Chieko Hasui

Effects of child abuse history on borderline personality traits, negative life events, and depression: A study among a university student population in Japan

To simultaneously examine the impact of childhood abuse history on borderline personality traits, negative life events, and depression, undergraduate students (N=243) were studied by questionnaire surveys with one week intervals. Neglect and emotional abuse as well as sexual maltreatment predicted borderline personality traits and baseline depression. Baseline depression as well as the impact of negative life events occurring the week prior predicted depression a week later. However, after considering the baseline depression level, child abuse history failed to predict the follow-up depression level. Borderline personality traits did not moderate these findings. Childhood emotional and sexual abuse history may influence depression and borderline personality traits.

Respecting Autonomy in Difficult Medical Settings: A Questionnaire Study in Japan

Some people in Japan are still comfortable with the paternalistic role of doctors, but others wish that their own decisions would receive a greater amount of respect. A total of 747 students of universities and colleges and 114 parents of these students participated in a questionnaire survey. Most of the participants thought that autonomy should be respected in situations involving death with dignity and euthanasia, whereas it should not be respected in attempted suicide and involuntary admission of individuals with mental illness. A cluster analysis revealed that the participants could be divided into the following groups: aid in dying advocates (n = 577), complete libertarians (n = 109), protectors of the mentally ill (n = 90), complete paternalists (n = 29), and questionables (n = 27). The assertion of independence score of the Scale for Independent and Interdependent Construal of the Self showed a significant difference among the 5 clusters. These findings suggest that the traditional paternalistic relationship between doctor and patient is undergoing a gradual transformation in Japan.

Correlates of the categories of adolescent attachment styles: Perceived rearing, family function, early life events, and personality

Aims:u2002 To identify the psychosocial correlates of adolescents.

The Inventory of Personality Organisation: its psychometric properties among student and clinical populations in Japan

BackgroundThe Inventory of Personality Organisation (IPO) is a self-report measure that reflects personality traits, as theorised by Kernberg.MethodsIn study 1, the Japanese version of the IPO was distributed to a population of Japanese university students (N = 701). The students were randomly divided into two groups. The factor structure derived from an exploratory factor analysis among one subsample was tested using a confirmatory factor structure among another subsample. In study 2, the factor-driven subscales of the IPO were correlated with other variables that would function as external criteria to validate the scale in a combined population of the students used in study 1 and psychiatric outpatients (N = 177).ResultsIn study 1 the five-factor structure presented by the original authors was replicated in exploratory factor analyses in one subgroup of students. However, this was through reduction of the number of items (the number of the primary items was reduced from 57 to 24 whereas the number of the additional items was reduced from 26 to 13) due to low endorsement frequencies as well as low factor loadings on a designated factor. The new factor structure was endorsed by a confirmatory factor analysis in the other student subgroup. In study 2 the new five subscales of the Japanese IPO were likely to be correlated with younger age, more personality psychopathology (borderline and narcissistic), more dysphoric mood, less psychological well-being, more insecure adult attachment style, lower self-efficacy, and more frequent history of childhood adversity. The IPO scores were found to predict the increase in suicidal ideation in a weeks time in a longitudinal follow-up.ConclusionAlthough losing more than 40% of the original items, the Japanese IPO may be a reliable and valid measure of Kernbergs personality organisation for Japanese populations.

The Resilience Scale: A Duplication Study in Japan

To examine the factor structure, construct, and predictive validity of the Resilience Scale (RS), Japanese uni- versity students (N = 504 to 547) were examined. The RS has a good internal consistency and a single factor structure. Students high in resilience were less likely to be depressed or suicidal; more likely to adopt task-oriented coping but less likely to adopt emotion-oriented coping; more likely to have secure attachment with an opposite-sex partner; less likely to have shame feeling but more likely to have pride feeling; more likely to show healthy narcissistic personality traits but less likely to show identity diffusion; more likely to report their parents as high in care and low in overprotection; and more likely to report receiving punishment as a child. The RS is shown to be a significant predictor of the depressive se- verity two weeks later after controlling for demographic variables, baseline depression, and negative life events, which occurred during the previous week. Thus, the RS is a valid measure in a Japanese student population.

The Link Between Response Styles and Major Depression and Anxiety Disorders After Child-Loss

Although several studies have indicated that persons with a high ruminative coping style experience higher depression after the loss of a loved one, the relationship between ruminative coping and the occurrence of clinical depression and anxiety disorders after a loss has not been thoroughly investigated. This study investigated the relationship between response styles (ruminative coping v distractive coping) and the onset of major depression and anxiety disorders in a sample of parents who had experienced sudden child-loss (N = 106). The incidence of major depression after the loss of a child was very high (69%). After controlling for demographic variables and psychiatric history, ruminative coping was significantly associated with the onset of major depression, as defined by DSM-IV, but not with the onset of anxiety disorders. Thus ruminative coping after the loss of a child appears to be a risk factor specifically for major depression.

Anger Feelings and Anger Expression as a Mediator of the Effects of Witnessing Family Violence on Anxiety and Depression in Japanese Adolescents

The effects of anger feelings (rated by the State-Trait Anger Expression Inventory) and witnessing family violence on anxiety and depression (rated by the Hospital Anxiety and Depression Scale) were examined in 457 junior high school students. Anxiety and depression scores were correlated with frequencies of witnessing family violence. In a regression analysis, however, after controlling for the demographic variables and depression score, the anxiety score was predicted by State Anger, Anger-Out, and Anger-Control; the depression score was predicted, after controlling for the demographic and anxiety score, by State Anger, Anger-In positively, and by Anger-Out and Anger-Control negatively. Witnessing family violence failed to add significant contribution in predicting anxiety or depression. These results were generally supported by structural equation modeling. The effects of witnessing family violence on dysphoric mood may be mediated by anger feelings. The style of dysphoric mood may be predicted by the style of anger expression.

PATIENTS' DESIRE TO PARTICIPATE IN DECISION-MAKING IN PSYCHIATRY: A QUESTIONNAIRE SURVEY IN JAPAN

Japanese national sentiment has been described as paternalistic, which has potentially wide-ranging implications for the manner in which psychiatric patients should participate in medical decision-making. To examine the extent and possible determinants of the desire to participate in medical decision-making among Japanese people, we distributed a packet of questionnaires to 747 (nonmedical) university students and 114 of their parents. The questionnaires included an imaginary case vignette of psychotic depression. The participants were asked whether they would want various types of medical information, i.e., diagnosis, aetiology, treatment, outcomes, medical charts, etc., disclosed to them were they in such a psychiatric condition. Also included was the 1995 Scale for Independent and Interdependent Construal of the Self by Kiuchi. More than half of the participants wanted all the types of medical information disclosed to them. Those participants who wanted to have all types of information disclosed to them (n = 413) as compared to those who did not want to know at least one type of information (n = 445), tended to be male and to have an educational background in psychiatry (9.7% vs 5.4%) as well as an assertive attitude as indicated by a higher score on Independence on the Scale for Independence and Interdependent Construal of the Self. These results suggest that the Japanese in this sample are more likely to want to make an autonomous contribution to the psychiatric decision-making process and that less desire for information can be predicted by some demographic and personality factors.

The Test of Self-Conscious Affect-3 in Japanese university students.

The psychometric properties of the Japanese Test of Self-Conscious Affect-3 (TOSCA-3), a self-report measure of self-conscious emotions, were examined in Japanese university students. Confirmatory factor analyses showed good fits of the theory-driven model for 6 emotions to the data. The subscales of the TOSCA-3 showed moderate correlations and internal consistency. Only the Shame subscale was greater among younger students, but women had higher shame and guilt than men. Social desirability moderately influenced some subscales. Test-retest reliability was good for shame and guilt. Time 1 shame predicted time 2 depression a week later. The Japanese version of the TOSCA-3 is a reliable and valid measure of self-conscious emotions among a Japanese population.

Japanese psychology students as psychiatric diagnosticians: application of criteria of mood and anxiety disorders to written case vignettes using the RDC and DSM-IV.

It is commonly believed in Japan that only psychiatrists are capable of providing reliable psychiatric diagnosis. The present study, therefore, examined using a case vignette design, how well Japanese psychology students agreed with a psychiatrist on the diagnoses of mood disorders (major depressive disorder and bipolar disorder) and anxiety disorders (panic disorder, obsessive-compulsive disorder, phobic disorder, and generalized anxiety disorder). The results suggest that appropriately trained Japanese psychology students can apply reliably the diagnostic criteria for these disorders, except for generalized anxiety disorder. It appeared that the students did not identify symptoms of restlessness and nervous tension, which may explain the relatively low reliability of the diagnosis for generalized anxiety disorder. The cross-cultural variation in the experience of anxiety is suggested as an explanation. The present study argues that it is feasible that Japanese nonmedical mental health professionals become familiar with the psychiatric diagnoses.