Skills Training in Affective and Interpersonal Regulation Narrative Therapy for women with ICD-11 complex PTSD related to childhood abuse in Japan: a pilot study.

Background: Skills Training in Affective and Interpersonal Regulation (STAIR) Narrative Therapy (SNT) has shown efficacy in alleviating symptoms of posttraumatic stress disorder (PTSD) and improving emotion regulation and interpersonal skills among individuals with complex trauma, such as childhood abuse. Although this therapy is expected to be effective for patients with complex PTSD (CPTSD), no study has directly assessed diagnostic and symptom outcomes. Moreover, the potential of therapy to achieve good outcomes in non-Western countries remains unclear. Objective: This pilot study examined the feasibility, safety, and outcomes of SNT for CPTSD among women with a history of childhood abuse in a Japanese clinical setting. Methods: Ten women aged 21-54 years (M = 29.1 years) with childhood-abuse-related ICD-11 CPTSD were enrolled in this study. The International Trauma Interview and International Trauma Questionnaire were administered to diagnose CPTSD and assess its severity. Symptoms of dissociation and depression, difficulties in emotion regulation and interpersonal relationships, quality of life, and negative cognitions were assessed pretreatment, midtreatment (after the STAIR phase), and immediately posttreatment (after the Narrative Therapy phase), in addition to 3 months after treatment. Results: Seven of the 10 participants completed the treatment. The therapists' adherence to the therapy protocol was 96.4%, ranging from 93.6% to 100% across therapists. Serious adverse events were not observed. Among the seven completers, six at posttreatment and all at follow-up no longer met CPTSD diagnosis. Exploratory analyses using the linear mixed-effects model showed significant improvements at posttreatment and follow-up for almost all the variables. Conclusions: The results provide preliminary evidence for the feasibility and safety of SNT for CPTSD in a Japanese clinical setting. This study is the first to report the use of SNT for individuals diagnosed with ICD-11 CPTSD using reliable clinician and self-report measures. HIGHLIGHTS: This study examined the feasibility and safety of STAIR Narrative Therapy for women with ICD-11 CPTSD related to childhood abuse in a Japanese clinical setting.High therapy adherence was observed.No serious adverse events occurred.

Antecedentes: La terapia narrativa (SNT en su sigla en inglés) de Entrenamiento de habilidades en regulación afectiva e interpersonal (STAIR en su sigla en inglés) ha demostrado eficacia en el alivio de los síntomas del trastorno de estrés postraumático (TEPT) y mejorar regulación emocional y las habilidades interpersonales entre individuos con trauma complejo, como el abuso en la infancia. Aunque esta terapia se espera que sea efectiva para pacientes con TEPT complejo (TEPT-C), ningún estudio ha evaluado directamente su estado diagnóstico y síntomas. Además, el potencial de la terapia para alcanzar resultados parecidos en países no Occidentales sigue sin estar claro.Objetivo: Este estudio piloto examinó la viabilidad, seguridad y resultados de la SNT para TEPTC en mujeres con historia de abuso en la infancia en un contexto clínico japonés.Métodos: Se inscribieron en este estudio diez mujeres de edad entre los 21­54 años (M = 29.1) con TEPT-C según la CIE-11 relacionado con abuso infantil. Se aplicó la Entrevista Internacional de Trauma y el Cuestionario Internacional de Trauma para diagnosticar TEPT-C y evaluar su gravedad. Los síntomas de disociación y depresión, dificultades en la regulación emocional y relaciones interpersonales, calidad de vida y cogniciones negativas se evaluaron durante el pretratamiento, a la mitad del tratamiento (después de la fase STAIR) e inmediatamente postratamiento (después de la fase de Terapia Narrativa), además de a los 3 meses después del tratamiento.Resultados: Siete de las 10 participantes completaron el tratamiento. La adherencia de los terapeutas al protocolo de la terapia fue del 96.4%, con una variación del 93.6% al 100% entre terapeutas. No se observaron eventos adversos serios. Entre las siete que completaron el tratamiento, seis en el postratamiento y todas al seguimiento ya no cumplían con el diagnóstico de TEPT-C. Los análisis exploratorios que utilizaron el modelo lineal de efectos mixtos mostraron una mejoría significativa en el postratamiento y seguimiento para casi todas las variables.Conclusiones: Los resultados entregan evidencia preliminar para la viabilidad y seguridad de la SNT para TEPT-C en un contexto clínico japonés. Este estudio es el primero en reportar el uso de la SNT para individuos diagnosticados con TEPT-C según la CIE-11 usando medidas clínicas y de auto-reporte confiables.

The Tohoku Theater Project in Postdisaster Japan: An Exemplar for Addressing Community Mental Health in the Context of Disaster.

The Tohoku Theater Project was completed 2 years after the natural and nuclear disasters in Tohoku, Japan, on March 11, 2011. It employed the dramatic arts to support the healing process, promote resilience, and increase dialogue and understanding about mental health among individuals who were directly affected by the disasters. The four performances fostered important discussions regarding the psychological impact of the Tohoku disasters. Participants (N=143) found the theater performance effective at facilitating discussion, increasing empathy, and enhancing mental health knowledge, coping, and resilience. The performances provided critical information about access to services; many participants reported that they had not known where to seek help for mental health prior to their involvement with the Tohoku Theater Project. Lessons learned may inform community-based strategies that promote mental health and healing in the wake of the COVID-19 pandemic and other public health disasters.

Cognitive function in Japanese women with posttraumatic stress disorder: Association with exercise habits.

BACKGROUND: Posttraumatic stress disorder (PTSD) has been associated with cognitive impairments, yet little is documented on the cognitive function of PTSD patients in Asian countries. It is shown that regular exercise can reduce PTSD symptoms, while no study has investigated the association between exercise and cognition in PTSD patients. This study aimed to examine cognitive functions of Japanese women with PTSD, and to explore the association between regular exercise and cognitive functions. METHODS: Forty-two women with DSM-IV PTSD and 66 demographically matched healthy control women participated in this study. Most of the patients developed PTSD after experiencing interpersonal violence. Cognitive functions were assessed by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Regular exercise habit was assessed by a self-reported questionnaire. RESULTS: Compared to controls, PTSD patients performed significantly more poorly in all cognitive domains examined, including immediate memory, visuospatial construction, language, attention, delayed memory, as well as the total score of RBANS (all p < 0.001). Compared to PTSD patients without the habit of exercise, those who habitually exercised showed significantly better performance on delayed memory (p = 0.006), which survived after controlling for potentially confounding variables in a multiple regression model. LIMITATIONS: The cross-sectional design and relatively small sample size limited our findings. CONCLUSIONS: PTSD in Japanese women is associated with pervasively impaired cognitive functions, including notable impairments in verbal memory. Such memory deficits might be improved by regular exercise, although further studies are needed to investigate the causal relationship between exercise and cognition in PTSD.

Reliability and validity of a self-report emotional expressivity measure: The Japanese version of the Berkeley Expressivity Questionnaire.

AIM: This study developed the Japanese version of the Berkeley Expressivity Questionnaire (BEQ), a self-report measure of three emotional expressivity facets, and provided evidence of its reliability and validity. METHODS: Five hundred and four students answered an online survey. To determine test-retest reliability, 241 of the participants completed the Japanese version of the BEQ again approximately 1 month after initial surveying was completed. RESULTS: Cronbach's alpha coefficients were 0.83 for the BEQ full scale, and 0.61-0.77 for subscales. Test-retest correlations were 0.61 for the full scale, and 0.57-0.61 for subscales. Construct validity was demonstrated by correlations between BEQ scores and scores on measures of emotional expressivity, self-monitoring, self-esteem, depression, "Big Five" (neuroticism, extraversion, openness, agreeableness, and conscientiousness) personality traits, and emotional control. CONCLUSION: The Japanese version of the BEQ has adequate internal consistency, reliability, and construct validity. Test-retest reliability was lower than that of the original scale. This study was the first in Japan to develop a self-rating questionnaire assessing multiple facets of emotional expressivity.