Low-intensity mindfulness and cognitive-behavioral therapy for social anxiety: a pilot randomized controlled trial.

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.

Effects of work-family life support program on the work-family interface and mental health among Japanese dual-earner couples with a preschool child: A randomized controlled trial.

OBJECTIVES: This study examined the effectiveness of a newly developed work-family life support program on the work-family interface and mental health indicators among Japanese dual-earner couples with a preschool child(/ren) using a randomized controlled trial with a waitlist. METHODS: Participants who met the inclusion criteria were randomly allocated to the intervention or the control groups (n = 79 and n = 85, respectively). The program comprised two 3-h sessions with a 1-month interval between them and provided comprehensive skills by including self-management, couple management, and parenting management components. The program sessions were conducted on weekends in a community center room with 3-10 participants. Outcomes were assessed at baseline, 1-month, and 3-month follow-ups. Primary outcomes were work-family balance self-efficacy (WFBSE), four types of work-family spillovers (i.e., work-to-family conflict, family-to-work conflict, work-to-family facilitation, and family-to-work facilitation), psychological distress, and work engagement reported by the participants. RESULTS: The program had significantly pooled intervention effects on WFBSE (P = .031) and psychological distress (P = .014). The effect sizes (Cohen's d) were small, with values of 0.22 at the 1-month follow-up and 0.24 at the 3-month follow-up for WFBSE, and -0.36 at the 3-month follow-up for psychological distress. However, the program had nonsignificant pooled effects on four types of work-family spillovers and work engagement. CONCLUSIONS: The program effectively increased WFBSE and decreased psychological distress among Japanese dual-earner couples with a preschool child(/ren).

Clinical effects of wasabi extract containing 6-MSITC on myalgic encephalomyelitis/chronic fatigue syndrome: an open-label trial.

BACKGROUND: Wasabi (Eutrema japonicum) is a common pungent spice used in Japan. 6-Methylsulfinylhexyl isothiocyanate (6-MSITC) found in the rhizome of wasabi has been shown to have anti-inflammatory and antioxidant effects, as well as improve neuroinflammation and memory. Therefore, we hypothesized that these effects would be beneficial for treating myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). The present study was conducted to investigate the effectiveness of wasabi extract containing 6-MSITC on ME/CFS in an open-label trial. METHODS: Fifteen patients (3 males, 12 females, 20-58 years old) were orally administered wasabi extract (9.6 mg of 6-MSITC/day) for 12 weeks. The following parameters and test results were compared pre- and post-treatment: performance status (PS), self-rating questionnaires, pressure pain threshold (PPT) on the occiput, Trail Making test-A (TMT-A), and hemodynamic patterns determined by an active standing test. RESULTS: After treatment with 6-MSITC, PS improved significantly (p = 0.001). Although the scores on the 11-item Chalder Fatigue scale (CFS-11) and numerical rating scale (NRS) of fatigue did not show significant changes, subjective symptoms improved significantly, including headache frequency (4.1 to 3.0 times/week, p = 0.001) and myalgia (4.1 to 2.4 times/week, p = 0.019), NRS brain fog scores (5.7 to 4.5, p = 0.011), difficulty finding appropriate words (4.8 to 3.7, p = 0.015), photophobia (4.8 to 3.5, p = 0.008), and the Profile of Mood Status vigor score (46.9 to 50.0, p = 0.045). The PPT of the right occiput (17.3 to 21.3 kPa, p = 0.01) and TMT-A scores (53.0 to 38.1 s, p = 0.007) also changed, suggesting reduced pain sensitivity, and improved cognitive function, respectively. Orthostatic patterns determined by a standing test did not show remarkable changes. There were no serious adverse reactions. CONCLUSION: This study suggests that 6-MSITC improves PS as well as subjective symptoms such as pain and cognitive dysfunction, and psychological vitality of patients with ME/CFS. It also improved cognitive performance and increased pain thresholds in these patients. 6-MSITC may be a promising therapeutic option especially for improving cognitive dysfunction associated with ME/CFS.

Associations between Workers' Health and Working Conditions: Would the Physical and Mental Health of Nonregular Employees Improve If Their Income Was Adjusted?

Precarious employment can negatively affect health, but workers may be healthy if they earn enough income. This study uses equivalent disposable income and examines the interaction between income classes and employment types to clarify whether workers' health improves as the income classes rise. In Japan, nonstandard workers, called nonregular employees, have remained high since 2013. Therefore, using data from the national cross-sectional Comprehensive Survey of Living Conditions 2013, an official survey performed in Japan, we targeted a sample of employees aged 18 to 45 who graduated during the economic recession. Our final sample included 8282 employees (4444 males and 3838 females). The health (general and mental) status indicators used the dichotomized self-rated health and scores of the K6 questionnaires scored in the national survey. The association between income and health was almost proportional. Female workers tended to improve their health as their income class increased; however, this tendency was not observed in male workers, especially nonregular employees. Although the associations were weakened by added income information on the regression models, nonregular employees always showed inferior health to regular employees. The health status of nonregular employees, especially female nonregular employees, is statistically significantly lower than that of regular employees, even when the economic class is similar. In conclusion, improving low incomes for nonregular employees could improve health challenges, but income alone may not result in the same health status for regular and nonregular employees.

Descriptive review of internet-based cognitive behavior therapy on anxiety-related problems in children under the circumstances of COVID-19.

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.

A pilot randomized controlled trial of the shogi-assisted cognitive behavioral therapy (S-CBT) preventive stress management program.

BACKGROUND: Shogi is a traditional board game in Japan. A preventive stress management program based on Shogi-assisted cognitive behavioral therapy (S-CBT) was applied in the Japanese municipality of Kakogawa City. The study aimed to develop an S-CBT preventive stress management program for the elderly and determine its efficacy. METHODS: The participants were 67 elderly men with amateur-level Shogi skills. They were randomly assigned to either the S-CBT group (n = 33) or the waiting-list control group (n = 34). The S-CBT program was conducted over six 90-min sessions. The outcome measures were recorded using K6 instrument, the Japanese version of the abbreviated Lubben Social Network Scale, five items on cognitive behavioral functioning, and subjective well-being scale. RESULTS AND CONCLUSIONS: The dropout rates of the S-CBT group and waiting-list control groups were 36.4 and 44.1%, respectively. Effect sizes (Cohen's d) and 95% confidence intervals (CIs) were calculated for each group. Domains that changed immediately after the S-CBT intervention were problem-solving skills, self-reinforcement, and negative automatic thoughts. Future research should promote mental and physical health through the design of intervention programs using familiar materials. TRIAL REGISTRATION: University Hospital Medical Information Network (UMIN CTR) UMIN000036003 .

Cognitive behavioral treatment for irritable bowel syndrome: a recent literature review.

Irritable bowel syndrome (IBS) is a gastrointestinal psychosomatic disorder that often develops and worsens with stress. Hence, it is important to treat it from both, its physical and mental aspects. We reviewed recent research on cognitive-behavioral therapy (CBT)-one of the most widely studied psychological treatments for IBS-since it focuses on addressing the cognitions and behaviors associated with IBS symptoms, and combines diverse content, such as cognitive techniques, exposure, stress management, and mindfulness, whose effects have been widely studied. Research on CBT for IBS varies not only in terms of content of the interventions, but also in terms of implementation (individual or group, face-to-face or online). Internet-delivered CBT has recently shown the possibility of providing more accessible and cost-effective psychological intervention to IBS patients in formats, other than face-to-face. In recent years, many standardized scales that allow for IBS-specific psychological assessments have been used in clinical studies of CBT for IBS. Tools that competently deliver effective interventions and properly measure their effectiveness are expected to spread to many people suffering from IBS.

Cognitive-behavioral therapy for management of mental health and stress-related disorders: Recent advances in techniques and technologies.

Cognitive-behavioral therapy (CBT) helps individuals to eliminate avoidant and safety-seeking behaviors that prevent self-correction of faulty beliefs, thereby facilitating stress management to reduce stress-related disorders and enhance mental health. The present review evaluated the effectiveness of CBT in stressful conditions among clinical and general populations, and identified recent advances in CBT-related techniques. A search of the literature for studies conducted during 1987-2021 identified 345 articles relating to biopsychosocial medicine; 154 (45%) were review articles, including 14 systemic reviews, and 53 (15%) were clinical trials including 45 randomized controlled trials. The results of several randomized controlled trials indicated that CBT was effective for a variety of mental problems (e.g., anxiety disorder, attention deficit hypersensitivity disorder, bulimia nervosa, depression, hypochondriasis), physical conditions (e.g., chronic fatigue syndrome, fibromyalgia, irritable bowel syndrome, breast cancer), and behavioral problems (e.g., antisocial behaviors, drug abuse, gambling, overweight, smoking), at least in the short term; more follow-up observations are needed to assess the long-term effects of CBT. Mental and physical problems can likely be managed effectively with online CBT or self-help CBT using a mobile app, but these should be applied with care, considering their cost-effectiveness and applicability to a given population.

Social-life factors associated with participation in screening and further assessment of colorectal cancer: A nationwide ecological study in Japanese municipalities.

The burden of colorectal cancer in developed countries is high, and it is a major public health concern in Japan. Improving the quality of evidence on colorectal cancer screening participation and further assessment participation rates is important to reduce this burden. This study examined the social-life factors that influence colorectal cancer screening programs in Japan, particularly the effects of the proportion of elderly people and social capital, using a municipality-level national database and existing health reports. Data from a national municipality-based study were analyzed to identify social-life factors associated with participation in colorectal cancer screening and further assessment. Administrative data on the Japanese municipal screening programs were drawn from the Report on Regional Public Health Services and Health Promotion Services 2017. Available data used as predictors of interest for all 1719 municipalities as of 2017 were from the national census, statistical reports on the land area by prefecture and municipality, municipal financial surveys, a survey of physicians, dentists and pharmacists, and other databases. The mean rate of participation in colorectal cancer screening was 13.8%, and that of further assessment was 73.6%. Multiple linear regression analyses of the two outcomes showed that the proportion of elderly people was most significantly positively associated with colorectal cancer screening programs (ß = 0.51 for participation, ß = 0.13 for further assessment participation), and the proportion of single-elderly-person households was most significantly negatively associated (ß = -0.45 and -0.19, respectively). It is suggested that the health behaviors required for participation in colorectal cancer programs in Japanese elderly populations are greatly affected by family members.

Heart Rate Variability and Perceived Stress as Measurements of Relaxation Response.

Stress is a term used to define the body's physiological and psychological reactions to circumstances that require behavioral adjustment [...].

The effectiveness of intervention with board games: a systematic review.

To examine the effectiveness of board games and programs that use board games, the present study conducted a systematic review using the PsycINFO and PubMed databases with the keywords "board game" AND "trial;" in total, 71 studies were identified. Of these 71 studies, 27 satisfied the inclusion criteria in terms of program content, intervention style, and pre-post comparisons and were subsequently reviewed. These 27 studies were divided into the following three categories regarding the effects of board games and programs that use board games: educational knowledge (11 articles), cognitive functions (11 articles), and other conditions (five articles). The effect sizes between pre- and post-tests or pre-tests and follow-up tests were 0.12-1.81 for educational knowledge, 0.04-2.60 and - 1.14 - - 0.02 for cognitive functions, 0.06-0.65 for physical activity, and - 0.87 - - 0.61 for symptoms of attention-deficit hyperactivity disorder (ADHD). The present findings showed that, as a tool, board games can be expected to improve the understanding of knowledge, enhance interpersonal interactions among participants, and increase the motivation of participants. However, because the number of published studies in this area remains limited, the possibility of using board games as treatment for clinical symptoms requires further discussion.

Correction to: BPSM-D-19-00022R2 Subjective well-being and problem-solving skills for alleviating the stress of elderly men attending a randomized controlled trial of shogi-assisted cognitive behavioral therapy.

[This corrects the article DOI: 10.1186/s13030-019-0153-4.].

BPSM-D-19-00022R2 Subjective well-being and problem-solving skills for alleviating the stress of elderly men attending a randomized controlled trial of shogi-assisted cognitive behavioral therapy.

Shogi is a popular board game in Japan, and shogi-assisted cognitive-behavioral therapy (S-CBT) has been applied in Kakogawa City, a Japanese municipality. The purpose of this study was to clarify the effects of S-CBT on the subjective well-being of elderly men. Participants were 61 elderly men with amateur skill at shogi. They were randomly assigned to either the S-CBT group or a wait list group (control). The S-CBT group participated in a weekly, six-session S-CBT program. The intervention outcomes were scores on the K6, Lubben Social Network Scale, and a five-item cognitive-behavioral functioning scale. The Subjective Well-being Scale was used to assess happiness and satisfaction with life, and all the participants were classified into high- and low-happiness groups using the median score as the cutoff. The results showed that scores on "self-reinforcement" were significantly (P < 0.05) increased for those receiving S-CBT compared with controls, regardless of the participants' happiness scores. In contrast, the scores on "problem solving skills for alleviating stress" were significantly (P < 0.05) increased for those receiving S-CBT compared with controls only among those in the low-happiness group. These results remained significant after controlling for the effects of age and baseline scores on the K6, Social Network Scale, and "problem solving skills for alleviating stress" category. The S-CBT may be especially beneficial when focused on practical advice for the stress management of older people with low subjective well-being. (trial registration: 000036003 [UMIN, Japan]). Trial Registration: Trial registration number: 000036003 [UMIN, Japan].

Special series on "effects of board games on health education and promotion" board games as a promising tool for health promotion: a review of recent literature.

Board games are played by moving game pieces in particular ways on special boards marked with patterns. To clarify the possible roles of board game use in psychosomatic medicine, the present review evaluated studies that investigated the effects of this activity on health education and treatment. A literature search conducted between January 2012 and August 2018 identified 83 relevant articles; 56 (67%) targeted education or training for health-related problems, six (7%) examined basic brain mechanisms, five (6%) evaluated preventative measures for dementia or contributions to healthy aging, and three (4%) assessed social communication or public health policies. The results of several randomized controlled trials indicated that the playing of traditional board games (e.g., chess, Go, and Shogi) helps to improve cognitive impairment and depression, and that the playing of newly developed board games is beneficial for behavioral modifications, such as the promotion of healthy eating, smoking cessation, and safe sex. Although the number of studies that have evaluated board game use in terms of mental health remains limited, many studies have provided interesting findings regarding brain function, cognitive effects, and the modification of health-related lifestyle factors.

Alexithymia and Somatosensory Amplification Link Perceived Psychosocial Stress and Somatic Symptoms in Outpatients with Psychosomatic Illness.

BACKGROUND: Psychosomatic patients often complain of a variety of somatic symptoms. We sought to clarify the role of clinical predictors of complaints of somatic symptoms. METHODS: We enrolled 604 patients visiting a psychosomatic outpatient clinic. The outcome was the total number of somatic symptoms, and the candidate clinical predictors were perceived psychosocial stress, alexithymia, somatosensory amplification, adaptation, anxiety, and depression. All participants completed questionnaires assessing the outcome and the predictors. RESULTS: The average number of reported somatic symptoms was 4.8; the most frequent was fatigue (75.3%), followed by insomnia (56.1%), low-back pain (49.5%), headache (44.7%), and palpitations (43.1%). Multiple regression analysis showed that the total number of somatic symptoms was significantly associated with the degree of perceived psychosocial stress, alexithymia, somatosensory amplification, and depression. Also, structural equation models indicated links between excessive adaptation (via perceived psychosocial stress, alexithymia, and somatosensory amplification) and the total number of somatic symptoms. CONCLUSION: The results suggested that the association between psychosocial stress and reported somatic symptoms is mediated by alexithymia and somatosensory amplification in psychosomatic patients.

Cost-effectiveness analysis of suvorexant for the treatment of Japanese elderly patients with chronic insomnia in a virtual cohort.

AIMS: This study assessed the cost-effectiveness of the orexin receptor antagonist suvorexant against zolpidem, the most widely used hypnotic benzodiazepine receptor agonist in Japan. To this end, a model was used that factored in insomnia and the risk for hip fractures, which have devastating effects on the elderly. METHODS: Data were derived from published papers. The target population was a virtual cohort of elderly patients (≥65 years) with insomnia residing in Japan. Cost-effectiveness was evaluated using quality-adjusted life years (QALYs) and the incremental cost-effectiveness ratio as effectiveness measures. The investigators assumed the perspective of healthcare payers. RESULTS: In the base-case analysis, suvorexant was cost-saving (suvorexant: $252.3, zolpidem: $328.7) and had higher QALYs gained (suvorexant: 0.0641, zolpidem: 0.0635) for elderly Japanese patients with insomnia compared with zolpidem, indicating that suvorexant was dominant. In the sensitivity analysis, the outcome changed from dominant to dominated due to the relative risk for hip fractures associated with suvorexant. However, when the other parameters were varied from the lower to the upper limits of their ranges, suvorexant remained dominant compared to zolpidem. LIMITATIONS: The relative risk for hip fractures for suvorexant used in the model was based on data from pre-approval clinical trials. More precise data may be needed. CONCLUSIONS: Suvorexant seemed to be more cost-effective than the alternative zolpidem. The findings suggested that suvorexant might be a viable alternative to zolpidem for elderly patients with insomnia. A sensitivity analysis showed that outcome varied depending on the relative risk for hip fractures associated with suvorexant. Further investigations may be needed for more precise results.

Relationships between catastrophic thought, bodily sensations and physical symptoms.

BACKGROUND: Researchers have recently begun to seek cognitive explanations for physical symptoms with no obvious biological cause. Concepts such as somatization, somatosensory amplification, and somatosensory catastrophizing have been invoked to explain these phenomena. Somatosensory amplification occurs when these bodily sensations become stronger and more painful. Somatosensory catastrophizing is the tendency to attribute these bodily sensations to unbearable functional modulation or as signs of serious illness. This causes the sufferer to pay excessive attention to these physical sensations. However, there is no scale for evaluating somatosensory catastrophizing, and there are no standard diagnostic criteria. There were two objectives for this study: to develop a scale for evaluating somatosensory catastrophizing and to investigate relationships between somatosensory amplification, somatosensory catastrophizing, and physical symptoms. METHODS: In the first part of this study, in which we developed the scale, there were 231 student participants with an average age of 20.1 years. Of these, 57% of the participants were female. In the second part of the study, there were two groups of participants. The first group consisted of 158 non-patient subjects, 56% of whom were female, with an average age of 20.2 years. There were 33 outpatients receiving treatment for somatoform disorders in the second group. The average age of these participants, of whom 67% were female, was 48.8 years. The second part of the study was conducted using standardized self-rating questionnaires to assess somatosensory amplification and catastrophizing. RESULTS: We developed a 27-item scale, which we have called the Somatosensory catastrophizing scale (SSCS). The SSCS assesses five key areas, and our analysis confirmed it to be valid and highly reliable. The scale identified that the patient group from the second part of the study scored more highly than the control group for both somatosensory amplification and catastrophizing. Additionally, the results of covariance structure analyses revealed a significant causal relationship of the form "somatosensory amplifcation" via "somatosensory catastrophizing" to "physical symptoms". This relationship held in both groups of participants. The key difference between the patient and non-patient groups was that somatosensory catastrophizing had a greater impact on the physical symptoms of the participants in the patient group. CONCLUSIONS: In this study, we developed the SSCS, which enables us to measure somatosensory catastrophizing empirically. We then clarified the relationship between somatosensory amplification, somatosensory catastrophizing, and physical symptoms. In the future, we expect to be able to apply our new understanding to developing intervention techniques to mitigate the physical symptoms caused by somatosensory catastrophizing.