Effects of behavioural activation on the neural circuit related to intrinsic motivation

[Background] Behavioural activation is an efficient treatment for depression and can improve intrinsic motivation. Previous studies have revealed that the frontostriatal circuit is involved in intrinsic motivation; however, there are no data on how behavioural activation affects the frontostriatal circuit. [Aims] We aimed to investigate behavioural activation-related changes in the frontostriatal circuit. [Method] Fifty-nine individuals with subthreshold depression were randomly assigned to either the intervention or non-intervention group. The intervention group received five weekly behavioural activation sessions. The participants underwent functional magnetic resonance imaging scanning on two separate occasions while performing a stopwatch task based on intrinsic motivation. We investigated changes in neural activity and functional connectivity after behavioural activation. [Results] After behavioural activation, the intervention group had increased activation and connectivity in the frontostriatal region compared with the non-intervention group. The increased activation in the right middle frontal gyrus was correlated with an improvement of subjective sensitivity to environmental rewards. [Conclusions] Behavioural activation-related changes to the frontostriatal circuit advance our understanding of psychotherapy-induced improvements in the neural basis of intrinsic motivation. [Declaration of interest] None.This work was supported by a Grant-in-Aid for Scientific Research on Innovative Areas from Japan Society for the Promotion of Science, JSPS (grants 16H06395 and 16H06399), and grant 23118004 from the Ministry of Education, Culture, Sports, Science and Technology, Japan. This work was partially supported by the programme for Brain Mapping by Integrated Neurotechnologies for Disease Studies (Brain/MINDS) by Japan Agency for Medical Research and Development, AMED (grant 15dm0207012h0002) and Integrated Research on Depression, Dementia and Development Disorders by AMED (grant 16dm0107093h0001). The funders had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation or review of the manuscript or decision to submit the manuscript for publication

Stressors and depressive symptoms in university students who do not receive counseling

抑うつ症状を有する大学生への心理療法は有効であることが示されているが，これらの効果は心理療法を受けた者に限られる。今後は，悩みを抱えながら相談に来ない学生へのサポートも重要になると考えられる。そこで，悩みを抱えながら相談に来ない学生の特徴を明らかにするために，本研究では，カウンセリングを受けている大学生とカウンセリングを受けていない大学生で，抑うつ症状と各ストレッサーの頻度に違いがあるかを明らかにすることを目的とした。本研究の結果，カウンセリングを受けていない大学生のうち，37.57％の大学生が高い抑うつ症状を有し，およそ15% から20％の大学生が高ストレッサーにさらされていることも明らかになった。大学生にもストレスチェック制度のように，学生自身のストレスへの気づきを促し，メンタルヘルスの不調を予防するような取り組みが必要ではないかと考えられる。Psychotherapy is effective for university students with depressive symptoms, but these effects are limited to those who receive psychotherapy. In the future, it will be important to provide support for students who have such issues but do not come for counseling. Therefore, to determine the characteristics of students with depressive problems who do not attend counseling, this study aimed to examine whether there is a difference in the frequency of depressive symptoms and each stressor between university students who did and did not receive counseling. The results of this study revealed that 37.57% of university students who did not receive counseling had high depressive symptoms and around 15–20% of them were exposed to high stressors. This study suggested that measures may be necessary to encourage university students to be aware of their own stress to prevent mental health problems such as through the use of a stress check system.本研究は，JSPS科研費（19K14449）の助成を受けて実施された

Transition of the psychosomatic symptoms in young patients with developmental disorder <Original Article>

青年期に初めて精神科を受診する発達障害は多くが高機能であるが，二次障害（併存症）が問題となることが多い。早期に何らかの症状を呈していなかったであろうか。今回われわれは，メンタルヘルス問題をかかえて受診した，発達障害症例73例（男性47例，女性26例）について，過去の心身医学的症状の有無や変遷について調査した。過去の情報が入手できた42例では，59.5％が幼少期に心身症症状を呈していた。心身症症状は多くが青年期になると，抑うつ等の精神症状に変化していた。また，過去に治療を受けた症例の多くは，青年期の適応が良好であった。幼少期の心身症症状などのサインを発見し，早期に介入することで，青年期の二次障害を防ぐことができる可能性が示唆された。Most young patients with developmental disorders who consult psychiatrists for the first time during their adolescence may not have mental weakness, but there is high possibility that they may be suffering from comorbidities. We investigated the presence and transition of past psychosomatic symptoms of 73 patients (47 male and 26 female) with developmental disorders. Past information was available in 42 cases, and 59.5% of them had psychosomatic symptoms in their childhood. The symptoms changed for depressive symptoms in many cases. Many cases treated in the past showed good adaptation during their adolescence. Finding psychosomatic symptoms during childhood and intervening at an early time may prevent secondary psychiatric symptoms in their adolescence

Inward-oriented Japanese students and international exchange <Original Article>

グローバル人材育成の一環として，日本人大学生の海外留学を促進させるべく多くの留学プログラムが高等教育機関では提供されている。しかし，国内での国際交流も，グローバル人材育成において重要な役割を担っている。本研究では，「内向き志向」と国際交流について検討した。国際交流における問題や利点について検討し，「内向き」と「外向き」な大学生を比較検討した。その結果，国際交流の意思と経験には差がなかった。しかし，「内向き」な大学生は，留学生との文化の違いや留学生とかかわることに対する不安が高く，その一方で，「外向き」な大学生は，国際感覚や就職に役立つ経験を，国際交流を通して得ることができると感じていた。国際交流を促す際，国際交流の良さや注意点について十分に情報提供し，特に「内向き」な大学生の不安を和らげることの重要性が示唆された。Higher education institutions are offering many study abroad programs for Japanese university students for them to build their global talents. However, international exchange programs with international students in Japan are also thought to play an important role in building Japanese students’ global talents. In this study, the relationship between inward-oriented students and international exchange was discussed. The problems and merits of international exchange were examined, and inward-oriented students and outward-oriented students were compared. There were no differences in their willingness or in their experiences of international exchange. However, inward-oriented students felt more anxious about the difference in cultures and about having relationships with international students. On the other hand, outward-oriented students thought that they will be able to build their international sensibility through international exchange and that it will be an experience which will help them with their career. The importance of presenting the students with enough information about the good aspects and cautions of international exchange is emphasized especially to decrease the anxiousness of inward-oriented students

Relationship between developmental disabilities and school avoidance tendencies in university students <Original Article>

本研究は大学生の発達障害の特性と不登校傾向との関連について検討することを目的とした。無記名自記式の質問紙調査を行い，分析対象者は284名であった。クラスタ分析の結果，全ての尺度において困難を頻繁に感じている群の学生は，登校回避傾向が最も高かった。重回帰分析の結果，「不注意」が「登校回避行動」に影響を与え，「不安・抑うつ」「不注意」が「登校回避感情」に影響を与えることが示された。対人関係や心理的問題に限らず，学生の自己管理能力にも注目して関わることが，不登校の学生支援において有効である可能性が示唆された。The purpose of this study was to disclose the relationship between developmental disabilities and school avoidance tendencies in university students. Data of 284 university students who answered questionnaires anonymously were analyzed. As a result of the cluster analysis, students who frequently feel difficulty in all measures had the highest school avoidance tendencies. As a result of the multi-regression analysis, it was indicated that “carelessness” had influence on “attitudes of school avoidance tendency”, and that “anxiety and depression” and “carelessness” had influence on “feelings of school avoidance tendency”. Focusing on the students’ self-management abilities as well as interpersonal relationships and psychological problems is suggested to be effective when supporting students with school avoidance tendencies

Insomnia disorder in university students <Original Article>

日本では約５人に１人が入眠困難，中途覚醒，早朝覚醒などの睡眠の問題を抱えていることが報告されている。大学生においても生活が深夜型化しており，睡眠の問題を主訴にメンタルヘルス相談を希望する学生が増加している。われわれは，本学の教養科目を受講した大学生を対象に，睡眠に関するアンケート調査を実施した。多くの学生が，睡眠時間の不足や日中の眠気，睡眠の質への不満を感じていた。不眠障害はうつ病の発症や不登校への関与も報告されており，身体面や精神面への影響は大きい。大学生活への適応が困難となる事例もあるため，大学メンタルヘルスにおいても，学生に対して不眠障害に関する知識や情報の提供，早期の支援が必要であると思われる。It is reported that twenty percent of Japanese people suffer from sleeping problems such as difficulty getting to sleep, arousal during sleep, and early-morning awakening. This is also thought to be true with university students who tend to have life styles that last through the night. The number of university students who come for mental health consultations about their sleeping problems are increasing. A questionnaire about sleep was conducted to university students in a class. Many students felt that they did not have enough sleep, felt sleepy during the day, and was unsatisfied with the quality of their sleep. Insomnia disorder is said to be related to depression and school refusal, and its physical and mental effects are significant resulting in, for example, difficulty adapting to campus life. On campus, it would be important to provide the students with appropriate information about insomnia disorders, and to offer early support

Evaluation of depression when entering a university <Original Article>

近年，大学生のうつは増加傾向にあり，学校生活にも大きな影響を及ぼす。また，早期にうつ病を発症すると，その後も再発しやすく，慢性的な経過をたどる。そのために，大学メンタルヘルスの現場において，抑うつ症状の早期発見と早期治療は極めて重要である。そこで，本研究では，抑うつ症状の程度によって，BDI-IIの各項目得点に違いがあるかを検討した。その結果，自殺念慮，悲しみや喜びの消失，罪責感，活力喪失といった項目が高得点の場合には，総得点が有意に高くなることが明らかになった。また，これらの項目で高得点を示した新入生は，全体の約１％であった。今回の検討から，総得点だけでなく，自殺念慮や悲しみ，喜びの消失，罪責感，活力喪失などの項目にも注目して検討し，早期の支援につなげていく必要があると考えられた。In recent years, the number of university students with depression is increasing, and depressive symptoms have substantial impact on school life. Additionally, the early onset of depression is more likely to relapse and have a chronic course. Therefore, early detection and treatment of depressive symptoms are extremely important. We examined whether there were significant differences in item scores of BDI-II among the degrees of depressive symptoms. Results showed that the total score is significantly higher when the scores of suicidal thoughts, sadness, loss of pleasure, guilty feelings, and loss of energy are high. About one percent of the freshmen reported high scores in these items. Our study suggested importance of paying attention to the items such as suicidal thoughts, sadness, loss of pleasure, guilty feelings, and loss of energy