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Ohashi Y, Takegata M, Takeda S, Hada A, Usui Y, Kitamura T. Is Your Pregnancy Unwanted or Unhappy? Psychological Correlates of a Cluster of Pregnant Women Who Need Professional Care. Healthcare (Basel) 2023; 11:2196. [PMID: 37570436 PMCID: PMC10418804 DOI: 10.3390/healthcare11152196] [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: 05/09/2023] [Revised: 07/31/2023] [Accepted: 08/01/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND A negative response towards a current pregnancy consists of two elements: unwantedness of and unhappiness about the current pregnancy. Little is clear about whether pregnant women can be categorized in terms of unwantedness and unhappiness as well as what the correlates are of these categories. METHODS An internet survey of 696 women in their first trimester of pregnancy examined the participants' intention of and emotional reaction towards pregnancy, borderline personality traits, adult attachment style, depression, fear of childbirth, obsessive-compulsive symptoms, fetal bonding disorder, avoidance of taking part in child care, and consideration about termination of pregnancy (TOP). About one third of the participants were followed up with in their second trimester. RESULTS Two-step cluster analysis using the participants' intention of and emotional reaction towards pregnancy revealed three groups of pregnant women: those who wanted and were happy about the pregnancy (Cluster 1), those who were unhappy about the pregnancy (Cluster 2), and those who did not intend to be pregnant but were happy about pregnancy (Cluster 3). Cluster 2 women, but not Cluster 3 women, were likely to be single, with borderline personality traits as well as unstable adult attachment styles, accompanied by depression, fear of childbirth, obsessive-compulsive symptoms, and fetal bonding disorder. They were more likely to avoid caring for the baby after childbirth and consider TOP. CONCLUSION Expectant women who were unhappy about their pregnancy were at risk of psychological adjustment and need specific perinatal mental health assessment and care.
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Affiliation(s)
- Yukiko Ohashi
- Faculty of Nursing, Josai International University, Togane 283-8555, Japan;
- Kitamura Institute of Mental Health Tokyo, Tokyo 151-0063, Japan; (M.T.); (A.H.)
| | - Mizuki Takegata
- Kitamura Institute of Mental Health Tokyo, Tokyo 151-0063, Japan; (M.T.); (A.H.)
| | - Satoru Takeda
- Department of Obstetrics & Gynecology, Faculty of Medicine, Juntendo University, Tokyo 113-8421, Japan;
- Aiiku Research Institute for Maternal, Child Health and Welfare, Imperial Gift Foundation Boshi-Aiiku-Kai, Tokyo 106-8580, Japan
| | - Ayako Hada
- Kitamura Institute of Mental Health Tokyo, Tokyo 151-0063, Japan; (M.T.); (A.H.)
- Kitamura KOKORO Clinic Mental Health, Tokyo 151-0063, Japan
- Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo 187-8553, Japan
| | - Yuriko Usui
- Department of Midwifery and Women’s Health, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan;
| | - Toshinori Kitamura
- Kitamura Institute of Mental Health Tokyo, Tokyo 151-0063, Japan; (M.T.); (A.H.)
- Kitamura KOKORO Clinic Mental Health, Tokyo 151-0063, Japan
- T. and F. Kitamura Foundation for Studies and Skill Advancement in Mental Health, Tokyo 151-0063, Japan
- Department of Psychiatry, Graduate School of Medicine, Nagoya University, Nagoya 464-8601, Japan
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Relationships between Depression, Fear of Childbirth, and Obsessive-Compulsive Symptoms among Pregnant Women under the COVID-19 Pandemic in Japan. Healthcare (Basel) 2023; 11:healthcare11030361. [PMID: 36766936 PMCID: PMC9914326 DOI: 10.3390/healthcare11030361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 01/17/2023] [Accepted: 01/24/2023] [Indexed: 02/03/2023] Open
Abstract
Little is known about the causality of antenatal depression (AND). We focused on the causal relationships between AND, fear of childbirth (FOC), and obsessive-compulsive symptoms (OCS) during the COVID-19 pandemic in Japan. We also examined whether the perceived threat of COVID-19 is associated with AND. Participants were recruited for an Internet survey conducted in December 2020. A total of 245 pregnant women completed the online survey at 12 to 15 weeks' gestational age (Time 1) and approximately 10 weeks later (Time 2). AND was estimated using the first two diagnostic items of Major Depressive Episode. The estimated prevalence of AND was 4.5% and 2.9% at Time 1 and Time 2, respectively. At both time points, no association was found between AND and the perception of COVID-19 threat. Structural equation modeling showed that AND predicted OCS (β = 0.16, p < 0.001), which, in turn, predicted FOC (β = 0.09, p = 0.042); FOC, in turn, predicted AND (β = 0.23, p < 0.001). AND, OCS, and FOC were predicted by borderline personality traits. Insecure adult attachment influenced AND and FOC via the perceived negative impact of the current pregnancy. Perinatal care providers should assess the personality and perception of pregnancy to prevent depression and pay attention to symptoms such as FOC and OCS in addition to those of depression.
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Development of a Scale for COVID-19 Stigma and Its Psychometric Properties: A Study among Pregnant Japanese Women. Behav Sci (Basel) 2022; 12:bs12080257. [PMID: 36004828 PMCID: PMC9405207 DOI: 10.3390/bs12080257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/20/2022] [Accepted: 07/20/2022] [Indexed: 11/30/2022] Open
Abstract
Background: Stigma towards COVID-19 may negatively impact people who suffer from it and those supporting and treating them. Objective: To develop and validate a scale to assess 11-item COVID-19−related stigma. Methods: A total of 696 pregnant women at a gestational age of 12 to 15 weeks were surveyed using an online survey with a newly developed scale for COVID-19 stigma and other variables. The internal consistency of the scale was calculated using omega indices. We also examined the measurement invariance of the scale. Results: Exploratory factor analyses (EFAs) of the scale items were conducted using a halved sample (n = 350). Confirmatory factor analyses (CFAs) among the other halved sample (n = 346) compared the single-, two-, three-, and four-factor structure models derived from the EFAs. The best model included the following three-factor structure (χ2/df = 2.718, CFI = 0.960, RMSEA = 0.071): Omnidirectional Avoidance, Attributional Avoidance, and Hostility. Its internal consistency was excellent (all omega indices > 0.70). The three-factor structure model showed configuration, measurement, and structural invariances between primiparas and multiparas, and between younger (less than 32 years) and older women (32 years or older). Fear of childbirth, mother−fetal bonding, obsessive compulsive symptoms, depression, adult attachment self-model, and borderline personality traits were not significantly correlated with the Omnidirectional Avoidance subscale but correlated with the Attributional Avoidance and Hostility subscales (p < 0.001). Conclusion: The findings suggested that our scale for COVID-19 stigma was robust in its factor structure, as well as in construct validity.
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Sashikata K, Ozawa E. Development of a scale to assess obsessive-compulsive tendencies among Japanese university students. Heliyon 2022; 8:e09646. [PMID: 35734565 PMCID: PMC9207615 DOI: 10.1016/j.heliyon.2022.e09646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 02/03/2022] [Accepted: 05/30/2022] [Indexed: 11/25/2022] Open
Abstract
Obsessive-compulsive (OC) tendencies refer to obsessions and compulsions in a nonclinical group, which are risk factors for obsessive-compulsive disorder (OCD). OC tendencies and OC symptoms are mainly assessed using five factors: ordering, obsessions, cleaning, hoarding, and checking. However, since hoarding is now classified as an independent diagnosis in the DSM-V, this factor was not included and was instead replaced by indecisiveness. Furthermore, many established scales used for measuring OC tendencies were originally created for OCD patients; thus, they cannot adequately capture OC tendencies. Therefore, this study aimed to develop a scale to assess OC tendencies among Japanese university students with a revised five-factor structure: ordering, obsessions, cleaning, indecisiveness, and checking. We examined the factor structure, reliability, criterion-related validity, and convergent validity of the OC tendencies scale by administering two surveys. In Survey 1 (N = 216), an exploratory factor analysis (EFA) was conducted to examine the criterion-related and convergent validity and reliability of the OC tendencies scale. In Survey 2 (N = 202), a confirmatory factor analysis (CFA) was conducted. EFA and CFA utilized a five-factor structure comprising checking, ordering, indecisiveness, cleaning, and obsessions. Correlations with other scales indicated that the OC tendencies scale had efficient convergent validity, criterion-related validity, internal consistency, and test-retest reliability. This study validated the five-factor structure of OC tendency in Japanese university students. However, indecisiveness was also strongly correlated with trait-anxiety. As this scale is easy to administer among large groups, it has the potential to contribute to mental health support for university students by measuring OC tendencies experienced on a daily basis, which have not been adequately measured in the past.
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Affiliation(s)
- Kenta Sashikata
- Department of Graduate School of Human-Environment Studies, Kyushu University, 744, Motooka, Nishi-ku, Fukuoka, 819-0395, Japan
| | - Eiji Ozawa
- Faculty of Human-Environment Studies, Kyushu University, 744, Motooka, Nishi-ku, Fukuoka, 819-0395, Japan
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Ishibashi S, Ide S, Suzuki F, Teo A, Nagata T, Kosaka H. Development of the Japanese version of the Coronavirus Anxiety Scale and Obsession with COVID-19 Scale. Psychiatry Clin Neurosci 2022; 76:124-125. [PMID: 35043511 DOI: 10.1111/pcn.13333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 12/10/2021] [Accepted: 01/07/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Saeko Ishibashi
- Faculty of Nursing Science, Tsuruga Nursing University, Tsuruga-city, Japan.,University of Fukui Graduate School of Medical Sciences, Yoshida-gun, Japan
| | - Sohei Ide
- Center for Education in Liberal Arts and Sciences, Osaka University, Toyonaka, Japan
| | - Futoshi Suzuki
- Research Center for Child Mental Development, University of Fukui, Yoshida-gun, Japan.,Department of Child and Adolescent Psychological Medicine, University of Fukui Hospital, Eiheiji-cho, Japan
| | - Alan Teo
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon, USA.,Department of Psychiatry, Oregon Health & Science University, Portland, Oregon, USA
| | | | - Hirotaka Kosaka
- Research Center for Child Mental Development, University of Fukui, Yoshida-gun, Japan.,Department of Neuropsychiatry, University of Fukui Hospital, Yoshida-gun, Japan
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Kashihara J, Takebayashi Y, Kunisato Y, Ito M. Classifying patients with depressive and anxiety disorders according to symptom network structures: A Gaussian graphical mixture model-based clustering. PLoS One 2021; 16:e0256902. [PMID: 34469469 PMCID: PMC8409670 DOI: 10.1371/journal.pone.0256902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 08/17/2021] [Indexed: 11/27/2022] Open
Abstract
Patients with mental disorders often suffer from comorbidity. Transdiagnostic understandings of mental disorders are expected to provide more accurate and detailed descriptions of psychopathology and be helpful in developing efficient treatments. Although conventional clustering techniques, such as latent profile analysis, are useful for the taxonomy of psychopathology, they provide little implications for targeting specific symptoms in each cluster. To overcome these limitations, we introduced Gaussian graphical mixture model (GGMM)-based clustering, a method developed in mathematical statistics to integrate clustering and network statistical approaches. To illustrate the technical details and clinical utility of the analysis, we applied GGMM-based clustering to a Japanese sample of 1,521 patients (Mage = 42.42 years), who had diagnostic labels of major depressive disorder (MDD; n = 406), panic disorder (PD; n = 198), social anxiety disorder (SAD; n = 116), obsessive-compulsive disorder (OCD; n = 66), comorbid MDD and any anxiety disorder (n = 636), or comorbid anxiety disorders (n = 99). As a result, we identified the following four transdiagnostic clusters characterized by i) strong OCD and PD symptoms, and moderate MDD and SAD symptoms; ii) moderate MDD, PD, and SAD symptoms, and weak OCD symptoms; iii) weak symptoms of all four disorders; and iv) strong symptoms of all four disorders. Simultaneously, a covariance symptom network within each cluster was visualized. The discussion highlighted that the GGMM-based clusters help us generate clinical hypotheses for transdiagnostic clusters by enabling further investigations of each symptom network, such as the calculation of centrality indexes.
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Affiliation(s)
- Jun Kashihara
- Department of Social Psychology, Faculty of Sociology, Toyo University, Tokyo, Japan
| | - Yoshitake Takebayashi
- Department of Health Risk Communication, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Yoshihiko Kunisato
- Department of Psychology, School of Human Sciences, Senshu University, Kawasaki, Japan
| | - Masaya Ito
- National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, Tokyo, Japan
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