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Bloss C, Brown S, Sawrikar V. Does behavioural parent training reduce internalising symptoms (or not) among children with externalising problems? Systematic review and meta-analysis. Eur Child Adolesc Psychiatry 2024; 33:2485-2501. [PMID: 36527525 PMCID: PMC11272747 DOI: 10.1007/s00787-022-02122-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022]
Abstract
Behaviour parent training (BPT) is known to effectively reduce child externalising problems. However, evidence for BPT to have secondary benefits for reducing internalising symptoms remains unclear. To address this, electronic databases (PsycINFO, MEDLINE, EMBASE, CINAHL, and SCOPUS) were systematically searched for studies examining internalising outcomes from BPT among children aged 2-12 years with clinically elevated externalizing problems. Outcomes for internalising problems following BPT were analysed by meta-analysis. Of 9105 studies identified, 24 studies met the eligibility criteria. Results from meta-analysis demonstrated a significant small treatment effect size (g = - 0.41) for reducing internalising symptoms immediately after treatment. Studies showed moderate heterogeneity (I2 = 44%). Moderation analyses indicated that the overall treatment effect was robust against variations in treatment and study design characteristics. However, a review of individual study methods indicate that these results are limited by significant heterogeneity and limitations in clinical assessment. Overall, the results suggest that BPT programmes for reducing externalising problems have the potential to improve internalising outcomes, but that there is limited information to determine the reliability of these effects, highlighting the need for further investigation.
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Affiliation(s)
- Christy Bloss
- Department of Clinical Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - Sophie Brown
- Department of Clinical Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - Vilas Sawrikar
- Department of Clinical Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, UK.
- Centre of Applied Developmental Psychology, University of Edinburgh, Edinburgh, UK.
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Parent J, Highlander A, Loiselle R, Yang Y, McKee LG, Forehand R, Jones DJ. Technology-Enhanced BPT for Early-Onset Behavior Disorders: Improved Outcomes for Children With Co-Occurring Internalizing Symptoms. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2024; 53:246-259. [PMID: 37494309 PMCID: PMC10811290 DOI: 10.1080/15374416.2023.2222391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
OBJECTIVE Early-onset behavior disorders (BDs) are common and costly. The evidence-base for Behavioral Parent Training (BPT), the standard of care for early intervention for BDs in young children, is well-established; yet, common comorbidities such as internalizing symptoms are common and their impact, not well understood. The goal of the current study was to examine the potential for technology to improve BPT effects on observed parenting and child behavior outcomes for families of children recruited for clinically significant problem behavior who also presented with relatively higher internalizing symptoms. METHOD Families with low incomes (N = 101), who are overrepresented in statistics on early-onset BDs, were randomized to an evidence-based BPT program, Helping the Noncompliant Child (HNC), or Technology-Enhanced HNC (TE-HNC). Children were ages 3 to 8 years (55.4% were boys). Child race included White (64.0%), Black or African American (21.0%), more than one race (14.0%), and Hispanic/Latinx (13.9%). RESULTS Families in both groups evidenced improvement in internalizing symptoms at posttreatment; however, TE-HNC yielded the greatest improvement in positive parenting and child compliance at posttreatment and follow-up for children with the highest internalizing symptoms at baseline. CONCLUSIONS TE-HNC resulted in improved parenting and child behavior outcomes for children with elevated levels of co-occurring internalizing symptoms at baseline relative to standard HNC. We posit that these added benefits may be a function of TE-HNC, creating the opportunity for therapists to personalize the treatment model boosting parent skill use with more complex presentations, although a formal test of mediation will be important in future work.
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Affiliation(s)
- Justin Parent
- Warren Alpert Medical School, Brown University, Providence, RI
- Bradley/Hasbro Children’s Research Center, E. P. Bradley Hospital, East Providence, RI
| | | | - Raelyn Loiselle
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Yexinyu Yang
- University of North Carolina at Chapel Hill, Chapel Hill, NC
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Mestermann S, Kleinöder JM, Arndt M, Krämer J, Eichler A, Kratz O. The Father's Part: A Pilot Evaluation of a Father-Centered Family Intervention Group in Child and Adolescent Psychiatry. Behav Sci (Basel) 2023; 14:13. [PMID: 38247664 PMCID: PMC10812738 DOI: 10.3390/bs14010013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/19/2023] [Accepted: 12/19/2023] [Indexed: 01/23/2024] Open
Abstract
Changes in parental roles have renewed the focus on a father's involvement in an offspring's psychological development. However, fathers are still under-represented in family research. There are only a few structured father-centered intervention programs in child and adolescent psychiatry. In a German population sample, a pilot father-centered family intervention program with n = 16 participants, conducted in person (n = 8) and online (n = 8), in a child and adolescent psychiatry inpatient/day clinic setting was evaluated by comparing paternal stress, PSE, and child-rated paternal competence in a pre-post design. Participating fathers showed significant decreases in child-related parenting stress (presence: p = 0.042, online: p = 0.047) and significant increases in PSE (p = 0.006/0.012). Parent-related stress and child-rated paternal competence were unaffected (p = 0.108/0.171; p = 0.167/0.101), while small-to-medium effect size measures pointed in the direction of our hypothesis (d = 0.48/0.36; d = 0.37/0.50). Participant satisfaction was higher in person than online (p = 0.008). As social and biological fathers have important influences on child and adolescent well-being and development, they should be included more frequently in prevention and intervention programs. Fathers seem to benefit from gender-specific intervention programs with regard to stress reduction, as well as experiencing competence- and PSE-increasing effects.
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Hudson JL, Minihan S, Chen W, Carl T, Fu M, Tully L, Kangas M, Rosewell L, McDermott EA, Wang Y, Stubbs T, Martiniuk A. Interventions for Young Children's Mental Health: A Review of Reviews. Clin Child Fam Psychol Rev 2023; 26:593-641. [PMID: 37488453 PMCID: PMC10465658 DOI: 10.1007/s10567-023-00443-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2023] [Indexed: 07/26/2023]
Abstract
To determine the efficacy of intervention programs for young children (4-9 years) with emerging mental health needs, we conducted a review of meta-analytic and systematic reviews of the intervention literature. Of 41,061 abstracts identified and 15,076 screened, 152 review articles met the inclusion criteria. We reviewed interventions across multiple disciplines targeting: (1) general mental health concerns; (2) internalizing symptoms; (3) externalizing symptoms; (4) anxiety; (5) depression; (6) trauma; (7) symptoms of attention-deficit/hyperactivity disorder; and (8) mental health concerns associated with autism spectrum disorder. Substantial evidence was found for the efficacy of behavioral and cognitive behavioral interventions for general mental health concerns, externalizing symptoms (generally, as well as ADHD, conduct, and other behavioral symptoms) and internalizing symptoms (generally, as well as anxiety) aged 4-9 years. Emerging evidence was identified for interventions targeting trauma symptoms, depression symptoms, and social, emotional and behavioral symptoms in autism spectrum disorder in children aged 4-9 years. Currently there is only limited emerging evidence regarding non-behavioral or non-cognitive behavioral interventions for programs targeting children ages 4-9 years where the aim is to deliver an evidence-based program to improve child social, emotional and/or behavioral functioning. Given the recent rises in mental health needs reported in children, targeted behavioral-and/or cognitive behavior therapy-based interventions should be made widely available to children (and their families) who experience elevated symptoms.
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Affiliation(s)
- Jennifer L Hudson
- Black Dog Institute, University of New South Wales, Sydney, Australia.
| | - Savannah Minihan
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Wenting Chen
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Talia Carl
- Black Dog Institute, University of New South Wales, Sydney, Australia
- School of Psychology, University of Sydney, Sydney, Australia
| | - Michele Fu
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Lucy Tully
- School of Psychology, University of Sydney, Sydney, Australia
| | - Maria Kangas
- School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Linda Rosewell
- School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Emma A McDermott
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Yiwen Wang
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Thomas Stubbs
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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Bado P, da Costa R, Bernardes C, Tripp G, Mattos P, Furukawa E. Needs assessment for behavioral parent training for ADHD in Brazil. Front Psychiatry 2023; 14:1191289. [PMID: 37575579 PMCID: PMC10415012 DOI: 10.3389/fpsyt.2023.1191289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/10/2023] [Indexed: 08/15/2023] Open
Abstract
Introduction Attention-Deficit/Hyperactivity Disorder (ADHD) is a debilitating condition affecting children and their families worldwide. Behavioral parent training is a recommended form of empirically supported non-pharmacological intervention for young children with mild to moderate ADHD. However, access to such treatment is limited in many countries. Here we identify the treatment needs of Brazilian families with children demonstrating symptoms of ADHD, and the barriers families face in accessing behavioral treatment. Methods A qualitative needs assessment was undertaken with parents (n = 23), educators (n = 15), and healthcare providers (n = 16). Semi-structured telephone interviews were conducted, and common themes were identified through inductive coding of participants' responses. Results Participants reported a lack of accessible behavioral treatment, and delays in accessing treatment when available. The majority of parents had not received behavioral parent training, despite it being a recommended form of treatment. Parents, educators and healthcare providers strongly endorsed a need for practical tools to manage the behavior of children with ADHD. Conclusion Existing services might not meet the needs of children with ADHD and their families in Brazil. Easily accessed behavioral parent training programs are recommended to address the identified treatment gap for Brazilian children with ADHD and their families.
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Affiliation(s)
- Patricia Bado
- D’Or Institute for Research and Education, Rio de Janeiro, Brazil
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Raquel da Costa
- D’Or Institute for Research and Education, Rio de Janeiro, Brazil
| | - Camila Bernardes
- D’Or Institute for Research and Education, Rio de Janeiro, Brazil
| | - Gail Tripp
- Okinawa Institute of Science and Technology Graduate University, Okinawa, Japan
| | - Paulo Mattos
- D’Or Institute for Research and Education, Rio de Janeiro, Brazil
| | - Emi Furukawa
- Okinawa Institute of Science and Technology Graduate University, Okinawa, Japan
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Effect of parenting intervention through "Care for Child Development Guideline" on early child development and behaviors: a randomized controlled trial. BMC Pediatr 2022; 22:690. [PMID: 36461019 PMCID: PMC9716152 DOI: 10.1186/s12887-022-03752-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 11/14/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Several studies showed that parenting intervention programs play a core component in early child development. Considering the limited healthcare resources in developing countries, group-session intervention based on care for child development (CCD) guideline might be cost-effective. METHODS This randomized controlled trial was conducted at an outpatient public Pediatrics clinic in Isfahan, Iran. We included 210 pregnant women aged 18-45 years in their third trimester and followed their children for 18 months. The intervention group underwent 5 educational group sessions, each lasting for almost 45 minutes. The main outcomes were the children's development and socio-emotional behavior problems based on Bayley Scales of Infant and Toddler Development-III (BSID-III) at 12 months and the Children Behavior Checklist (CBCL) at 18 months. RESULTS Overall, data of 181 children were included in the current study, including 80 in the intervention group and 101 controls. The adjusted median/mean differences between intervention and control groups using median/linear regression were not significant for all BSID-III domains except for median differences for cognitive score based on BSID-III (β (SE): - 4.98(2.31), p:0.032) and mean differences for anxiety/depression score based on CBCL (β (SE): - 2.54(1.27), p:0.046). CONCLUSION In this study, parenting interventions through CCD group sessions were significantly effective on just one subscale of children's socio-emotional behavior domains based on CBCL and one domain of children's development based on BSID-III. There might be a ceiling or floor effects for the BSID-III and CBCL assessment, respectively, leaving little room for improvement as almost all children have achieved their full developmental potential in our study. TRIAL REGISTRATION IRCT20190128042533N2, Date of registration: 16/01/2020, www.irct.ir.
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Herbell K, Breitenstein SM, Ault S. Web-Based Parent Training in Parents with Adolescents Admitted to Psychiatric Residential Treatment: A Mixed-Methods Study. JOURNAL OF CHILD AND FAMILY STUDIES 2022; 31:3533-3549. [PMID: 36345383 PMCID: PMC9629754 DOI: 10.1007/s10826-022-02478-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 10/17/2022] [Indexed: 06/16/2023]
Abstract
Despite intensive treatment, adolescents discharged from residential treatment (RT) often do not maintain treatment gains in the community. Providing support and education to caregivers through parent training may ameliorate the loss of treatment gains. Successful parent training programs have been delivered to this population; however, these interventions were delivered in-person, posing significant barriers affecting reach, access, and engagement. A convergent mixed methods design was used to assess the acceptability, appropriateness, and feasibility of a web-based parent training in a sample of parents (N = 20) with adolescents admitted to RT. Parents completed two interviews and an end-of-program survey. Parents completed at least 80% of the assigned modules and felt that PW was easy to use and that the features facilitated learning. Parents reported practicing the skills in their daily lives and found it beneficial to have a partner to practice with. Consistent with previous studies, parents perceived the delivery method as a strength because the web-based delivery circumvented multiple known barriers to in-person interventions. A large subset of parents related to the scenarios, while a small subset of parents felt the modules were challenging to relate to because of the severity of their adolescent's mental health challenges. Overall, findings indicate that web-based parent training programs may be an acceptable, appropriate, and feasible adjuvant evidence-based support. However, tailoring the intervention content is necessary to create a more relatable intervention that captures the breadth and severity of mental health challenges adolescents in RT face.
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Affiliation(s)
- Kayla Herbell
- Ohio State University, College of Nursing, 1585 Neil Ave, Columbus, 43210 OH USA
| | | | - Samantha Ault
- Ohio State University, College of Nursing, 1585 Neil Ave, Columbus, 43210 OH USA
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Jugovac S, O'Kearney R, Hawes DJ, Pasalich DS. Attachment- and Emotion-Focused Parenting Interventions for Child and Adolescent Externalizing and Internalizing Behaviors: A Meta-Analysis. Clin Child Fam Psychol Rev 2022; 25:754-773. [PMID: 35680711 PMCID: PMC9622525 DOI: 10.1007/s10567-022-00401-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2022] [Indexed: 11/24/2022]
Abstract
Attachment- and emotion-focused parenting interventions (AE) have grown in popularity as an alternative to behavioral parent training (BPT) for children and adolescents. AE go beneath behavior by helping parents understand and respond to their child’s underlying attachment and emotional needs. Past reviews have examined their effects on attachment security and caregiver sensitivity, though less is known regarding their effects on child mental health symptoms. Reported here is the first systematic review and meta-analysis of individual and group AE on externalizing behavior (EXT) and internalizing behavior (INT) for children aged 0–18 years. A search of four databases prior to July 2021 elicited 43 studies that met eligibility criteria. Meta-analysis revealed that AE were superior to waitlist controls for EXT (SMD = − 0.17) and INT (SMD = − 0.34). Effects were sustained at follow-up periods of 6 months and greater, and AE considered to target child mental health were significantly more effective than those that did not in reducing EXT and INT. Two studies retrieved directly compared AE to BPT, which showed no evidence of a difference for follow-up measures of EXT. No studies compared AE to BPT on INT. AE demonstrated no evidence of superiority compared to controls for parent mental health. Findings support the potential for AE to reduce EXT and INT in children and adolescents; however, future research should consider the relative effectiveness of AE.
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Affiliation(s)
- Samantha Jugovac
- Research School of Psychology, Australian National University, Canberra, Australia.
| | - Richard O'Kearney
- Research School of Psychology, Australian National University, Canberra, Australia
| | - David J Hawes
- School of Psychology, The University of Sydney, Sydney, Australia
| | - Dave S Pasalich
- Research School of Psychology, Australian National University, Canberra, Australia
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Li X, Zhu YT, Jiao DD, Sawada Y, Tanaka E, Watanabe T, Tomisaki E, Zhu Z, Ajmal A, Matsumoto M, Zhang JR, Banu AA, Liu Y, Cui MY, Graça Y, Wang YL, Qian ML, Anme T. Subtyping of Internalizing and Externalizing Behaviors in Japanese Community-Based Children: A Latent Class Analysis and Association with Family Activities. CHILDREN 2022; 9:children9020210. [PMID: 35204930 PMCID: PMC8870000 DOI: 10.3390/children9020210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 01/29/2022] [Accepted: 02/03/2022] [Indexed: 12/02/2022]
Abstract
Externalizing and internalizing behavioral problems occurs at a high rate among children. However, this has rarely been examined among Japanese children using a person-oriented method. Hence, this study aims to explore its subtypes and clarify their association with family-based group activities. We conducted a cross-sectional survey in a typical community-based suburban area for all families with primary school children in Japan. We investigated children’s internalizing and externalizing behaviors based on the Japanese version of the Strengths and Difficulties Questionnaire (SDQ), and different types of activities that family members frequently engaged in. Data from 206 families were collected and used for the analysis. The subtypes were explored using latent class analysis (LCA). The relationship between family activities and latent class membership was analyzed using a logistic regression model. Moreover, three latent class models and their probabilities were identified, namely, risk group (31.3%), moderate group (44.9%), and normal group (23.8%). Frequent family activities including play sports, traveling or hiking, watching TV and communicating, cooking or making a dessert, and doing housework, which were significantly related to the normal group. These results would add evidence to potential types of children’s behavioral problems and preventive childcare practices needed in the primary gate of families.
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Affiliation(s)
- Xiang Li
- School of Comprehensive Human Science, University of Tsukuba, Tsukuba 3058577, Japan; (X.L.); (Y.-T.Z.); (D.-D.J.); (Z.Z.); (A.A.); (M.M.); (J.-R.Z.); (A.A.B.); (Y.L.); (M.-Y.C.); (Y.G.); (Y.-L.W.); (M.-L.Q.)
| | - Yan-Tong Zhu
- School of Comprehensive Human Science, University of Tsukuba, Tsukuba 3058577, Japan; (X.L.); (Y.-T.Z.); (D.-D.J.); (Z.Z.); (A.A.); (M.M.); (J.-R.Z.); (A.A.B.); (Y.L.); (M.-Y.C.); (Y.G.); (Y.-L.W.); (M.-L.Q.)
| | - Dan-Dan Jiao
- School of Comprehensive Human Science, University of Tsukuba, Tsukuba 3058577, Japan; (X.L.); (Y.-T.Z.); (D.-D.J.); (Z.Z.); (A.A.); (M.M.); (J.-R.Z.); (A.A.B.); (Y.L.); (M.-Y.C.); (Y.G.); (Y.-L.W.); (M.-L.Q.)
| | - Yuko Sawada
- Faculty of Health Medicine, Morinomiya University of Medical Sciences, Osaka 5598611, Japan;
| | - Emiko Tanaka
- Faculty of Nursing, Musashino University, Tokyo 2028585, Japan;
| | - Taeko Watanabe
- Faculty of Nursing, Shukutoku University, Chiba 2608701, Japan;
| | | | - Zhu Zhu
- School of Comprehensive Human Science, University of Tsukuba, Tsukuba 3058577, Japan; (X.L.); (Y.-T.Z.); (D.-D.J.); (Z.Z.); (A.A.); (M.M.); (J.-R.Z.); (A.A.B.); (Y.L.); (M.-Y.C.); (Y.G.); (Y.-L.W.); (M.-L.Q.)
| | - Ammara Ajmal
- School of Comprehensive Human Science, University of Tsukuba, Tsukuba 3058577, Japan; (X.L.); (Y.-T.Z.); (D.-D.J.); (Z.Z.); (A.A.); (M.M.); (J.-R.Z.); (A.A.B.); (Y.L.); (M.-Y.C.); (Y.G.); (Y.-L.W.); (M.-L.Q.)
| | - Munenori Matsumoto
- School of Comprehensive Human Science, University of Tsukuba, Tsukuba 3058577, Japan; (X.L.); (Y.-T.Z.); (D.-D.J.); (Z.Z.); (A.A.); (M.M.); (J.-R.Z.); (A.A.B.); (Y.L.); (M.-Y.C.); (Y.G.); (Y.-L.W.); (M.-L.Q.)
| | - Jin-Rui Zhang
- School of Comprehensive Human Science, University of Tsukuba, Tsukuba 3058577, Japan; (X.L.); (Y.-T.Z.); (D.-D.J.); (Z.Z.); (A.A.); (M.M.); (J.-R.Z.); (A.A.B.); (Y.L.); (M.-Y.C.); (Y.G.); (Y.-L.W.); (M.-L.Q.)
| | - Alpona Afsari Banu
- School of Comprehensive Human Science, University of Tsukuba, Tsukuba 3058577, Japan; (X.L.); (Y.-T.Z.); (D.-D.J.); (Z.Z.); (A.A.); (M.M.); (J.-R.Z.); (A.A.B.); (Y.L.); (M.-Y.C.); (Y.G.); (Y.-L.W.); (M.-L.Q.)
| | - Yang Liu
- School of Comprehensive Human Science, University of Tsukuba, Tsukuba 3058577, Japan; (X.L.); (Y.-T.Z.); (D.-D.J.); (Z.Z.); (A.A.); (M.M.); (J.-R.Z.); (A.A.B.); (Y.L.); (M.-Y.C.); (Y.G.); (Y.-L.W.); (M.-L.Q.)
| | - Ming-Yu Cui
- School of Comprehensive Human Science, University of Tsukuba, Tsukuba 3058577, Japan; (X.L.); (Y.-T.Z.); (D.-D.J.); (Z.Z.); (A.A.); (M.M.); (J.-R.Z.); (A.A.B.); (Y.L.); (M.-Y.C.); (Y.G.); (Y.-L.W.); (M.-L.Q.)
| | - Yolanda Graça
- School of Comprehensive Human Science, University of Tsukuba, Tsukuba 3058577, Japan; (X.L.); (Y.-T.Z.); (D.-D.J.); (Z.Z.); (A.A.); (M.M.); (J.-R.Z.); (A.A.B.); (Y.L.); (M.-Y.C.); (Y.G.); (Y.-L.W.); (M.-L.Q.)
| | - Yan-Lin Wang
- School of Comprehensive Human Science, University of Tsukuba, Tsukuba 3058577, Japan; (X.L.); (Y.-T.Z.); (D.-D.J.); (Z.Z.); (A.A.); (M.M.); (J.-R.Z.); (A.A.B.); (Y.L.); (M.-Y.C.); (Y.G.); (Y.-L.W.); (M.-L.Q.)
| | - Mei-Ling Qian
- School of Comprehensive Human Science, University of Tsukuba, Tsukuba 3058577, Japan; (X.L.); (Y.-T.Z.); (D.-D.J.); (Z.Z.); (A.A.); (M.M.); (J.-R.Z.); (A.A.B.); (Y.L.); (M.-Y.C.); (Y.G.); (Y.-L.W.); (M.-L.Q.)
| | - Tokie Anme
- Faculty of Medicine, University of Tsukuba, Tsukuba 3058577, Japan
- Correspondence: ; Tel.: +81-029-853-3436
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