Yuko Morimoto

Dementia behaviour management programme at home : impact of a palliative care approach on care managers and professional caregivers of home care services

ABSTRACT Objectives: Care managers and professional caregivers of home care services are sometimes unaware of the psychosocial approaches to the challenging behaviour of dementia. Therefore, we developed a Behaviour Analytics & Support Enhancement (BASE) programme. We investigated the effects of the programme on the attitudes towards dementia care among professionals. Method: Forty-six participants in Japan received training in August 2016. The ongoing monitoring and assessment system was introduced to the participants for repeated measures of challenging behaviour. A 1-day follow-up meeting for debriefing was also performed after two months. A baseline and follow-up questionnaire survey was administered to the participating caregivers using a Japanese version of the Approaches to Dementia Questionnaire (ADQ) and the Zarit Burden Interview (ZBI). Results: A significant improvement was observed in the total ADQ score among the participating caregivers from baseline to follow-up assessment. There was no significant difference between the baseline and follow-up assessment in the ZBI scores. In the follow-up meeting, several participants reported challenges and suggested solutions in facilitating a discussion on an action plan among professionals from various organizations. Conclusion: The implementation of the programme resulted in enhanced attitudes towards dementia care among the participants without an increased burden of care. Future studies should examine the programmes effectiveness on the challenging behaviour of persons with dementia.

Enuresis and hyperactivity-inattention in early adolescence: Findings from a population-based survey in Tokyo (Tokyo Early Adolescence Survey).

Background Enuresis (9% at age 9.5) negatively affects children’s psychosocial status. Clinically-diagnosed enuresis (2% at the age) is associated with hyperactivity-inattention, and common neural bases have been postulated to underlie this association. It is, however, unclear whether this association is applicable to enuresis overall among the general population of early adolescents when considered comorbid behavioral problems. We aimed to examine whether enuresis correlates with hyperactivity-inattention after controlling for the effects of other behavioral problems. Methods Participants were 4,478 children (mean age 10.2 ± 0.3 years old) and their parents from the Tokyo Early Adolescence Survey (T-EAS), a population-representative cross-sectional study conducted in Tokyo, Japan conducted from 2012 to 2015. Children’s enuresis and behavioral problems, including hyperactivity-inattention (as measured by the Strength and Difficulties Questionnaire), were examined using parent-reporting questionnaires. Multivariate linear regression was used to explore whether enuresis predicts hyperactivity-inattention. Results The hyperactivity-inattention score was significantly higher in the enuretic group than the non-enuretic group (enuretic: M (SD) = 3.8 (2.3), non-enuretic: M (SD) = 3.0 (2.1), Hedge’s g = 0.39, p < .001). This association remained significant even after controlling for other behavioral problems and including sex, age, intelligence quotient (IQ), low birth weight and parents’ education (β = .054 [95% CI: .028–.080], p < .001). Conclusions Enuresis was independently associated with hyperactivity-inattention in early adolescents among general population even when other behavioral problems were considered. These results suggest that, as with clinically-diagnosed cases, enuresis may predict need for screening and psychosocial support for hyperactivity-inattention.

Faces in the dark: interactive effects of darkness and anxiety on the memory for threatening faces

In the current research, we extend past work on the effects of ambient darkness and threat to the domain of memory for expressive faces. In one study, we examined the effects of ambient darkness and individual differences in state anxiety on memory of unfamiliar expressive faces. Here, participants were seated in either a dark or light room and encoded a set of unfamiliar faces with angry, happy, and neutral facial expressions. A subsequent recognition task revealed an interactive effect of ambient darkness, anxiety, and target expression. Highly anxious participants in ambient darkness had worse memory for angry faces than did low-anxiety participants. On the other hand, the recognition performance for happy faces was affected neither by the darkness nor state anxiety. The results suggest not only that ambient darkness has its strongest effect on anxious perceivers, but also that person × situation effects should be considered in face recognition research.

Disciplinary slapping is associated with bullying involvement regardless of warm parenting in early adolescence

INTRODUCTION Bullying among adolescents can cause depression and suicidality. Identifying the risk factors for bullying in early adolescence, when its prevalence tends to increase, would assist in its prevention. Although certain parenting styles are known to be associated with bullying, the association of slapping as a parental disciplinary practice with early adolescent bullying is not sufficiently understood. Furthermore, little is known about how warm parenting modifies this association although slapping and warm parenting are not mutually exclusive. The aim of this study was to investigate the association of slapping with the experience of early adolescent bullying--categorized in terms of victims, bullies, and bully-victims--while considering how warm parenting modifies this association. METHODS This study used data from the Tokyo Early Adolescence Survey, a cross-sectional survey of 4478 children aged 10 from the general population. Data were collected from both children and their primary parent using self-administered questionnaires and face-to-face interviews. Responses from 4326 participants with no missing data were usable for the current analysis (mean age,  10.2 ± 0.3 years; 53 % boys). RESULTS Frequent and occasional slapping was associated with increased odds of youth being identified as bullies or bully-victims, even after adjusting for warm parenting. The likelihood of being victims, bullies or bully-victims increased as the frequency of slapping increased. CONCLUSION Disciplinary slapping was associated with increased odds of bullying in early adolescence, regardless of whether warm parenting was present or not.

Purpose in life and tobacco use among community-dwelling mothers of early adolescents

Objectives The rising prevalence of tobacco use and tobacco-attributable deaths among women is of worldwide concern. In particular, smoking prevention for mothers in early midlife is a significant international public health goal. A higher sense of purpose in life (PIL) is thought to reduce detrimental health behaviours. However, little is known about the association between a sense of PIL and tobacco use. This study investigates this association among community-dwelling mothers of early adolescents. Design This population-based cross-sectional study uses a self-reported questionnaire from the Tokyo Early Adolescence Survey, a large community-based survey conducted in Japan between 2012 and 2015. Setting Participants were randomly recruited from the resident registries of three municipalities in Tokyo, Japan. Participants A total of 4478 children and their primary parents participated. Responses from 4063 mothers with no missing data were analysed (mean age=42.0 years (SD=4.2)). Measures Participants’ tobacco use, including the number of cigarettes smoked per day, was documented using a questionnaire. PIL was assessed using a Purpose in Life scale derived from Ryff’s Psychological Well-Being Scale. Results Greater PIL was associated with a decreased likelihood of tobacco use, even when adjusted for confounders (OR=0.80, 95% CI 0.70 to 0.91). Multinomial logistic regression analyses revealed that PIL was inversely associated with tobacco consumption among mothers. These associations remained after controlling for psychological distress, socioeconomic factors and frequency of alcohol consumption among moderate to heavy smokers (OR=0.70, 95% CI 0.57 to 0.86), while attenuated among light smokers. Conclusions Increasing PIL may be a valuable intervention for reducing tobacco use among women in early midlife. This study can contribute to our understanding of the psychology of smoking behaviour and shed light on the targeted intervention to reduce tobacco use among early midlife mothers.

Sex differences in auditory verbal hallucinations in early, middle and late adolescence: results from a survey of 17 451 Japanese students aged 12–18 years

Objectives Women have higher rates of auditory verbal hallucinations (AVH) than men; however, less is known about sex differences in the prevalence of AVH in early, middle and late adolescence. We sought to elucidate the differences in the prevalence of AVH and to examine the degree to which these differences could be explained by differences in levels of depressive symptoms. Design We used a cross-sectional design and a self-reported questionnaire. Setting Participants were recruited from public junior and senior high schools in Tsu, Mie Prefecture and Kochi Prefecture, Japan. Participants In total, 19 436 students were contacted and 18 250 participated. Responses from 17 451 students with no missing data were analysed (aged 12–18 years, Mage=15.2 years (SD=1.7), 50.6% girls). Measures AVH were assessed through one of four items adopted from the schizophrenia section of the Japanese version of the Diagnostic Interview Schedule for Children. Depressive symptoms were assessed using the 12-item General Health Questionnaire. Results The prevalence of AVH was 7.0% among early adolescents (aged 12–13 years), 6.2% among middle adolescents (aged 14–15 years) and 4.8% among late adolescents (aged 16–18 years). Being female was significantly associated with a higher prevalence of AVH through adolescence (OR=1.71, 95% CI 1.31 to 2.23 in early adolescence; OR=1.42, 95% CI 1.14 to 1.76 in middle adolescence; OR=1.52, 95% CI 1.23 to 1.87 in late adolescence); however, these differences became non-significant after adjusting for depressive symptoms (OR=1.21, 95% CI 0.92 to 1.60; OR=1.00, 95% CI 0.80 to 1.25; OR=1.16, 95% CI 0.93 to 1.44, respectively). Conclusions Sex differences in auditory hallucinations are seen in both adult and youth populations. The higher rates of auditory verbal hallucinations seen in girls may be secondary to the differences in the rate of depressive symptoms.