The Effects of Bereavement Time on the Relationship Between Coping Strategies and Psychological Distress.

The purpose of this study was to investigate the relationship between bereaved individuals' coping patterns, mental health, and time post-loss. A questionnaire using the Coping with Bereavement Scale (CBS) and the Kessler Psychological Distress Scale (K6) was completed by 173 family members of individuals who died from cancer between August 2013 and March 2016. Confirmatory factor analysis revealed a three-factor solution for the CBS comprised of "life orientation," "avoidance," and "retaining ties" with the deceased. Scores on retaining ties were significantly but weakly correlated with K6 scores; however, the intensity of this relationship increased with more time post-bereavement, and individuals who retained strong ties with the deceased for two years or more demonstrated poorer mental health. Although retaining ties with the deceased might be an adaptive psychological process following bereavement, in this study, long-term persistence with that coping strategy was associated with greater overall psychological distress. Further research is needed to identify optimal coping methods to address evolving needs during the bereavement process.

Bereavement risk assessment of family caregivers of patients with cancer: Japanese version of the Bereavement Risk Assessment Tool.

OBJECTIVES: The Bereavement Risk Assessment Tool (BRAT) seems to be useful in identifying those who are likely to suffer from the more severe consequences of bereavement. To date, however, only a few studies have examined bereavement risk using the BRAT. This study investigated bereavement risk in family caregivers of patients with cancer using the Japanese version of the Bereavement Risk Assessment Tool (BRAT-J). We also investigated the relationship of bereavement risk with psychological distress and resilience among caregivers to determine the validity of the BRAT-J. METHODS: We conducted family psychoeducation in the palliative care unit of Tohoku University Hospital with participants who were recruited in this study. Among the participants, 50 family caregivers provided their written informed consent and were included in this study. Participants were assessed using the BRAT-J and completed the Japanese version of the Kessler Psychological Distress Scale (K6) and the Tachikawa Resilience Scale (TRS). RESULTS: According to the BRAT-J, five individuals (10%) were in the high category of bereavement risk (level 4 or 5). We also found that family caregivers of patients experienced many different pressures, such as facing the unknown; their own work; and insufficient financial, practical, or physical resources. These issues are associated with various mental problems. Additionally, the level of bereavement risk was significantly correlated with K6 scores (ρ = 0.30, p = 0.032), and the TRS score (ρ = -0.44, p = 0.001). These correlations confirmed previous findings and that the BRAT-J can be an efficient screening tool for the bereavement risk of family caregivers of patients with cancer. SIGNIFICANCE OF RESULTS: It appears that the BRAT-J is useful in predicting the likelihood of difficulties or complications in bereavement for family caregivers and could help to provide support with these issues when needed.

Effects of an educational intervention on oral hygiene and self-care among people with mental illness in Japan: a longitudinal study.

BACKGROUND: The oral hygiene of patients with a mental illness is an important concern in psychiatric care, and it is necessary to increase the level of self-care among these patients. In this study, we administered an oral care questionnaire to people with mental illness in Japan and compared their answers before (baseline) and at 1 week and 1, 3 and 6 months after they participated in an educational program. METHODS: The questionnaire was distributed to 390 patients. It included questions about age, education, income, between-meal snacks, number of teeth, frequency of tooth brushing, and other items. The educational program was developed for the purposes of improving self-care. RESULTS: Before the program, the proportion of male patients who had had a mental illness for ≥ 10 years was significantly higher among those patients who did not brush their teeth before bed. In addition, such patients did not have primary care dentists, and a significantly higher proportion of male patients, compared with female patients, did not undergo routine dental checkups more than once per year. The educational program resulted in an improvement in the use of fluoride toothpaste from baseline to 6 months after the intervention (p = 0.001). The daily use of interdental brushes or floss was significantly different 6 months after the intervention. CONCLUSIONS: Male and long-term inpatients need oral hygiene instructions. Our educational program showed the effects of using oral hygiene tools. Future studies should include a control group to measure the impact of the educational program.

Life and mental health of medical students after the Great East Japan Earthquake.

Students of the Tohoku University School of Medicine experienced the Great East Japan Earthquake on March 11, 2011. We conducted a series of surveys to examine the relationships among their experiences and activities on the day of the earthquake, their physical, mental, and economic problems following the disaster, and how their problems changed over time. The initial survey was performed in April 2011, with three follow-up surveys in July 2011, February 2012, and April 2013. The initial survey focused on students' experiences and living conditions during the disaster, which contained questions on their locations and circumstances, family circumstances, lives after the earthquake, voluntary works, physical or mental health problems, and desire for counseling. The follow-up surveys included new items regarding their circumstances, changes in their health problems, and their desire for economic assistance. Students who answered the first survey to the 4th one, with response rates in the following bracket, were as follows: 472 (28.0%), 640 (29.9%), 681 (36.0%), and 678 (39.0%), respectively. Six months after the earthquake, about 20% having experienced physical and/or mental problems. Although there was a trend toward a reduction in suffering and health problems over time, some students' conditions remained unchanged or worsened. It is notable that students who had participated in voluntary activities, despite their own suffering of harm and distress, were identified as the group that required the closest attention. Our present results can be applied to appropriate supports for students in future large-scale disasters.

Report on maternal anxiety 16 months after the great East Japan earthquake disaster: anxiety over radioactivity.

The Great East Japan Earthquake occurred on March 11, 2011. The tsunami caused extensive damage to the Fukushima Daiichi Nuclear Power Plant, resulting in a level 7 nuclear accident. Among those affected by this combined disaster were many pregnant and parturient women. Sixteen months after the earthquake, we conducted a questionnaire survey on anxiety among 259 women who gave birth around the time of the earthquake in Miyagi Prefecture, one of the affected areas. Participants reported 12 categories of anxiety, including anxiety over radioactivity. This study aimed to determine anxiety over radioactivity among this specific population and to record measures for future study. Anxiety over radiation was classified into seven subcategories: food safety, outdoor safety, effects on the fetuses of pregnant women, effects on children, radiation exposure, economic problems, and distrust of information disclosed. This study confirmed that concrete types of anxiety over radiation were keenly felt by mothers who had experienced the disaster who were currently raising children. The findings suggest the need to provide accurate information to these mothers, who are otherwise inundated with miscellaneous confusing information.

Reliability and validity of the workplace social distance scale.

Self-stigma, defined by a negative attitude toward oneself combined with the consciousness of being a target of prejudice, is a critical problem for psychiatric patients. Self-stigma studies among psychiatric patients have indicated that high stigma is predictive of detrimental effects such as the delay of treatment and decreases in social participation in patients, and levels of self-stigma should be statistically evaluated. In this study, we developed the Workplace Social Distance Scale (WSDS), rephrasing the eight items of the Japanese version of the Social Distance Scale (SDSJ) to apply to the work setting in Japan. We examined the reliability and validity of the WSDS among 83 psychiatric patients. Factor analysis extracted three factors from the scale items: "work relations," "shallow relationships," and "employment." These factors are similar to the assessment factors of the SDSJ. Cronbach's alpha coefficient for the WSDS was 0.753. The split-half reliability for the WSDS was 0.801, indicating significant correlations. In addition, the WSDS was significantly correlated with the SDSJ. These findings suggest that the WSDS represents an approximation of self-stigma in the workplace among psychiatric patients. Our study assessed the reliability and validity of the WSDS for measuring self-stigma in Japan. Future studies should investigate the reliability and validity of the scale in other countries.

Reduced word-repetition effect in the event-related potentials of thought-disordered patients with schizophrenia.

Repetition effect in event-related potentials (ERPs) was studied in 10 non-thought-disordered (non-TD) patients with schizophrenia, 8 thought-disordered (TD) patients with schizophrenia, and 10 normal control subjects while they performed a semantic categorization task with incidental word repetitions. All patients were in a stable or partially remitted stage. Although both healthy control and non-TD groups produced more positive ERPs to the repeated words than to the new words (ERP repetition effect) for 250-500 ms, the TD group did not show the ERP repetition effect. These findings suggest that the abnormal attenuation of the ERP repetition effect during semantic processing may be more prominent in schizophrenic patients with thought disorder than in those without the symptom.