城月 健太郎

Self-focused attention, cost/probability bias, and avoidance behavior are maintaining factors of social anxiety. The manipulation of dispositional mindfulness has been shown to reduce social anxiety and its maintaining factors. This study examined the associations among dispositional mindfulness, self-focused attention, cost/probability bias, avoidance behavior, and social anxiety to explore the mechanism of mindfulness and its relationship with social anxiety in patients with social anxiety disorder (SAD) and university students. Data from 412 patients with SAD and 367 students were analyzed using psychometric network analysis. Both groups completed self-report measures assessing dispositional mindfulness, self-focused attention, cost/probability bias, avoidance behavior, and social anxiety. A weak negative association was found between non-judging in dispositional mindfulness and self-focused attention to one's behavior in the SAD patients' network. In the students' network, a weak negative association was observed between non-judging and self-focused attention to one's behaviors, as well as between describing and social anxiety. In the SAD patients' network, nodes with the highest strength centrality were probability bias and social anxiety. In the students' network, nodes with the highest strength centrality were social anxiety and cost bias. The global network structure and connectivity differed between patients with SAD and students. The findings support the cognitive-behavioral model of SAD and highlight the heterogeneity of social anxiety, necessitating tailored intervention strategies.

Abstract Background Cognitive–behavioral therapy (CBT) effectively improves the clinical symptoms of social anxiety disorder. However, there are non-responders who cannot decrease their cost/probability bias significantly; hence, their social anxiety symptoms remain unaddressed. Mindfulness training and cognitive–behavioral approaches promote a reduction in cost/probability bias and social anxiety symptoms. This study examines the effectiveness of a four-session program of mindfulness and CBT (M-CBT) in a non-clinical sample of individuals with high social anxiety. Methods Participants were 50 Japanese undergraduate students (37 women and 13 men) randomly allocated to an intervention group (n = 27) and a control group (n = 23). The intervention group underwent a four-session M-CBT program, while the control group did not receive any treatment. Results A group × time analysis of covariances showed significant interactions in the negative cognition generated when paying attention to others in probability bias, fear of negative evaluation by others, dispositional mindfulness, depressive symptoms, and subjective happiness. M-CBT also produced significant pre-post improvements in the above outcomes with moderate to high effect sizes (ds = .51–1.55). Conversely, there were no interactions in social anxiety symptoms and self-focused attention. Conclusions These results indicate that M-CBT was effective for the negative cognition generated when paying attention to others in probability bias, fear of negative evaluation by others, dispositional mindfulness, depressive symptoms, and subjective happiness. The combination of mindfulness training with cognitive restructuring is proposed as potentially helpful for individuals with probability bias, leading to negative cognition from paying attention to others. Trial registration University Hospital Medical Information Network (UMIN CTR) UMIN000036763. Registered May 16, 2019.

Abstract A four-session program of mindfulness and cognitive behavioral therapy (M-CBT) is a low-intensity treatment module for individuals with high cost/probability bias and social anxiety symptoms. We tested its effectiveness with 23 patients with social anxiety disorder. The patients completed a set of questionnaires that evaluated social anxiety symptoms, cost/probability bias, fear of negative evaluation from others, self-focused attention, trait mindfulness, depressive symptoms, cognitive reappraisal, and suppression at pretreatment, the time before each session of treatment, post-treatment, and follow-up. Linear mixed-effects models showed that the M-CBT was effective for social anxiety symptoms, cost/probability bias, fear of negative evaluation from others, self-focused attention, trait mindfulness, depressive symptoms, and cognitive reappraisal. The M-CBT also produced significant pre-post-improvements in social anxiety symptoms and cost bias with high effect sizes (social anxiety symptoms: d = 1.04–1.06, cost bias: d = 0.82–1.02). These results suggest that M-CBT is effective for treating social anxiety symptoms and cost bias. This study demonstrates that M-CBT is feasible and acceptable for social anxiety disorder. It may comprise a treatment module for those who do not respond to traditional cognitive behavioral therapy. Trial registration number: University Hospital Medical Information Network (UMIN CTR) UMIN000043720, Registered 23 Mar 2021.

BACKGROUND: Recent studies have shown an association between psychological distress and emotion malleability beliefs, meaning mindsets about whether one's emotions are fixed or changeable. However, most studies have not examined the association between these beliefs and sociodemographic factors. METHODS: A nationwide cross-sectional Internet survey of residents of Japan aged 15-79 years was conducted using sampling weights for national estimates to investigate the association between emotion malleability beliefs and sociodemographic factors and between fixed beliefs and severe psychological distress (SPD). SPD was defined as a Kessler 6 Scale score of ≥13. Adjusted odds ratios for SPD were calculated considering potential confounders. Further analyses were stratified by sex, age and presence of any psychiatric disorder. RESULTS: The analysis included 23,142 participants (female, 48.64%). Fixed beliefs were associated with female sex, age < 45 years, and presence of psychiatric disorders. These beliefs were associated with SPD, and additional analysis showed stronger associations with SPD among female respondents, respondents aged 45-59 years, and those aged ≥60 years. CONCLUSION: Results indicate that female sex, age < 45 years, and current mental disorders were associated with fixed emotion malleability beliefs. Associations between fixed emotion malleability beliefs and SPD were particularly strong among female respondents and people aged ≥45 years compared with the general population. Our study extends the association between emotion malleability beliefs and psychological health to the general population. Future studies should explore mechanisms underlying individual differences in emotion beliefs.

Self-focused attention, cost/probability bias, and avoidance behavior are maintaining factors for social anxiety. In particular, cost bias and avoidance behavior predict social anxiety. It has been shown that the enhancement of trait mindfulness improves these maintaining factors. This study examines the relationships among trait mindfulness, self-focused attention, cost/probability bias, avoidance behavior, and social anxiety, and clarifies whether they mediate the relationship between trait mindfulness and social anxiety. A cross-sectional design was used to examine the relationships among these variables. Participants were recruited from three universities in Japan (January 2019–December 2019). Undergraduate students (N = 367) completed a set of self-report measures assessing trait mindfulness, self-focused attention, cost/probability bias, avoidance behavior, and social anxiety. Results of path analyses revealed that the hypothesized model’s goodness-of-fit indices had high values. Trait mindfulness showed a direct negative association with self-focused attention, cost/probability bias, avoidance behavior, and social anxiety. Moreover, trait mindfulness was negatively associated with social anxiety via self-focused attention, cost/probability bias, and avoidance behavior. These findings indicate that mindfulness plays an important role in social anxiety and provide impetus for future research involving clinical studies of mindfulness-based interventions for social anxiety.

BACKGROUND: The Cognitive Scale for Functional Bowel Disorders (CS-FBD) and Irritable Bowel Syndrome-Behavioral Responses Questionnaire (IBS-BRQ) are a useful measures to assess cognitive-behavioral aspects in individuals with IBS. This study aimed to confirm the reliability and validity of the Japanese versions of the CS-FBD (CS-FBD-J) and IBS-BRQ (IBS-BRQ-J). METHODS: Participants comprised 192 students and 22 outpatients diagnosed with irritable bowel syndrome (IBS). There were 76 students who met the diagnostic criteria for IBS and two students who received treatment for IBS. Participants completed questionnaires containing the CS-FBD-J, IBS Severity Index (IBS-SI), Visceral Sensitivity Index (VSI), 24-item Dysfunctional Attitudes Scale (DAS-24), Hospital Anxiety and Depression Scale (HADS), and Social Adaptation Self-evaluation Scale (SASS). RESULTS: Our exploratory factor analysis revealed that the CS-FBD-J had a unidimensional factor structure and that the factor loadings for two of the 25 items were less than 0.4. The IBS-BRQ-J had a two-factor structure, and the factor loadings for eight of the 26 items were less than 0.4. The confirmatory factor analysis for the 18-item version of IBS-BRQ-J showed that the model fit indices were not sufficient. The CS-FBD-J and IBS-BRQ-J had significant, moderate correlations with the IBS-SI and VSI in the IBS and control groups. Correlation between the DAS-24 and the CS-FBD-J was not significant. The CS-FBD-J and IBS-BRQ-J were significantly correlated to the HADS and SASS (IBS-BRQ-J) only in the IBS group. The scores of CS-FBD-J and IBS-BRQ-J showed significant group differences between the IBS patient group, non-patient IBS group, and control group. The internal consistencies of the CS-FBD-J and IBS-BRQ-J were high. The item-total correlation analysis for the CS-FBD-J and IBS-BRQ-J showed that the correlations between each item and the total score were significant. CONCLUSION: This study confirmed the reliability and validity of the 23-item version of the CS-FBS-J and the 18-item version of the IBS-BRQ-J with the deletion of items with low factor loadings. Regarding the IBS-BRQ-J, two factor structures were confirmed (factor 1: behavior obsessed with abdominal symptoms, factor 2: avoidance of abdominal symptoms and associated difficulties) although the model fit of the structure needs further study.

BACKGROUND: COVID-19 continues to have a global impact and has yet to converge. Behavioral restrictions in daily life are widespread, forcing changes to the behavioral patterns of people. Significant changes have also occurred in children's lives, raising concerns about mental health. The same is true for anxiety symptoms. RESEARCH: In this paper, we described the COVID-19 pandemic effects on mental health, summarized Internet-based cognitive behavioral therapy (ICBT) as an applicability of cognitive behavioral therapy (CBT) for COVID-19, and summarized ICBT's current state as a response for anxiety. An overview of previous intervention studies, including randomized controlled trials (RCTs) on ICBT, showed that many studies were highly effective against anxiety symptoms. Furthermore, regarding the follow-up of ICBT's intervention effect, long-term effect maintenance was also clarified. It was likewise pointed out that ICBT may be used in the future since it is beneficial for children's anxiety symptoms in telemedicine. CONCLUSIONS: Based on these results from previous studies, we discuss ICBT's applicability during the COVID-19 pandemic. Additionally, future measures and prospects for children's mental health during the pandemic are discussed in this study.

OBJECTIVE: Self-focused attention is a maintaining factor for social anxiety disorder. It was shown that self-focused attention correlates with trait mindfulness, but not with attention control. This study examined the reliability and validity of the Japanese version of the self-focused attention (J-SFA) scale. METHOD: Students (N = 502) completed a set of questionnaires, measuring self-focused attention, social anxiety symptoms, trait mindfulness, and attention control. RESULTS: A confirmatory factor analysis indicated that the J-SFA scale has a bi-factor structure. The Cronbach's α coefficient was high. Correlation analysis showed that each factor of the J-SFA scale was significantly weakly to moderately correlated with social anxiety symptoms and trait mindfulness, and the J-SFA scale's factors were significantly or non-significantly very weakly correlated with attentional control functions. CONCLUSION: The findings indicate that the J-SFA demonstrated satisfactory reliability and validity for our sample and provide impetus for future research into the measure for clinical and nonclinical samples in Japan.

Several studies have focused on the cortisol levels in fingernail samples as a possible index of cumulative hormone production; however, the biological validity of fingernail cortisol has not been fully established. We investigated the association between cortisol levels in fingernail samples and other biological specimens, including hair and saliva samples, in healthy young adults to determine whether fingernail cortisol was associated with past cumulative hormone production. Participants were 23 adults (14 men and 9 women; mean age = 22.7 ± 2.8 years). Saliva samples were collected three times per day for 30 days, and hair samples (1 cm) from participants' scalps were obtained. Fingernail samples were repeatedly collected for 8 months, considering growth rate of fingernail and time lag for fingernails to fully extend from the nail matrix. Cortisol levels in hair samples were significantly associated with the levels in fingernail samples that were obtained 3 months after hair collection (r = .48, p < .05). The 30-day integrated area under the curve, based on salivary cortisol levels at awakening and bedtime, were significantly associated with cortisol levels in fingernail samples that were collected 2-5 months after saliva collection. This finding was especially significant after adjusting for the awakening time when the saliva was collected. This study provided evidence that fingernail cortisol was associated with cumulative hormone levels measured several months before but not those in the present. The samples may be useful for endocrinological evaluation in the investigation of chronic stress, cortisol levels, and health; moreover, the use of fingernail samples would permit larger-scale studies.

<p>Relationships among social anxiety, fear of negative evaluation from others, avoidance behavior, and self-disclosure were investigated. Undergraduate students (n=308) completed self-report measures assessing the above factors. The results of cluster analysis by the Ward method showed that social anxiety, fear of negative evaluation from others, and avoidance behavior were composed of three clusters: Low social anxiety, Moderate social anxiety, and High social anxiety. A one-way analysis of variance conducted on these clusters indicated that the High social anxiety cluster had lower self-disclosure scores concerning hobbies, and difficult experiences, compared to the other clusters. Moreover, the multiple regression analysis showed that avoidance behavior had significant effects on each type of self-disclosure. These findings suggest that the reduction of avoidance behavior might affect the increase of self-disclosure.</p>

本研究は，急性心理社会的ストレスに対するコルチゾールの反応性が脅威刺激からの注意解放の困難さと関連するか否かを検討した。この目的のため，手がかり刺激の提示時間を比較的長くした(1,000 ms)空間手がかり課題を用いて怒り顔への注意バイアスを計測した。実験参加者は，急性心理社会的ストレス課題を行った後空間手がかり課題を行った。本研究では，急性心理社会的ストレス課題により上昇した唾液中コルチゾール値に基づき，実験参加者をコルチゾール反応者と非反応者に分けた。その結果，反応者は怒り顔に対する注意の解放困難を示したのに対して，非反応者は怒り顔からの迅速な注意解放を示した。これらの結果は，急性心理社会的ストレスに対するコルチゾールの反応性の高さが脅威刺激からの注意解放の困難さと関連することを示唆する。

Social Anxiety Disorder (SAD) is known as the most common type of Anxiety Disorder. In the cognitive and behavioral model of SAD, cost bias and perceived anxiety control are factors maintaining and mediating SAD symptoms. The relationship between cost bias and perceived anxiety control in social anxiety was investigated in present study. Undergraduate students (n=341) were administered self-report measures assessing each component of SAD symptoms. Path analysis was conducted to identify relationships between these components. The result indicated the high validity of the model (Goodness of Fit Index=.972, Adjusted Goodness of Fit Index=.929, Root Mean Square Error of Approximation=.083). These findings suggest that SAD symptoms could be improved by changing the cost bias and perceived anxiety control.

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.