はじめに : 近年, 摂食障害を呈する女子学生が増加している. 本研究の目的は, 新版食行動異常傾向測定尺度 (Abnormal Eating Behavior Scale new version : 以下AEBS-NV) の開発と信頼性および妥当性を検討することであった. 対象者 : 一般女子学生へ調査を実施し, 調査用紙への身長・体重を除く項目へ完答し, また摂食障害の罹患歴がない者226名 (20.4±2.6歳) (調査1) および104名 (19.9±1.1歳) (調査2) を分析対象とした. 方法 : 想定した項目の因子構造を確認するため, 因子分析を行った. また, 尺度の妥当性を検討するため, 因子得点により対象者を3群に分類し (low group : LG, middle group : MG, high group : HG), EAT-26およびEDI得点について, 群における一要因分散分析を行った. また, 尺度のカットオフポイントを検討するため, 下位尺度得点ごとにROC分析を行った. 結果 : 因子分析の結果, "非機能的ダイエット" 因子・ "食事へのとらわれ" 因子・ "むちゃ食い" 因子の3因子 (14項目) が抽出され, 信頼性係数の値は十分であ

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.

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.

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.

本研究は,社交不安障害(SAD)の維持要因である不安のコントロール感を取り上げ,測定尺度を整備するとともに,その特徴について明らかにすることが目的であった.調査の回答に同意の得られた大学生251名およびSAD患者14名に対して,質問紙調査を行った.分析の結果,不安のコントロール感尺度は,回避・冷静・願望の3つの因子から構成されることが明らかにされた.各因子は,SAD症状と中程度の正および負の相関関係が認められた.また,SAD患者は,一般大学生に比べて,SAD症状が有意に高く,不安のコントロール感が有意に低いことが示された.以上から,SAD患者は,SAD症状は高く,不安のコントロール感の低いことが示された.さらに,他の不安障害との違いを検討する必要性についても示唆された.

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.

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.;

線維筋痛症（fibromyalgia syndrome：FMS）は痛みだけでなく種々の身体症状や精神症状を呈する疾患である．本邦では心理尺度を用いたFMS患者の心理的特徴に関する報告は少なく，これを調査し把握することを目的とした．FMS患者（n＝20）で精神健康調査票（general health questionnaire：GHQ）を用いて調査し，FMS以外の慢性痛患者（非FMS慢性痛患者，n＝20）を対照に比較した．さらに，FMS患者にはハミルトンうつ病評価尺度（Hamilton's rating scale for depression：HRSD）による評価を行った．罹病期間はFMS患者24.1カ月，非FMS慢性痛患者54.1カ月であった．FMS患者のGHQ総合得点と全下位尺度得点は非FMS慢性痛患者より有意に高く，HRSDの結果中等度のうつ状態にあることが示された．これらのことから，FMS患者は著しく精神的健康度が低く，心身ともに疲弊していることが示唆され，治療の際には痛みだけでなく精神症状や心理社会的要因も含めた評価と治療が不可欠であると考えられる．

目的:本研究では摂食障害の治療初期において患者が有する治療に対する抵抗感を明らかにし,治療行動に関連する認知的要因との関連性について検討を行った.方法:(予備調査)ED患者6名を対象とした半構造化面接を行い,治療初期における治療に対する抵抗感に関する項目を抽出した.抽出された143項目について整理・検討を行い,最終的に26項目からなる治療に対する抵抗感の質問紙が作成された.(本調査)外来通院中のED患者56名を対象とした自己記入式質問紙調査を行い,治療初期における治療に対する抵抗感,治療行動に関連する認知的要因の評価を行った.結果:治療に対する抵抗感の原項目26項目について,主因子法・プロマックス回転による因子分析を行い,最終的に4因子10項目からなる因子構造が得られた.抽出された4因子について,それぞれ「無力感」「回避的態度」「治療意欲の欠如」「世間体の悪さ」と命名した.治療に対する抵抗感の各因子得点と治療に関連する認知的要因の各得点についてSpearmanの順位相関係数を算出した.その結果,治療に対する抵抗感の第III因子「治療意欲の欠如」と「治療に対する重要性」「治療に対するセルフ・エフィカシー」「治療内容の理解」「治療への満足感」において有意な負の相関が認められた.考察:EDの治療初期に患者が有する治療に対する抵抗感の特徴が明らかにされた.治療に対する抵抗感にはED患者の中核的病理に関連する項目も含まれ,特に患者の治療意欲と治療行動に関連する認知的要因との関連性が示された.患者が有する治療に対する抵抗感を低減させることにより適切な治療導入を図ることが,患者の治療行動の促進に有効である可能性が示唆された.

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

近赤外分光法(near-infrared spectroscopy:NIRS)は神経イメージング技法の1つであり,その非侵襲性と簡便性から近年多くの研究者の注目を集めている.我々は,このNIRSを用いてストレスの測定と評価に関する研究を推進しており,本稿では2つの基礎的研究を紹介した.1つはヴァーチャル・リアリティ(仮想現実,virtual reality:VR)視聴時の脳活動を測定,評価した研究である.健常な大学生を対象に2種類のVR映像を呈示し,映像の種類に関わらず,映像を視聴することによって同じように脳が活性化したことが示唆された.もう1つは感情喚起時の前頭前野活動に関する研究である.International Affective Picture System(IAPS)を用い,3つの感情状態(ネガティブ,中性,ポジティブ)を喚起した時の前頭前野活動をNIRSによって測定した.測定されたデータから,感情の種類によって活動部位が異なることが示唆された.

近赤外分光法(near-infrared spectroscopy:NIRS)は神経イメージング技法の1つであり,その非侵襲性と簡便性から近年多くの研究者の注目を集めている.我々は,このNIRSを用いてストレスの測定と評価に関する研究を推進しており,本稿では2つの基礎的研究を紹介した.1つはヴァーチャル・リアリティ(仮想現実,virtual reality:VR)視聴時の脳活動を測定,評価した研究である.健常な大学生を対象に2種類のVR映像を呈示し,映像の種類に関わらず,映像を視聴することによって同じように脳が活性化したことが示唆された.もう1つは感情喚起時の前頭前野活動に関する研究である.International Affective Picture System(IAPS)を用い,3つの感情状態(ネガティブ,中性,ポジティブ)を喚起した時の前頭前野活動をNIRSによって測定した.測定されたデータから,感情の種類によって活動部位が異なることが示唆された.

本研究では摂食障害(Eating Disorders:ED)のQuality of Life(QOL)およびEDのQOLに影響を与える要因について検討した.自己記入式質問紙調査を実施し,ED患者76名(男性3名,女性73名,25.96±6.97歳)および健常群36名(女性36名,21.77±6.68歳)を分析対象とした.調査材料としてWorld Health Organization Quality of Life 26(QOL-26),State-Trait Anxiety Scale(STAI),Center for Epidemiologic Studies-Depression Scale(CES-D)を用いた.ED群のQOL-26は,健常群よりもQOL-26の下位因子において有意な低下が認められた(all p<.001).ED群において,病型,排出行動の有無および罹病期間,BMIによるQOLの違いは認められなかった.一方,過食行動の有無で比較をしたところ,過食行動を伴うEDにおけるQOL-26の「全体」領域での有意な低下(p<.05)が認められた.過食行動,STAI,CES-Dを独立変数とした重回帰分析の結果,過食行動とQOL-26「社会的関係」領域(p<.01),CES-D得点とQOL-26「身体的」「心理的」「社会的関係」「環境」「平均」領域(all p<.001)との間に有意な関連が認められた.本研究の結果から,ED患者のQOLが低下していること,QOLが保持されている状態が病識欠如などのED特有の問題を反映している可能性があること,特に抑うつ症状の改善がQOLの向上という視点からも重要であることが示唆された.

: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

感情喚起時の脳の活動メカニズムを明らかにすることは、うつ病や不安障害などの精神障害を理解するために重要な問題である。脳の前頭前皮質は感情の制御に重要な役割を担っていると考えられ、大きな注目を集めている。本発表では、感情と脳に関する先行研究を概観し、我々の研究について紹介する。我々の研究では、健常な大学生を対象に、感情喚起時の前頭前野活動を近赤外線分光法（near-infrared spectroscopy: NIRS）により測定した。NIRSは大脳皮質の血流量を非侵襲的に測定できる装置である。感情喚起にはInternational Affective Picture System（IAPS; Lang et al., 1995）を使用し、IAPSの中から不快、中性、快画像をそれぞれ15枚ずつ選定した。各画像（不快、中性、快）をブロック計画で提示し、各ブロックにおける前頭前野活動を比較した。

唾液バイオマーカーの利用は増加しているが，唾液を採取する器具の違いがホルモン濃度に与える影響は十分に検討されていない。本研究ではストローによる採取(Passive Drool)，コットンロールによる採取，ポリマーロールによる採取について，コルチゾール，デヒドロエピアンドロステロン(DHEA)，硫酸基結合型DHEA(DHEA-S)の各濃度への影響を調査した。また，検体の室温保存が各ホルモン濃度へ与える影響を検討するために，唾液検体を採取直後に冷凍保存する条件，4日後，9日後に冷凍保存する条件を設け，条件間の濃度の比較もおこなった。参加者は成人男性7 名，女性13 名であった。DHEAでは0日，4日と比べて9日目で濃度が高くなり，DHEA-Sはストローによる採取よりもコットンロールによる採取で濃度が高くなった。唾液を検体として内分泌を測定する場合，これらの影響を考慮しながら研究計画を立てる必要がある。

目的 近年，地域で介護予防を進めていくための強化分野の 1 つとして，「閉じこもり予防•支援」が展開されており，その効果を評価する心理的側面を含めた指標が求められている。行動変容の視点によれば，閉じこもりの改善には，外出に特化した自己効力感が潜在的に影響していると想定されるが，評価尺度は未だ存在しない。そこで本研究では，地域高齢者の外出に対する自己効力感を測定する尺度（self-efficacy scale on going out among community-dwelling elderly:以下，SEGE と略す）を開発し，その信頼性と妥当性を検証することを目的とした。&lt;br/&gt;方法 都内 A 区在住の地域高齢者18人から項目収集を行い，得られた項目をもとに，某県 O 市の地域高齢者258人に対する予備調査によって，13項目から成る尺度原案を作成した。本調査は，都内 A 区在住の地域高齢者8,000人を無作為抽出し，郵送法による調査を実施した。調査内容は，尺度原案，年齢，性別などの基本属性および妥当性を検討する

本研究の目的は，実際の就寝環境における入眠時選択的注意が入眠困難に及ぼす影響を2週間のホームワーク実験によって検証することが目的であった。13名の入眠困難者は実験群と統制群に割り付けられた。実験群は，後半の1週間，就寝時の注意統制のため毎日寝床で数息観（自発的な呼吸を数える禅瞑想課題）を実施した。実験群と統制群における，入眠時選択的注意尺度得点，入眠時認知活動尺度得点，1週間の平均入眠潜時の違いを検討するため，2要因反復測定分散分析（2群×2時期）を行った。その結果，入眠時選択的注意得点において有意な交互作用が確認された（F(1,11)=6.24，p=.030）。また入眠時認知活動尺度の第2因子（眠れないことへの不安）得点において交互作用の有意傾向が確認され（F(1,11)=3.78, p=.078）た。さらに1週間の入眠潜時において交互作用の有意傾向が確認された（F(1.11)=3.35, p=.095）。本研究より，入眠時選択的注意の入眠困難に及ぼす影響が示唆さ

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

本研究の目的は，実際の就寝環境における入眠時選択的注意が入眠困難に及ぼす影響を2週間のホームワーク実験によって検証することが目的であった。13名の入眠困難者は実験群と統制群に割り付けられた。実験群は，後半の1週間，就寝時の注意統制のため毎日寝床で数息観（自発的な呼吸を数える禅瞑想課題）を実施した。実験群と統制群における，入眠時選択的注意尺度得点，入眠時認知活動尺度得点，1週間の平均入眠潜時の違いを検討するため，2要因反復測定分散分析（2群×2時期）を行った。その結果，入眠時選択的注意得点において有意な交互作用が確認された（F(1,11)=6.24，p=.030）。また入眠時認知活動尺度の第2因子（眠れないことへの不安）得点において交互作用の有意傾向が確認され（F(1,11)=3.78, p=.078）た。さらに1週間の入眠潜時において交互作用の有意傾向が確認された（F(1.11)=3.35, p=.095）。本研究より，入眠時選択的注意の入眠困難に及ぼす影響が示唆され，数息観による注意統制が入眠困難に効果的である可能性が考えられた。

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.

本研究では,過敏性腸症候群(irritable bowel syndrome ; IBS)における心理社会的ストレス負荷時の副腎皮質ホルモン〔コルチゾールおよびデヒドロエピアンドロステロン(DHEA)〕,自律神経活動の反応を検討した.DHEAおよび自律神経指標についてはIBS群と統制群の差は認められなかったが,IBS群のコルチゾールの反応性は統制群よりも低下していた.本研究の結果から,IBS群において心理社会的ストレス負荷時のコルチゾールとDHEAの反応は一致していないことが示唆された.

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.

一貫しない唾液中分泌型免疫グロブリンA (sIgA) 濃度と心理社会的な要因の関連はsIgAの日内変動や急性ストレスによる変動が原因と考えられる。本研究ではそのような変動を避けるために起床時に測定したslgAと日常の出来事・気分の関連を調査した。54人の大学生が2週間の間隔を空けて2回, 起床後すぐに唾液を採取した。また唾液採取の前日, 実験参加者は過去2週間の日常の出来事や気分について質問紙で回答した。一回目から二回目の変化値について日常の出来事・気分とsIgAの間の相関を求めたところ, 日常のネガティブな出来事を多く報告していた参加者や抑うつ気分を報告していた参加者は低いsIgA濃度を示した (それぞれr=-.294, r=-.283) 。また男性ではネガティブな出来事が, 女性では抑うつ気分がsIgAの値と負の相関を示した。女性ではポジティブな出来事と気分がsIgA濃度と正の相関を示した。ネガティブな心理社会的要因はsIgAの減少を, ポジティブな心理社会的要因はsIgAの増加を, それぞれ引き起こすことが示された。

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.

過敏性腸症候群(IBS)を伴うパニック障害(PD)患者の臨床的特徴を調査することを目的とし, DSM-IVの基準を満たすPD患者150名(平均年齢33.7±9.5歳)を対象に調査を行った.その結果, PD患者中36.0%がIBSを伴っていた.IBS先行例は38.9%, PD先行例は29.6%, 同時発症例は14.8%であった.IBSを伴う患者は伴わない患者と比較して, 広場恐怖併存率と抑うつの程度が有意に高く, 予期不安頻度に高い傾向がみられた.さらに, IBSと広場恐怖両方を伴う患者とIBSを伴わず広場恐怖を伴う患者はIBSと広場恐怖両方を伴わない患者と比較して予期不安の程度・頻度および抑うつの程度が有意に高かつた.

過敏性腸症候群(IBS)を伴うパニック障害(PD)患者の臨床的特徴を調査することを目的とし, DSM-IVの基準を満たすPD患者150名(平均年齢33.7±9.5歳)を対象に調査を行った.その結果, PD患者中36.0%がIBSを伴っていた.IBS先行例は38.9%, PD先行例は29.6%, 同時発症例は14.8%であった.IBSを伴う患者は伴わない患者と比較して, 広場恐怖併存率と抑うつの程度が有意に高く, 予期不安頻度に高い傾向がみられた.さらに, IBSと広場恐怖両方を伴う患者とIBSを伴わず広場恐怖を伴う患者はIBSと広場恐怖両方を伴わない患者と比較して予期不安の程度・頻度および抑うつの程度が有意に高かつた.

多くの欧米の研究者は、冠動脈疾患のリスクを考慮するうえで、敵意性、とくにシニシズムの役割を強調している。本研究の目的は、シニシズム尺度 (CQ) の作成とその妥当性を検討することであった。718名の学生と102名の従業員を対象にBarefootら (1989) の分類に基づく13のシニシズムを表す項目を実施した。探索的・検証的因子分析を行った結果、6項目1因子が抽出された。これらの項目の信頼性係数は学生サンプルで.753、従業員サンプルで.758であった。CQは敵意尺度の間に中程度の関連が示された。また日常ストレッサー・気分との相関を求めたところ、シニシズムの高いものは高頻度の日常ストレッサーと怒り気分を示した。12週間の間隔をあけて行われた再テスト結果との相関係数は十分に高いものであった (r=.704)。これらの結果はCQの妥当性と信頼性を支持するものである。CQはパブリックヘルスの調査において標準化された有用な尺度であると考えられる。

血圧バイオフィードバック療法は,測定機器の開発につれ高血圧症に臨床応用する研究が増えてきた.22件のランダム化比較試験による血圧バイオフィードバック研究の結果を合わせ,高血圧患者905人への降圧効果をメタ分析で検討した.その結果,非介群に比べ,血圧降下量の差は収縮期で7.3[2.6, 12.0]mmHg,拡張期で5.8[2.9, 8.6]mmHgとなり,バイオフィードバック群のほうが大きな効果を示した(値は平均と95%信頼区間).一方,一般的なストレスマネージメントなどを行った群と比較したところ,バイオフィードバック群は降圧量に有意差を認めなかった.今後は,血圧バイオフィードバック療法自体の特異的な治療効果を明らかにする必要がある.

人の心理・行動特性と疾病の関連について多くの研究が行われている。とくに近年、海外では怒り・敵意と冠動脈疾患の関連について数多くの研究が多様な視点から行われている。しかし日本においてそのような試みは十分に行われていない。本研究では、怒り・敵意の次元と心臓血管系反応の関連について調査する事を目的とした。<br>202人の大学生にBuss-Perry Aggression Questionnaire (BAQ) を実施し、そのうちの32人に実験協力の依頼が行われた。安静期測定の後、被験者は鏡映描写器を用いた迷路課題を2回行った。1回目は統制条件で、彼らは通常どおり課題を行った。2回目は対人ストレス条件であり、彼らは課題の遂行中に、「もっと速くやってください」「枠からはみ出さないように丁寧にやってください」「もっと本気をだしてやってください」などの言語刺激が与えられた。またBAQに対する因子分析の結果、「怒り表出」「怒り経験」「自己主張」の3因子が得られ、これらの因子得点を各被験者の怒り・敵意特性得点とみなした。<br>結果、統制条件から対人ストレス条件にかけて、血圧・心拍率が有意に上昇しており、また怒り気分が上昇していた。BAQの3因子と対人ストレス条件から統制条件への心臓血管系の変化値の相関を求めたところ、「怒り表出」は収縮期血圧の上昇と有意に関連していた。また男性の「怒り経験」と平均血圧・拡張期血圧の間に有意傾向の負の相関係数が認められた。<br>これらの結果は、怒り・敵意の次元のうちでも、怒り表出の要素が心臓血管系の賦活と関連していることを示唆している。近年の日本の横断的研究では、怒り表出に関連する因子と冠動脈疾患の関連を述べているが、本研究の結果はこれらの研究成果と一致するものとなった。対人ストレス葛藤に伴うエピソード的な怒り表出が過剰な心臓血管系賦活を引き起こし、冠動脈疾患の発症と関連する可能性が示された。また男性における「怒り経験」と平均血圧・拡張期血圧の間の負の相関係数は実験状況による可能性が推測された。

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.