Cultural Adaptation of the Actionable Health App Evaluation in Japan: Protocol for a Web-Based Modified Delphi Expert Consensus Study.

BACKGROUND: With an increase in both the number of mental health disorders people are experiencing and the difficulty in accessing mental health care, the demand for accessible mental health care services has increased. The use of mobile devices has allowed people to receive care in their daily lives without restrictions on time or location. However, the majority of publicly available mobile health apps are not evidence-based, and the top-rated apps are not always safe or user-friendly and may not offer clinically beneficial results. OBJECTIVE: This study aims to create a cultural adaptation of the American Psychiatric Association's comprehensive app evaluation framework in Japan using a web-based modified Delphi expert consensus. METHODS: A web-based modified Delphi study includes developing the Japanese version of the comprehensive app evaluation framework and 3 Delphi rounds. In the first round, our working group sends a questionnaire to the panelists, who then complete it. In the second and third rounds, the working group sends a questionnaire and a summary of the panelists' answers based on each of the previous rounds. The panelists answer the questionnaires based on this summary. The summarization procedure is automated to help reduce the biases that can be generated when panelists' answers are summarized and when the panelists receive them. The working group sends only the result of the summarization with the next round's questionnaire. All interactions between the working group and the panelists will be conducted on Qualtrics (Qualtrics Japan LLC), a questionnaire platform. To culturally validate the comprehensive mental health app evaluation framework, participants from the following three categories will be recruited in Japan: (1) researchers, (2) practitioners, and (3) app developers. RESULTS: This study received funding from a crowdfunding campaign in Japan (April 2023). The Delphi study began in January 2023 and will be completed in December 2023. We had already completed the translation of the 105 original app evaluation item questions by December 2022. CONCLUSIONS: While the need for treatment using mental health apps is increasing, no framework that can be used to develop a centralized database for health apps is available or accessible, and no consensus has been reached among stakeholders in Japan about an appropriate framework. The results of the web-based modified Delphi method presented in this paper may provide direction for the development and use of mental health apps in the future among the relevant stakeholders. Furthermore, this study will enhance recognition of the framework among researchers, clinicians, mental health app developers, and users, in addition to devising new instruments to help users or practitioners efficiently choose the right app for their situations. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/44469.

Developing and validating the Japanese version of the Referential Thinking Scale: A cross-sectional study.

It has been shown that ideas of reference in the context of paranoia (IoR-P) and schizophrenia spectrum disorders (IoR-S) are caused by different psychological constructs. Although it is well known that both IoR-P and IoR-S are frequently evoked during the same period of life, how they interact with each other is unknown. The purpose of the present study was to develop the Japanese version of the Referential Thinking Scale (J-REF) to assess IoR-S, examine its validity and reliability, and explore the predictors of IoR-P and IoR-S. In this study, several subgroups of Japanese individuals in their 20s were included in the analysis. The J-REF had high internal consistency, high test-retest reliability, good convergent, and discriminant validity. Two hierarchical regression analyses showed that public self-consciousness predicted the manifestation of IoR-P, while the dimensions of schizotypy predicted that of IoR-S. Moreover, social anxiety and negative moods could cause IoR-P and IoR-S. This study directly showed the existence of two different types of ideas of reference in terms of their predictors. It is also significant in that it first examined referential thinking using the REF scale in the context of Asia and showed that there may not be much difference in the frequency of ideas of reference from other cultures. Future research directions are also discussed.

Evaluating the psychometric properties of the fatigue severity scale using item response theory.

BACKGROUND: Fatigue is a common daily experience and a symptom of various disorders. While scholars have discussed the use of the Fatigue Severity Scale (FSS) using item response theory (IRT), the characteristics of the Japanese version are not yet examined. This study evaluated the psychometric properties of the FSS using IRT and assessed its reliability and concurrent validity with a general sample in Japan. METHODS AND MEASURES: A total of 1,007 Japanese individuals participated in an online survey, with 692 of them providing valid data. Of these, 125 participants partook in a re-test after approximately 18 days and had their longitudinal data analyzed. In addition, the graded response model (GRM) was used to assess the FSS items' characteristics. RESULTS: The GRM's results recommended using seven items and a 6-point scale. The FSS's reliability was acceptable. Furthermore, the validity was adequate from the results of correlation and regression analyses. The synchronous effects models demonstrated that the Multidimensional Fatigue Inventory (MFI) enhanced depression, and depression enhanced FSS. CONCLUSION: This study suggested that the Japanese version of the FSS should be a 7-item scale with a 6-point response scale. Further investigations may reveal the different aspects of fatigue assessed by the analyzed fatigue measures.

The Effect of Enumeration of Self-Relevant Words on Self-Focused Attention and Repetitive Negative Thoughts.

Self-focused attention refers to awareness of self-referent, internally generated information. It can be categorized into dysfunctional (i.e., self-rumination) and functional (self-reflection) aspects. According to theory on cognitive resource limitations (e.g., Moreno, 2006), there is a difference in cognitive resource allocation between these two aspects of self-focused attention. We propose a new task, self-relevant word (SRW) enumeration, that can aid in behaviorally identifying individuals' use of self-rumination and self-reflection. The present study has two purposes: to determine the association between self-focus and SRW enumeration, and to examine the effect of dysfunctional SRW enumeration on repetitive negative thinking. One hundred forty-six undergraduate students participated in this study. They completed a measure of state anxiety twice, before and after imagining a social failure situation. They also completed the SRW enumeration task, Repetitive Thinking Questionnaire, Short Fear of Negative Evaluation Scale, and Rumination-Reflection Questionnaire. A correlational analysis indicated a significant positive correlation between self-reflection and the number of SRWs. Furthermore, individuals high in self-reflection had a tendency to pay more attention to problems than did those high in self-rumination. A significant positive correlation was found between self-rumination and the strength of self-relevance of negative SRWs. Through a path analysis, we found a significant positive effect of the self-relevance of negative SRWs on repetitive negative thinking. Notably, however, the model that excluded self-rumination as an explanatory variable showed a better fit to the data than did the model that included it. In summary, SRW enumeration might enable selective and independent detection of the degree of self-reflection and self-rumination, and therefore should be examined in future research in order to design new behavioral procedures.