注意力與自我監控能力仍維持在中上水準，日常行為之情緒 調控與監控能力維持於無異常表現，職業適應功能除持續穩定就業外，薪資亦 顯著提升，顯示訓練成效可於訓練後持續維持。研究討論：對思覺失調症個案 進行注意力與目標管理訓練介入，初步證實對其就業準備度與後續之就業穩定 度具相當助益。未來研究可增加樣本數，用以討論個別差異對介入之影響。 14.黃睿謙、郭乃文、許立港 (2017)。提升執行功能之神經心理團體治療於高身心症 狀 抱 怨 青 少 女 之 效 果 。 臨 床 心 理 學 刊 ， ( 預 刊 文 章 ) ， 41–56 。 https://doi.org/10.6550/ACP.0802.004 目的：高身心症狀抱怨與注意力控制缺乏彈性具有相關，為青少女中常見的身 心健康問題。本研究旨在討論神經心理治療團體介入對缺乏彈性的注意力控制、 身心健康狀態以及生活適應的療效。方法：受試者為41 位身心篩檢為二級高風 險之青少女，於篩檢後隨機分派至兩組，實驗組接受為期八週，每週兩小時之 提升執行功能之神經心理團體治療，控制組則等待未有介入。兩組於學期初、 學期末以及一個月後進行問卷測量，包括身心生活適應量表、一般性自我效能、 日常生活注意力功能以及執行功能行為量表，並於一年後追蹤身心生活適應量 表之篩檢結果，共37 位完成研究。 結果：實驗組（n = 9）與控制組（n = 28） 的身心症狀抱怨數皆顯著下降，但實驗組於各個指標之效果量多為中高程度， 控制組僅為低度以下。身心健康篩檢結果顯示實驗組於學期末全數返回一級， 控制組卻仍有20%為二級以上；一年後控制組有 7.1%加重為三級，實驗組則未 有三級。結論：雖然本研究樣本數尚少，但此一治療團體能大幅度地提升青少 女之自我監控功能、身心健康狀態以及生活適應。此外，此治療團體能避免二 級高風險群體加重至三級。22
附件(C)
近三年研究成果於國際與國內研討會摘要發表：
共41 篇，
1.Chia-Jung Chiang, Bei-Yi Su, Nai-Wen Guo. Crisis Intervention Application of Neuropsychological Rehabilitation Program (NPRP): A Case Report of Aseptic Meningoencephalomyelitis Patient. The Tenth Asian Conference on Psychology & the Behavioral Sciences 2020, Japan.
Background: Aseptic encephalitis may affect different parts of the central nervous system, and cause variable severity in physical and even neuropsychological dysfunctions. Such dysfunctions could place a great burden of physical and mental health on the patients and their caregivers’ adaptation to the disease in relation to emotional regulation, and further influence the patient’s rehabilitation progressions. Therefore, this study aims to discuss the crisis intervention experience with meningoencephalomyelitis patient, and develop effective intervention programs for clinical application.
Case Report: The patient was a 46-year-old male who had been working as an engineer since graduated from college. He was presented with headache, urinary retention, drowsiness, involuntary body movement, and general weakness when referred to clinical psychologist. The pre-intervention results showed moderate psychological crisis state, he was depressed about the disease’s prognosis and his family’s source of income. Crisis Intervention in Neuropsychological Rehabilitation Program(NPRP) targets at emotional, cognitive, behavioral, and resources perceptional domain of psychological crisis state. After 11 sessions of intervention, the patient’s psychological crisis evaluation indicated low crisis state, and he was able to cooperate with medical team as well as the discharge planning actively.
Discussion: This case report was about a patient with aseptic meningoencephalomyelitis who had experienced physical and mental health dysfunctions which had led to depression. During crisis intervention sessions, therapists empowered the patient to overcome the psychological crisis through enhancing the patient and his caregiver’s insight about the disease and the rehabilitation program, strengthening their emotional regulation strategies, and improving the patient’s coping self-efficacy.
2.Yu-Chi Liao, Nai-Wen Guo, Bei-Yi Su, Jen-Shen Chang, Pin-Chun Chou, Shin-Jaw Chen, Hsing-Fang Tsai (2020, Feb). Effectiveness of the 4m-SRT and QEEG as a Regrouping Protocol for Children and Adolescents with ADHD. Journal of the International
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Neuropsychological Society, 26(s1), in press). (the INS Denver 2020 Annual Meeting, Denver, USA.)
Objective: Applied quantitative electroencephalography (QEEG) and event-related potential (ERP) as neurophysiological markers to aid objective ways to a precise diagnosis. The previous studies used four-minutes simple reaction time task (4m- SRT) to develop indexes, including EEG valid rate (EEGVR) to screen the attention function, response-locked error-related negativity (ERN) as well as stimulus-locked N2 to investigate ADHD with less-ERN/less-N2 with poor executive attentions (EA). This study aimed to construct a protocol based on QEEG/ERP methods and the neuropsychological approach to regroup ADHD, as well as to investigate the specific EA problems of them.
Participants and Methods: One hundred and three children (53 with ADHD and 50 neurotypical controls) matched IQ, age, sex, SES, and home status were investigated by a 4m-SRT and a simultaneous EEG. Three criteria, including EEGVR, the ratio of artifact-free EEG epochs divided by total epochs, less or enough ERN/N2 while making an impulsive error (IE) scored 0 or 1 separately for regrouping the
children. EAs from Comprehensive Nonverbal Attention Test (CNAT) were used as objective indices, and parent-report behavioral questionnaires were used as subjective indices and statistically analyzed within ADHD groups.
Results: There were 33 (66%) neurotypical and 8 (15.1%) ADHD had 0 of 3 criteria; none of neurotypical and 16 (30.2%) had 3 criteria. The receiver operating characteristic (ROC) curve showed optimal cut-point was between 1 and 2, which showed that 2 (4%) of neurotypical and 24 (45.3%) of ADHD seems to have specific EA problems. There was no difference between subgroup of ADHD in parent-report behavioral functions, while the subgroup had less 2 criteria did better performance in CNAT, making more correct trials, fewer IE, and shorter reaction time. Conclusions: The 3 of QEEG criteria in 4m-SRT could help to differentiate a subgroup in ADHD that had specific EF problem, which might not show in parent- report. This assessment protocol can be used as a simplified method to measure the EA problem in children and adolescents and to be a training index for precision medicine.
3. Jen-Shen Chang, Nai-Wen Guo, Yu-Chi Liao (2020, Feb). Applying N2 and P3 Event-Related Potentials of Non-Target Stimulus as Grouping Index for Children with Attention Deficit Hyperactivity Disorder. Journal of the International Neuropsychological Society, 26(s1), in press). (the INS Denver 2020 Annual Meeting, Denver, USA.)
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(ADHD) children. Quantified electroencephalogram (QEEG) and Event-Related Potential (ERP) are frequently used to explore underlying mechanism of disinhibition in ADHD. The stimulus-locked ERPs N2 and P3 are defined as conflict monitoring and response inhibition, respectively. This study aimed to apply N2/P3 amplitudes of impulsive error (IE) to the grouping of ADHD children and to investigate the executive attention functions (EAFs) of ADHD subgroups.
Participants and Methods: Forty-four ADHD children and 44 typically developing (TD) children (with comparable age, gender, home environment, IQ, and social economic status) performed a 4-minute simple reaction time (SRT) task and ERPs were recorded simultaneously. Each single trial had a warning tone as non-target stimulus and false alarm responses would be defined as IEs. The most negative peak in the time windows 200–300ms following non-target stimulus was defined as N2, and the most positive peak in 350–600ms was P3. IE trial with the reaction time below 600ms had been excluded due to the overlap of stimulus-locked and response-locked ERPs. The mean amplitudes of N2 and P3 within each IE trial in the TD group were used to regroup the ADHD children with IE (ADHD-IE) into subgroups with enough or less N2/P3. The Comprehensive Nonverbal Attention Test Battery (CNAT) and the daily inattention questionnaire (DIQ) were used to assess EAFs.
Results: Twenty-six of 33 ADHD children with IE were regrouped based on N2 index into subgroups with 8 enough N2 and 18 less N2, besides, based on P3 index, they were regrouped again into subgroups with 11 enough P3 and 15 less P3. Considering EAFs performances of ADHD subgroups, the subgroup without IE performed the best while the subgroup with less N2/P3 did the worst. Moreover, P3 can better differentiate ADHD than N2.
Conclusions: Investigating the stimulus-locked N2/P3 of IE in children with ADHD might help to explore subtypes of ADHD with different neuropsychological abilities. In addition, the ADHD-IE subgroup with less P3 require intensive follow-up and individualized treatment.
4.Bei-Yi Su, Sheng-Sian Lin, Nai-Wen Guo, Yu-Chi Liao, Willy Chou, Jinn-Rung Kuo, Ming-Tsung Chuang (2020, Feb). The Association Between Illness Representations and Quality of Life in Patients with Traumatic Brain Injury is Mediated by Executive Functions. Journal of the International Neuropsychological Society, 26(s1), in press). (the INS Denver 2020 Annual Meeting, Denver, USA.)
Objective: Traumatic brain injury (TBI) patients remained executive functions (EF) impairments that can affect patient’s cognitive, emotional, behavioral, social function
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and quality of life (QoL). Illness representations (IR) also affects psychosocial burden in patients TBI, even in the chronic stage post-injury.
However, the effects of IR and EF on quality of life (QoL) were unknown. The present study investigated whether the association between IR and QoL is mediated by EF. Participants and Methods: Sixty-two patients enrolled in study while and medical records were retrospectively analyzed by physicians and neuropsychologists.
The IR were measured by Illness Representations Questionnaire (IRQ). The QoL were examined by World Health Organization Quality of Life-BREF (WHOQOL- BREF) Taiwan Version, including physical health, psychological, social relationships, and environment domain.
EF assessments included Comprehensive Nonverbal Attention test (CNAT), Comprehensive Nonverbal Memory test (CNMT), Instrumental Verbal Working Memory of Daily Life, Serial Verbal Memory Task, Wisconsin Card Sorting Test (WCST), Tower of Landon (ToL), and Daily executive behaviors scale (DEBS).
The assessment conducted at 19.87 months (SD=5.08) post-injury. The regression analysis proposed by Baron and Kenny (1986) were used to test the effects of IRQ and EF on QoL.
Results: There were 51 patients (82.26%) with mild TBI, the mean age at injury was 32.69 (SD=12.81) years. Patients had significantly lower QoL scores on physical health, psychological, and social relationships domains than normal population. When EF was added to the regression model with IRQ, the association of IRQ with three domains of QoL were no longer significant, whereas the association of EF with three domains of QoL were essentially unchanged.
Conclusions: The effects of IRQ on QoL are mediated by EF in the chronic phase of patients with TBI, and such findings might provide meaningful information for healthcare planning.
5.Bei-Yi Su, Nai-Wen Guo, Ta-Shen Kuan. (2019, Sep). Entrustable Professional Activities (EPAs) Scale for Core Competencies on Early Intervention of Rehabilitation Psychology in Taiwan. 2019 International Forum on Quality and Safety in Healthcare, Taipei, Taiwan.
Backgrounds: Clinical psychologist, as scientist-practitioner, is a mental health professional with specialized training in psychological assessment and therapy of cognitive, behavioral, as well as emotional health care. Early intervention is a service for children with the developmental delay with cognitive or physical disability that help them improve function and performance that they need to participate in school or everyday life. Though there is strong evidence supporting the effectiveness of
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based early neuropsychological intervention, equips clinical psychologists with the necessary competencies have always been a challenge. To enhance the quality of competencies and health care, the choice of an effective management scale is important. The objective of this study was to measure the competencies of group-based early neuropsychological intervention service providers.
Methods: We provided group-based early neuropsychological intervention for children younger than 7 years of age with developmental delay, attention-deficit/hyperactivity disorder (ADHD), and autism spectrum disorder (ASD). We used Entrustable Professional Activities (EPAs) scale for Core Competencies of Rehabilitation Psychology (CCRP) to explore four domains of competence before and after the intervention, including (1) psychopathology of rehabilitation psychology and neuropsychology, (2) case formulation, (3) skills of psychotherapy, and (4) psychotherapy process and procedure.
Outcome: Neuropsychological function and performance improvements were reported by parents after the intervention. Furthermore, feedback received from clinical psychology interns showed that they had significant improvements on four domains of CCRP (p<0.001), especially in the domain of case formulation and skills of psychotherapy.
Conclusion: The core competencies are the foundation required for high-quality health care. The CCRP is helpful to assess the quality of group-based early neuropsychological intervention, which could also have a positive impact on early intervention services. 6.Yu-Chi Liao, Nai-Wen Guo, Bei-Yi Su, Shin-Jaw Chen, Hsing-Fang Tsai (2019, Jul). Effect of Neurofeedback-based Neuropsychotherapy on Executive Functions for ADHD Children. Journal of the International Neuropsychological Society, 25(s2), in press) (2019 89th INS MEETING AND 18∘CONGRESSO DA SBNP, Rio De Janeiro, Brazil.) MOST 98-2410-H-006-030- MY3.
Overview and aim(s): According to related researches, Neurofeedback on attention deficit hyperactivity disorder (ADHD) can effectively reduce inattention and behavioral symptoms. However, current training programs can be relatively lengthy, with less effort on the effect of executive functions (EF). The present study aimed to demonstrate a neuropsychotherapy program (Will Well NF, WWNF), combined with 20 hours neurofeedback and computerized training (Comprehensive Attention Training Systems, CATS) to investigate if it is effective on executive functions.
Methods: Forty-eight ADHD children were randomly assigned to either the experimental group (WWNF) or waitlist control group (CON), who took WWNF
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training after post-tests. The curative effects as the dependent variable were multilevel of indexes. EF measures were Tower of London (ToL) and Wisconsin Card Sorting Test (WCST). Symptoms from SNAP-IV and daily behavioral questionnaires reported by their parents were behavioral level of generalization. The two-way repeated measures ANOVA and dependent t-test were used for statistical analysis.
Results: F-test revealed that there were interaction effects in ADHD symptoms. WWNF group had increased ToL scores, decreased perseverative and non-perseverative error rates on WCST. Besides, the WWNF group showed increased daily behavioral function of EF.
Discussion and Conclusions: This study found that children can not only improve EF, but also show the generalization of that from WWNF training. The training effects were on planning ability, cognitive flexibility, and daily behavioral functions. We suggested that future studies could examine individual differences in effectiveness and maintenance.
KEYWORDS: ADHD, executive function
7. Bei-Yi Su, Nai-Wen Guo, Yu-Chi Liao, Ming-Tsung Chuang, Jinn-Rung Kuo, Willy Chou (2019, Jul). The effects of individualized neuropsychological rehabilitation program for severe traumatic brain injury on executive function and daily life independence. Journal of the International Neuropsychological Society, 25(s2), in press) (2019 89th INS MEETING AND 18∘CONGRESSO DA SBNP, Rio De Janeiro, Brazil)
Overview and aim(s): Executive function (EF) deficits were frequently observed after severe traumatic brain injury(TBI), and caused disability when deficits interfered with a patient's ability to perform daily activities. This study aimed to investigate the effects of individualized neuropsychological rehabilitation program (NPRP) in severe TBI patients with EF deficits and poor functional independence.
Methods: Ten adult patients suffered with severe TBI (60% male), the mean age at injury was 30.77(SD=9.96) years. The EF and functional independence were evaluated in all patients by clinical neuropsychologists before(T0), directly after(T1), and 6 months post-NPRP(T2). The EF assessment included Stroop, Instrumental Verbal Working Memory of Daily Life (IVWM), Wisconsin Card Sorting Test(WCST), Tower of Landon(ToL). The daily life independence as measured by Hierarchy of the Care Required (HCR), including activities of daily living (ADLs), instrumental activities of daily living(IADLs), and cognition and emotion(C&E). The NPRP tailored specifically to the assessment and conducted after acute stage of injury (1-14 months, M=5.27,
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SD=3.78).
Results: Of the 10 patients, 6 completed T2 follow-up. Outcome measures revealed large effect size for improvements in EF at T1 and T2. Significant improvements in ADLs and IADLs at T1 and T2 were reported by patients, and improvements in ADLs and IADLs at T2, C&E at T1 and T2 were also reported by family.
Discussion and Conclusions: This study provided support for the efficacy of individualized NPRP toward the treatment of EF and functional independence in patients with severe TBI.
Keywords: TBI, executive function, neuropsychological rehabilitation
8. Bei-Yi Su, Willy Chou, Nai-Wen Guo, Ming-Tsung Chuang, Yu-Chi Liao, Jinn- Rung Kuo (2019, Jul). Gender differences in the effects of complicated mild traumatic brain injury on the memory complaints among the patients with Glasgow Coma Scale scores of 14 to 15. Journal of the International Neuropsychological Society, 25(s2), in press) (2019 89th INS MEETING AND 18∘CONGRESSO DA SBNP, Rio De Janeiro, Brazil) MOST 104-2314-B-006-033.
Overview and aim(s): Memory complaints(MCs) in patients with complicated mild traumatic brain injury(mTBI) might persist for years. However, few studies have explored MCs according to gender and control for confounders. We investigated gender differences in risk factors for MCs in chronic phase of patients with complicated mTBI and Glasgow Coma Scale(GCS) scores of 14 to 15.
Methods: Medical records were retrospectively analyzed by physicians and clinical neuropsychologists in teaching hospitals in southern Taiwan, complicated mTBI had been identified by means of computed tomography. MCs were determined in structured telephone interviews with patients in chronic phase of complicated mTBI.
Results: Four hundred and three patients with GCS scores of 14 to 15 at admission and hospitalization were identified (229 male; mean age at time of injury: 40.47 ± 16.71 years; mean follow-up: 1.93 ± 0.60 years). MCs were found in 87(37.99%) of the male and 87(43.68%) of the female, and 35(15.28%) of the male and 23(13.22%) of the female complained about memory complaints only(MCOs). Male patients with mixed types of hemorrhage (brain contusions and subarachnoid hemorrhage [SAH]) had significantly higher odds of MCs and MCOs.
Discussion and Conclusions: Brain contusions and SAH in male patients with complicated mTBI might be a meaningful marker for detecting high-risk patients with memory complaints in the chronic phase, and such findings might provide meaningful
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information for healthcare planning.
Key words: traumatic brain injury, memory complaints, gender
9. Nai-Wen Guo, Yu-Chi Liao*, Bei-Yi Su, Shin-Jaw Chen, Hsing-Fang Tsai, Kuan- Ying Lee (2019, Jul). The Role of Frontal Beta Wave in Meta-Intention of ADHD Children. Journal of the International Neuropsychological Society, 25(s2), in press) (2019 89th INS MEETING AND 18∘CONGRESSO DA SBNP, Rio De Janeiro, Brazil). MOST 106-2410-H-006-030-SSS.
Overview and aim(s): Amongst extant studies, Children with attention deficit hyperactivity disorder (ADHD) show high theta and low beta activities in frontal area. The higher the theta/beta ratio, the lower the cortical arousal. However, there is little evidence in the relationship between quantitative electroencephalogram and intentional regulation of cortical activity with executive attention (EA) tasks. We investigated whether ADHD children intended to improve their performance in EA task would increase their brain activity.
Methods: Both 51 ADHD children and 51 normal controls were investigated by the focus attention (FA) and search attention (SA) tasks with simultaneous EEG. Children were regrouped into 4 groups as faster (ADHD-F, Con-F) and slower (ADHD-S, Con-S) depending on reaction time (RT). Besides, theta and beta waves at frontal (F3, F4, Fz) were applied.
Results: There were 28 ADHD regrouped as ADHD-S and 14 controls regrouped as Con-S. Four groups had similar intelligence quotient. ADHD-S revealed poor FA and SA performance than the other 3 groups, showing less correctness, more impulsive errors, more omissions, and high RT variations. Four groups had no difference in theta wave. Con-S showed higher beta activity, while ADHD-S did not.
Discussion and Conclusions: The results revealed different attention processes between ADHD-F and ADHD-S. The frontal beta didn’t increase in ADHD-S, while they showed poor EA performance in FA and SA. Accordingly, ADHD-S might have poor meta-intention function. Therefore, the frontal beta might be the training target of neurofeedback in ADHD-S.
KEYWORDS: attention deficit hyperactivity disorder, executive attention, frontal beta 10. Nai-Wen Guo (Mar. 2019) Parental stress and coping for children with congenital musculoskeletal deformities. Taiwan Paediatric Orthopaedic Symposium, Hong Kong Orthopaedic Association, Hong Kong.
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11. Pi, Y.T., Liao, Y. C., Guo, N. W., Chou, P. C., Chang, J. S., & Lee, K. Y. (2019). The Effectiveness of Neuropsychological Approach Based Neurofeedback Training Program Training for Ages 10 to 16 with Comorbidity of IA and ADHD: Five-case report. in The Asian Conference on Ethics, Religion & Philosophy 2019 Official Conference Proceedings (pp. 49). MOST 106-2410-H-006-030-SSS.
Background: Internet Addiction (IA) has become a psychiatric disorder in DSM-5 and ICD-11. Many studies have showed the comorbidity of IA and ADHD (IA&ADHD) in children and adolescents, and they both perform poorly on their executive functions especially in regard to attention and inhibition. A neuropsychology-based neurofeedback (Npsy-NF) training program was administered to improve the executive functions of those with IA&ADHD.
Methods: Five IA&ADHD subjects ages 10-16, were trained for a total of 20 hours over a ten-week period. The Npsy-NF fosters successful experiences for subjects by acknowledging appropriate behavior, responses or decisions while engaged in a task thus bolstering their self-regulation. Theaneuropsychological tasks including Tower of London(ToL), Wisconsin Card Sorting Test(WCST), Stroop Test and Comprehensive Nonverbal Attention Test(CNAT), and questionnaires including SNAP-IV, CIAS, daily inattention function, daily executive function, and daily time management were applied as indexes of effectiveness after the Npsy-NF.
Results: All five subjects showed improvement in search attention subtest of CNAT, and made less preservation error in WCST. Four of five subjects improved in focus attention and inhibition attention subtests of CNAT and correct trials in ToL. Three of five did better in Stroop task. And three subjects reported better executive and time management function. Additionally, four parents reported better attention functions, and three parents reported the improvements in SNAP-IV and CIAS.
Discussion: Although there were only five subjects, multi-indexes were provided to prove the effectiveness of Npsy-NF. However, further studies with more participants are needed to solidify the results.
12. Ching-Hua Shen, Bei-Yi Su, Nai-Wen Guo, Ta-Shen Kuan, Yu-Ching Lin. The Therapeutic Effects of Combining Neuropsychological Treatment Strategies with Family-centred service model in doctor-patient cooperation and parenting efficacy. 2019 International Forum on Quality and Safety in Healthcare, Taipei, Taiwan.
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13. 沈慶華、蘇倍儀、郭乃文、官大紳、謝佩君。(2018 年 11 月)。遊戲情境中應用短 期神經心理治療於以家庭為中心之服務模式-受不當對待兒童之適應行為改善之個案 報告。2018 遊戲治療國際研討會暨台灣遊戲治療學會年會。台南，台南大學。（口頭 報告） 緒論：兒童不當對待(child maltreatment)不僅造成身體上的傷害，也可能干擾後續 認知、行為，以及社會之發展。研究指出無論是長期或偶發，皆可能阻礙兒童早 期依附行為，並影響其尋求舒適與調整自身生理、情緒歷程之能力(Crooks & Wolfe, 2007)，因而有早期介入之必要與急迫性。本研究報告治療一名受不當對待兒童與 其主要照顧者，應用神經心理治療與以家庭為中心模式融入遊戲情境中。並以個 案適應行為之改善作為療效指標。 研究方法：個案女童有發展遲緩病史，早療中心有2 歲 1 個月接受貝萊嬰兒發展 量表(Bayley-III)評估，認知與語言發展分別落於百分等級(PR)25 和 3。後因疑似 幼稚園管教不當而出現睡眠障礙、情緒不穩定，以及人際退縮等情況，於2 歲 6 個月經復健科醫師轉介臨床心理師。此時，Bayley-III 之認知、語言及社會情緒發 展(SE)分別落於 PR 25、0.2 及 9；呈現明顯適應行為問題，於兒童行為檢核表之 整體、內化及外化問題分別落在PR 88、93 及 84。短期神經心理治療之運作以每 次30 分鐘，共 10 次，介入目標為強化自主掌控感與正向人際記憶，主要應用的 策略為知覺重整與記憶建構。以家庭為中心模組主要對象為主要照顧者，強化其 覺察、情境規劃力，及執行演練能力。 結果：介入後，個案之適應行為問題不再具備臨床顯著性，於兒童行為檢核表之 整體、內化及外化問題分別達到PR 72、81 及 69，顯示個案適應性行為增加。利 社會行為(prosocial behavior)如眼神接觸、人際互動，以及探索環境之主動性提升。 主要照顧者報告個案之睡眠、情緒，以及社交互動狀況皆有改善。 討論：運用神經心理治療介入模組具備初步成果，未來可持續追蹤療效穩定性， 並以實徵資料證實之。 關鍵字：不當對待兒童、神經心理治療、以家庭為中心、遊戲情境14. Chou, P. C., Chang, J. S., Liao, Y. C., Guo, N. W., & Lee, K. Y. (Jun, 2018). Neurofeedback Based Neuropsychological Therapy for Patient with ADHD Combined with International Addiction Problem- Case report. Poster session presented at the 7th annual conference of International Society on Internet Addiction, Taichung, Taiwan. MOST 106-2410-H-006-030-SSS; MOST 98-2410-H-006-020-MY3.
Objectives: Previous studies have found that the neurophysiological and neuropsychological deficit of attention deficit hyperactivity disorder with international addiction problems (ADHD with IA) related to failure of frontal executive function.
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Moreover, studies showed curative effect of outcome of neurofeedback-based neuropsychotherapy (NB-NpsyT) for children with ADHD. This study was to explore the curative effect of this therapy model for ADHD with IA children, and its long-term follow up of outcome.
Methods: Two ADHD with IA were referred from psychiatrist, mean age were 10. The NB-NpsyT consisted of approximately 10 sessions, totally took 20 hours. In the training process, the therapist help patient to increase their self-awareness and self-monitor for attention and regulate the use of internet. Moreover, to enhance the ecological validity, they applicate the experience and strategies in their daily life by homework. After the 10 weeks NB-NpsyT, post-test and 6-months follow-up were measured with neuropsychological assessments.
Results: Compare to pre-test, there were highly brain activity at F3, F4, and Fz when patients did Comprehensive Nonverbal Attention Test (CNAT); the neuropsychological level showed the improvement of performance in CNAT, cognitive flexibility in Wisconsin Card Sorting Test (WCST); the behavior adaptive level showed the improvement of daily attention, daily executive functions, time management and internet addiction on questionnaires. Moreover, the follow-up measure maintains the improvements.
Conclusions: Based on our result, this study supports that patient of ADHD with IA gain improvement after received NB-NpsyT, and remain curative effects at 6-month follow-up. However, controlled follow up study was need to claim the effectiveness.
15. Guo, N.W, Liao, Y. C. (Jun, 2018). Neuropsychotherapy for ADHD with Internet Addiction. Workshop session presented at the 7th annual conference of International Society on Internet Addiction, Taichung, Taiwan. MOST 106-2410-H-006-030-SSS; MOST 98-2410-H-006-020-MY3.
The prevalence rate of internet addiction (IA) was estimated from 5.9% to 22.5% in Taiwanese children and adolescents. The diagnostic criteria of IA included compulsive use of internet, inability to control when using internet, withdrawal syndrome, and problem with inhibition. Studies showed both the neurophysiological and neuropsychological deficit of IA and attention deficit hyperactivity disorder (ADHD) were often related to failure of frontal control processing, including inhibition, self-control, executive attention, and self-monitoring ability.
We found two novel neurophysiological indexes in simple reaction time task, named EEGVR (the valid rate of electroencephalogram) and IE-ERN (the amplitude of error-related negativity (ERN) at impulsive error). These two indexes revealed the special
