⦁ 研究背景：在台灣，一起關於思覺失調症患者的悲劇事件凸顯了社會對精神疾病的污名及其對照顧者的負面影響，尤其照顧者的羞恥感和罪惡感，對其福祉和患者的預後皆扮演著關鍵的角色。
⦁ 研究目的：本研究旨在評估思覺失調症照顧者的羞恥感與罪惡感，探討其如何影響他們的心理健康，包括憂鬱症 (MDD) 或複雜性創傷 (CPTSD) 的症狀。
⦁ 研究方法：採兩階段方法：首先，發展思覺失調症照顧情境篩選表(SCSS)，選擇事件相關簡短羞恥感與罪惡感量表(ERB SGS) 並翻譯為中文版，以評估照顧情境和情緒。項目發展以項目分析與探索性因素分析確保量表的構念效度，量表驗證則涵蓋Cronbach's α、再測信度ICC值，並以PHQ-9和ITQ檢驗同時效度；其次，以雙變量相關和多元迴歸評估照顧者的兩種情緒對其心理健康的共同與獨特變異量，以獨立與成對t檢定評估罹患MDD、CPTSD和PTSD照顧者的兩情緒是否高於未罹病者，及其罹病組內的兩情緒間是否有差異。
⦁ 結果與結論：以滾雪球及便利抽樣法，共招募130位照顧對象為思覺失調症的照顧者完成線上問卷。結果顯示兩量表皆有良好的信效度，雙變量相關則顯示羞恥感和罪惡感皆與MDD和CPTSD有中度到很高的相關 (rS&MDD = .624; rG&MDD .45=; rS&CPTSD =;.887 rG&CPTSD =.707)，考量羞恥感和罪惡感的高相關 (rS&G =.739)，再以多元迴歸控制共同變異量，發現羞恥感皆解釋了對MDD和CPTSD的獨特變異量，罪惡感卻皆失去了顯著性。t考驗則顯示MDD和CPTSD的照顧者的兩情緒皆顯著地高於未罹病組；但只有CPTSD的照顧者在其罹病組內的羞恥感顯著地高於罪惡感；PTSD則在組間及組內皆無差異。推測罪惡感當中，與羞恥感重疊的無力感，很可能是其不適應的關鍵成分。
⦁ 研究貢獻：理論上，可增進對照顧者在羞恥感與罪惡感的跨文化理解、本土化評估工具，並發展創傷相關的情緒反應理論模型；實務上，可據此結果，改善對照顧者的支持政策、促進跨專業合作、提高公眾意識，並應用量表提供個別化的心理介入，除了預防患者復發，也可滿足照顧者在華人文化下的心理需求。

⦁ Background: In Taiwan, a tragic incident involving a patient with schizophrenia underscored the stigma arround mental illness and its negative impact on caregivers, particularly the shame and guilt experienced by caregivers. These emotions are crucial for caregiver well-being and patient prognosis.
⦁ Purpose: This study assesses the shame and guilt in caregivers of schizophrenia patients, examining their impact on caregivers' mental health, particularly regarding complex posttraumatic stress disorder (CPTSD) and major depression disorder (MDD).
⦁ Methods: A two-phase approach was adopted. First, the Schizophrenia Caregiving Situation Screen (SCSS) is developed and the Event-Related Brief Shame and Guilt Scale (ERB SGS) is translated to Chinese version. Both scales were used to assess the caregiving situation and these emotions, ensuring construct validity via item and exploratory factor analysis. The scales were validated using Cronbach’s α, ICC values, and concurrent validity tested with the PHQ-9 and ITQ. Second, the study used bivariate correlations and multiple regressions to further analyze the shared and unique variances of shame and guilt on caregivers’ mental health outcomes, using t-tests to compare emotion levels in caregivers with and without MDD, CPTSD, and PTSD.
⦁ Results and Conclusion: From 130 caregivers, Findings indicated that both emotions were significantly correlated with MDD and CPTSD. Regressions showed that shame, but not guilt, still had unique variance in these disorders. MDD and CPTSD caregivers exhibited higher levels of both emotions compared to those without mental disorders, with CPTSD caregivers particularly showing higher shame. The powerlessness overlapping with shame is considered mostlikely maladaptive within guilt.
⦁ Contributions: Theoretically, this study enhances understanding of the interplay between caregiver emotions and mental health in a cross-cultural context, contributing to localized scales and theoretical models for trauma-related emotional responses. Practically, it can improve policies, promote interdisciplinary cooperation, increase public awareness, and apply the scales to provide tailored psychological interventions for caregivers, addressing their needs and helping to prevent patient relapse.

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