Isao Fukunishi

IS ALEXITHYMIA A CULTURE-BOUND CONSTRUCT? VALIDITY AND RELIABILITY OF THE JAPANESE VERSIONS OF THE 20-ITEM TORONTO ALEXITHYMIA SCALE AND MODIFIED BETH ISRAEL HOSPITAL PSYCHOSOMATIC QUESTIONNAIRE '

The possibility remains that alexithymia is a culture-bound construct. The authors examined the validity and reliability of the Japanese versions of the 20-item Toronto Alexithymia Scale and the modified Beth Israel Hospital Psychosomatic Questionnaire, testing two samples of 473 college students and 149 psychiatric outpatients. The face validity and internal consistencies were suggested by factor analysis, adequate internal consistency, relatively high test-retest correlations, and high specificity and sensitivity. The Japanese versions of these two alexithymia scales therefore seem suitable for use among college students and psychiatric outpatients. However, there were several problematic points which may be associated with cultural differences.

Emotional disturbances in trauma patients during the rehabilitation phase: Studies of posttraumatic stress disorder and alexithymia

Recent studies have shown a partial similarity between posttraumatic stress disorder (PTSD) and alexithymia. In this study, the authors examined the relationship between PTSD and alexithymia in two samples of 26 patients with burn injury and 27 patients with digit amputation during rehabilitation. The prevalence rates of DSM-III-R PTSD and alexithymia assessed by the Toronto Alexithymia Scale (TAS) were significantly higher for injury patients than for healthy volunteers. The rate of PTSD symptoms of avoidance and emotional numbing was significantly and positively correlated with the TAS scores in injury patients. The PTSD symptoms of avoidance and emotional numbing had a significant relationship with function after digit replantation. Alexithymia also had a similar relationship with physical conditions. These results suggest that 1) in some cases, alexithymia may be evident when PTSD emotional symptoms appear in injury patients, and 2) emotional disturbances (i.e., PTSD symptoms of avoidance and emotional numbing and alexithymia) may be influenced by the level of functional recovery after digit replantation.

Alexithymia and Coping with Stress in Healthy Persons: Alexithymia as a Personality Trait is Associated with Low Social Support and Poor Responses to Stress:

We examined the relationship between alexithymia and coping with stress among 179 Japanese healthy volunteers. Two correlational analyses indicated that persons scored as alexithymic were more likely to indicate lower social support and poorer responses to stress. Multiple regression analysis also indicated that these lowered coping responses were fully explained by alexithymia scores. These results suggest that alexithymia, as a personality trait, may help to explain these individuals low social support and poor responses to stress.

Validity and reliability of the Japanese version of the Stress and Coping Inventory

Abstract We examined the validity and reliability of the Japanese version of the Stress and Coping Inventory (SCI) among 170 Japanese college students and 234 healthy subjects. The validity and reliability of this version of the SCI in the college student group were supported by significant test‐retest correlations, relatively high internal consistency coefficients, and adequate correlations with the Coping Inventory for Stressful Situations (CISS). AS for the healthy subject group, the reliability was supported by relatively high internal consistency coefficients, although further analyses, such as test‐retest, are required. The Japanese version of the SCI appears to be suitable for use among college students.

Epidemiological Surveys of Senile Dementia in Japan

Epidemiological surveys of senile dementia at home were carried out on 3,754 subjects for two consecutive years, 1987 and 1988. The prevalence and incidence rates were 4.1% and 1.01%, respectively. Concerning the incidence rate, the sample populations of previous reports were small in number — less than 1,000. If we suppose that the incidence were to be approximately 1%, then it follows that dementia would be noted yearly in no more than one out of 100 senile subjects. A difference in subject number leads to a great difference in the incidence. Therefore, it is necessary that the number of subjects should be more than 1,000 for a comprehensive epidemiological survey of incidence rate of senile dementia. Accordingly, the present study is a better representation of the true picture as it was obtained by a more accurate method accompanied by less errors.

Criterion-Related Validity of Diagnostic Criteria for Alexithymia in a General Hospital Psychiatric Setting

BACKGROUNDnThe diagnostic criteria for alexithymia (DCA) was proposed by Fava et al. in 1995. The purpose of this study was to examine the criterion-related validity of the DCA in a general hospital psychiatric setting.nnnMETHODSnThe subjects included 126 outpatients with psychiatric disturbance. The severity of alexithymic characteristics was assessed using the DCA and Beth Israel Hospital Psychosomatic Questionnaire (BIQ). Two Japanese versions of the 26-item Toronto Alexithymia Scale (TAS-26) and Minnesota Multiphasic. Personality Inventory-2 (MMPI-2) were administered.nnnRESULTSnThe DCA had relatively high sensitivity and specificity, indicating adequate discriminant validity. The discriminant validity of the DCA was also supported by significant associations of the DCA with the TAS-26 and MMPI-2. These results indicate that when used for screening, the DCA has adequate criterion-related validity.nnnCONCLUSIONSnThe DCA may be clinically useful in a general hospital psychiatric setting.

RELATIONSHIPS BETWEEN TYPE A BEHAVIOR, NARCISSISM, AND MATERNAL CLOSENESS FOR COLLEGE STUDENTS IN JAPAN, THE UNITED STATES OF AMERICA, AND THE PEOPLE'S REPUBLIC OF CHINA

The authors examined the relationships between Type A behavior and narcissism based on scores of college students in Japan, the United States of America, and the Peoples Republic of China. The scores on narcissism and Type A behavior differed significantly across the groups, being highest among the Chinese. In all three groups, the Type A scores were significantly and positively correlated with the scores on narcissism, and the latter were significantly and negatively correlated with the scores of mothers care. We refer in this study to cross-cultural comparisons from viewpoints of sociocultural and psychological family structure.

Japanese Type a Behavior Pattern Is Associated With "Typus Melancholicus": a Study From the Sociocultural Viewpoint

An examination of the relationship between Type A behavior pattern (TABP) and Typus Melancholicus (TM) in 212 coronary heart disease (CHD) patients in Japan revealed that: CHD patients with TABP were significantly more likely to have a depression-prone personality, what Tellenbach calls Typus Melancholicus; this tendency was observed not only in CHD patients but also among healthy Type A subjects; and TM is positively correlated with Type A. The results of our studies from a comparative sociocultural viewpoint indicate that TM may be involved in Japanese TABP, suggesting the possibility that driving, self-sacrificing and obsessional traits are related to Type A behavior in a variety of different cultural contexts.

Somatic Complaints Associated with Depressive Symptoms in HIV-Positive Patients

BACKGROUNDnAlthough several studies have indicated the association of mood states including depression with somatic complaints in HIV patients, there has been no report on Japanese HIV patients. The purpose was to examine the relationship between somatic complaints and mood states in HIV patients without AIDS.nnnMETHODSnSubjects were 50 HIV patients without AIDS. As controls, we used 47 healthy persons without HIV, matched for age and gender of the subjects. After the Structured Clinical Interview for the DSM-III-R, several inventories including the Profile of Mood States (POMS) were administered. The presence or absence of somatic complaints were examined.nnnRESULTSnNo patients fulfilled the criteria for the DSM-III-R Mood Disorders Including Major Depression. However, scores on depression as measured by the POMS were significantly higher for the HIV group than for the healthy group. Although depressive symptoms in the HIV group may not be strong enough to warrant a psychiatric diagnosis of mood disorders, these HIV patients may be prone to a depressive state. The HIV patients indicated somatic complaints more frequently. Among these, the presence or absence of five complaints (i.e., abdominal distress, sleep disturbance, smothering sensations, chest pain or discomfort, and numbness or chills) was significantly discriminated based on scores on depression.nnnDISCUSSIONnThe results suggest that depressive symptoms accompany several somatic complaints in HIV patients without AIDS. Although a longitudinal follow-up study is required, the assessments of somatic symptoms may bring clinical benefits such as earlier diagnosis and/or intervention for a depressive state.

Are abnormal gastrofiberscopic findings related to hostility with poor social support or to negative responses to stress

Recent studies have highlighted physiological effects of emotional stress presumably leading to gastrointestinal disease. This study examined the effects of stress (hostility) and coping (social support and negative responses to stress) on asymptomatic gastric diseases. We investigated whether gastrofiberscopic findings were related to stress and coping in 269 volunteers without gastrointestinal complaints. These subjects were taking part in primary health care assessments. Analysis of variance found that volunteers with abnormal gastrofibercopic findings (i.e., erosions and/or ulceration) demonstrated significantly higher hostility and lower social support scores than those without abnormal findings. Analysis of covariance found that abnormal gastrofiberscopic findings remained significantly related to hostility scores after controlling for hostilitys correlations with social support and negative responses to stress. The results suggest that hostility, along with poor social support or negative responses to stress, is associated with asymptomatic gastric disease.