Mental health problems among children and adolescents have been increasing worldwide, highlighting the need for preventive interventions in schools. This study examined the effectiveness of a school-based universal prevention program on self-efficacy and mental health problems in Japanese children using a quasi-experimental design with intervention and control groups. A total of 1,281 third- and fourth-grade students participated, with 264 assigned to the intervention group and 1,017 to the control group. The intervention group received the Universal Unified Prevention Program for Diverse Disorders (Up2-D2), a 12-session program based on cognitive-behavioral and positive psychological interventions. A significant universal-level effect was found for positive attitude (a self-efficacy subscale), which improved over time in the intervention group but not in the control group. At the indicated level, a Time × Group interaction was observed for depressive symptoms among children with elevated baseline depression; however, the group effect at Time 4 did not reach statistical significance after covariate adjustment. Effect sizes at Time 4 were small for positive attitude at the universal level (g = 0.19) and small-to-moderate for depressive symptoms at the indicated level (g = 0.36). These findings suggest that Up2-D2 may promote positive attitude at the universal level, while potential indicated-level benefits for depressive symptoms may warrant further confirmation. Evaluating outcomes in both general and at-risk subgroups may help clarify for whom and on which outcomes universal school-based prevention programs are most beneficial.

Information on child irritability varies by informant, yet little is known about how ratings differ between male and female parent respondents, and psychometric evidence for father-reported irritability is scarce. This study evaluated the psychometric properties and measurement invariance of the Japanese Affective Reactivity Index Parent-Report Form (ARI-p) across parent respondent gender groups, then examined group differences and their interactions with sociodemographic variables. In a two-wave community-based online panel survey, 4,800 parents (2,633 male and 2,167 female parent respondents) of children aged 6–18 years completed the ARI-p, the Strengths and Difficulties Questionnaire (SDQ), and demographic questions; 3,847 (80.1%) completed a follow-up after two months. The ARI-p showed good internal consistency (α = 0.885, 95% CI [0.880, 0.890]) and moderate test-retest reliability (ICC = 0.570, 95% CI [0.548, 0.591]). Approximate configural, metric, and scalar measurement invariance was supported, with qualifications including an elevated RMSEA. The ARI-p correlated positively with SDQ Emotional Symptoms (ρ = .46) and modified Conduct Problems (ρ = .50), and each one-point increase was associated with higher odds of a parent-reported disruptive mood dysregulation disorder classification (OR = 1.53, 95% CI [1.41, 1.65]). Score distributions were similar between the two respondent groups (p = .211); after adjusting for sociodemographic variables, male parent respondents reported slightly higher scores (B = 0.32, 95% CI [0.15, 0.48], p < .001), with no statistically detectable gender-by-sociodemographic interactions (p = .541). The Japanese ARI-p is reliable and valid for community samples, and the gender of parental respondents merits consideration when interpreting irritability ratings.

The Disruptive Behavior Disorders Rating Scale (DBDRS) is widely used in many countries as a questionnaire to measure each symptom of attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD) in children and adolescents. This study’s objectives were (a) to examine the psychometric properties of the Japanese version of the DBDRS (J-DBDRS), measuring the symptoms of ADHD, ODD, and CD in children and adolescents reported by parents; (b) to estimate the prevalence of ADHD, ODD, and CD in Japanese children and adolescents using the J-DBDRS; and (c) to examine the relationship between its symptoms, anxiety, depression, and irritability. A total of 2442 parents who had children and adolescents aged 6–15 participated in the study. The results confirmed the structural validity for the four-factor structure, internal consistency, test–retest reliability, and convergent validity of the J-DBDRS. According to the results, the psychometric properties of the J-DBDRS; the characteristics of the estimated prevalence of ADHD, ODD, and CD in Japan; and the associations between each mental symptom were discussed.

Background/Objectives: School-based universal mental health interventions offer an inclusive and scalable approach to promote mental health and well-being among children. This study evaluates the Let’s Learn About Emotions (Opitaan tunteista in Finnish) program, an evidence-based, teacher-led universal school-based intervention originally developed in Japan and culturally adapted for Finnish primary schools. Methods: A total of 512 fourth-grade students from 14 schools participated in the 12-week program during spring 2023. Using a mixed-methods design, we assessed (1) the program’s acceptability among students, parents, teachers, and school principals, (2) fidelity of implementation, and (3) changes in students’ mental well-being pre- to post-intervention. Quantitative data included standardized questionnaires with valid responses collected from 233 students at baseline and 209 students at post-intervention, as well as parents and teachers. Qualitative data were collected through focus group discussions involving parents, teachers, and school principals during spring 2024. Results: Acceptability was high across all respondent groups. Teachers adhered closely to the teaching manual, as confirmed by self-reports and direct classroom observations. Statistically significant improvements were observed in parent-reported conduct problems, hyperactivity, and peer problems, though student self-reports did not show similar benefits. Conclusions: The program was found to be both acceptable and culturally appropriate in the Finnish context. Findings from this study provide valuable insights for refining and improving the program for future implementation. To more rigorously examine its effectiveness, future studies should employ a randomized controlled trial design.

The present article reviews the current status of cognitive-behavioral therapy (CBT) interventions for anxiety and depression in Japanese youth. First, a literature review of youth CBT programs for anxiety and depression is provided. Through this process, we identify which program/protocol has been most researched within Japan. Second, through a systematic interview to the authors, the development process of four predominant programs is outlined. The programs included were a family CBT program for anxiety disorders (the Japanese Anxiety Children/Adolescents Cognitive Behavior Therapy program), two school-based prevention programs for anxiety and depression (Journey of the Brave and Phoenix Time), and a transdiagnostic protocol for anxiety and depression (Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children and the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents). Third, cultural adaptation and modification of the programs are discussed from the scope of user-centered design principles as described by Lyon and Koerner (Sci Pract 23:180–200, 2016). As a result, changes in program content and material, as represented by the use of culture-friendly program names, acronyms, illustrations, and characters were endorsed in all of the programs. Structured but flexible session formats helped increase learnability and efficiency while keeping the cognitive load of providers and consumers low. A careful selection of providers, as well as quality training and consultation are important factors to maximize competency and ensure appropriate implementation. Application of existing time frames and staff who work in each setting were effective ways to increase scalability. Overall, it was shown that many of the modifications adopted overlap among successful programs; these represent the most basic and essential requirements for a program to be applicable to a wide range of contexts. Implications and further directions are explored.

問題を未然に防ぐための予防的介入は,目の前にある問題を解決する治療的介入と比較して,効果が見えにくいために実施が遅れることが多い。しかし,子どもたちのメンタルヘルスの悪化やコロナ禍の影響を踏まえると,学校教育現場における予防的介入の実装が求められている。本総説では学校でのメンタルヘルス予防教育の現状と課題について,こころあっぷタイム(Up2-D2: Universal Unified Prevention Program for Diverse Disorders)の社会実装を通じて解説を行った。本総説では社会実装における研究面での課題として,有効性の確立,測定指標の選定,対象者の拡大,構成要素の洗練化と短縮化,既存プログラムからの選定,若手研究者の育成,について議論した。加えて,実践面での課題として,キーパーソンの確保,授業時間の確保,実施者の養成,運営資金の調達,広報活動の実施,について議論した。

School closures due to the coronavirus disease 2019 (COVID-19) pandemic have worsened mental health problems for children and adolescents worldwide. We aimed to examine the follow-up effectiveness of a transdiagnostic universal prevention program for anxiety of junior high school students after a nationwide school closure during the COVID-19 outbreak in Japan. A total of 117 junior high school students were included in the analysis. We used the Unified Universal Prevention Program for Diverse Disorders (Up2-D2) program; the Up2-D2 comprises cognitive-behavioral and positive psychological interventions provided over twelve 45-minute sessions. The program was originally implemented between June and July 2020, immediately after pandemic-related school closures had ended in Japan. The program assessments were based on students' responses to a questionnaire incorporating five scales to measure indicators such as internalizing and externalizing problems. Assessments were carried out before, immediately after, two-month, and six-month after implementing the program. Mixed models for the whole sample showed small anxiety improvement effects immediately post-intervention and two-month, and six-month assessments (g = -0.25, g = -0.44, and g = -0.30, respectively). The anxiety reducing effects were even greater for the higher-anxiety group at the post-, 2-month, and 6-month assessments (g = -1.48; g = -1.59; g = -1.06, respectively). Although there was no control group, these results indicate that the transdiagnostic universal prevention intervention reduce only anxiety, but not other outcomes (depression, anger, and self-efficacy) in junior high students returning to school following school closures related to the COVID-19 pandemic in Japan.

•A development of age-suitable prevention program for mental health is indispensable.•A new adolescent version of mental health prevention program was developed through three phases.•However, the child version showed higher teacher's usability than the adolescent version.•Age appropriateness must be examined using multiple methods from multi-informants.

Abstract Background: Empirical studies between anger and anger-provoking cognitive variables in children and adolescents are lacking, despite numerous studies on internalising and externalising problems. Aim: The purpose of this study was to develop new questionnaires for anger-provoking cognitive errors and automatic thoughts, and examine relationships between anger, cognitive errors, and automatic thoughts in children and adolescents. Method: Participants were 485 Japanese children and adolescents aged 9–15 years old (254 females; average age 12.07; SD = 1.81). They completed the Anger Children’s Cognitive Error Scale (A-CCES) and the Anger Children’s Automatic Thought Scale (A-CATS), which were developed in this study, as well as the Anger Scale for Children and Adolescents and the Japanese version of Short Spence Children’s Anxiety Scale. Results: Both the A-CCES and the A-CATS had adequate reliability (internal consistency) and validity (face validity, structural validity and construct validity). A hierarchal regression analysis indicated that automatic thoughts were positively and moderately related to anger (β = .37) after controlling for age, gender, anxiety symptoms, cognitive errors and interaction term. Moreover, a mediation analysis indicated that automatic thoughts significantly mediated the relationship between cognitive errors and anger (indirect effect, 0.24; 95% CI: .020 to .036). Conclusions: This study developed the new questionnaires to assess anger-provoking cognitive errors and automatic thoughts. In addition, this study revealed that automatic thoughts rather than cognitive errors are associated with anger in children and adolescents.

Abstract There is increasing support for the efficacy of transdiagnostic cognitive behavioural interventions for anxiety and depression. However, little is known about the applicability of transdiagnostic behavioural interventions for children younger than 12 years old. This study was conducted to examine the feasibility and potential efficacy of Streamlined Transdiagnostic Intervention for Anxiety and Depression (STREAM) for children with anxiety and/or depressive disorders using a randomised controlled design with a wait-list control (WLC) condition and blind-assessments. Of the 22 potential participants, 16 Japanese children (M = 9.81; SD = 0.75; range 9–12 years) with principal anxiety or depressive disorder were eligible and enrolled. Then, the participants were randomly assigned to the STREAM or WLC condition. The dropout rates were 0% for both the conditions at post-assessment. Mixed model analyses showed that, although there were no significant interactions at post-assessment between both the conditions, both anxiety and depressive disorders significantly improved at 3 months compared with pre-assessment for the combined condition (the STREAM and WLC conditions). Therefore, this study demonstrated the feasibility of the STREAM in the Japanese clinical setting and potentially supported its efficacy for children with anxiety and depressive disorders at the follow-up assessment.

Background: Irritability is a transdiagnostic symptom that accompanies both internalizing and externalizing problems. However, there has been a scarcity of research concerning the relationships between irritability and mental health profiles among children and adolescents. Aim: This study aimed to identify latent profiles in children and adolescents using anxiety, depression, oppositionality, and irritability. In addition, the profiles were further examined in their relationships with mental health symptoms. Method: The study analyzed data from 1867 children and adolescents aged 6-15 years from the COVID-19 Online-Survey for Children and Adolescents in Japan (J-COSCA). Parent-reported questionnaires were used in this study. Results: A latent profile analysis detected five latent profiles. High oppositionality characterized the first profile ("oppositional": n = 405, 22%). High levels of depression and other less pronounced symptoms characterized the second profile ("depressed": n = 276, 15%). The third profile ("average": n = 602, 33%) presented average symptoms of anxiety, depression and oppositionality and low irritability. The fourth profile ("well-adjusted": n = 235, 13%) presented low values for all the applicable symptoms. The last profile ("comorbid": n = 308, 17%) exhibited high values for all the symptoms and the highest level of irritability of the five profiles. Limitation: We analyzed the data from a community sample alone after capturing it using parent-reported questionnaires. Conclusion: This study revealed that the five profiles (oppositional, depressed, average, well-adjusted, and comorbid) were identified, and children and adolescents in the comorbid profiles had high irritability as well as high anxiety, depression, and oppositionality.

Abstract Background The present study examined the effectiveness of the Universal Unified Prevention Program for Diverse Disorders (Up2-D2) for internalizing and externalizing problems for children aged 9–11 years. Methods We used two feasibility studies. The Up2-D2 entailed 12 sessions delivered by teachers; each session was developed based on cognitive-behavioral and positive psychological interventions. In Studies 1 and 2, 58 elementary school children aged 9–11 and 73 elementary school children aged 10–11 attended the Up2-D2. The teachers in Study 1 received 1.5 h of on-site teacher training for learning rationales for interventions, how to run the program, and received ongoing supervision by professionals with mental health expertise. In contrast, the teachers in Study 2 were given self-learning DVD materials in place of on-site training and ongoing supervision. Results Mixed models revealed that general difficulties, which is total score of both internalizing and externalizing problems, decreased in Study 1 but not in Study 2. Additional analyses for children with subclinical general difficulties revealed that general difficulties, internalizing problems, and externalizing problems decreased in Study 1, whereas in Study 2, general difficulties and internalizing problems decreased, except for externalizing problems. Conclusions These results suggest that on-site teacher training and ongoing supervision are imperative for improving general difficulties in children at a universal level. In addition, universal preventive interventions by classroom teachers without on-site training and continuous supervision might be efficacious for reducing general difficulties and internalizing problems for children with subclinical difficulties.

Although there are a variety of treatment options for social anxiety, effective prevention strategies for those with subclinical social anxiety are limited. This study evaluated a single session group formatted prevention program focused on the reduction of safety behaviors in both a proof-of-concept study and a randomized controlled trial (RCT). Participants (N = 59) were nontreatment seeking Japanese university students with high levels of social anxiety. Participants were randomized to either an active treatment focused on identification and elimination of safety behavior or a control group involving the discussion of healthy coping strategies. Both conditions met for 120 min in small groups (4 to 6 participants per group). The preliminary proof-of-concept study as well as the RCT demonstrated high levels of acceptability. Findings from the RCT indicated significant improvement in social anxiety symptoms among those in the active treatment condition at post-treatment, which was maintained at follow-up. In addition, participants in the treatment condition showed significant improvement in levels of depression. The effect size difference in symptoms between conditions was in the large range. The present study provides preliminary support for the efficacy of a newly developed treatment program targeting safety behaviors in students with subclinical social anxiety. The current results also illustrate the promise of a brief, indicated prevention strategy focused on safety behavior among those with subclinical social anxiety.

The present study examined effects of 2 school-based strengths interventions on junior high school students ' mental health, as reflected in their life satisfaction and depressive symptoms. In Study 1 , which had 128 partici-pants, an intervention for promoting the recognition of and focus on one ' s own and others ' strengths resulted in post-intervention improvements only in life satisfaction. Study 2 , with 87 participants, showed that an intervention for promoting the use of one ' s own strengths in addition to recognizing and focusing on one ' s own and others ' strengths resulted in post-intervention and 1 -month follow-up improvements in life satisfaction and decreases in depressive symptoms. The association between changes in the strength variables (strengths knowledge, strengths use, focus on self- and other-strengths) and changes in the students ' mental health was examined for the purpose of exploring important components of school-based strengths interventions. The results suggested that the changes observed from pre- to post-intervention in strengths knowledge and in focus on other-strengths were associated positively with the changes observed in life satisfaction from pre- to post-intervention, and that the changes in strengths use from pre- to post-intervention and 1 -month follow-up were associated negatively with changes in depressive symptoms from pre- to post-intervention and also in a 1 -month follow-up. These results suggest that strengths knowledge and focus on other-strengths may be important for improving life satisfaction, and that strengths use was important for decreasing depressive symptoms. Limitations of the present study and directions for future research are discussed.

The widespread impacts of COVID-19 have affected both child and parent mental health worldwide. This study aimed to investigate the relationship between school closures due to COVID-19 and child and parent mental health in Japan. A sample of 1,984 Japanese parents with children and adolescents aged 6-15 years participated. The parents responded to online questionnaires about their own mental health and that of their children cross-sectionally. Participants were divided into three school situations based on the past week: full school closure, partial school closure, and full school open. Results indicated that 2.02% (n = 40) of the participants were in full school closure and 5.95% (n = 118) of the participants were in partial school closure. The results indicated that, after controlling for other variables regarding the pandemic, full school closure was associated with much higher scores in both child and parent mental health problems compared to full school open. Moderately higher scores were found only for anxiety symptoms in both children and parents under partial school closure compared to where schools were fully open. Consideration of the needs of families is necessary in the context of both full and partial school closures to prevent deteriorating mental health.

This study was a preliminary examination of follow-up effects and an exploration of potential predictors of treatment outcomes associated with an open trial of a transdiagnostic intervention for anxiety and depressive disorders in children and adolescents. Eight children or adolescents with anxiety or depressive disorders participated in the Avoidance Behavior-focused Transdiagnostic Intervention Program (ATP). Follow-up effects at 3 and 6 months were assessed using a multi-source (clinician, youth, parent) and multi-domain (diagnoses, symptoms, general difficulties) approach. The clinician-rated clinical severity rating of principle diagnosis and number of diagnoses were lower at both follow-up time points compared to pre-intervention. In addition, separation anxiety disorder, selective mutism, and chronic school refusal might predict poorer ATP treatment outcomes. Limitations and emerging issues in ATP were discussed.

本研究の目的は，日本の小学校教師の抑うつ症状に対する教師ストレッサー及び自動思考の影響を検討することであった。日本の小学校教師164名を対象として，教師ストレッサー，自動思考，抑うつ症状について質問紙調査を行った。構造方程式モデリングにより，教師ストレッサーはネガティブな自動思考を介して抑うつ症状に正の影響を与えることが示された。さらに，ポジティブな自動思考は，抑うつ症状に負の影響を与えることが示された。最後に，日本の小学校教師の抑うつ症状に対する今後の研究と実践の課題が議論された。

目 的 強み介入とは,ポジティブ心理学的介入の1つであり,自己 の強みを特定したり活用・育成したりする介入のことである (Ghielen et al., 2017)。これまで,大人を対象とした研究 を中心に,強み介入が幸福感の向上や抑うつ症状の低減に対 して有効であることが報告されてきた (Seligman et al., 2005)。また,近年,学校で子どもを対象とした強み介入も実 施されるようになってきた。しかし,子どもを対象とした研 究では,子どもの幸福感 (生活満足度) の向上に対する効果 は示されているものの (Proctor et al., 2011),強み介入 が子どもの幸福感だけでなく抑うつ症状に対しても有効であ るのかについては十分明らかにされていない。精神的健康 は,幸福感と精神症状 (抑うつ等) の両者を用いて包括的に 捉える必要があることが指摘されている (Suldo & Shaffer, 2008)。これを踏まえ,本研究では,生活満足度 (幸福感) と抑うつ症状 (精神症状) の両指標を用いて,強み介入が中 学生の精神的健康に及ぼす影響について検討することを目的 とした。