Objectives : In recent years, the number of female college students with eating disorders has been increasing. This study aimed to develop the Abnormal Eating Behavior Scale-new version (AEBS-NV) and examine its reliability and the validity. Participants : In order to develop the AEBS-NV, we conducted a survey among female college students, and eliminated incomplete responses. Two hundred twenty-six participants (mean age : 20.4±2.6) were included in survey 1, and 104 participants (mean age : 19.9±1.1) were included in survey 2. Method : In order to examine the structure of the AEBS-NV, factor analysis was conducted. In order to test the validity of the scale, we classified the participants into three groups based on factor scores (low group : LG, middle group : MG, high group : HG). For the Eating Attitude Test-26 (EAT-26) and Eating Disorder Inventory (EDI) scores, we conducted a single-factor, within-groups analysis of variance. In addition, in order to determine the scale's cut-off score, we performed a receiver operating characteristic (ROC) analysis for each of the subscale scores. Results : The factor analysis extracted the following three factors from 33 items : Fac

Background: Several studies have reported an increased tendency towards anger in patients with panic disorder (PD). If this propensity for anger arises from the pathological process of PD, it may be associated with the duration of the illness. The present study therefore examined the relationship between duration of PD and the personality tendency to experience anger in PD patients.
Methods: Participants were 413 patients (132 men and 281 women; age = 38.7 years) with PD. Diagnoses were confirmed using the Mini-International Neuropsychiatric Interview. Illness duration ranged from less than a year to 51 years. After participants completed the Revised NEO Personality Inventory, we examined the association between illness duration and the Angry Hostility and Impulsiveness subscale scores. In the analysis, participants were divided into two groups by duration of illness (long group, n = 186 and short group, n = 200) using the median value (9 years) as a cut-off because of the skewed distribution of the duration. Patients with an illness duration of 9 years (n = 27) were excluded from the comparison.
Results: The duration of illness was significantly correlated with the Angry Hostility score (p = 0.002) after controlling for age. Scores were significantly higher in the long group than in the short group (p = 0.04). No significant association was observed between Impulsiveness scores and duration of illness.
Conclusion: The present study suggests that longer PD duration is related to a stronger tendency to experience anger.

Background: The purpose of this study was to investigate the effect of prolonged stress on the salivary adrenal hormones (cortisol, dehydroepiandrosterone [DHEA], DHEA-sulfate [DHEA-S]) of individuals with irritable bowel syndrome (IBS).
Methods: The participants were female college students, including 10 with IBS and 16 without IBS (control group), who were scheduled for a 2-week teaching practice at a kindergarten. Participants were asked to collect saliva for determining adrenal hormones immediately and 30 min after awakening and before sleep, 2 weeks before the practice, the first week of the practice, the second week of the practice, and a few days after the practice.
Results: Regarding cortisol/DHEA ratio, significantly increased levels were found during the first week of the practice, and a significant interaction between group and time was found; the ratio at 30 min after awakening in the IBS group was higher than that in the control group. For the other adrenal hormone indexes, no significant differences due to the presence of IBS were found.
Conclusions: Individuals with IBS showed an elevated cortisol/DHEA ratio after awakening compared with individuals without IBS, and the elevated ratio peaked under the prolonged stress. The present study suggests that the cortisol effect is dominant in individuals with IBS under prolonged stress.

Research has demonstrated the effectiveness of both individual and group cognitive behavior therapy (CBT) programs for social anxiety disorder (SAD) with patients in many countries. The present preliminary study reports the effectiveness of individual CBT for Japanese patients with SAD. Fifteen outpatients diagnosed with SAD completed an individual CBT program of six 50-min sessions with several components, including cognitive restructuring to modify cost and probability bias, repeated speech exposure, and homework about idiosyncratic anxiety-provoking situations. The results show that SAD symptoms improved after completion of the program. Large effect sizes were found for cognitive factors of SAD. In addition, repeated speech exposure was highly effective for improving the self-perception of subjective anxiety. The present findings suggest that an individual CBT program can be effective for reducing SAD symptoms with Japanese patients.

Objectives<BR>To develop a stressor scale for Japanese overseas residents that takes their general and specific circumstances into consideration.<BR>Methods<BR>In Study 1, an original version of the Stressor Scale for Japanese Overseas Residents - United Kingdom version (SSJR-UK) consisting of 47 items was drafted based on the Daily Hassles Scale and 13 items extracted using the KJ Method. Next, we administered it to Japanese residents in the UK (n = 369) to assess its reliability and construct validity. In Study 2, a subset of the UK group (n = 100) was compared to three other groups: Nordic countries (n = 65), Southeast Asia (n = 61), and Japan (n = 148) to identify stressors specific to life in the UK.<BR>Results<BR>Factor analysis was conducted using promax rotation and the following six factors were identified: daily life circumstances, psychological pressure, sense of fulfilment, health and future of the family, interpersonal relationships, and oral communication. Overall Cronbach's alpha was .90, which provides evidence of the scale's high internal consistency. Pearson product-moment correlation coefficients between each SSJR-UK factor scores and the CES-D were .28-.58 (p < .01) and between SSJR-UK factor scores and the SRS18 were .38-.67 (p <.01), which are indicative of the construct validity of the scale. The discriminability of the scale indicated that only the overall score and scores for the factors specific to conditions in the UK were significantly higher than in the other countries: F (4,370) = 9.19 (p < .001) and F (4,370) = 16.48 (p < .001), respectively.<BR>Conclusion<BR>The SSJR-UK has sufficient reliability and validity to measure the stressors of Japanese residents in the UK.

:Research has demonstrated the effectiveness of both individual and group cognitive behavior therapy (CBT) programs for social anxiety disorder (SAD) with patients in many countries. The present preliminary study reports the effectiveness of individual CBT for Japanese patients with SAD. Fifteen outpatients diagnosed with SAD completed an individual CBT program of six 50-min sessions with several components, including cognitive restructuring to modify cost and probability bias, repeated speech exposure, and homework about idiosyncratic anxiety-provoking situations. The results show that SAD symptoms improved after completion of the program. Large effect sizes were found for cognitive factors of SAD. In addition, repeated speech exposure was highly effective for improving the self-perception of subjective anxiety. The present findings suggest that an individual CBT program can be effective for reducing SAD symptoms with Japanese patients.

Objectives&lt;BR&gt;To develop a stressor scale for Japanese overseas residents that takes their general and specific circumstances into consideration.&lt;BR&gt;Methods&lt;BR&gt;In Study 1, an original version of the Stressor Scale for Japanese Overseas Residents - United Kingdom version (SSJR-UK) consisting of 47 items was drafted based on the Daily Hassles Scale and 13 items extracted using the KJ Method. Next, we administered it to Japanese residents in the UK (n = 369) to assess its reliability and construct validity. In Study 2, a subset of the UK group (n = 100) was compared to three other groups: Nordic countries (n = 65), Southeast Asia (n = 61), and Japan (n = 148) to identify stressors specific to life in the UK.&lt;BR&gt;Results&lt;BR&gt;Factor analysis was conducted using promax rotation and the following six factors were identified: daily life circumstances, psychological pressure, sense of fulfilment, health and future of the family, interpersonal relationships, and oral communication. Overall Cronbach&#039;s alpha was .90, which provides evidence of the scale&#039;s high internal consistency. Pearson product-moment correlation coefficients between each SSJR-UK factor scores and the CES-D were .28-.58 (p &lt;

Although interleukin-6 (IL-6) has been investigated frequently in stress research, knowledge regarding the biological processes of IL-6 in association with psychosocial stress remains incomplete. This study focused on salivary IL-6 and reports its temporal variation and biological correlates following acute psychosocial stress. Fifty healthy young adults (39 male and 11 female students) were subjected to the psychosocial stress test 'Trier Social Stress Test' (TSST), wherein the participants were asked to deliver a speech and perform a mental arithmetic task in front of 2 audiences. Collection of saliva samples, measurement of heart rate, and assessment of negative moods by visual analogue scales were conducted before, during, and after TSST. Salivary IL-6 levels increased by approximately 50% in response to the TSST and remained elevated for 20 min after the stress tasks were completed. Cluster analyses revealed that individuals with sustained elevation of IL-6 levels following the TSST exhibited a lower cortisol response compared to individuals with lower IL-6 levels. In the correlation analyses, a greater IL-6 response was associated with a higher heart rate during the mental arithmetic task (r = .351, p < .05) and with a lower cortisol response (r = -.302, p < .05). This study demonstrates that salivary IL-6 levels are elevated for a relatively long period following acute psychosocial stress, and suggests that sympathetic activity and cortisol secretion are involved in elevation of salivary IL-6 levels. (C) 2013 Elsevier B.V. All rights reserved.

Aim: The present study examined the effect of irritable bowel syndrome (IBS), cognitive appraisal of IBS, and anxiety sensitivity on anticipatory anxiety (AA) and agoraphobia (AG) in patients with panic disorder (PD).
Methods: We examined 244 PD patients who completed a set of questionnaires that included the Rome II Modular Questionnaire to assess the presence of IBS, the Anxiety Sensitivity Index (ASI), the Cognitive Appraisal Rating Scale (CARS; assessing the cognitive appraisal of abdominal symptoms in four dimensions: commitment, appraisal of effect, appraisal of threat, and controllability), and items about the severity of AA and AG. The Mini International Neuropsychiatric Interview was used to diagnose AG and PD.
Results: After excluding individuals with possible organic gastrointestinal diseases by using red flag items,' valid data were obtained from 174 participants, including 110 PD patients without IBS (PD/IBS[-]) and 64 with IBS (PD/IBS[+]). The PD/IBS[+] group had higher AA and higher comorbidity with AG than the PD/IBS[-] group. In the PD/IBS[+] group, the controllability score of CARS was significantly correlated with AA and ASI. Multiple regression analysis showed a significant effect of ASI but not of controllability on AA in PD/IBS[+] subjects.
Conclusion: This study suggested that the presence of IBS may be related to agoraphobia and anticipatory anxiety in PD patients. Cognitive appraisal could be partly related to anticipatory anxiety in PD patients with IBS with anxiety sensitivity mediating this correlation.

Social anxiety disorder (SAD) is known as the most common type of Anxiety Disorder. In recent studies, it was suggested the perceived anxiety control is considered to be a maintaining factor of anxiety disorders, including SAD. Perceived anxiety control is the cognition how individuals perceive that they could control their anxiety responses. In present study, the purpose was to develop the scale to assess the perceived anxiety control, which is the maintaining factor in SAD, and clarify the characteristics of perceived anxiety control in SAD. Undergraduate students (n=251) and SAD patients (n=14) completed a set of questionnaires : the Liebowitz Social Anxiety Scale (LSAS) ; the Social Cost/Probability scale (SCOP) ; the Tri-axial Coping Scale 24-item version (TAC-24) ; and the Perceived Anxiety Control scale (PAC). Exploratory factor analysis by using maximum likelihood method and promax rotation revealed that the PAC consisted of three factors that were named : "Avoidance", "Calm", and "Desire." The Cronbach's α coefficients indicated that each factor of the PAC had a high internal consistency (alpha=.77-.83). Correlation analysis between each scale revealed that each factor score and total scores of the PAC was associated moderately with the scales of SAD symptoms (p<.01). Additionally, t-tests showed that the mean scores of the SCOP and the LSAS in SAD patients and the scores of each factor and of the PAC in SAD patients were higher than college students, except the "Calm" factor of SAD patients was lower than college students (p<.05). In addition, the total scores of PAC in SAD patients was significantly higher (p<.05). These results suggested that SAD patients had high SAD symptoms and low perceived anxiety control. In summary, the present study indicated that SAD patients had low perceived anxiety control. Future studies needs to clarify the relationship between the PAC and each component of SAD. In addition, it was required to examine the difference between SAD and other anxiety disorders.

This study investigated variations in salivary levels of cortisol and dehydroepiandrosterone (DHEA) in a prolonged stressful situation (a two-week teaching practice). Thirty-three women for whom a two-week teaching practice at a kindergarten was scheduled were asked to collect saliva samples at awakening, 30 min after awakening, and bedtime at four time points: two weeks before the practice, the first week of the practice, the second week of the practice, and a few days after the practice. In addition, they completed questionnaires for assessing perceived stress and subjective moods on each day. A linear mixed model indicated that cortisol levels significantly increased during the first and second week of the practice compared with those before and after the practice period, and that DHEA levels significantly decreased after the practice period compared with those at the other time points. Further, cortisol awakening response after the practice period significantly reduced compared with that at the other time points. Scores of perceived stress and negative moods were also higher during the practice period. This study showed that prolonged stress affected cortisol and DHEA secretion during as well as after the stress period. (C) 2011 Elsevier Ltd. All rights reserved.

The death of a loved one is one of the most stressful events in life and is related to the physical and psychological wellbeing of the bereaved. Some bereaved individuals seek medical counseling to alleviate their distress. However, no studies have focused on the bereaved who have lost a loved one to cancer and have asked for medical help at a cancer center as a result. The aim of this study was to investigate the distress of the bereaved who sought consultation, as basic information for considering support.
We conducted a survey of people consulting outpatient services for bereaved families between April 2007 and September 2009. Data were obtained from medical records at initial consultation and qualitatively analyzed by content analysis using all statements related to their distress.
Their statements were classified into 11 categories, which were further classified into six themes. The main categories of bereavement-related distress were as follows: (i) regret; (ii) anger; (iii) memories; (iv) loneliness; (v) anxiety; and (vi) hopelessness. oRegret' was frequently recognized in their distress and it includes some points related to the cancer trajectory.
Psychological distresses of the bereaved who have lost a loved one and have asked for medical counseling are revealed. Their distresses are strongly related to the cancer trajectory of a family member. Some of these distresses are related to medical misunderstanding about the course of cancer. These findings might provide basic information for considering their appropriate treatment.

Objective: In this study, we investigated levels and relative ratios of adrenal hormones (including cortisol, dehydroepiandrosterone [DHEA], and DHEA-sulfate [DHEA-S]) and their psychophysiological correlates under acute psychosocial stress in individuals with irritable bowel syndrome (IBS).Methods: Fifty-three college students participated in the study (male: 42, female: 11; mean age: 22.64 years), including 13 individuals with IBS (IBS group) and 40 individuals without IBS (control group). The participants were exposed to a standardized laboratory stressor, which included delivering a speech and performing a mental arithmetic task. We measured subjective stress levels and salivary cortisol, DHEA, and DHEA-S levels at relevant time points before, during, and after the tasks.Results: DHEA-S level and the DHEA-S/DHEA ratio in the IBS group were significantly lower than those in the control group, and the cortisol/DHEA-S ratio in the IBS group was higher than that in the control group throughout the experiment. In the IBS group, the appraisal of a threat was positively correlated with cortisol levels (r = 0.61), and the appraisal of controllability was negatively correlated with cortisol levels (r = -0.64) and with the cortisol/DHEA ratio (r = -0.71). The control group showed a significant positive correlation between the appraisal of threat and cortisol levels (r = 0.32).Conclusion: The present study indicates that individuals with IBS had lower DHEA-S levels, and that their stressful cognitive appraisals under acute psychosocial stress caused the effects of cortisol to dominate. This adrenal hormone response may be involved in exacerbating abdominal symptoms in individuals with IBS. (C) 2012 Elsevier B.V. All rights reserved.

OBJECTIVE:The death of a loved one is one of the most stressful events in life and is related to the physical and psychological wellbeing of the bereaved. Some bereaved individuals seek medical counseling to alleviate their distress. However, no studies have focused on the bereaved who have lost a loved one to cancer and have asked for medical help at a cancer center as a result. The aim of this study was to investigate the distress of the bereaved who sought consultation, as basic information for considering support.;METHODS:We conducted a survey of people consulting outpatient services for bereaved families between April 2007 and September 2009. Data were obtained from medical records at initial consultation and qualitatively analyzed by content analysis using all statements related to their distress.;RESULTS:Their statements were classified into 11 categories, which were further classified into six themes. The main categories of bereavement-related distress were as follows: (i) regret; (ii) anger; (iii) memories; (iv) loneliness; (v) anxiety; and (vi) hopelessness. &#039;Regret&#039; was frequently recognized in their distress and it includes some points related to the cancer trajectory.;

Patients with fibromyalgia syndrome (FMS) have not only pain but also various somatic and psychiatric symptoms. Reports of patients with FMS having been analyzed by psychological scales were few in Japan. The purpose of this study was to investigate the psychological aspects of patients with FMS. We used the general health questionnaire (GHQ) and Hamilton's rating scale for depression (HRSD) to investigated mental health degrees in patients with FMS (n=20) , and the results were compared with those of chronic pain patients without FMS (non-FMS, n=20). The durations of illness were 24.1 months and 54.1 months for patients with FMS and non-FMS, respectively. The GHQ total scores and all subordinate scale scores of FMS patients were significantly higher than those of non-FMS patients, suggesting that the mental health degree of patients with FMS was lower than that of non-FMS patients. Moreover the patients with FMS had moderate degrees of depression. These results indicated that patients with FMS were exhausted physically and mentally. Evaluating the mental and psychosocial aspects of patients with FMS is equally essential to treatment for pain.

Objective: This study investigated the resistance to treatment in patients with Eating Disorders (ED) in early treatment and relationships between the resistance to treatment and cognitive factors related to treatment. Subjects and methods: Data about the resistance to treatment in ED patients were collected from semi-structured interviews for 6 ED patients and developed the questionnaire about the resistance to treatment in ED patients. Fifty-six ED out-patients completed the self-reported questionnaires of the resistance to treatment and cognitive factors related to treatment. Consent to study participation was obtained from all subjects. Results: The factor analysis confirmed the four postulated factors: "ineffectiveness", "evasive attitude", "lack of willingness" and "concerned with the public image". The internal consistencies for four scales were between α=.66〜.86. Spearman rank correlation revealed that the factor score of "lack of willingness" was negatively correlated with the scores of "importance of treatment", self-efficacy for treatment", "understanding of treatment" and "satisfaction for treatment". (r(s)=-.43〜-.24, ps<.10). Conclusion: We revealed the characteristics of the resistance to treatment in ED patients. These results suggested that intervention for diminishing the resistance to treatment in ED patients would be effective in leading to treatment in the early stage of the treatment.

OBJECTIVE:There have been no previous studies about consultation of the bereaved who have lost a loved one to cancer and ask for medical help. The aim of this study was to investigate their basic characteristics and their psychiatric disorders.;METHODS:A retrospective study using clinical and background data obtained over 30 months (from April 2007 to September 2009) was conducted at outpatient services for bereaved families at the Department of Psycho-Oncology at Saitama Medical University International Medical Center, Japan.;RESULTS:During the period of investigation, 51 patients underwent consultation. The patients were frequently female (P &lt; 0.0001) and the spouse of the deceased. Regarding the psychiatric diagnoses, major depression was the most common (39%), followed by adjustment disorders (28%).;CONCLUSIONS:This study revealed basic characteristics and psychiatric disorders of the bereaved who asked for medical help. Most of the patients were women (86.3%) and 86.3% of them received a psychiatric diagnosis. This information is important for both physicians and psychologists since the bereaved who have lost a loved one to cancer often ask for medical help in clinical setting

The near-infrared spectroscopy (NIRS) is a noninvasive method, neuroimaging, to be estimating brain activity from the blood flow of cerebral cortex. In this article, we present our two studies about the measurement and evaluation of stress. The one study is to investigate the impact of virtual reality (VR) to brain function in order to measure and evaluate brain activities during viewing the moving image constructed of VR. Six healthy undergraduate students viewed two kinds of VR. Similar part of prefrontal cortex activated during viewing both VR. The other research is to investigate the prefrontal region activation to the stress and emotional stimuli. The International Affective Picture System (LAPS, Lang et al., 1995) was used so as to elicit the three kinds of emotional state of the participants (negative, neutral, positive). Data showed that the sort of emotion activated the different area of prefrontal cortex.

The near-infrared spectroscopy (NIRS) is a noninvasive method, neuroimaging, to be estimating brain activity from the blood flow of cerebral cortex. In this article, we present our two studies about the measurement and evaluation of stress. The one study is to investigate the impact of virtual reality (VR) to brain function in order to measure and evaluate brain activities during viewing the moving image constructed of VR. Six healthy undergraduate students viewed two kinds of VR. Similar part of prefrontal cortex activated during viewing both VR. The other research is to investigate the prefrontal region activation to the stress and emotional stimuli. The International Affective Picture System (LAPS, Lang et al., 1995) was used so as to elicit the three kinds of emotional state of the participants (negative, neutral, positive). Data showed that the sort of emotion activated the different area of prefrontal cortex.

This study investigated Quality of Life (QOL) in Eating Disorders (ED) patients and the factors affected to QOL in ED. Seventy-six ED patients (three males and 73 females, 25.96±6.97 years) and 36 healthy controls (36 females, 21.77±6.68 years) completed the self-reported questionnaires of World Health Organization Quality of Life 26 (QOL-26), State-Trait Anxiety Scale (STAI) and Center for Epidemiologic Studies-Depression Scale (CES-D). The scores of QOL-26 in ED patients were significantly lower than those in healthy controls (all p<.001). In ED patients, t-test for with and without binge-eating revealed that the score for "total" domain of QOL-26 in ED patients with binge-eating behavior was significantly lower (p<.05). Multiple regression analyses showed that binge-eating behavior and CES-D scores were associated with the scores of QOL-26 (all p<.001). Our study showed QOL in ED patients was significantly poorer than that in controls and keeping QOL in ED patients might suggest absence of concerns of illness. Furthermore, it was suggested that improvements of depressive mood are important for not only the recovery from ED symptoms but also QOL improvements in ED patients.

Objective: The death of a person is a stressful event. Such stress affects the physical and psychological well-being of the bereaved. As an associated mental disorder, major depressive disorder (MDD) is common. Some dream of the deceased, and these dreams are called bereavement dreams. Some MDD patients also experience dreams. These two types of dreams are sometimes difficult to differentiate. The dream of the bereaved might be only a bereavement-related dream, yet it might be a symptom of MDD. Herein, we report one patient who had distressing dreams after the death of her mother.
Methods: A 63-year-old woman was referred for psychiatric consultation because of generalized fatigue and insomnia. Questioning her about recent events, she said that her mother had died of colonic carcinoma 5 months previously. Two months after the death, she suddenly started dreaming of her mother, getting angry with her almost every night. Generalized fatigue, insomnia, and distressing dreams appeared simultaneously. The dream caused much distress, making her afraid to fall asleep.
Results: Her psychiatric features fulfilled the DSM-IV-TR criteria for MDD, single episode. The death of her mother was considered to be one of the causes of MDD. She was administered 25 mg/day of sertraline hydrochloride. After that, her symptoms gradually disappeared, and the frequency of distressing dreams was reduced. Five months later, physical and psychiatric symptoms of MDD were completely resolved. Subsequently, she has not suffered from any distressing dreams of her mother.
Significance of results: This case indicates that dreams experienced after the death of a loved one should not be regarded simply as bereavement dreams. Some of the dreams may be symptoms of MDD. If the dreams are the symptoms of MDD, antidepressant treatment as well as psychotherapy may be useful. Therefore, we should avoid regarding symptoms of MDD as reactions to bereavement.

:The cost and probability bias in social situations are considered to be a maintaining factor for social anxiety disorder (SAD) symptoms. However, the process by which the cost and probability bias influences other SAD symptoms, such as avoidance behavior, self-perception of autonomic responses, and anxiety in social situations has not been investigated. We developed a model of the cost and probability bias and investigated the process through which the cost and probability bias influences SAD symptoms. Undergraduate students (N=290) were administered self-report measures assessing each component of SAD symptoms. A path analysis was conducted using the cost and probability bias model, which indicated high validity for the model (goodness of fit index = .99, adjusted goodness of fit index = .92, root mean square error of approximation = .09). The results also indicated that the cost bias had a strong effect on each component of SAD symptoms, and that the probability bias mediated the relationship between fear of negative evaluation and the cost bias. These findings suggest that changing the cost and probability bias may improve SAD symptoms.

INTRODUCTION:The hypothalamic-pituitary-adrenal axis is known to be related to abdominal symptoms, and the relationship between abdominal pain and cortisol secretory patterns has been previously investigated using a cross-sectional approach. Here, we investigated the effect of day-to-day variations in salivary cortisol and dehydroepiandrosterone-sulfate levels on abdominal symptoms in healthy individuals.;METHODS:Eleven college students (4 males and 7 females) participated in this study. The participants were asked to collect their saliva immediately after awakening and before bedtime for eight consecutive days. They also completed a questionnaire about abdominal symptoms before bedtime. The linear mixed model was applied to analyze the effects of the day-by-day variability or the 8-day average adrenal hormone level (at awakening, before bedtime, slope from awakening to bedtime) on abdominal symptoms.;RESULTS:The day-to-day variability of cortisol levels before bedtime was negatively related with loose stool, while the day-to-day variability of the cortisol slope was positively correlated with loose stool. A low 8-day average dehydroepiandrosterone-sulfate level at awakening was po

OBJECTIVE:The death of a person is a stressful event. Such stress affects the physical and psychological well-being of the bereaved. As an associated mental disorder, major depressive disorder (MDD) is common. Some dream of the deceased, and these dreams are called bereavement dreams. Some MDD patients also experience dreams. These two types of dreams are sometimes difficult to differentiate. The dream of the bereaved might be only a bereavement-related dream, yet it might be a symptom of MDD. Herein, we report one patient who had distressing dreams after the death of her mother.;METHODS:A 63-year-old woman was referred for psychiatric consultation because of generalized fatigue and insomnia. Questioning her about recent events, she said that her mother had died of colonic carcinoma 5 months previously. Two months after the death, she suddenly started dreaming of her mother, getting angry with her almost every night. Generalized fatigue, insomnia, and distressing dreams appeared simultaneously. The dream caused much distress, making her afraid to fall asleep.;RESULTS:Her psychiatric features fulfilled the DSM-IV-TR criteria for MDD, single episode. The death of her mother was consi

To find out the mechanism of brain activity during emotional elicitation is an important issue for understanding mental disorders including depression and anxiety disorders. Prefrontal cortex of the brain has received considerable attention because it is thought to have the important rule of emotion regulation. This presentation provides an overview of previous study on emotion and the brain, and the introduction of our research. In our research, near-infrared spectroscopy (NIRS) was used to measure prefrontal activities with healthy college students during emotion elicitation. NIRS is the noninvasive device that can mesure cerebral blood flow. The International Affective Picture System (IAPS; Lang et al., 1995) was used to elicit emotions. Fifteen negative, 15 neutral and 15 positive pictures of the IAPS were presented in a block design. Prefrontal activity was compared in each block.

Although commercial saliva collectors are available, their reliability for use in the analysis of salivary hormones remains uncertain. Here, we investigated the impact of saliva collection methods (passive drool [straws], cotton rolls and polymer rolls) on the outcome of measurements of salivary adrenal hormones (cortisol, dehydroepiandrosterone [DHEA] and dehydroepiandrosterone sulfate [DHEA-S]). We also investigated the effects of the storage of saliva at room temperature on the measurements. Saliva samples were collected from 20 adults (7 men, 13 women) by using straws, cotton rolls and polymer rolls. Some of these samples were stored at room temperature for 4 or 9 days. Samples stored at room temperature for 9 days had significantly higher DHEA levels than those frozen on the day of collection (p &lt; .05). Compared to the samples collected using straws, those collected using cotton rolls showed high concentration of DHEA-S (p &lt; .01). For future studies involving examination of salivary adrenal hormone levels, it is crucial that researchers are aware of these issues regarding the effects of the saliva collection methods and storage.

Objectives Prevention and support for Tojikomori has been a focus of recent regional preventive efforts in reducing the need for nursing care in the elderly, requiring indicators for evaluating effects including psychological influences on the elderly. Behavior change theory suggests potential benefits of self-efficacy in outing to reduce Tojikomori elderly. However, evaluation scales for such psychological effects have hitherto been lacking. The purpose of this study was to develop a self-efficacy scale regarding going out among community-dwelling elderly (hereinafter referred to as the SEGE) and to assess its reliability and validity.&lt;br/&gt;Methods We collected survey items from 18 community-dwelling older people in A Ward, Tokyo. Based on these items, we developed a 13-item prototype scale through a preliminary survey among 258 community-dwelling elderly in O City, located in Japan. The main survey was conducted through the mail by randomly selecting 8,000 community-dwelling elderly in A Ward. The survey included the prototype scale&#039; items and basic attributes, such as age and gender, and items from evaluation scales to be used to examine the validity of the prototype scale.&lt;b

The purpose of this study was to examine the influence of pre-sleep selective attention on sleep onset insomnia in daily life using a two-week homework procedure. Thirteen university students with sleep onset insomnia were divided into experimental group and control group. For the latter week, the experimental group performed Breath Counting Exercise as training to control their attention before sleep every night. To investigate the differences in the Pre-sleep Selective Attention Scale (PSAS), Pre-Sleep Cognitive Activity Scale (PCAS) score and mean Sleep Onset Latency (SOL) between experimental group and control group, two way MANOVAs (2 Condition × 2 Times) were performed. The analysis of PSAS score indicated significant interaction effect for Condition by Time (F(1,11)=6.24, p=.030). The analysis of PCAS Factor 2 (Anxiety for Sleep Onset Insomnia) score indicated marginally significant interaction effect (F(1,11)=3.78, p=.078). The analysis of mean SOL indicated marginally significant interaction effect (F(1.11)=3.35, p=.095). The results of this study suggested that att

The Speech Perception Questionnaire (SPQ) is a subjective and objective measure of public speaking performance. The purpose of present study was to develop the Japanese version of the SPQ. First, the permission was obtained from the author of the original SPQ and it was translated into Japanese. Then, the content validity of a back-translated version of the Japanese SPQ was confirmed and approved by the author of the original SPQ. Three hundred and forty-three undergraduate students were screened by using the Short Fear of Negative Evaluation scale (SFNE). Of these, two groups of participants, with high (HS group; n = 10) and low social anxiety (LS group; n = 10) were selected based on the scores of SFNE. The participants engaged in 3-minute speech task. ANOVA were conducted on the Z-scores of the SPQ based on their self-ratings and observers&#039; ratings. The results indicated that the HS group rated their own performance to be worse than the LS group (p &lt; .05). Moreover, there was a significantly greater discrepancy between their self-ratings and observers&#039; ratings in the SPQ (p &lt; .05). Furthermore, Cronbach&#039;s α indicated the high internal consistency of the SPQ. These results sugge

The purpose of this study was to examine the influence of pre-sleep selective attention on sleep onset insomnia in daily life using a two-week homework procedure. Thirteen university students with sleep onset insomnia were divided into experimental group and control group. For the latter week, the experimental group performed Breath Counting Exercise as training to control their attention before sleep every night. To investigate the differences in the Pre-sleep Selective Attention Scale (PSAS), Pre-Sleep Cognitive Activity Scale (PCAS) score and mean Sleep Onset Latency (SOL) between experimental group and control group, two way MANOVAs (2 Condition × 2 Times) were performed. The analysis of PSAS score indicated significant interaction effect for Condition by Time (F(1,11)=6.24, p=.030). The analysis of PCAS Factor 2 (Anxiety for Sleep Onset Insomnia) score indicated marginally significant interaction effect (F(1,11)=3.78, p=.078). The analysis of mean SOL indicated marginally significant interaction effect (F(1.11)=3.35, p=.095). The results of this study suggested that attentional bias contributes to maintenance of sleep onset insomnia. And attention control by the Breath Counting Exercise is effective in treating sleep onset insomnia.

Objective. To investigate the relationship between subtypes of irritable bowel syndrome (IBS) and severity of symptoms associated with panic disorder (PD). Material and methods. The study comprised 178 consecutive new PD outpatients. Sixty-four patients met the Rome-II criteria for IBS (IBS[+]; 29 diarrhea-predominant IBS (IBSD), 14 constipation-predominant IBS (IBSC), 21 other types of IBS). Results. IBSD patients with agoraphobia avoided a greater number of scenes owing to fear of panic attack than did PD patients without IBS (IBS[-]) and with agoraphobia. IBS[+] patients with avoidant behavior due to fear of IBS symptoms had significantly higher Beck Depression Inventory (BDI) scores and avoided a larger number of scenes owing to fear of panic attack than IBS[+] patients with agoraphobia and without avoidant behavior due to fear of IBS symptoms or IBS[-] patients with agoraphobia. Conclusions. The results suggest that the presence of IBSD or avoidant behavior because of fear of IBS symptoms may be associated with a more severe form of agoraphobia, and the latter may also be associated with depression.

Introduction : In the previous researches on irritable bowel syndrome (IBS), it was reported that Hypothalamus-Pituitary-Adrenal (HPA) axis related to IBS symptoms. However, the results of previous researches on cortisol level of IBS were inconsistent and dehydroepiandrosterone (DHEA) level of IBS has not been measured in these researches. In this study, we investigated adrenal (including cortisol and DHEA) and autonomic response to stress in individuals with IBS. Methods : The participants were 33 male college students (mean age=22.64yrs.) including 10 individuals with IBS met Rome II criteria and 23 individuals without IBS (control group). All of the participants were nonsmokers. All experiments were conducted after 15 : 00. The participants were exposed to a standardized laboratory stressor (Trier Social Stress Test : TSST) including a speech and a mental arithmetic task. We measured subjective stress level (visual analogue scale : 0-1), salivary cortisol and DHEA, and autonomic nerve activity (Cardiac Sympathetic Index : CSI, Cardiac Vagal Index : CVI) repeatedly during the experiment, and asked participants to complete perceived stress scale (PSS : measuring stress level during the recent week). The area under the curve on the basis of the ground (AUC_G) of cortisol level and DHEA level was calculated to assess the responsiveness of them. Statistical analyses were made using 2way ANOVA and t test. Results : There were no significant interactions between groups and time in cortisol, DHEA, CSI, CVI, and subjective stress level. However, there were significant main effect of groups in cortisol (F [1, 31]=4.39, p<0.05), and significant main effects of time in all dependent variables (cortisol : F [6, 26]=4.75, p<0.01, DHEA : F [6, 26]= 7.58, p<0.001, subjective stress : F [6, 26]=16.87, p<0.001). IBS group had lower AUC_G of cortisol than control group (t [31]=2.72, p<0.05). There were no significant differences between IBS and control group in AUC_G of DHEA, DHEA and cortisol at rest, and PSS score. Conclusion : Although individuals with IBS had lower responsiveness of cortisol, they showed about the same responsiveness of DHEA level and autonomic nerve activity as control groups. Therefore, it was suggested that individuals with IBS had the discrepancy between secretion of cortisol and DHEA in response to psychosocial stress.

Cortisol secretion after awakening, an index of hypothalamus-pituitary-adrenal axis activity, appears to be related to psychosocial stressors, or to symptoms caused by psychosocial stressors. The relationship between the quality, duration, and magnitude of psychosocial factors and cortisol secretion is however, unclear. Therefore, the effect of episodic stress associated with writing a graduation thesis on cortisol secretion after awakening was investigated. Saliva samples were collected from 10 undergraduate students at awakening, and 30, 45, and 60 min after awakening 1 month, 2 weeks, and a few days before the thesis submission and 1 week after the submission. They also completed the Short form of Profile of Moods Scale (POMS-S) on the night before each sampling. Results indicated that cortisol levels were higher a few days before the thesis submission compared to 1 month before submission. Scores of "Fatigue" and "Tension-Anxiety" in POMS-S were also higher a few days before submission. These results suggest that episodic stress associated with writing a graduation thesis caused an increase in cortisol levels after awakening. (c) 2007 Elsevier B.V. All rights reserved.

The anomalous relationship between secretory immunoglobulin A (sIgA) concentration in saliva and psychosocial factors is considered to be caused by circadian variations and acute stress-induced variations in sIgA levels. To prevent such variations in sIgA levels, we investigated the relationship between sIgA concentration that was estimated upon awakening and daily events and moods. University students (N = 54) were instructed to collect their saliva samples immediately upon awakening and again after 2 weeks. On the day before saliva collection, the students completed questionnaires on their daily events and moods over the past 2 weeks. Correlations of daily events and moods and sIgA concentration changes from the first and second measurement sessions indicated that participants who reported a higher frequency of daily negative events and depressive mood exhibited lower sIgA concentrations (r =-.294 and-.283, respectively). Moreover, negative events in male participants and depressive mood in female participants were negatively correlated with sIgA concentration, whereas positive events and mood in female participants were positively correlated with sIgA concentration. We clearly demonstrated that negative and positive psychosocial factors caused a decrease and increase in sIgA concentration in saliva, respectively. (Japanese Journalof Physiological Psychology and Psychophysiology, 25 (3) : 237-244, 2007.)

Japanese undergraduate students (N = 512) completed the Japanese versions of 4 hostility questionnaires: Aggression Questionnaire (Ando et al., 1999); State-Trait Anger Expression Inventory (Suzuki & Haruki, 1994); Midler Anger Coping Questionnaire (Otake et al., 2000); and Cynicism Questionnaire (Izawa & Nomura, 2004). Dimensions of hostility, determined by factor analysis for the 12 subscales of the 4 questionnaires, revealed a 4-factor solution: Expressive Hostility, Inhibitive Hostiliol, Assertiveness, and Hostile Cognition. Prior studies with Western participants had suggested a 2-factor solution of Expression and Experience dimensions of hostility. However our results forcing a 2-jactor solution showed a different pattern: The first factor included Expressive Hostility and Hostile Cognition, and the second factor included Inhibitive Hostility. These results indicate that the dimensions of hostility in Japanese students differed from those in American and European participants. This may be related to characteristics of Japanese society that emphasize cooperative behavior and not expressing angry emotions.

Objective : High prevalence of irritable bowel syndrome (IBS) in patients with panic disorder (PD) has been reported. PD has a lot in common with IBS on the viewpoints of symptomatology, pharmacotherapy and the brain-gut axis theory. However, precise characteristics of PD patients with IBS are not well understood. Therefore, the purpose of this study is to investigate the clinical characteristics of PD patients with IBS. Method : The participants of this study were 150 PD outpatients (37 males and 113 females, mean age was 33.7±9.5 years old), who met DSM-IVcriteria. PD patients completed Rome II Modular Questionnaire (RMQ), Scale of PD symptoms, and Beck Depression Inventory (BDI). Results : The prevalence of IBS who met Rome II criteria was 36.0% of all participants. The onset of IBS preceded in 38.9%, the onset of PD preceded in 29.6%, and the simultaneous onset was found in 14.8%. The PD patients with IBS (PD[+]/IBS[+]) had significantly higher prevalence of agoraphobia and depression than those without IBS (PD[+]/IBS[-]). PD[+]/IBS[+] was apt to have higher frequency of anticipatory anxiety than PD[+]/IBS[-]. Furthermore, as compared among PD[+]/IBS[+] with agoraphobia (IBS[+]/AP[+]), PD[+]/IBS[+] without agoraphobia (IBS[+]/AP[-]), PD[+]/IBS[-] with agoraphobia (IBS[-]/AP[+]), and PD[+]/IBS[-] without AP (IBS[-]/AP[-]), IBS[+]/AP[+] and IBS[-]/AP[+] had significantly higher degree and frequency of anticipatory anxiety and depression than IBS[-]/AP[-]. Conclusion : High frequency of anticipatory anxiety and depression of PD[+]/IBS[+] may be associated with agoraphobia. However, there was no significant difference between IBS[+]/AP[+] and IBS[+]/AP[-], and between IBS[-]/AP[+] and IBS[+]/AP[-]. Therefore, we should not disregard the relationship between IBS and high score of anticipatory anxiety and depression. Further studies on relationship between IBS and agoraphobia may be required in larger sample.

Objective : High prevalence of irritable bowel syndrome (IBS) in patients with panic disorder (PD) has been reported. PD has a lot in common with IBS on the viewpoints of symptomatology, pharmacotherapy and the brain-gut axis theory. However, precise characteristics of PD patients with IBS are not well understood. Therefore, the purpose of this study is to investigate the clinical characteristics of PD patients with IBS. Method : The participants of this study were 150 PD outpatients (37 males and 113 females, mean age was 33.7±9.5 years old), who met DSM-IVcriteria. PD patients completed Rome II Modular Questionnaire (RMQ), Scale of PD symptoms, and Beck Depression Inventory (BDI). Results : The prevalence of IBS who met Rome II criteria was 36.0% of all participants. The onset of IBS preceded in 38.9%, the onset of PD preceded in 29.6%, and the simultaneous onset was found in 14.8%. The PD patients with IBS (PD[+]/IBS[+]) had significantly higher prevalence of agoraphobia and depression than those without IBS (PD[+]/IBS[-]). PD[+]/IBS[+] was apt to have higher frequency of anticipatory anxiety than PD[+]/IBS[-]. Furthermore, as compared among PD[+]/IBS[+] with agoraphobia (IBS[+]/AP[+]), PD[+]/IBS[+] without agoraphobia (IBS[+]/AP[-]), PD[+]/IBS[-] with agoraphobia (IBS[-]/AP[+]), and PD[+]/IBS[-] without AP (IBS[-]/AP[-]), IBS[+]/AP[+] and IBS[-]/AP[+] had significantly higher degree and frequency of anticipatory anxiety and depression than IBS[-]/AP[-]. Conclusion : High frequency of anticipatory anxiety and depression of PD[+]/IBS[+] may be associated with agoraphobia. However, there was no significant difference between IBS[+]/AP[+] and IBS[+]/AP[-], and between IBS[-]/AP[+] and IBS[+]/AP[-]. Therefore, we should not disregard the relationship between IBS and high score of anticipatory anxiety and depression. Further studies on relationship between IBS and agoraphobia may be required in larger sample.

Western researchers have emphasized the role of hostility, especially cynicism, in causing coronary heart disease. The purpose of this study was to develop and validate the Cynicism Questionnaire (CQ). Undergraduates (n=718) and office workers (n=102) completed the prototype CQ that included 13 items based on Barefoot's (1989) categories of cynicism. Exploratory and confirmatory factor analysis revealed one factor structure with six items. Reliability coefficients of these items (Cronbach's alpha) were .753 and .758 for undergraduates and office workers respectively. The CQ was moderately correlated with other hostility scales. Analysis of the relationship between the CQ, daily stressors, and mood, indicated that participants who scored high on the CQ reported a higher frequency of daily stressors and angry mood. Additionally, a study conducted after 12 weeks indicated that the test-retest reliability of the test was sufficiently high (r=0.704). These results support the validity and reliability of the CQ. Therefore, it is suggested that CQ should be considered as a useful, standardized, measure of cynicism for use in public health-related research.

Biofeedback is defined as a group of nonpharmacological therapeutic procedures that use electronic instruments to measure. process, and provide information to patients regarding their neuromuscular and autonomic nervous system activity in the form of analogue (or binary) and visual (or auditory) signals. Recent technical improvements in blood pressure monitoring and data processing make biofeedback more reliable and comfortable to apply for the treatment of hypertension. In the present study, a meta analysis was conducted to examine treatment effects of biofeedback on lowering blood pressure of essential hypertension. A total of 22 randomized controlled studies with 905 essential hypertensive patients were selected for review. When biofeedback intervention was compared with sham or non specific behavioral control intervention, the net reductions in systolic and diastolic blood pressures were 3.9 [95% confident interval, [-0.3 to 8.2] and 3.5 [-0.1, 7.0] mmHg, respectively. Compared with clinical visits or self monitoring of blood pressure (non intervention control), the degrees of reductions in systolic and diastolic blood pressures were significantly greater in the biofeedback intervention by 7.3 [2.6, 12.0] and 5.8 [2.9, 8.6] mmHg, respectively. When biofeedback intervention types were classified into the simple biofeedback group and relaxation assisted biofeedback group, only the relaxation-assisted biofeedback group showed significant decreases in both systolic and diastolic blood pressures, compared with sham or non specific behavioral control trials (p<0.05). The results suggested that biofeedback was superior to sham or non specific behavioral intervention when combined with other relaxation therapies in essential hypertension, whereas biofeedback alone was more effective in reducing blood pressure than no intervention control. At the present stage, it is still inconclusive that biofeedback itself has anti hypertensive effect beyond the placebo effect or "remembered wellness". Future studies are needed to clarify the specific psychological and physiological mechanisms of biofeedback treatment.

The purpose of this study was to investigate the relationships between anger dimensions and cardiovascular reactivity. 202 university students were asked to complete Buss-Perry Aggression Questionnaire (BAQ) and 32 of them (13 male and 19 female) were asked to take part in the experiment.<br>After the rest period, the subjects executed mirror-drawing task two times: they performed the task normally (control condition) and they were harassed during their task performing (interpersonal stress condition).<br>Factor analysis for BAQ revealed 3 factors: "anger expression", "anger experience", and "assertiveness". Correlation coefficient between 3 factors and cardiovascular changes from control condition to interpersonal stress condition indicated that "anger expression" were related to increasing systolic blood pressure significantly.<br>These results are in agreement with recent cross-sectional studies in Japan, suggesting that "anger expression" may be related to coronary heart disease. There is a possibility that episodic anger expression with interpersonal conflict can cause coronary heart disease.

To examine the blood pressure-lowering effects of biofeedback treatment in patients with essential hypertension, a meta-analysis was conducted on studies published between 1966 and 2001. A total of 22 randomized controlled studies with 905 essential hypertensive patients were selected for review. Compared with clinical visits or self-monitoring of blood pressure (non-intervention controls), biofeedback intervention resulted in systolic and diastolic blood pressure reductions that were greater by 7.3 mmHg (for systole; 95% confidence interval: 2.6 to 12.0) and 5.8 mmHg (for diastole; 95% confidence interval: 2.9 to 8.6). Compared with sham or non-specific behavioral intervention controls, the net reductions in systolic and diastolic blood pressures by biofeedback intervention were 3.9 (95% confidence interval: -0.3 to 8.2) and 3.5 (-0.1 to 7.0) mmHg, respectively. The results of multiple regression analysis also indicated that biofeedback intervention decreased systolic and diastolic blood pressures more than non-intervention controls (p&lt;0.001), but not more than sham or non-specific behavioral intervention controls (p&gt;0.05), when controlling for the effects of initial blood pressures. When biofeedback intervention types were classified into two types, simple biofeedback and relaxation-assisted biofeedback, only the relaxation-assisted biofeedback significantly decreased both systolic and diastolic blood pressures (p&lt;0.05) compared with those in sham or non-specific behavioral intervention controls. The results suggested that biofeedback was more effective in reducing blood pressure in patients with essential hypertension than no intervention. However, the treatment was only found to be superior to sham or non-specific behavioral intervention when combined with other relaxation techniques. Further studies will be needed to determine whether biofeedback itself has an anti hypertensive effect beyond the general relaxation response.

Screening of young hypercholesterolemics is important because they are highly susceptible to atherosclerotic diseases. However, in some cases, serum cholesterol level may be elevated temporarily due to stress or other psychological factors. This study examined the effects of mood states on 'persistent' hypercholesterolemia in comparison with 'temporary' hypercholesterolemia among students entering a university. The subjects were 114 untreated first-year Students aged 18 to 20 years old. All had been screened positive for hypercholesterolemia (serum total cholesterol greater than or equal to220 mg/dl) upon enrolling in the university. Three months after the screening, they were divided into two groups according to the re-examined serum total cholesterol level; a persistent hypercholesterolemic group (n=41) with &gt;220 mg/dl and a temporary hypercholesterolemic group (n=73) with &lt;220 mg/dl. At that time, they completed the Profile of Mood States (POMS) with tension-anxiety, depression, anger-hostility, vigor, fatigue and confusion scales. The POMS depression scores and the female ratio were higher (both p&lt;0.01) and body mass index was lower (p&lt;0.05) in the persistent hypercholesterolemic subjects than in the temporary-hypercholesterolemic subjects the POMS depression scores were still higher (p&lt;0.05) after controlling for the effects of gender, body mass index, and other POMS scales by multiple logistic regression analysis, Depressive mood appeared to relate to hypercholesterolemia when the university students were screened. Assessment of mood states may be important in screening young hypercholesterolemic patients.

Objective: The objective of the study was to compare blood pressure (BP) biofeedback treatment (BF) effects between white-coat hypertension and essential hypertension. Methods: Fifteen white-coat hypertensive out-patients and 23 essential hypertensive out-patients were randomly assigned to groups A or B. Subjects in group A underwent BF once a week for a total of four sessions. Those in group B visited the clinic only to measure BP and later underwent the same BF. Results: In group A, BPs of white-coat hypertensives and essential hypertensives were significantly reduced by 22/11 and 14/8 mmHg, respectively. In group B, they were unchanged during the same period but later suppressed by BF. Under BF, pulse and respiratory rates were significantly higher, and elevation of diastolic BP due to mental stress testing was better suppressed in white-coat hypertensives than in essential hypertensives. Conclusion: This treatment was effective in both types of hypertension, and presser response to stress seems to be important in the differentiated BF effect. (C) 2000 Elsevier Science Inc. All rights reserved.