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Yang C, Huebner ES, Tian L. Prediction of suicidal ideation among preadolescent children with machine learning models: A longitudinal study. J Affect Disord 2024; 352:403-409. [PMID: 38387673 DOI: 10.1016/j.jad.2024.02.070] [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: 08/19/2023] [Revised: 02/15/2024] [Accepted: 02/19/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND Machine learning (ML) has been widely used to predict suicidal ideation (SI) in adolescents and adults. Nevertheless, studies of accurate and efficient models of SI prediction with preadolescent children are still needed because SI is surprisingly prevalent during the transition into adolescence. This study aimed to explore the potential of ML models to predict SI among preadolescent children. METHODS A total of 4691 Chinese children (54.89 % boys, Mage = 10.92 at baseline) and their parents completed relevant measures at baseline and the children provided 6-month follow-up data for SI. The current study compared four ML models: Random Forest (RF), Decision Tree (DT), Support Vector Machine (SVM), and Multilayer Perceptron (MLP), to predict SI and to identify variables with predictive value based on the best-performing model among Chinese preadolescent children. RESULTS The RF model achieved the highest discriminant performance with an AUC of 0.92, accuracy of 0.93 (balanced accuracy = 0.88). The factors of internalizing problems, externalizing problems, neuroticism, childhood maltreatment, and subjective well-being in school demonstrated the highest values in predicting SI. CONCLUSION The findings of this study suggested that ML models based on the observation and assessment of children's general characteristics and experiences in everyday life can serve as convenient screening and evaluation tools for suicide risk assessment among Chinese preadolescent children. The findings also provide insights for early intervention.
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Affiliation(s)
- Chi Yang
- Philosophy and Social Science Laboratory of Reading and Development in Children and Adolescents, South China Normal University, Ministry of Education, Guangzhou 510631, People's Republic of China; School of Psychology, South China Normal University, Guangzhou 510631, People's Republic of China
| | - E Scott Huebner
- Department of Psychology, University of South Carolina, Columbia, SC 29208, USA
| | - Lili Tian
- Philosophy and Social Science Laboratory of Reading and Development in Children and Adolescents, South China Normal University, Ministry of Education, Guangzhou 510631, People's Republic of China.
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Wang P, Wang Z, Qiu S. Universal, school-based transdiagnostic interventions to promote mental health and emotional wellbeing: a systematic review. Child Adolesc Psychiatry Ment Health 2024; 18:47. [PMID: 38600562 PMCID: PMC11007989 DOI: 10.1186/s13034-024-00735-x] [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: 01/09/2024] [Accepted: 03/20/2024] [Indexed: 04/12/2024] Open
Abstract
OBJECTIVE This systematic review aims to evaluate the effectiveness of universal school-based transdiagnostic interventions in promoting the mental health of children and adolescents. It compares and discusses interventions targeting the prevention of mental disorders versus the promotion of mental health. Additionally, the roles of teachers and psychologists as intervention conductors are examined. METHODS A comprehensive search of the Psycinfo, Pubmed, and Web of Science databases was conducted without any time restrictions to identify relevant literature on universal school-based transdiagnostic interventions promoting children and adolescents' mental health. RESULTS AND DISCUSSION The findings reveal that universal school-based transdiagnostic promotion/prevention programs have a small to medium overall effect size. These interventions demonstrate a broad coverage of different aspects of children and adolescents' mental health. However, the relative effectiveness of teacher-led versus psychologist-led interventions remains unclear. Interventions focused on preventing mental disorders exhibit a higher effect size, albeit on a narrower range of mental health aspects for children and adolescents. SIGNIFICANCE This study enhances our understanding of universal school-based transdiagnostic interventions and their impact on children and adolescents' mental health. Further research is needed to elucidate the comparative efficacy of teacher-led and psychologist-led interventions and to explore the specific dimensions of mental health targeted by these interventions.
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Affiliation(s)
- Peng Wang
- Moray House School of Education and Sport, University of Edinburgh, Edinburgh, UK.
- Department of Language, Literature and Communication, Faculty of Humanities, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
- Department of Psychology, Education and Child Studies, Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, Netherlands.
| | - Zhaoqi Wang
- School of Foreign Studies, China University of Petroleum, Qingdao City, China
| | - Shuiwei Qiu
- Department of Cardiothoracic Surgery, Quzhou People's Hospital, Quzhou City, China
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Sourander A, Ishikawa S, Ståhlberg T, Kishida K, Mori Y, Matsubara K, Zhang X, Hida N, Korpilahti-Leino T, Ristkari T, Torii S, Gilbert S, Hinkka-Yli-Salomäki S, Savolainen H, Närhi V. Cultural adaptation, content, and protocol of a feasibility study of school-based "Let's learn about emotions" intervention for Finnish primary school children. Front Psychiatry 2024; 14:1334282. [PMID: 38274431 PMCID: PMC10810134 DOI: 10.3389/fpsyt.2023.1334282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 12/11/2023] [Indexed: 01/27/2024] Open
Abstract
Introduction Emotional awareness and emotion regulation are crucial for cognitive and socio-emotional development in children. School-based interventions on socio-emotional skills have the potential to prevent these problems and promote well-being of children. The Japanese school-based program, Universal Unified Prevention Program for Diverse Disorders (Up2-D2), has shown preventive effects on mental health of children in Japan. The aims of this protocol paper are to describe the unique process of adapting the Up2-D2 from Eastern to Western context, and to present a feasibility study of the intervention, conducted in Finland. Methods The cultural adaptation process started with the linguistic translation of materials, followed by the modification of language to fit the Finnish context. While the Japanese ideology was saved, some content was adapted to fit Finnish school children. Further modifications were made based on feedback from pupils and teachers. The Finnish version of the program was named "Let's learn about emotions" and consisted of 12 sessions and targeted 8- to 12-year-old pupils. A teacher education plan was established to assist Finnish teachers with the intervention, including a workshop, teachers' manual, brief introductory videos, and online support sessions. A feasibility study involving 512 4th graders in the City of Hyvinkää, South of Finland, was conducted. It assessed emotional and behavioral problems, classroom climate, bullying, loneliness, perception of school environment, knowledge of emotional awareness, and program acceptability. Discussion The originality of this study underlies in the East-West adaptation of a cognitive behavioral therapy-based program. If promising feasibility findings are replicated in Finland, it could pave the way for further research on implementing such programs in diverse contexts and cultures, promoting coping skills, awareness, social skills and early prevention of child mental health problems. Ethics The ethical board of the University of Turku gave ethics approval for this research. The educational board of the City of Hyvinkää accepted this study.
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Affiliation(s)
- A. Sourander
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Flagship Centre, University of Turku, Turku, Finland
- Department for Child Psychiatry, Turku University Hospital, Turku, Finland
| | - S. Ishikawa
- Faculty of Psychology, Doshisha University, Kyoto, Japan
| | - T. Ståhlberg
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Flagship Centre, University of Turku, Turku, Finland
- Department for Adolescent Psychiatry, Turku University Hospital, Turku, Finland
| | - K. Kishida
- School of Humanities, Kwansei Gakuin University, Nishinomiya, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
| | - Y. Mori
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Flagship Centre, University of Turku, Turku, Finland
| | - K. Matsubara
- Organization for Research Initiatives and Development, Doshisha University, Kyoto, Japan
| | - X. Zhang
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Flagship Centre, University of Turku, Turku, Finland
| | - N. Hida
- Center for Wing of Empirically Supported Treatments, Doshisha University, Kyoto, Japan
| | - T. Korpilahti-Leino
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Flagship Centre, University of Turku, Turku, Finland
| | - T. Ristkari
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Flagship Centre, University of Turku, Turku, Finland
| | - S. Torii
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Flagship Centre, University of Turku, Turku, Finland
| | - S. Gilbert
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Flagship Centre, University of Turku, Turku, Finland
| | - S. Hinkka-Yli-Salomäki
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Flagship Centre, University of Turku, Turku, Finland
| | - H. Savolainen
- School of Educational Sciences and Psychology, University of Eastern Finland, Kuopio, Finland
| | - V. Närhi
- Department of Education, University of Jyväskylä, Jyväskylä, Finland
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Ishikawa SI, Kishida K, Takahashi T, Fujisato H, Urao Y, Matsubara K, Sasagawa S. Cultural Adaptation and Implementation of Cognitive-Behavioral Psychosocial Interventions for Anxiety and Depression in Japanese Youth. Clin Child Fam Psychol Rev 2023; 26:727-750. [PMID: 37500948 DOI: 10.1007/s10567-023-00446-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2023] [Indexed: 07/29/2023]
Abstract
The present article reviews the current status of cognitive-behavioral therapy (CBT) interventions for anxiety and depression in Japanese youth. First, a literature review of youth CBT programs for anxiety and depression is provided. Through this process, we identify which program/protocol has been most researched within Japan. Second, through a systematic interview to the authors, the development process of four predominant programs is outlined. The programs included were a family CBT program for anxiety disorders (the Japanese Anxiety Children/Adolescents Cognitive Behavior Therapy program), two school-based prevention programs for anxiety and depression (Journey of the Brave and Phoenix Time), and a transdiagnostic protocol for anxiety and depression (Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children and the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents). Third, cultural adaptation and modification of the programs are discussed from the scope of user-centered design principles as described by Lyon and Koerner (Sci Pract 23:180-200, 2016). As a result, changes in program content and material, as represented by the use of culture-friendly program names, acronyms, illustrations, and characters were endorsed in all of the programs. Structured but flexible session formats helped increase learnability and efficiency while keeping the cognitive load of providers and consumers low. A careful selection of providers, as well as quality training and consultation are important factors to maximize competency and ensure appropriate implementation. Application of existing time frames and staff who work in each setting were effective ways to increase scalability. Overall, it was shown that many of the modifications adopted overlap among successful programs; these represent the most basic and essential requirements for a program to be applicable to a wide range of contexts. Implications and further directions are explored.
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Affiliation(s)
- Shin-Ichi Ishikawa
- Faculty of Psychology, Doshisha University, 1-3 Tatara Miyakodani, Kyotanabe, Kyoto, 610-0394, Japan.
| | - Kohei Kishida
- Japan Society for the Promotion of Science, Tokyo, Japan
- Kwansei Gakuin University, Hyogo, Japan
| | | | | | | | - Kohei Matsubara
- Faculty of Psychology, Doshisha University, 1-3 Tatara Miyakodani, Kyotanabe, Kyoto, 610-0394, Japan
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Tan R, Guo X, Chen S, He G, Wu X. Callous-unemotional traits and externalizing problem behaviors in left-behind preschool children: the role of emotional lability/negativity and positive teacher-child relationship. Child Adolesc Psychiatry Ment Health 2023; 17:82. [PMID: 37386597 DOI: 10.1186/s13034-023-00633-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 06/21/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Callous-unemotional traits and emotional lability/negativity of young children have been regarded as the markers of externalizing problem behaviors. Based on the sensitivity to threat and affiliative reward model and the general aggression model, emotional lability/negativity may act as a mediator in the relationship between callous-unemotional traits and externalizing problem behaviors. Additionally, a positive teacher-child relationship could act as a buffer given the parental absence in left-behind children. However, these links remain unexplored in left-behind preschool children. Therefore, this study explored the link between callous-unemotional traits of left-behind preschool children and externalizing problem behaviors, as well as the mediating role of emotional lability/negativity and the moderating role of a positive teacher-child relationship. METHOD Data were collected on 525 left-behind children aged 3 to 6 years from rural kindergartens in China. Preschool teachers reported all data through an online survey platform. Moderated mediation analysis was performed to examine whether the mediated relation between callous-unemotional traits and externalizing problem behaviors was moderated by a positive teacher-child relationship. RESULTS The results showed callous-unemotional traits significantly predicted externalizing problem behaviors and lability/negativity acted as a mediator, while a positive teacher-child relationship acted as a protective factor in moderating the relationship between callous-unemotional traits and emotional lability/negativity. This study identified a moderated mediation effect among the four variables in left-behind preschool children in China. CONCLUSION The findings provide support for the advancement of theoretical foundations, and provide an avenue for further exploration to support the mental health and overall development of left-behind children during early childhood.
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Affiliation(s)
- Ruifeng Tan
- School of Education, Guangzhou University, Guangzhou, China
| | - Xinying Guo
- School of Education, Guangzhou University, Guangzhou, China
| | - Suiqing Chen
- School of Education, Guangzhou University, Guangzhou, China.
| | - Guixian He
- School of Education, Guangzhou University, Guangzhou, China
- Luoding Secondary Vocational Technical school, Yunfu, China
| | - Xingtao Wu
- School of Education, Guangzhou University, Guangzhou, China
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Vivas-Fernandez M, Garcia-Lopez LJ, Piqueras JA, Muela-Martinez JA, Canals-Sans J, Espinosa-Fernandez L, Jimenez-Vazquez D, Diaz-Castela MDM, Morales-Hidalgo P, Rivera M, Ehrenreich-May J. Randomized controlled trial for selective preventive transdiagnostic intervention for adolescents at risk for emotional disorders. Child Adolesc Psychiatry Ment Health 2023; 17:77. [PMID: 37353831 PMCID: PMC10290361 DOI: 10.1186/s13034-023-00616-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 05/15/2023] [Indexed: 06/25/2023] Open
Abstract
Significant evidence does exist on the effectiveness of transdiagnostic interventions to improve emotional problems in clinical populations, and their application as universal and indicated prevention programs. However, no randomized controlled trials (RCT) studying selective transdiagnostic prevention intervention have been published. This is the first known RCT to evaluate the efficacy/effectiveness of an evidence-based selective prevention transdiagnostic program for emotional problems in adolescents. The impact of three different interventions was evaluated: (1) PROCARE (Preventive transdiagnostic intervention for Adolescents at Risk for Emotional disorders), which is a group-based, abbreviated version of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A), along with adding a booster session to reduce risk of onset of anxiety and depression, (2) PROCARE + , which includes the PROCARE protocol along with personalized add-on modules tailored to match adolescents' risk factors, and (3) an active control condition (ACC) based on emotional psychoeducation. In total, 208 adolescents (48.5% girls) evidencing high risk and low protective factors were randomized and allocated to PROCARE, PROCARE + or ACC. Data from 153 adolescents who completed all assessments in the different phases of the study were analyzed. Self- and parent-reported measures were taken at baseline, as well as after the intervention, a 6 month follow-up was carried out, together with a 1 month follow-up after the booster session. Differences between conditions were significant on most of the outcome measures, with superior effect sizes for PROCARE + in the short and long term. Interventions were acceptable in terms of acceptability, with good satisfaction rates. Tailored targeted selective transdiagnostic interventions focused on mitigating risk factors and promoting protective factors in vulnerable adolescents are promising.
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Affiliation(s)
| | - Luis-Joaquin Garcia-Lopez
- University of Jaen, Jaen, Spain
- Division of Clinical Psychology, Department of Psychology, University of Jaen, Campus de las Lagunillas s/n, C-5., Jaen, Spain
| | | | | | | | | | | | | | - Paula Morales-Hidalgo
- Universitat Rovira I Virgili, Tortosa, Spain
- Universitat Oberta de Catalunya, Barcelona, Spain
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Vivas-Fernandez M, Garcia-Lopez LJ, Piqueras JA, Muela-Martinez JA, Canals-Sans J, Espinosa-Fernandez L, Jimenez-Vazquez D, Diaz-Castela MDM, Morales-Hidalgo P, Rivera M, Ehrenreich-May J. Randomized controlled trial for selective preventive transdiagnostic intervention for adolescents at risk for emotional disorders. Child Adolesc Psychiatry Ment Health 2023; 17:7. [PMID: 36635735 PMCID: PMC9835742 DOI: 10.1186/s13034-022-00550-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 12/19/2022] [Indexed: 01/14/2023] Open
Abstract
Significant evidence does exist on the effectiveness of transdiagnostic interventions to improve emotional problems in clinical populations, and their application as universal and indicated prevention programs. However, no randomized controlled trials (RCT) studying selective transdiagnostic prevention intervention have been published. This is the first known RCT to evaluate the efficacy/effectiveness of an evidence-based selective prevention transdiagnostic program for emotional problems in adolescents. The impact of three different interventions was evaluated: (1) PROCARE (Preventive transdiagnostic intervention for Adolescents at Risk for Emotional disorders), which is a group-based, online-delivered, abbreviated version of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A), along with adding a booster session, to reduce risk of onset of anxiety and depression, (2) PROCARE + , which includes the PROCARE protocol along with personalized add-on modules tailored to match adolescents' risk factors, and (3) an active control condition (ACC) based on emotional psychoeducation. In total, 286 adolescents (53.3% girls) evidencing high risk and low protective factors were randomized and allocated to PROCARE, PROCARE + or ACC. Self- and parent-reported measures were taken at baseline, as well as after the intervention, a 6-month follow-up was carried out, together with a 1-month follow-up after the booster session. Differences between conditions were significant on most of the outcome measures, with superior effect sizes for PROCARE +. Interventions were excellent in terms of acceptability, with good satisfaction rates. Tailored selective transdiagnostic interventions focused on mitigating risk factors and promoting protective factors in vulnerable adolescents are promising.
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Affiliation(s)
| | - Luis-Joaquin Garcia-Lopez
- University of Jaen, Jaen, Spain
- Department of Psychology, Division of Clinical Psychology, University of Jaen, Campus de Las Lagunillas S/N, C-5 Jaen, Spain
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Kishida K, Hida N, Matsubara K, Oguni M, Ishikawa SI. Implementation of a Transdiagnostic Universal Prevention Program on Anxiety in Junior High School Students After School Closure During the COVID-19 Pandemic. JOURNAL OF PREVENTION (2022) 2023; 44:69-84. [PMID: 36180665 PMCID: PMC9524327 DOI: 10.1007/s10935-022-00709-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 09/07/2022] [Indexed: 02/02/2023]
Abstract
School closures due to the coronavirus disease 2019 (COVID-19) pandemic have worsened mental health problems for children and adolescents worldwide. We aimed to examine the follow-up effectiveness of a transdiagnostic universal prevention program for anxiety of junior high school students after a nationwide school closure during the COVID-19 outbreak in Japan. A total of 117 junior high school students were included in the analysis. We used the Unified Universal Prevention Program for Diverse Disorders (Up2-D2) program; the Up2-D2 comprises cognitive-behavioral and positive psychological interventions provided over twelve 45-minute sessions. The program was originally implemented between June and July 2020, immediately after pandemic-related school closures had ended in Japan. The program assessments were based on students' responses to a questionnaire incorporating five scales to measure indicators such as internalizing and externalizing problems. Assessments were carried out before, immediately after, two-month, and six-month after implementing the program. Mixed models for the whole sample showed small anxiety improvement effects immediately post-intervention and two-month, and six-month assessments (g = -0.25, g = -0.44, and g = -0.30, respectively). The anxiety reducing effects were even greater for the higher-anxiety group at the post-, 2-month, and 6-month assessments (g = -1.48; g = -1.59; g = -1.06, respectively). Although there was no control group, these results indicate that the transdiagnostic universal prevention intervention reduce only anxiety, but not other outcomes (depression, anger, and self-efficacy) in junior high students returning to school following school closures related to the COVID-19 pandemic in Japan.
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Affiliation(s)
- Kohei Kishida
- Organization for Research Initiatives and Development, Doshisha University, 1-3, Tatara Miyakodani, Kyotanabe-shi, Kyoto, Japan.
- Faculty of Psychology, Doshisha University, 1-3, Tatara Miyakodani, Kyotanabe-shi, Kyoto, Japan.
| | - Noriko Hida
- Organization for Research Initiatives and Development, Doshisha University, 1-3, Tatara Miyakodani, Kyotanabe-shi, Kyoto, Japan
| | - Kohei Matsubara
- Organization for Research Initiatives and Development, Doshisha University, 1-3, Tatara Miyakodani, Kyotanabe-shi, Kyoto, Japan
| | - Mayuko Oguni
- Organization for Research Initiatives and Development, Doshisha University, 1-3, Tatara Miyakodani, Kyotanabe-shi, Kyoto, Japan
| | - Shin-Ichi Ishikawa
- Faculty of Psychology, Doshisha University, 1-3, Tatara Miyakodani, Kyotanabe-shi, Kyoto, Japan
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