This study examined associations of parents’ subjective perceptions of disaster-related harm from the Great East Japan Earthquake (GEJE) with their mental health and with emotional and behavioral problems in their children born post-disaster. Participants included 218 parents (207 mothers, 11 fathers) and 219 children born post-GEJE, residing in affected areas. Parents served as proxy reporters, completing measures assessing their disaster-related experiences, psychological distress, depressive symptoms, post-traumatic stress symptoms, and their children's emotional and behavioral problems. Structural equation modeling was conducted to evaluate pathways among variables. Higher disaster-impact scores were significantly associated with poorer parental mental health (β = 0.15, p = .048), which was associated with more emotional and behavioral problems in children (β = 0.43, p < .001). The relationship between disaster impact and children's outcomes was mediated through parental mental health rather than through a direct pathway. Children’s psychological adjustment following large-scale disasters may be influenced by their caregivers’ mental health, even without direct trauma exposure. Family-centered mental health interventions are essential components of comprehensive disaster-recovery strategies.

Physical inactivity is considered to increase depressive symptoms. There are also studies reporting that overly strenuous physical activity can negatively affect a person's mental state. Insomnia, which is associated with lower levels of physical activity and increased sleep reactivity, is also known to be associated with depression. However, the directionalities of the associations among these factors remain unclear. The aim of this study was to investigate whether both insufficient and excessive physical activity affect depressive symptoms through sleep reactivity and sleep quality. Between April 2017 and April 2018, self-administered surveys were provided to adult volunteers through our acquaintances at Tokyo Medical University. The study included 526 volunteers whose responses were considered valid. Demographic information, results of the International Physical Activity Questionnaire, the Ford Insomnia Response to Stress Test (FIRST), the Pittsburgh Sleep Quality Index, and the Patient Health Questionnaire-9 (PHQ-9) were used for analysis. Quadratic regression was performed to examine whether the PHQ-9 score was significantly explained by physical activity duration in a U-shaped curve. Path analysis was performed to identify indirect effects. Quadratic regression indicated the presence of an optimal physical activity duration (25.7 h/week) that was related to the lowest PHQ-9 score, and both insufficient and excessive physical activity could be expressed as a Difference from Optimal Physical Activity Duration (DOP). Path analysis demonstrated that DOP increased the PHQ-9 score through the FIRST score.These findings indicate that deviation from the optimal physical activity duration worsens depressive symptoms through high sleep reactivity.

Aim:Previous research has primarily explored the negative impacts of caregiving on young carers (YCs)' mental health during childhood and adolescence, with limited focus on emerging adulthood. In particular, quantitative evidence on the development of depression in YCs in emerging adulthood is limited, especially regarding its persistence after caregiving ends. To address this, we aimed to assess the mental health of emerging adults with YC experience by categorizing them into past YCs (pYCs) who no longer provide care and those who continue to provide care (current young adult carer/past YCs, cYAC/pYCs) alongside a non-YCs control group. We also aimed to identify factors contributing to depressive symptoms in these groups, focusing on caregiving-related environmental factors during childhood and adolescence. Methods:Participants aged 18-25 were recruited online and divided into three groups. Demographic information, depressive/anxiety symptoms, well-being, and peer victimization were assessed, and binomial logistic regression analysis was performed to examine the factors contributing to depressive symptoms. Results:A total of 162 cYAC/pYCs, 161 pYCs, and 534 non-YCs were analyzed. Both the cYAC/pYCs and pYCs groups had higher levels of depressive and anxiety symptoms than the non-YCs group, with no significant differences between cYAC/pYCs and pYCs. Multivariable analysis demonstrated that female sex, taking care of their own caregiver, solo family caregiving, and experiencing peer victimization were significant predictors of depressive symptoms. Conclusion:Being a YC has lasting impacts on mental health and the risk of depressive symptoms, emphasizing the need for targeted interventions to support this vulnerable population.

Parental attitudes and peer victimization experiences in childhood influence anxiety. Depressive rumination is associated with these factors, but the interrelationship between them remains unclear. In this study, we hypothesized that “inadequate parental attitudes” and “peer victimization” experienced in childhood worsen “depressive rumination” and “state anxiety”, and that “depressive rumination” is an intermediate factor that worsens anxiety symptoms in adulthood. We verified this interrelationship by structural equation modeling. A cross-sectional questionnaire study was conducted on 576 adult volunteers, who gave written consent. Demographic data and scores from the Parental Bonding Instrument, Childhood Victimization Rating Scale, Ruminative Responses Scale, and state anxiety of State-Trait Anxiety Inventory Form Y were collected. Data were analyzed by multiple regression analysis and structural equation modeling. In the study models, inadequate parental attitudes (low care and high overprotection) and depressive rumination directly worsened anxiety. Inadequate parental attitudes and peer victimization experienced in childhood indirectly worsened anxiety via depressive rumination. Furthermore, inadequate parental attitudes experienced in childhood indirectly worsened depressive rumination via peer victimization in childhood. Our results indicate that depressive rumination influences the relationship between inadequate parental attitudes, peer victimization, and adulthood anxiety. Therefore, assessing the quality of parental attitudes and peer victimization experienced in childhood and depressive rumination may help to clarify the antecedents of anxiety and how to intervene effectively.

Aim:Previous studies have documented the beneficial effects of leisure activities on mental health. However, limited methods or scales are available to measure leisure activities for the evaluation of mental health or the intervention of mental disorders, and data on the therapeutic benefits of leisure activities for mental health are scarce. Furthermore, few studies have investigated the effects of leisure activities on the mental health of young individuals. Therefore, we developed the Leisure Activity Scale (LAS; a 7-item, 5-point scale) to assess the leisure activities of young adults, and aimed to confirm its reliability and validity. Methods:This study involved 551 Japanese participants aged 18-25 years and was conducted through an online survey from September to November 2022. Reliability of the LAS was assessed through internal consistency analysis. To determine convergent and discriminant validity, the LAS was compared with various scales measuring psychometric properties, including depression, anxiety, work fatigue recovery, resilience, neuroticism, emotion regulation, well-being, and ill-being. Results:Factor analysis indicated that the 7-item LAS was the most appropriate measure for use in mental health (Cronbach's α coefficient = 0.756). Total LAS7 scores positively correlated with recovery experience, resilience, emotion regulation, and well-being, and negatively correlated with state anxiety. These were all weak correlations, with correlation coefficients of less than 0.3. Total LAS7 scores did not correlate with trait anxiety, neuroticism, or ill-being. Conclusions:Our results demonstrated the reliability of the LAS, but its convergent validity was insufficient. The LAS can comprehensively assess leisure activities, although further improvement regarding its validity is needed.

Background:The mechanism underlying how parental attitudes in childhood, trait anxiety (TA), and adult life events cause depression remains unclear. In this study, we investigated the associations among parental attitudes in childhood, TA, adult life events, and depressive symptoms to assess the mechanism of the development of depressive symptoms. Participants and Methods:This study was conducted between January and August 2014. A total of 404 Japanese adult volunteers completed questionnaires, including Parental Bonding Instrument, State-Trait Anxiety Inventory Form Y, Life Experiences Survey, and Patient Health Questionnaire-9, to assess the parental attitudes of care and overprotection experienced in childhood, TA, life events, and depressive symptoms, respectively. The associations among these variables were analyzed by structural equation modeling. Results:Parental attitude did not affect depressive symptoms directly, but affected TA directly. The influence of "care" on TA was negative, but that of "overprotection" on TA was positive. TA had a positive influence on negative life events (NLEs) and depressive symptoms in adulthood. Although NLEs in adulthood had a positive influence on depressive symptoms, positive life events in adulthood did not have any effect. Regarding indirect effects, parental attitude influenced NLEs and depressive symptoms through TA. TA worsened depressive symptoms through NLEs in adulthood. Regarding the parental attitude subscale of "care", this decreased depressive symptoms through TA and NLEs in adulthood. Care and overprotection showed opposite effects. The model fit was good or acceptable (Comparative Fit Index > 0.97 and Root Mean Square Error of Approximation < 0.08). Conclusion:This study suggested that parental attitudes in childhood influence adult depressive symptoms through TA and NLEs. Improving the quality of child care may decrease TA, reduce NLEs in adulthood, and reduce depressive symptoms indirectly. Guidance for parents and interventions to reduce TA may be useful for the prevention of depression in adulthood.

Young carers (YCs), defined as children or adolescents with substantial caregiving responsibilities for family members, face increased mental health risks, particularly depression. However, the mechanisms underlying this association remain unclear due to limited quantitative research. Emerging adulthood is a psychologically vulnerable period involving key life decisions, when the mental health effects of early caregiving may become more apparent. Understanding how depression develops in YCs during this stage may inform effective interventions to support their long-term well-being. Prior studies insufficiently examined depressive symptoms and caregiving burden using standardized measures, with limited focus on YCs’ mental health trajectories. This study addresses these gaps by using caregiving time as an objective burden indicator and testing a path model with neuroticism and resilience as mediators. A cross-sectional internet-based survey of 323 YCs and 551 non-YCs aged 18–25 collected demographic data, daily caregiving hours, neuroticism, resilience, depressive symptoms, and childhood peer victimization using standardized questionnaires. A path model analyzed the indirect impact of caregiving hours on depressive symptoms via neuroticism and resilience. YCs reported higher levels of depressive symptoms, neuroticism, and peer victimization. Path analysis revealed that longer caregiving time was indirectly associated with depressive symptoms through reduced resilience and increased neuroticism, in addition to a modest direct effect. This model explained 42.9

Aim:Demoralization, which is characterized by helplessness, hopelessness, and the loss of meaning, has gained increasing attention in psychiatry and palliative care. Robinson et al. developed the Demoralization Scale-II (DS-II) to assess this construct in a brief and reliable format. However, a validated Japanese version has not been developed to date. The purpose of this study was to develop a Japanese version of the DS-II (DS-II-J) and to evaluate its psychometric properties in cancer patients. Methods:A total of 147 cancer patients from 3 acute care hospitals in Japan were included in the study. Participants completed the DS-II-J, Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder 7-item Scale (GAD-7), and Edmonton Symptom Assessment System Revised Version (ESAS-r). Internal consistency was assessed using Cronbach's α. Convergent validity was evaluated by examining correlations with the PHQ-9, GAD-7, and ESAS-r. Confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) were conducted to assess factor structure. Results:The DS-II-J demonstrated high internal consistency (α = 0.92). Strong positive correlations were found between DS-II-J scores and PHQ-9 and GAD-7 scores, and moderate correlations with selected ESAS-r physical symptoms, supporting convergent validity. CFA results showed a suboptimal model fit for both a one-factor model and the original two-factor model proposed by Robinson et al. EFA supported a two-factor structure, but with a different item composition, suggesting cultural influences. Conclusion:The DS-II-J is a valid and reliable tool for assessing demoralization in Japanese cancer patients.

Aim:Childhood abuse, personality traits, and stressful life events are among the many factors that contribute to the development of depression, yet the nature of their interrelationships has not been fully clarified. This research set out to investigate the interrelationships among childhood abuse, stressful life events, behavioral inhibition system (BIS)/behavioral activation system (BAS) sensitivity, and depressive symptoms in adults from a nonclinical population using structural equation modeling. Methods:A total of 286 Japanese adults without any psychiatric history participated in the study. Participants filled out a set of self-report instruments, including the Patient Health Questionnaire-9 (PHQ-9), the BIS/BAS scale, the Child Abuse and Trauma Scale, and the Life Experiences Survey (LES). Data analysis was conducted using multiple regression and structural equation modeling. Results:By structural equation modeling, childhood abuse showed a significant indirect effect on PHQ-9 through BIS. The pathway from childhood abuse to the LES negative change score via BIS reached statistical significance, while the remaining indirect routes did not show significance. Childhood abuse had a significant total indirect effect on PHQ-9 scores (indirect coefficient = 0.092, p = 0.001). Conclusion:Childhood abuse influences the increase in depressive symptoms via increased BIS sensitivity, but not via stressful life events.

ABSTRACT:The aim of this study was to analyze whether interpersonal sensitivity mediates the effect of qualitative parenting characteristics experienced during childhood on the appraisal of life experiences and depression severity during adulthood in adult community volunteers. A total of 404 Japanese adult volunteers answered the following four self-report questionnaires: Parental Bonding Instrument, Interpersonal Sensitivity Measure, Life Experiences Survey, and Patient Health Questionnaire-9. Structural equation modeling was performed to analyze whether childhood parenting quality increases depressive symptom severity through interpersonal sensitivity, which then affects the appraisal of recent life events. In the two structural equation models, inadequate care and excessive overprotection received during childhood were associated with the negative evaluation of life experiences and depression severity in adulthood through high interpersonal sensitivity. Our findings indicate interpersonal sensitivity as a mediator of the effect of inadequate care and excessive overprotection experienced in childhood on the negative evaluation of life experiences and depression severity in adulthood.

Background:Subjective social status influences anxiety, but at present, the mechanism is not fully understood. It has been reported that negative childhood experiences, such as abuse, can influence depressive symptoms through subjective social status and personality traits, such as self-esteem. A similar mechanism is presumed to underlie anxiety symptoms in adulthood. Therefore, we hypothesized that subjective social status and self-esteem are intermediate factors in the indirect effects of childhood abuse on state anxiety in adulthood, and analyzed the indirect effects via these factors using a path analysis.Subjects and Methods:Child Abuse and Trauma Scale, Subjective Social Status, Rosenberg Self-Esteem Scale, and State-Trait Anxiety Inventory Form Y questionnaires were administered in a self-report format to 404 adult volunteers from January 2014 to August 2014. In addition, a path analysis was conducted to determine whether subjective social status and self-esteem are associated with the indirect effects of childhood abuse on anxiety symptoms in adulthood.Results:Childhood abuse did not directly affect state anxiety in adulthood, but affected state anxiety via subjective social status and self-esteem. Subjective social status affected state anxiety via self-esteem. This model explained 25.2% of the variation in state anxiety in adult volunteers.Conclusion:The present study demonstrated that childhood abuse affects anxiety in adulthood through subjective social status and self-esteem. Therefore, interventions that enhance subjective social status and self-esteem for adults who experienced childhood abuse may help reduce their anxiety.

Objectives: Social jetlag (SJL), the discrepancy between an individual's inherent circadian rhythm and external social schedule, is associated with obesity. This study aimed to investigate whether SJL also influences body weight and body fat loss during dieting. Methods: This was an observational study from 2015 to 2018 with participants who had joined an exercise and nutrition program at a private personal training gym. Data from 11,829 individuals provided by the gym along with their sleep logs were analyzed. Differences in change in body mass index (BMI) and body fat percentage (%body fat) were compared by the degree of SJL. Regression was conducted for the change in BMI and %body fat on SJL, adjusted for gender, age, engagement duration in the program, initial BMI, initial %body fat, chronotype, and dietary intakes. Results: The subjects comprised 3,696 men and 8,133 women with a mean age of 40.4 years. Greater SJL was associated with a lower efficacy of BMI and %body fat reduction. The change in BMI (+ 0.56 / hour: SJL) and %body fat (+ 1.40 / hour: SJL) was associated with SJL after adjusting for each variable including dietary intake. Conclusion: SJL was associated with the effect of exercise and nutrition instruction on BMI and body fat reduction, even after adjustment for covariates related to dietary intake. Maintaining consistent sleep-wake rhythms may be crucial for enhancing the efficacy of weight loss programs.

Aim:Various risk factors, such as childhood nurturing experiences and subjective social status, have been identified to be involved in the onset of depression. However, the mechanism of depression is not yet fully understood. In this study, we hypothesized that nurturing experienced in childhood affects subjective social status and current personality traits, which in turn influence depressive symptoms in adulthood, and verified this hypothesis through structural equation modeling. Methods:A questionnaire survey was conducted on 404 adults. Multiple regression analysis and structural equation modeling were conducted using demographic information and scores for the Patient Health Questionnaire-9, Parental Bonding Instrument, and NEO Five-Factor Inventory. Results:Subjective social status was found to mediate the association between nurturing experiences and neuroticism (0.029 for Overprotection and -0.034 for Care). On the other hand, neuroticism was found to mediate the association between subjective social status and depressive symptoms (-0.097 in Care model and -0.103 in Overprotection model), as well as the association between nurturing experiences and depressive symptoms (0.144 for Overprotection and -0.134 for Care). Furthermore, it was also shown that complex paths, in which the association of nurturing experiences with depressive symptoms was mediated by two factors, namely, subjective social status and neuroticism, were statistically significant as indirect effects (0.016 for Overprotection and -0.018 for Care). Conclusion:In this study, we clarified that nurturing experienced in childhood affects neuroticism in adulthood, which is mediated by subjective social status, and furthermore, the effects of nurturing on neuroticism lead to varying levels of depressive symptoms in adulthood. The mediation effects demonstrated in the present study may contribute towards unraveling the causes of depression and developing effective treatments for depressive symptoms.

Aim:Various factors are thought to be involved in the development of depression, but the mechanisms are not yet clear. Although several reports have demonstrated that parental attitude experienced in childhood, depressive rumination, and sleep disturbances each influence depressive symptoms, and the association between two of these four variables, to our knowledge, no reports to date have investigated the association among the four variables. Methods:A questionnaire survey was administered to 576 adults who agreed to participate in this study between April 2017 and April 2018. Questionnaires assessed parental attitudes experienced in childhood, depressive rumination, sleep disturbances, and depressive symptoms in adulthood. The associations among the four variables were tested by structural equation modeling. Results:Regarding the direct effects, the parental attitude of "care" had a negative influence on depressive rumination and depressive symptoms, whereas "overprotection" had a positive influence on depressive rumination. Depressive rumination had a positive influence on sleep disturbance and depressive symptoms, whereas sleep disturbances had a positive influence on depressive symptoms. Regarding indirect effects, depressive rumination mediated the association between parental attitudes and sleep disturbances or depressive symptoms. Furthermore, sleep disturbances mediated the association between depressive rumination and depressive symptoms. Care and overprotection showed opposite effects. The goodness of fit of this model was high. Conclusion:The results of this study demonstrated that there were associations among the four variables. Clinical assessment and intervention of depressive rumination and sleep disturbances that are closely associated with previous parental attitudes may lead to an improvement of depressive symptoms.

AbstractBackgroundStressors induce depression together with parenting experienced in childhood, personality traits, and sleep. In this study, we investigated factors associated with the development of depression in a long‐term stressful environment, namely, the Antarctic Research Expedition wintering party, by comparing 2 groups, the depression and nondepression groups.MethodsA self‐administered questionnaire was used to survey 91 members of the Japanese Antarctic Research Expedition who spent winters in the Antarctic base. Psychological evaluations of depression, anxiety, and sleep were performed using a questionnaire every 3 months during the participants’ stay in Antarctica. The primary endpoint was the occurrence of minor or major depression, as evaluated by the PHQ‐9 score.ResultsParticipants with a PHQ‐9 score of 5 or more during their stay in Antarctica were defined as the depression group (25 subjects), and participants with a PHQ score of 4 or less were defined as the nondepression group (43 subjects). Compared with the nondepression group, the depression group had significantly higher scores for predeparture PHQ‐9, state and trait anxiety, sleep disturbance, and neuroticism. Multivariable logistic regression analyses showed that higher predeparture scores of subthreshold depressive symptoms and neuroticism were found to be significant predictors of the occurrence of depression during their stay in Antarctica.ConclusionsThis study prospectively showed that subthreshold depressive symptoms and neuroticism, which were suggested as risk factors in previous studies, were confirmed to be risk factors for depression. The results of our study are expected to contribute to the understanding of depression in harsh environments.

COVID-19 adversely affected mental health care and service delivery globally. Continuing its thrust on improving child and adolescent mental health, the National Center for Global Health and Medicine conducted a training program in collaboration with the University of the Ryukyus, University of the Philippines Manila, the National Center for Mental Health, and the Philippine Society of Child and Adolescent Psychiatry in 2020 and 2021 to discuss the situation, challenges, and good practices in mental health treatment, care, and promotion for children and adolescents during the COVID-19 pandemic. Composed of 15 on-demand lectures and a webinar on three general mental health themes, the training identified the need for strengthening the provision of care not only in specialized health facilities but also in empowering communities in addressing children and adolescent mental health concerns. Collaboration between different stakeholders is needed to ensure child and adolescent well-being during public health emergencies.

Background:The experience of peer victimization in childhood increases the risk of developing anxiety disorders and depression, risk of suicide, as well as sensitivity to stress, in adulthood. Various personality traits are known to be associated with these effects. However, the influence of trait anxiety on job stress has not yet been reported. In the present study, we tested the hypothesis that the experience of peer victimization in childhood and trait anxiety influence job stress in adulthood.Methods:A questionnaire survey, including State-Trait Anxiety Inventory, Childhood Victimization Rating Scale, and Brief Job Stress Questionnaire, was administered to 566 adult workers. The interrelationship between multiple variables was analyzed by multiple regression analysis and path analysis.Results:In the path model, childhood peer victimization had a positive direct effect on trait anxiety and the psychological and physical stress response (PPSR). Trait anxiety had a positive direct effect on job stressors and PPSR, and job stressors had a positive direct effect on PPSR. Regarding indirect effects, childhood peer victimization had a significant adverse effect on job stressors and PPSR via trait anxiety.Conclusion:Our results showed that childhood peer victimization has a negative impact on job stress in adulthood, which is influenced by trait anxiety. Interventions to address peer victimization in childhood and trait anxiety may reduce job stress in adulthood, and thus contribute to improved occupational mental health and productivity in the workplace.