野田 義和

BACKGROUND: Several studies have shown that parental relationships between infants and their caregivers, and their mental health condition in childhood, influence children's development. The present study aimed to predict the effects of maternal mental health and mother-infant bonding at 10 months of age on Japanese children's behavioral development at 5 years. We analyzed factors including maternal mental health and mother-infant bonding to predict subtype classes as a prospective cohort study. METHODS: Data from Japan's Chiba Study of Mother and Child Health (C-MACH) were used. The Japanese versions of the Mother-to-Infant Bonding Scale (MIBS) and Strengths and Difficulties Questionnaire (SDQ) were administered to 275 consenting mothers and their children. We used latent class analysis (LCA) to classify the children's characteristics. We analyzed the relationship between sociodemographics, maternal mental states, and latent classes using ANOVA and multinomial logistic regression. RESULTS: Three latent classes were found: "asocial" (41.3 %), "well-adjusted" (20.3 %), and "highly difficult" (38.4 %). Children in the "asocial" class had a low probability for all behaviors (emotional, conduct, hyperactivity, peer problems, and prosocial behaviors). Children in the "highly difficult" class were more likely to exhibit conduct problems, hyperactivity, and peer problems as well as fewer prosocial behaviors. In addition, there were more males in the "asocial" class than in the "well-adjusted" class (Odds Ratio (OR) = 0.30, 95 % confidence interval (CI) [0.11; 0.83]), and they had higher MIBS 10-month scores (OR = 1.39, 95%CI [1.00; 1.94]).There were fewer females in the "highly difficult" than in the "well-adjusted" class (OR = 0.16, 95 % CI [0.06; 0.43]), and they had higher MIBS 10-month scores (OR = 1.65, 95%CI [1.21; 2.26]). CONCLUSIONS: The results suggest that insufficient mother-infant bonding at 10 months may contribute to males' asocial behavior at five years. These findings can help parents better understand and manage these issues in their children for prevention and intervention.

BACKGROUND: Emergency service workers have highly stressful occupations; the stressors encountered can contribute to the development of mental disorders such as depression, anxiety, and posttraumatic stress disorder (PTSD). OBJECTIVE: The present study used a conceptual model and survey to identify variables influencing the association between probable PTSD and quality of life (QOL) in emergency service workers. METHOD: PTSD was assessed using the Impact of Event Scale-Revised. QOL was assessed using the Medical Outcomes Study 36-Item Short-Form Health Survey. Path analysis was used to determine whether stress-coping (Brief Coping Orientation to Problems Experienced [Brief COPE] scores), social support (Multidimensional Scale of Perceived Social Support [MSPSS] scores), and resilience (Connor-Davidson Resilience Scale scores) explain the association between probable PTSD and QOL among 220 emergency service workers in Japan. RESULTS: Impact of Event Scale-Revised scores were significantly positively associated with Brief COPE Active coping scores and significantly negatively associated with MSPSS scores. Brief COPE Active coping and MSPSS scores were significantly positively associated with Connor-Davidson Resilience Scale scores, which were in turn significantly positively associated with Medical Outcomes Study 36-Item Short-Form Health Survey scores. CONCLUSION: Active coping in response to stressful situations is important for maintaining good mental health among emergency service workers. Active coping and social support may strengthen resilience, and resilience may improve QOL. Screening for mental health and QOL should include simultaneous assessment of stress-coping, social support, and resilience. Although the findings of this cross-sectional study are important, it could not confirm a causal relationship between PTSD and QOL.

BACKGROUND: Emergency service workers are often exposed to fatalities during accidents or disasters. Therefore, they may be more prone to experiencing posttraumatic stress disorder (PTSD) and depression. It has been shown that these comorbid disorders are related to personality traits and quality of life (QOL). METHODS: We hypothesized that mental disorders, such as symptoms of PTSD and depression, mediate the relationship between personality traits, as measured on the 10-Item Personality Inventory (TIPI), and QOL, as measured on the MOS 36-item Short-Form Health Survey (SF-36). RESULTS: Participants were aged 23-61 years. Questionnaires were sent to 373 participants, 220 of whom returned responses. A direct effect was found between two subscales of the TIPI (Extraversion and Emotional stability) and mental component summary scores of the SF-36 (Extraversion: β = 0.154, p < .001; Emotional stability: β = 0.179, p < .001), which indicated partial mediation. A significant indirect effect was revealed between two personality traits and mental health summary scores (Extraversion: β = 0.058, p < .001; Emotional stability: β = 0.087, p < .001). We also found a direct effect of extraversion scores of the TIPI on role/social component summary scores of the SF-36 (β = 0.084, p < .05). However, none of the 95% confidential intervals was significant, which indicated full mediation, and the indirect effect was significant (β = 0.023, p < .01). Sensitivity analysis indicated that a direct effect between extraversion scores of the TIPI and role/social component summary scores of the SF-36 was significant, which indicated partial mediation. CONCLUSIONS: The findings of direct and indirect effects highlight the importance of identifying effective methods for protecting individuals from developing symptoms of PTSD and depression; moreover, they may help improve QOL. The capacity of dealing with incidents among emergency service workers may vary depending on their personality traits. Therefore, the screening of mental health states that includes a personality trait inventory may be valuable.

OBJECTIVE: We examined the impact of demographic confounding factors on responses to the Impact of Event Scale-Revised. METHODS: Participants were rescue workers aged 20 to 65 years who had responded during the Great East Japan Earthquake in 2011. A multiple indicators, multiple causes model was used to examine associations between covariates and latent factors or items in the Impact of Event Scale-Revised. RESULTS: Participants were recruited from April to August 2015. The model fit indices in the confirmatory factor analysis and the multiple indicators, multiple causes model suggested an acceptable model fit. Higher education and the Connor-Davidson Resilience Scale score were significantly associated with a decrease in intrusion, avoidance, and hyperarousal. Counseling was significantly associated with increased avoidance. In the direct path model using modification indices, counseling and early arrival were identified as significant covariates. CONCLUSIONS: This study found that higher education and resilience reduced all 3 factors in the Impact of Event Scale-Revised and improved the symptoms of intrusion, avoidance, and hyperarousal. Counseling and early arrival were also associated with improvement in certain items. However, counseling was also linked to increased avoidance and worsening psychophysiological reactions. Further research is recommended to clarify these relationships. (Disaster Med Public Health Preparedness. 2019;13:309-318).