心理的ウェルビーイングの向上が全般性不安症状に影響を与えるプロセスの検討

内容の要約広島大学(Hiroshima University)博士(学術)Philosophydoctora

Factorial Validity and Invariance of the 7-Item Generalized Anxiety Disorder Scale (GAD-7) Among Populations With and Without Self-Reported Psychiatric Diagnostic Status

The 7-item Generalized Anxiety Disorder Scale (GAD-7) is commonly used to monitor anxiety symptoms. However, its factor structure has been inconsistent among competing models: unidimensional, two-dimensional, or higher order models. Additionally, it is unknown whether the scale has measurement invariance between populations with and without self-reported psychiatric diagnostic status. Participants were Japanese adults with self-reported anxiety disorder (AD; n = 479), self-reported AD and major depressive disorder (MDD; n = 314), or without self-reported psychiatric diagnostic status (self-reported non-MDD/AD; n = 654), who completed this questionnaire on the Internet. Confirmatory factor analyses showed the higher order model had similar fit indices to the unidimensional and two-dimensional factor models. For the higher order model of GAD-7, metric invariance was supported between the self-reported non-MDD/AD and self-reported AD status groups, and scalar invariance was supported between the self-reported AD status and self-reported AD with MDD status groups. Moreover, convergent and discriminant validity were consistent with previous findings in Western cultures. These results suggest that factor loadings are equivalent and the construct has the same meaning between the self-reported non-MDD/AD and self-reported AD status groups, and the total or sub-scale scores were comparable between self-reported AD status and self-reported AD with MDD status groups. The major limitation of this study is that the participants’ diagnoses were self-reported, not confirmed by clinical structured interview. Further studies that incorporate clinical structured interviews are needed

Well-Being and Generalized Anxiety in Japanese Undergraduates: A Prospective Cohort Study

Psychological well-being is thought to protect against common mental health problems. This study investigated the buffering effects of psychological well-being on the relationships between cognitive vulnerabilities (fear of anxiety and negative beliefs about worry) and GAD symptoms among 297 Japanese undergraduates (female = 62%, age = 18.91 ± 1.61) in a two-wave prospective cohort study. Participants completed the Generalized Anxiety Disorder Questionnaire for DSM-IV, Center for Epidemiologic Studies Depression Scale, anxiety control subscale of Affective Control Scale, negative belief about worry subscale of Meta-Cognitions Questionnaire, and Nishida’s psychological well-being scale. A moderated regression analysis tested the buffering effect of psychological well-being sub-dimensions on the relationship between cognitive vulnerabilities and generalized anxiety symptoms. Fear of anxiety (β = 0.16, p＜0.01) and negative beliefs about worry (β = 0.16, p＜0.01) at baseline predicted generalized anxiety at follow-up, after controlling for baseline symptoms, and three interaction terms significantly predicted generalized anxiety symptoms. Purpose in life and autonomy buffered the negative relationship between cognitive vulnerabilities and generalized anxiety symptoms. Contrary to the hypothesized relationship, positive relationships with others at baseline facilitated a positive relationship between fear of anxiety and generalized anxiety symptoms. Those results suggested that enhanced Purpose in life and Autonomy dimension of Psychological well-being may be useful in preventing GAD, while the enhanced positive relationship with others dimension of Psychological well-being may facilitate generalized anxiety, as a function of fear of anxiety. In a primary prevention setting, it may be useful to consider the dimensions of Psychological well-being.This study was supported by a Research Fellowships for Young Scientists (DC2) (13J01136, 16K17352) awarded to YT from the Japan Society for the Promotion of Science. The funders had no role in the study design, data collection and analysis, decision to publish, or manuscript preparation

A posteriori error estimates for discontinuous Galerkin Methods for the Generalised Korteweg-de Vries Equation

We construct, analyze and numerically validate a posteriori error estimates for conservative discontinuous Galerkin (DG) schemes for the Generalized Korteweg-de Vries (GKdV) equation. We develop the concept of dispersive reconstruction, i.e., a piecewise polynomial function which satisfies the GKdV equation in the strong sense but with a computable forcing term enabling the use of a priori error estimation techniques to obtain computable upper bounds for the error. Both semidiscrete and fully discrete approximations are treated

The relationship between geographical region and perceptions of radiation risk after the Fukushima accident: The mediational role of knowledge

Since the Fukushima accident, radiation risk perception has been of public concern. Factors related to regional differences in radiation risk perception and the role that knowledge of radiation effects plays are still not clearly understood. Here, we first assessed the validity of the Lindell radiation risk perception scale by comparing it with the mortality rate of traffic accidents. We then investigated the relationship between the perceptions and both the geographical regions and the knowledge of genetic effects and, further, verified the mediating role of knowledge in the perception. The sample comprised 832 participants who responded to an online questionnaire in August 2018, from Tokyo and Fukushima. There was a significant association between the Lindell scale and the perceived magnitude of genetic risk relative to traffic accident mortality. Knowledge of genetic effects after the atomic bombs was associated with perceptions of lower genetic risks. The relationship between geographical region and risk perception was mediated by knowledge. However, approximately 40% of those who had knowledge still perceived a high risk, indicating that perception is not governed by knowledge alone. In addition to efforts to share knowledge, it is important to interactively communicate regarding risk to alleviate the anxiety felt by individuals

Effect of Radiological Countermeasures on Subjective Well-Being and Radiation Anxiety after the 2011 Disaster: The Fukushima Health Management Survey

After the Fukushima Daiichi Nuclear Power Station accident in 2011, concerns about radiation exposure and decline in subjective well-being have been reported. To tackle these problems, various countermeasures in relation to radiation have been implemented. In this study, we comprehensively evaluated the effects of radiological countermeasures on subjective well-being (e.g., satisfaction with life (SWL) and emotional well-being) and radiation anxiety, through a questionnaire survey targeting Fukushima residents (N = 1023). Propensity scores matching was applied to evaluate significant effects of radiological countermeasures on subjective well-being and radiation anxiety. Among the radiological countermeasures, thyroid examination, whole body counter, and air dose monitoring showed the highest proportions of participation, utilization, and useful evaluation, suggesting a high degree of public attention focused on these countermeasures. The basic survey was associated with significant increases in SWL and self-rated health (SH). Thyroid examination was significantly associated with not only a reduction in radiation anxiety but also an increase of emotional stress, suggesting the importance of careful design of system and detailed communication. Food inspection was associated with deterioration in SH. Those who utilized explanatory meetings showed increases in sadness, worry, and radiation anxiety, indicating that additional attention is required of the experts and authorities involved in explanatory meetings

Pilot study of a basic individualized cognitive behavioral therapy program for chronic pain in Japan

Background: Chronic pain is a major health problem, and cognitive behavioral therapy (CBT) is its recommended treatment; however, efforts to develop CBT programs for chronic pain and assess their feasibility are remarkably delayed in Asia. Therefore, we conducted this pilot study to develop a basic individualized CBT for chronic pain (CBT-CP) and assessed its feasibility for use in Japan. Methods: Our study was an open-labeled before–after trial without a control group conducted cooperatively in five Japanese tertiary care hospitals. Of 24 outpatients, 15, age 20–80, who experienced chronic pain for at least three months were eligible. They underwent an eight-session CBT-CP consisting of relaxation via a breathing method and progressive muscle relaxation, behavioral modification via activity pacing, and cognitive modification via cognitive reconstruction. The EuroQol five-dimensional questionnaire five level (EQ5D-5 L) assessment as the primary outcome and quality of life (QOL), pain severity, disability, catastrophizing, self-efficacy, and depressive symptoms as secondary outcomes were measured using self-administered questionnaires at baseline, post-treatment, and 3-month follow-up. Intention-to-treat analyses were conducted. Results: Effect size for EQ5D-5 L score was medium from baseline to post-treatment (Hedge’s g = − 0.72, 90% confidence interval = − 1.38 to − 0.05) and up to the 3-month follow-up (g = − 0.60, CI = − 1.22 to 0.02). Effect sizes for mental and role/social QOL, disability, catastrophizing, self-efficacy, and depressive symptoms were medium to large, although those for pain severity and physical QOL were small. The dropout rate was acceptably low at 14%. No severe adverse events occurred. Conclusion: The findings suggest that CBT-CP warrants a randomized controlled trial in Japan

Relationships between radiation risk perception and health anxiety, and contribution of mindfulness to alleviating psychological distress after the Fukushima accident: Cross-sectional study using a path model.

One of biggest public health impacts of the Fukushima Daiichi Nuclear Power Station accident is psychosocial. Anxiety about radiation is still present, and radiation risk perception, particularly with regard to genetic effects, is known to affect mental health. However, roles of other risk factors such as health anxiety and of mindfulness remain to be proved. Here, we examined how radiation risk perception (genetic effects) mediates in health anxiety and psychological distress, and how mindfulness influences those variables. Seven years after the accident, we commissioned a self-reported online survey with 832 participants, 416 each from Fukushima and Tokyo, and modeled the relationship between those variables using Structural Equation Modeling. Health anxiety had a much stronger influence on psychological distress than radiation risk perception. Mindfulness was significantly correlated with both health anxiety and psychological distress, but not with radiation risk perception. The total effects on psychological distress were -0.38 by mindfulness and +0.38 by health anxiety. These results suggest the potential application of mindfulness-based interventions to alleviate health anxiety and psychological distress rather than therapy focused on radiation anxiety. The results underline the effectiveness of community support efforts in Fukushima and highlight the importance of enhancing mindfulness during the chronic phase following a disaster