大島 郁葉

This report presents the follow-up treatment course of a previously published case that demonstrated the effectiveness of prolonged exposure (PE) therapy for a disaster relief worker. The patient, a municipal employee in Fukushima Prefecture, developed post-traumatic stress disorder (PTSD) and mood disorders after the 2011 Great East Japan Earthquake and subsequent disasters. This follow-up focuses on the period from 2021 to early 2024, during which the patient experienced symptom recurrence after his father’s death. This event revealed psychological patterns similar to his disaster-related responses. Schema therapy was introduced to address over-adaptive work behaviors and vulnerabilities in relationships, identified as relapse risk factors. Combined with antidepressants, schema therapy achieved sustained improvement. This longitudinal perspective demonstrates schema therapy’s effectiveness in addressing underlying vulnerabilities when symptoms re-emerge after trauma-focused treatment. The findings underscore how initial trauma responses may interact with subsequent life events and suggest schema therapy’s potential as a secondary intervention for disaster relief workers facing complex challenges.

Abstract This study investigated the factor structure and determined the reliability and validity of the Camouflaging Autistic Traits Questionnaire–Japanese version (CAT‐Q‐J) among 204 autistic and 410 non‐autistic people. Since a confirmatory factor analysis revealed no factor validity of the CAT‐Q‐J for both autistic and non‐autistic adults, an exploratory factor analysis was conducted to ensure the psychometric properties matched those of the original scale as much as possible. The results showed the CAT‐Q‐J comprised three subscales, a four‐item compensation subscale, a five‐item masking scale, and a five‐item assimilation subscale. The overall CAT‐Q‐J and all three subscales showed sufficient internal consistency and moderate‐to‐good and stable test–retest reliability in both the autistic and non‐autistic samples. Convergent validity was also supported by the correlations found with measures of autistic traits, well‐being, anxiety, and depression. Different from the original CAT‐Q, compensation/masking for the autistic sample was not correlated with mental health or autistic traits. The reliability and the validity of the overall CAT‐Q‐J were confirmed; however, caution should be exercised when interpreting its subscales.

Abstract Background To examine the relationship between social camouflage and mental health in Japanese autistic adults and make an international comparison with a sample from the UK. Methods This study analysed secondary data of participants with a self-reported diagnosis of autism from Japan (N = 210; 123 men and 87 women) and the UK (N = 305; 181 women, 104, men, and 18 nonbinary). The relationships between the quadratic term of the Camouflaging Autistic Traits Questionnaire and mental health scales, including depression and anxiety, were assessed. Results The UK sample showed linear relationships, whereas the Japanese sample showed significant nonlinear relationships. The quadratic terms of the Camouflaging Autistic Traits Questionnaire slightly explained generalised anxiety (β = .168, p = .007), depression (β = .121, p = .045), and well-being (β = − .127, p = .028). However, they did not explain the association between social anxiety and the Camouflaging Autistic Traits Questionnaire. Limitations Participants had self-reported diagnoses, and while the autism-spectrum quotient provides a cut-off value for screening, it does not enable confirming diagnoses. Mean scores of the Japanese version of the Camouflaging Autistic Traits Questionnaire were lower as compared to the original CAT-Q, which implies that the social camouflage strategy types used by autistic people in Japan and the UK could differ. The cross-sectional design limits causal inferences. Conclusion In the UK, more social camouflage was associated with poorer mental health scores, whereas too little or too much social camouflage was associated with a low mental health score in Japan. The Japanese population is seemingly less aware of and educated on autistic characteristics and considers ‘average’ behaviour a good thing. This could influence Japanese autistic people’s social camouflage use, differing from that of autistic people in the UK. The differences in the relationship between social camouflage and mental health between Japan and the UK could be associated with national-level divergence regarding the culture of autism.