Shuji Honjo

Maternity blues and attachment to children in mothers of full‐term normal infants

Objective: This study was conducted for evaluating incidence of maternity blues in Japan, in addition to clarifying the relationship between maternity blues and maternal attachment, and the factors involved.

Antenatal Depression and Maternal-Fetal Attachment

Background: In recent years, attention has been turned to maternal mental health in relation to the mother-child relationship accompanying a widening in focus, i.e. taking into account not only the puerperium, but also the stage of pregnancy. This applies to studies that have revealed a connection between depression and maternal attachment in the postpartum period and late pregnancy. This study, however, was designed to evaluate the maternal-fetal relationship in the first and second trimesters, being the first one to address this issue in these early stages. Sampling and Methods: Zung’s Self-Rating Depression Scale (ZSDS), the original Antenatal Maternal Attachment Scale (AMAS), and a questionnaire addressing peripheral factors were given to 216 pregnant women (3–6 months of gestation) who visited the Nagoya University Hospital between September 1998 and June 2001. Results: Contrary to reports on the latter stages of pregnancy, no direct association was observed between depression in mothers and maternal-fetal attachment before fetal movement was perceived. Conclusion: However, education, form of employment, planning of pregnancy, and premenstrual mood changes were found to be associated with the ZSDS score (mean: 41.9), while form of employment, feelings regarding pregnancy, and sources of support were extracted as factors associated with the AMAS, which are of interest in terms of the subsequent association between depression and maternal-fetal attachment in the peri- and postnatal periods.

Depression in the Mother and Maternal Attachment – Results from a Follow-Up Study at 1 Year Postpartum

Although evidence exists pointing to the impact of maternal depression in puerperium upon mother-child interaction, longitudinal studies on this perspective are rare. Hence, this study was designed to examine the association between maternity blues and maternal attachment in the puerperium with depression in the mother and attachment after 1 year together with the factors involved. A questionnaire survey consisting of Zung’s Self-Rating Depression Scale (ZSDS) and a ‘maternal attachment’ scale, comprised of subscales on ‘core maternal attachment’ and ‘anxiety regarding children’, was conducted on mothers who had participated in a previous puerperium survey. The mean ZSDS score of 42.1 ± 7.45 after 1 year did not differ significantly from puerperium results. ‘Maternity blues’ was found to influence the maternal depression after 1 year, which was in turn associated with ‘core maternal attachment’ and ‘anxiety regarding children’, supporting the need for early intervention in maternity blues starting in the perinatal period for the mental health of mother and child.

School refusal and depression with school inattendance in children and adolescents: comparative assessment between the Children's Depression Inventory and somatic complaints.

Abstract School refusal has become a relatively common problem of increasing magnitude in Japan. Although clarification of the relationship between ‘school refusal’ and ‘depression with school inattendance’ is crucial in light of the difference in treatment modalities involved, it is not clear whether the two are to be regarded along the same tangent or as disparate entities. For clarification, a comparison was made between clinical diagnosis, Children’s Depression Inventory (CDI) scores, and scores for the three subordinate scales of the CDI in 34 cases of school refusal, 10 cases of depression with school inattendance, and normal students. Significant difference in CDI score was noted between the three groups: highest among depression cases, followed by school refusers, and lowest in normal students. A larger proportion of school refusers expressed somatic complaints together with low CDI scores. The typical case of school refusal appears to exhibit somatic complaints in the foreground rather than depression, both clinical characteristics and CDI scores indicate school refusal and depression to be separate entities. Although many approaches are being taken in the treatment of school refusal, the results appear to justify primacy of the psychotherapeutic approach with the possible adjuvant use of pharmacological agents, for the phenomenon as it presents in Japan.

Regional brain cerebral glucose metabolism and temperament : A positron emission tomography study

Personality, and in particular temperament, is thought to have a biological basis. In the present study, the relationships between regional brain glucose metabolism and temperament have been investigated. Regional brain glucose metabolism was measured using [18F] fluorodeoxyglucose positron emission tomography in 31 healthy subjects. Temperament was assessed using the Temperament and Character Inventory. Temperament dimensions were observed to be significantly correlated with specific brain regions. In particular, novelty seeking was significantly correlated with the superior temporal gyrus, inferior parietal lobule, and the precuneus, which have been reported to be related with impulsiveness, while reward dependence was significantly correlated with the caudate head, which has been shown to be associated with reward processing. The various aspects of temperament may have biological bases in the specific brain regions. The accumulation of results from studies of this kind should provide further evidence connecting personality traits with their biological bases.

Prefrontal overactivation, autonomic arousal, and task performance under evaluative pressure: A near‐infrared spectroscopy (NIRS) study

To study the mechanism underlying the influence of psychological pressure on task performance, we investigated the relationship between prefrontal activation, autonomic arousal, and performance in an n-back working memory task with 3 load levels (l-, 2-, and 3-back tasks) under evaluative pressure. The tasks were performed by 32 university students with or without evaluative observation by experimenters. The error rate and prefrontal activation were found to increase with pressure only in the highest load task (3-back). In contrast, autonomic arousal increased with pressure regardless of the task condition. Correlation analysis showed a positive correlation of the error rate with prefrontal activation in the 3-back task and no consistent correlation with autonomic arousal. We concluded that the inhibitory effect of evaluative pressure on task performance is mediated by prefrontal overactivation rather than autonomic arousal.

Hemodynamic Changes in the Prefrontal Cortex during Digit Span Task: A Near-Infrared Spectroscopy Study

Background/Aims: In this study, we examined changes in the concentrations of oxygenated and deoxygenated hemoglobin (oxy- and deoxy-Hb, respectively) in the prefrontal cortex (PFC) during the digit span task by using near-infrared spectroscopy (NIRS). Methods: The digit span task consists of the digit span forward and backward tasks. The tasks were performed by 22 healthy undergraduate students who participated in this study. Differences in the mean concentrations of oxy-Hb and deoxy-Hb between the baseline and task intervals were evaluated. Results: In digit span backward, oxy-Hb was significantly higher during the task interval than during the baseline. Further, deoxy-Hb was significantly lower during the task interval than during the baseline in both digit span forward and digit span backward. Digit span forward performance was significantly higher for the right-PFC-dominant group than for the left-PFC-dominant group. Conclusion: These results suggest that the digit span backward task is more demanding and requires greater activation of the prefrontal cortex than the digit span forward task. Our NIRS findings suggest that the digit span backward task involves executive functioning.

Personality and defense mechanisms in late adulthood.

Objective: Current understanding of the use of psychological defense mechanisms (DMs) in older adults is limited. This study set out to examine individual differences in DMs and Cloningers biosocial model of personality in two age groups (50—64, 65—93), as well as their influence on health. Methods: A Japanese community sample (N = 330) completed the Temperament and Character Inventory (TCI-125), the Defense Style Questionnaire (DSQ-40), and the General Health Questionnaire (GHQ-28). Results: Across age groups, psychological well-being was related to lower levels of harm avoidance and higher levels of self-directedness. In addition, older age was related to decreases in reward dependence, cooperativeness, and increases in self-transcendence, DMs of isolation, denial, and splitting. Discussion: An Age × Gender interaction revealed that men and women varied in their pattern of age differences for some specific DMs. Results further suggest that image-distortion defense may function to compensate resource loss.

A mother's complaints of overeating by her 25‐month‐old daughter: A proposal of anorexia nervosa by proxy

The following is a report on a case of a 25-month-old girl brought in by her mother with complaints of overeating. The patient was referred to the Psychiatric Clinic of Nagoya University Hospital from the Department of Pediatric Surgery. The mother indicated the patient to have begun overeating before the age of 1 year. However, the patient was of low height and low body weight, and appeared, rather, to have been underfed. The issue was the mother placing severe restrictions on the childs diet, pathologically afraid of the child overeating. The mother seemed to have been suffering from a disorder similar to anorexia nervosa, although not typical. Her fear that her child might eat too much was believed to be a projection of the mentality characteristic of anorexia nervosa on to her child, which would justify labeling the childs condition anorexia nervosa by proxy.

Study on feelings of school avoidance, depression, and character tendencies among general junior high and high school students

School refusal is a phenomenon that first drew attention in Japan around 1960 and it remains one of the major issues in child psychiatry today. Moreover, it is now said that there exists a large group of latent school refusers currently attending school but harboring feelings of school avoidance. To address this issue, a questionnaire survey was conducted on students enrolled in a junior high and high school affiliated with the Nagoya University School of Education. The questionnaire consisted of the Childrens Depression Inventory (CDI), a scale for evaluating feelings of school avoidance (School Avoidance Scale), and a scale for assessment of personality characteristics associated with school refusal (School Refusal Personality Scale). The subjects were 425 first‐year junior high to second‐year high school students. Factor analysis of each scale revealed the CDI to consist of three factors: ‘core depression’, ‘feelings of interpersonal maladaptation’, and ‘self‐revulsion’, and the School Avoidance Scale to consist of two factors: ‘school dislike’, and ‘school avoidance’. The School Refusal Personality Scale consisted of three factors: ‘obsessive–compulsive’, ‘passive/unsocial’, and ‘socially introverted’. Mean CDI score and standard deviation (SD) was 19.44 ± 7.49, and that for ‘feelings of school avoidance’ was 20.18 ± 5.61. The two subordinate factors of the School Avoidance Scale were intimately associated with both ‘feelings of interpersonal maladaptation’ and ‘core depression’ of the CDI, and negatively correlated with the ‘obsessive–compulsive’ factor of the School Refusal Personality Scale.