本研究旨在探討藥物成癮者之心智化功能、人際支持、拒用自我效能與藥物使用嚴重度之關聯，並進一步檢驗拒用自我效能是否在心智化功能與藥物使用嚴重度之間，以及人際支持與藥物使用嚴重度之間具有中介效果。本研究以年滿18歲且具有非醫療用途管制藥物使用經驗之成年人為研究對象，採立意取樣方式進行問卷調查，共回收有效問卷共152份。研究工具包括反思功能問卷、人際支持評估表、藥物使用信心問卷與藥物濫用篩檢測試，並以描述性統計、差異分析、皮爾森積差相關、結構方程模型進行資料分析。
研究結果顯示，心智化功能與藥物使用嚴重度具有顯著關聯，其中過度心智化與藥物使用嚴重度呈顯著負相關，缺乏心智化則與藥物使用嚴重度呈顯著正相關，顯示個體對自身與他人心智狀態之理解與反思能力，與藥物使用對其生活功能及後果之影響程度有關。拒用自我效能亦與藥物使用嚴重度呈顯著負相關，表示個體在高風險用藥情境中越有信心拒絕使用藥物，其藥物使用嚴重度越低。然而，人際支持與藥物使用嚴重度之關聯未達顯著，即使排除可能支持用藥之人際支持來源後，結果仍未呈現顯著關聯。中介效果檢驗結果則顯示，拒用自我效能在心智化功能與藥物使用嚴重度之間，以及人際支持與藥物使用嚴重度之間皆未具有顯著中介效果。
整體而言，本研究發現藥物成癮者之藥物使用嚴重度主要受到心智化功能與拒用自我效能之直接影響，而人際支持本身未必能直接轉化為降低藥物使用嚴重度之保護因子。未來戒癮實務除強化個體在具體用藥情境中的拒用信心外，亦可重視心智化功能之培養，協助藥物成癮者更清楚辨識自身情緒、需求與人際互動中的心智狀態，進而降低藥物使用對生活功能所造成之負向影響。

This study examined the relationships among mentalization capacity, interpersonal support, refusal self-efficacy, and severity of drug use among individuals with drug addiction. It further investigated whether refusal self-efficacy mediated the relationships between mentalization capacity and severity of drug use, and between interpersonal support and severity of drug use. Participants were adults aged 18 years or older with a history of non-medical controlled substance use. Using purposive sampling, 152 valid questionnaires were collected. The instruments included the Reflective Functioning Questionnaire, the Interpersonal Support Evaluation List, the Drug-Taking Confidence Questionnaire, and the Drug Abuse Screening Test. Data were analyzed using descriptive statistics, difference analysis, Pearson correlation, and structural equation modeling.
The results showed that mentalization capacity was significantly associated with severity of drug use. Specifically, hyper-mentalizing was significantly and negatively correlated with severity of drug use, whereas hypo-mentalizing was significantly and positively correlated with severity of drug use. These findings suggest that individuals’ ability to understand and reflect on their own and others’ mental states is related to the extent to which drug use affects life functioning. Refusal self-efficacy was also significantly and negatively correlated with severity of drug use, suggesting that individuals with greater confidence in refusing drug use in high-risk situations tend to report lower severity of drug use. However, interpersonal support was not significantly associated with severity of drug use, even after excluding support sources that might encourage drug use. Mediation analysis further showed that refusal self-efficacy did not significantly mediate the relationship between mentalization capacity and severity of drug use, nor between interpersonal support and severity of drug use.
Overall, this study found that severity of drug use among individuals with drug addiction was mainly influenced by the direct effects of mentalization capacity and refusal self-efficacy, whereas interpersonal support itself may not directly serve as a protective factor. Future addiction treatment practices may benefit from strengthening refusal confidence in specific high-risk situations and cultivating mentalization capacity. This may help individuals with drug addiction more clearly identify their emotions, needs, and mental states in interpersonal interactions, thereby reducing the negative impact of drug use on life functioning.

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