Development and validation of the Japanese version of the obsessive-compulsive inventory

Psychometric properties of the Japanese version of the standardised assessment of personality abbreviated scale

This study was undertaken to translate the Standardised Assessment of Personality - Abbreviated Scale (SAPAS) into Japanese and to evaluate its validity and reliability. SAPAS is one of the most rapid tools for assessing personality disorder (PD) and has excellent sensitivity and good specificity, whereas other PD assessment tools require such a significant investment of time that they are infeasible for large surveys or routine clinical practice. Customary assessment in clinical practice ideally incorporates screening for PD, as it is associated with a substantial public health burden, including premature mortality and increased health service utilization. Furthermore, PD's status as a key prognostic variable of mental disorders also drives PD screening. While SAPAS has been translated into several languages, there has been no Japanese version. Therefore, we translated SAPAS into Japanese (SAPAS-J) and evaluated its reliability and validity. Study 1 recruited undergraduates to reveal its test-retest reliability. Although its internal consistency was not high, since the intent of the original SAPAS was to assess the broad character of personality disorder with the fewest possible items, minimal correlations between items were reasonable. We tested two factorial models, the single-factor model and the higher-order-single-factor model, and the latter offered better fitting. This higher-order model contained a three-factor structure corresponding to clusters described in DSM-5. It measures general PD traits as a common higher-order latent variable comprising those factors. Correlations of SAPAS-J with the much longer PD screening questionnaire in Study 1 and depressive and anxiety symptoms in Study 2 from the general population support its validity. Although validation for the clinical use of SAPAS-J is limited, our research with non-clinical populations demonstrated sufficient validity to justify its use in the context of psychopathological analog research. Since PD is understood as a continuum, the severity of which is distributed dimensionally, the analog study recruiting from the general population and attempting to reveal psychopathological mechanisms of PD is meaningful.

Validity, reliability, and correlates of the Smartphone Addiction Scale-Short Version among Japanese adults

BACKGROUND

The short version of the smartphone addiction scale (SAS-SV) is widely used to measure problematic smartphone use (PSU). This study examined the validity and reliability of the SAS-SV among Japanese adults, as well as cross-sectional and longitudinal associations with relevant mental health traits and problems.

METHODS

Datasets from a larger project on smartphone use and mental health were used to conduct two studies. Participants were adults aged over 20 years who carried a smartphone.

RESULTS

Study 1 (n = 99,156) showed the acceptable internal consistency and structural validity of the SAS-SV with a bifactor model with three factors. For the test-retest reliability of the SAS-SV, the intraclass correlation coefficient (ICC) was .70, 95% CI [.69, 70], when the SAS-SV was measured seven and twelve months apart (n = 20,389). Study 2 (n = 3419) revealed that when measured concurrently, the SAS-SV was strongly positively correlated with another measure of PSU and moderately correlated with smartphone use time, problematic internet use (PIU), depression, the attentional factor of impulsiveness, and symptoms related to attention-deficit hyperactivity disorder and obsessive-compulsive disorder. When measured 12 months apart, the SAS-SV was positively strongly associated with another measure of PSU and PIU and moderately associated with depression.

DISCUSSION

The structural validity of the SAS-SV appeared acceptable among Japanese adults with the bifactor model. The reliability of the SAS-SV was demonstrated in the subsequent seven- and twelve-month associations.

CONCLUSION

The cross-sectional and longitudinal associations of the SAS-SV provided further evidence regarding PSU characteristics.

Less Maladaptiveness of the Maladaptive Coping Styles in Japan than in Germany: Cross-cultural Comparison of Adaptive and Maladaptive Coping Styles

The Maladaptive and Adaptive Coping Style Questionnaire (MAX) is a comprehensive tool for measuring coping styles including three subscales: maladaptive coping, adaptive coping, and avoidance. This study developed a Japanese version of MAX and evaluated the relationship between the coping styles and psychopathologies between the Japanese sample and the German sample. For the cross-cultural comparison, we used the Japanese community sample and German data set acquired by Moritz et al. (Journal of Affective Disorders 191:300–307, 2016). Factor analysis was conducted with the Japanese version of the MAX. Referring to the original version, we hypothesized the three-factor structure. However, the results showed that the adaptive coping subscale had less similarity to the original version, whereas the maladaptive coping and avoidance subscales were similar to the original. As the result of cultural comparison, the Japanese participants showed more maladaptive coping and avoidance. Moreover, the maladaptive coping styles had weaker correlations with the psychopathologies in the Japanese sample than with those in the German sample in the present study.

Guided internet-based cognitive behavioral therapy for obsessive-compulsive disorder: A multicenter randomized controlled trial in Japan

Few studies have compared the effectiveness of internet-based cognitive behavior therapy (ICBT) for obsessive-compulsive disorder (OCD) with treatment as usual (TAU). We investigated the effectiveness of guided ICBT for patients with OCD. This prospective, randomized, controlled, assessor-blinded, multicenter clinical trial was conducted at three facilities in Japan from January 2020 to March 2021. Thirty-one patients with OCD as the primary diagnosis participated in the trial and were randomly assigned to either the intervention group or the control group. The primary outcome was the Yale-Brown obsessive-compulsive scale score; the assessors were blinded. Results of the analysis of covariance among the groups were significantly different between the groups (p < 0.01, effect size Cohen's d = 1.05), indicating the superiority of guided ICBT. The results suggest that guided ICBT is more effective than TAU for treating OCD.

RCT REGISTRATION

UMIN Clinical Trials Registry (UMIN000039375).

Validation of the Russianversion of the Maudsley Obsessive-Compulsive Inventory (MOCI) in Population and Clinical Samples

Relevance. Obsessive-compulsive disorder (OCD) is the third most common psychiatric disorder, potentially disabling with significant social and economic consequences. In Russia, little attention is paid to the study of OCD, which leads to the problem of differential diagnosis and effective treatment of OCD. One of the reasons for the insufficient attention to OCD is the lack of validated Russian questionnaires for diagnosing OCD. The purpose of this work is the initial validation of a translated version of the Maudsley Obsessive-Compulsive Inventory (MOCI). Characteristics of the surveyed groups. A population-based sample of 300 students (212 women and 88 men) and a clinical sample of 13 patients with anxiety and depressive disorders (8 women and 5 men) and 13 patients with OCD (11 women and 2 men) participated in the study. Severity of OCD symptoms were assessed with the translated version of Maudsley questionnaire. Results. According to our data, the MOCI questionnaire allows to differentiate reliably (p = 0,027) patients with OCD from patients with anxiety-depressive disorders and can be suitable as a primary diagnostic test for identifying OCD patients (p < 0,05) and the risk group. The reliability and convergent validity of the questionnaire were shown.

Psychiatric symptoms influence reward-seeking and loss-avoidance decision-making through common and distinct computational processes

AIM

Psychiatric symptoms are often accompanied by impairments in decision-making to attain rewards and avoid losses. However, due to the complex nature of mental disorders (e.g., high comorbidity), symptoms that are specifically associated with deficits in decision-making remain unidentified. Furthermore, the influence of psychiatric symptoms on computations underpinning reward-seeking and loss-avoidance decision-making remains elusive. Here, we aim to address these issues by leveraging a large-scale online experiment and computational modeling.

METHODS

In the online experiment, we recruited 1900 non-diagnostic participants from the general population. They performed either a reward-seeking or loss-avoidance decision-making task, and subsequently completed questionnaires about psychiatric symptoms.

RESULTS

We found that one trans-diagnostic dimension of psychiatric symptoms related to compulsive behavior and intrusive thought (CIT) was negatively correlated with overall decision-making performance in both the reward-seeking and loss-avoidance tasks. A deeper analysis further revealed that, in both tasks, the CIT psychiatric dimension was associated with lower preference for the options that recently led to better outcomes (i.e. reward or no-loss). On the other hand, in the reward-seeking task only, the CIT dimension was associated with lower preference for recently unchosen options.

CONCLUSION

These findings suggest that psychiatric symptoms influence the two types of decision-making, reward-seeking and loss-avoidance, through both common and distinct computational processes.

Predictors of response to exposure and response prevention-based cognitive behavioral therapy for obsessive-compulsive disorder

BACKGROUND

Cognitive behavioral therapy (CBT), which includes exposure and response prevention (ERP), is effective in improving symptoms of obsessive-compulsive disorder (OCD). However, whether poor cognitive functions and autism spectrum disorder (ASD) traits affect the therapeutic response of patients with OCD to ERP-based CBT remains unclear. This study aimed to identify factors predictive of the therapeutic response of Japanese patients with OCD to ERP-based CBT.

METHODS

Forty-two Japanese outpatients with OCD were assessed using the Wechsler Adult Intelligence Scale-III (WAIS-III), Yale-Brown Obsessive-Compulsive Scale, Patient Health Questionnaire 9-item scale, and Autism Spectrum Quotient (AQ) at pre- and post-treatment. We used multiple regression analyses to estimate the effect on therapeutic response change. The treatment response change was set as a dependent variable in multiple regression analyses.

RESULTS

Multiple regression analyses showed that among independent variables, communication as an AQ sub-scale and Letter Number Sequencing as a WAIS-III sub-test predict the therapeutic response to ERP-based CBT .

CONCLUSIONS

Our results suggest that diminished working memory (Letter Number Sequencing), poor communication skill (AQ sub-scale) may undermine responsiveness to ERP-based CBT among patients with OCD.

TRIAL REGISTRATION

UMIN, UMIN00024087 . Registered 20 September 2016 - Retrospectively registered (including retrospective data).

Reinforcement Learning With Parsimonious Computation and a Forgetting Process

Decision-making is assumed to be supported by model-free and model-based systems: the model-free system is based purely on experience, while the model-based system uses a cognitive map of the environment and is more accurate. The recently developed multistep decision-making task and its computational model can dissociate the contributions of the two systems and have been used widely. This study used this task and model to understand our value-based learning process and tested alternative algorithms for the model-free and model-based learning systems. The task used in this study had a deterministic transition structure, and the degree of use of this structure in learning is estimated as the relative contribution of the model-based system to choices. We obtained data from 29 participants and fitted them with various computational models that differ in the model-free and model-based assumptions. The results of model comparison and parameter estimation showed that the participants update the value of action sequences and not each action. Additionally, the model fit was improved substantially by assuming that the learning mechanism includes a forgetting process, where the values of unselected options change to a certain default value over time. We also examined the relationships between the estimated parameters and psychopathology and other traits measured by self-reported questionnaires, and the results suggested that the difference in model assumptions can change the conclusion. In particular, inclusion of the forgetting process in the computational models had a strong impact on estimation of the weighting parameter of the model-free and model-based systems.

Problematic internet use and psychiatric co-morbidity in a population of Japanese adult psychiatric patients

BACKGROUND

Many studies reported the high prevalence of problematic internet use (PIU) among adolescents (13-50%), and PIU was associated with various psychiatric symptoms. In contrast, only a few studies investigated the prevalence among the adult population (6%). This study aimed to investigate the prevalence of PIU and psychiatric co-morbidity among adult psychiatric patients.

METHODS

Three hundred thirty-three adult psychiatric patients were recruited over a 3-month period. Two hundred thirty-one of them completed the survey (response rate: 69.4%, 231/333; Male/Female/Transgender: 90/139/2; mean age = 42.2). We divided participants into "normal internet users" and "problematic internet users" using a combination of Young's Internet Addiction Test (IAT) and the Compulsive Internet Use Scale (CIUS). Demographic data and comorbid psychiatric symptoms were compared between the two groups using self-rating scales measuring insomnia (Athens Insomnia Scale, AIS), depression (Beck Depression Inventory, BDI), anxiety (State-trait Anxiety Inventory, STAI), attention deficit hyperactivity disorder (ADHD) (Adult ADHD Self-report Scale, ASRS), autism (Autism Spectrum Quotient, AQ), obsessive-compulsive disorder (OCD) (Obsessive-Compulsive Inventory, OCI), social anxiety disorder (SAD) (Liebowitz Social Anxiety Scale, LSAS), alcohol abuse, and impulsivity (Barratt Impulsive Scale, BIS).

RESULTS

Among 231 respondents, 58 (25.1%) were defined as problematic internet users, as they scored high on the IAT (40 or more) or CIUS (21 or more). The age of problematic internet users was significantly lower than that of normal internet users (p < 0.001, Mann-Whitney U test). The problematic internet users scored significantly higher on scales measuring sleep problems (AIS, 8.8 for problematic internet users vs 6.3 for normal internet users, p < 0.001), depression (BDI, 27.4 vs 18.3, p < 0.001), trait anxiety (STAI, 61.8 vs 53.9, p < 0.001), ADHD (ASRS, part A 3.1 vs 1.8 and part B 3.5 vs 1.8, p < 0.001), autism (AQ, 25.9 vs 21.6, p < 0.001), OCD (OCI, 63.2 vs 36.3, p < 0.001), SAD (LSAS, 71.4 vs 54.0, p < 0.001), and impulsivity (BIS, 67.4 vs 63.5, p = 0.004).

CONCLUSIONS

The prevalence of PIU among adult psychiatric patients is relatively high. As previous studies reported in the general population, lower age and psychiatric comorbidity were associated with PIU among adult psychiatric patients. More research is needed to determine any causal relations between PIU and psychopathological illnesses.

The conditional process model of mindfulness and emotion regulation: An empirical test

BACKGROUND

The conditional process model (CPM) of mindfulness and emotion regulation posits that specific mediators and moderators link these constructs to mental health outcomes. The current study empirically examined the central tenets of the CPM, which posit that nonreactivity moderates the indirect effect of observation on symptoms of emotional disorders through cognitive emotion regulation strategies.

METHODS

A clinical sample (n=1667) of individuals from Japan completed a battery of self-report instruments. Several path analyses were conducted to determine whether cognitive emotion regulation strategies mediate the relationship between observation and symptoms of individual emotional disorders, and to determine whether nonreactivity moderated these indirect effects.

RESULTS

Results provided support the CPM. Specifically, nonreactivity moderated the indirect effect of observation on symptoms through reappraisal, but it did not moderate the indirect effect of observation on symptoms through suppression.

LIMITATIONS

Causal interpretations are limited, and cultural considerations must be acknowledged given the Japanese sample CONCLUSIONS: These results underscore the potential importance of nonreactivity and emotion regulation as targets for interventions.

Factor structure, reliability, and validity of the Japanese version of the Hoarding Rating Scale-Self-Report (HRS-SR-J)

BACKGROUND

The Hoarding Rating Scale-Self-Report (HRS-SR) is a five-item scale that assesses the symptoms of hoarding. These symptoms include excessive acquisition, difficulty in discarding, and excessive clutter that causes distress. We conducted three studies to examine the factor structure, reliability, and validity of the Japanese version of the HRS-SR (HRS-SR-J).

METHODS

Study 1 examined its reliability; 193 college students and 320 adolescents and adults completed the HRS-SR-J and, of the college students, 32 took it again 2 weeks later. Study 2 aimed to confirm that its scores in a sample of 210 adolescents and adults are independent of social desirability. Study 3 aimed to validate the HRS-SR-J in the aspects of convergent and discriminant validity in a sample of 550 adults.

RESULTS

The HRS-SR-J showed good internal consistency and 2-week test-retest reliability. Based on the nonsignificant correlations between the HRS-SR-J and social desirability, the HRS-SR-J was not strongly affected by social desirability. In addition, it also had a good convergent validity with the Japanese version of the Saving Inventory-Revised (SI-R-J) and the hoarding subscale of the Obsessive-Compulsive Inventory, while having a significantly weaker correlation with the five subscales of the Obsessive-Compulsive Inventory, except for the hoarding subscale. In addition, the strength of the correlation between the HRS-SR-J and the Japanese version of the Patient Health Questionnaire-9 and that between the HRS-SR-J and the Generalized Anxiety Disorder-7 were significantly weaker than the correlation between the HRS-SR-J and the SI-R-J. These results demonstrate that the HRS-SR-J has good convergent and discriminant validity.

CONCLUSION

The HRS-SR-J is a notable self-report scale for examining the severity of hoarding symptoms.

Putamen volume correlates with obsessive compulsive characteristics in healthy population

Obsessions and compulsions (OCs) are frequent in healthy subjects; however neural backgrounds of the subclinical OCs were largely unknown. Results from recent studies suggested involvement of the putamen in the OC traits. To investigate this issue, 49 healthy subjects were assessed using structural magnetic resonance imaging (MRI) and the Maudsley Obsessive Compulsive Inventory (MOCI). Anatomical delineation on MRI yielded the global volume and local shape of the putamen. Other striatal structures (the caudate nucleus and globus pallidus) were also examined for exploratory purpose. The relationship between volume/shape of each structures and MOCI measure was analyzed, with sex, age, state anxiety, trait anxiety, and full-scale Intelligence Quotient regressed out. The volume analysis revealed a positive relationship between the MOCI total score and the bilateral putamen volumes. The shape analysis demonstrated associations between the higher MOCI total score and hypertrophy of the anterior putamen in both hemispheres. The present study firstly revealed that the volume changes of the putamen correlated with the manifestation of subclinical OC traits. The dysfunctional cortico-anterior striatum networks seemed to be one of the neuronal subsystems underlying the subclinical OC traits.