Long-Term, Community-based Approach for Affected People Having Problems With Mental Health and Lifestyle Issues After the 2011 Fukushima Disaster: the Fukushima Health Management Survey.

A Mental Health and Lifestyle Survey (MHLS) has been conducted yearly as part of the Fukushima Health Management Survey since 2012, in order to monitor different health issues related to long-term evacuation of affected people after the 2011 Fukushima disaster. This survey is a mail-based one of nearly 210,000 affected people living in the evacuation zone at the time of the disaster. Another purpose of the MHLS is to provide efficient interventions by telephone based on the results of the survey. Significant findings contributing to understanding of non-radiological health effects caused by long-term evacuation were obtained from the MHLS, directly connecting to telephone-based interventions for over 3,000 respondents per year. In this article, the mental health outcomes of the MHLS, including depressive symptoms and posttraumatic responses, are reviewed, and the usefulness of telephone-based interventions is discussed. The evidence showed that, despite improvement of core mental health outcomes, the prevalence of respondents at high risk of some psychiatric problems remained high compared to that among the general population in Japan. In particular, several mental health consequences of respondents staying outside of Fukushima Prefecture were higher than those staying inside Fukushima. Along with further efforts to increase the response rate, we need to continue and modify the MHLS to meet the requirements of the affected people and communities.

The Association between Parenting Confidence and Later Child Mental Health in the Area Affected by the Fukushima Nuclear Disaster: The Fukushima Health Management Survey.

After the 2011 Fukushima Daiichi Nuclear Power Station accident, the Fukushima Health Management Survey was conducted to assess children's lifestyle and mental health conditions. The participants in this study were 1126 children, aged 0 to 3 years, living in the evacuation zone at the time of the disaster. The parenting confidence of their mothers was assessed using a self-administered questionnaire as a baseline in 2013. We examined the association of parenting confidence level at baseline, using a total difficulty score of the Strengths and Difficulties Questionnaire (SDQ) and reluctance to attend school among children in a follow-up study in 2016 and 2017. As a result, no confidence was reported by 178 (15.8%) mothers, while 477 (42.4%) responded with "not sure" and 471 (41.8%) were confident. In the multiple logistic analysis, after adjusting for covariates such as the child's sex, age, and current health condition, the group lacking parenting confidence demonstrated a significantly higher risk level for SDQ total difficulties (OR, 2.8; 95% CI, 1.59-4.93) and reluctance to attend school (OR = 1.98, 95% CI: 1.24-3.18) than the confident mothers. After a major disaster, which can have long-term effects on communities, intensive psychological care for mothers with young children is needed to prevent various mental health problems in their children.

Association Between Accumulation of Child Maltreatment and Salivary Oxytocin Level Among Japanese Adolescents.

Background: Child maltreatment is related to oxytocin (OT), which is related to social functioning. It may hamper the OT level to avoid a harmful situation and increase the OT level to adapt to the situation using a tend-and-befriend stress reaction. Objective: This study aims to examine the association between the accumulation of moderate-severe childhood maltreatment and salivary OT levels in Japanese adolescents. Participants: We used convenience samples of adolescents living in an institution (n = 31) and those living with their parents (n = 46). Methods: Child maltreatment experiences were measured with the Childhood Trauma Questionnaire. The salivary OT levels were assessed by enzyme linked immunosorbent assay. A multivariate regression analysis was performed to see the association between the accumulation of child maltreatment types and the salivary OT levels adjusted for covariates (i.e., age, sex, and duration of institutionalization). Results: Physical abuse was associated with higher OT, while emotional neglect showed an inverse association with OT. OT was the lowest with one maltreatment type group, which was significantly lower than the non-maltreatment group. As the number of maltreatment types increased from one maltreatment type to 2-3 types and to 4-5 types, OT also increased. This U-shaped association between the number of maltreatment types and OT was confirmed with the significant result of a square term of number of maltreatment type in the model (p = 0.012). Conclusion: We found herein a U-shaped association between the accumulation of child maltreatment and salivary OT levels. Also, different types of maltreatment had varied effects on the salivary OT. Further study is needed to elucidate the non-linear association between child maltreatment and OT levels.

Disruption of Child Environments and Its Psychological Consequences After the Fukushima Disaster: a Narrative Review Based on the Ecological Systems Model.

PURPOSE OF REVIEW: A high prevalence of clinically significant mental health problems was found in children affected by the Fukushima disaster in Japan. We reviewed the literature on child mental health to examine how disasters impacted children in Fukushima. RECENT FINDINGS: Children's environments, such as family and peer systems, were disrupted by radiation concerns and evacuation. As children struggled with less resources at home and school, they also had to deal with discrimination. Various interventions were implemented, ranging from government financial assistance to several mental health services provided by local care resources to families and children. In addition to organizing such interventions discretely in each microsystem, a collaborative approach involving various intervening entities across multiple levels was deemed necessary for providing comprehensive support to the affected children and their families. To promote the healthy psychological development of children, it is necessary to provide multidimensional support for their families, particularly parents, through multidisciplinary collaboration between professionals involved in child and family care.

Trajectories of peer relationship problems and emotional symptoms in children 5 years after a nuclear disaster: Fukushima Health Management Survey.

The Fukushima Daiichi Nuclear Power Station (NPS) accident, which occurred in March 2011, is having long-term effects on children. About 3 years after the accident, we identified three patterns of peer relationship problems and four patterns of emotional symptoms using group-based trajectory modeling. As a result, we reported that different factors might be related to very severe trajectories of peer relationship problems and emotional symptoms. In this study, we used five waves of data from fiscal year (FY) 2011 to FY2015 from the Mental Health and Lifestyle Survey, a detailed survey of the Fukushima Health Management Survey started in FY2011. We analyzed 7013 residents within the government-designated evacuation zone (aged 6-12 years old as of 11 March 2011) with responses to all items of psychological distress in at least one wave from FY2011 and FY2015. We planned this study to describe the trajectories of peer relationship problems and emotional symptoms in children and to examine potential risks and protective factors over the 5 years following the NPS accident. We identified four patterns of peer relationship problems and five patterns of emotional symptoms using latent class growth analysis. For peer relationship problems, male sex, experiencing the NPS explosion and lack of exercise habits were associated with the severe trajectory group. For emotional symptoms, experiencing the NPS explosion, experiencing the tsunami disaster and lack of exercise habits were associated with the severe trajectory group. Exercise habits are very important for the mental health of evacuees after a nuclear disaster.

Validation of the Japanese version of the Childhood Trauma Questionnaire-Short Form (CTQ-J).

Objective: Facing a surge of child maltreatment reports, Japan has a need for concise assessment tools. Although the Childhood Trauma Questionnaire (CTQ) is accepted internationally as an instrument for childhood maltreatment, its Japanese version has not been validated. The present study examined the validity of the Japanese version of the CTQ (CTQ-J). Method: The CTQ-J was administered to Japanese adolescents in a residential institution (institutionalized group; n = 31) and adolescents without experience of institutionalization (community group; n = 46) from the greater Tokyo area. Analysis of variance was conducted to compare CTQ-J scores among the institutionalized group with documented maltreatment, the institutionalized group without documented maltreatment, and the community group, for the total score and 5 subscale scores. The discrimination of scores assessed by the CTQ-J were calculated using receiver operating characteristic curve analysis and identifying documented maltreatment. Results: Internal consistency was "good" to "acceptable" in all subscales (Cronbach's alpha > .74). In each maltreatment type, the institutionalized group with documented maltreatment experiences showed significantly higher CTQ-J scores than did the other groups. The area under the curve showed higher discrimination for the total score of the CTQ-J (0.95) and each subscale (0.98-0.86). Conclusion: This study demonstrated the reliability of the CTQ-J at the "good" to "acceptable" level and supported the criterion validity by identifying documented maltreatment cases in the child welfare records, although careful attention should be paid in its application. Further research is needed to test the CTQ-J's ability to identify less severe form of maltreatment using a more representative sample. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Analysis of direction of association between radiation risk perception and relocation using a random-intercept and cross lagged panel model: The Fukushima Health Management Survey.

In the aftermath of a nuclear disaster, a person's radiation risk perception can harm their sociopsychological health. Although there are reports of an association between radiation risk perception and relocation, the direction of this association has not been clarified yet. In this study, we used a random-intercept and cross lagged panel model (RI-CLPM) to investigate the association and its direction between radiation risk perception and the prefectural-level relocation (i.e., inside/outside of Fukushima Prefecture). We did this by using five waves of longitudinal surveys between 2011 fiscal year and 2015 fiscal year among the people affected by the Fukushima disaster in 2011. We included 90,567 participants aged ≥15 years during the time of the disaster who responded to the questionnaire at least once. RI-CLPM was applied to examine the reciprocal relationship between radiation risk perception and locations. We used two radiation risk perception indicators (i.e., genetic effect and delayed effect) and two handling methods on missing data (i.e., listwise deletion and full information maximum likelihood estimation) as sensitive analyses. The effects of radiation risk perception on relocation were found to be negligibly small. Living inside Fukushima Prefecture reduced radiation risk perception irrespective of the difference of indicators or methods, highlighting that radiation risk perception did not dominantly govern whether people were living inside Fukushima Prefecture, but that the locations also affected radiation risk perception. This was the first study to reveal the direction of the association between radiation risk perception and relocation in the aftermath of nuclear disasters.

Association between facial expression and PTSD symptoms among young children exposed to the Great East Japan Earthquake: a pilot study.

"Emotional numbing" is a symptom of post-traumatic stress disorder (PTSD) characterized by a loss of interest in usually enjoyable activities, feeling detached from others, and an inability to express a full range of emotions. Emotional numbing is usually assessed through self-report, and is particularly difficult to ascertain among young children. We conducted a pilot study to explore the use of facial expression ratings in response to a comedy video clip to assess emotional reactivity among preschool children directly exposed to the Great East Japan Earthquake. This study included 23 child participants. Child PTSD symptoms were measured using a modified version of the Parent's Report of the Child's Reaction to Stress scale. Children were filmed while watching a 2-min video compilation of natural scenes ('baseline video') followed by a 2-min video clip from a television comedy ('comedy video'). Children's facial expressions were processed the using Noldus FaceReader software, which implements the Facial Action Coding System (FACS). We investigated the association between PTSD symptom scores and facial emotion reactivity using linear regression analysis. Children with higher PTSD symptom scores showed a significantly greater proportion of neutral facial expressions, controlling for sex, age, and baseline facial expression (p < 0.05). This pilot study suggests that facial emotion reactivity, measured using facial expression recognition software, has the potential to index emotional numbing in young children. This pilot study adds to the emerging literature on using experimental psychopathology methods to characterize children's reactions to disasters.

Association of oxytocin level and less severe forms of childhood maltreatment history among healthy Japanese adults involved with child care.

BACKGROUND: Oxytocin (OT) is known to play a role in stress regulation. The association between childhood maltreatment history and neuropeptide OT concentration is inconsistent due to the varying degrees of severity of childhood maltreatment, among other contributing factors. Less severe forms of childhood maltreatment history might enhance OT concentrations as a response to coping with social stress within the family. The purpose of this study is to investigate the association between less severe forms of childhood maltreatment history and OT concentrations among healthy adults. METHOD: Eighty adults (49 women and 31 men) with 18- to 48-month-old children were recruited using a snowball sample in Tokyo, Japan. Urine samples were collected for OT measurement. Less severe (low and moderate) childhood maltreatment history, including physical abuse, physical neglect, emotional abuse, emotional neglect, and sexual abuse, was assessed using the self-report questionnaire, the Childhood Trauma Questionnaire. RESULTS: Less severe physical abuse was significantly associated with higher OT concentration after adjusting for age (p = 0.014). Also, less severe forms of physical abuse were independently significantly associated with higher OT concentration after controlling for other types of childhood maltreatment (p = 0.027). A positive dose-response association between the number of less severe childhood maltreatment types and OT concentration was observed (p = 0.031). CONCLUSION: A history of less severe forms of childhood physical abuse was associated with higher OT concentration in healthy adults. Poly-victimization of several types of less severe childhood maltreatment was also associated with higher OT concentrations. Less severe forms of childhood maltreatment might enhance OT concentrations in order to cope with social stress.

Association of socioeconomic status in childhood with major depression and generalized anxiety disorder: results from the World Mental Health Japan survey 2002-2006.

BACKGROUND: Low socioeconomic status (SES) in childhood is known to be a significant risk factor for mental disorders in Western societies. The purpose of this study was to investigate whether a similar association exists in Japan. METHODS: We used data from the World Mental Health Japan Survey conducted from 2002-2006 (weighted N=1,682). Respondents completed diagnostic interviews that assessed lifetime prevalence of major depression (MD) and generalized anxiety disorder (GAD), as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Associations between parental education (a proxy of SES in childhood) and lifetime onset of both disorders were estimated and stratified by gender using discrete-time survival analysis. RESULTS: Among women, high parental education was positively associated with MD (odds ratio [OR]: 1.81, 95% confidence interval [CI]: 1.03-3.18) in comparison with low parental education, even after adjustment for age, childhood characteristics, and SES in adulthood. This same effect was not found for men. In contrast, higher parental education was associated with GAD (OR: 6.84, 95% CI: 1.62-28.94) in comparison with low parental education among men, but this association was not found among the women, in the fully adjusted model. CONCLUSIONS: In Japan, childhood SES is likely to be positively associated with the lifetime onset of mental disorders, regardless of family history of mental disorders, childhood physical illness, or SES in adulthood. Further study is required to replicate the current findings and elucidate the mechanism of the positive association between mental disorders and childhood SES.