Perceptions of traditional and modern types of depression: A cross‐cultural vignette survey comparing Japanese and American undergraduate students

Abstract

Aim Depression is a heterogeneous disorder that has various subtypes. In Japan, however, a prevailing misunderstanding is that the term utsu‐byo (clinical depression) indicates only the melancholic type. Consequently, a subtype called ‘modern‐type depression’ (MTD), which has contrasting features to those of melancholic or traditional‐type depression (TTD), is severely stigmatized in Japan these days. The present study conducted a cross‐cultural comparison of perceptions of TTD and MTD between Japan and the USA to examine how the Japanese collectivistic culture contributes to negative biases toward MTD. Methods Undergraduate students in Japan (N = 303) and the Midwestern USA (N = 272) completed the survey. They read two vignettes that described the conditions of fictional individuals with either TTD or MTD, and then reported their perceptions of each vignette. Results Mixed analyses of variance revealed significant interactions between nation (Japan or the USA) and vignette (TTD or MTD) on most perception items. These interactions and subsequent analyses with Bonferroni corrections mainly indicate the following: (i) Japanese are more likely to suppose that conditions of MTD are milder compared with TTD; and (ii) Japanese are more likely to hold stronger aversive attitudes and weaker willingness to provide support toward people with MTD than toward those with TTD. Conclusion These results indicate that people with MTD are more likely to be accepted in the US independent culture than in the Japanese collectivistic culture. Discussion highlights that cultural diversity education potentially reduces stigma of MTD in Japan.

Hikikomori : Multidimensional understanding, assessment, and future international perspectives

“…Instead, since around the late 1990s, hikikomori and a novel psychiatric syndrome called ‘modern‐type depression’ (MTD) have become a growing issue, especially among adolescents, initially in Japan . We believe that the world historical shift of psychiatric disorders is of great importance to understanding the psychopathology of hikikomori and MTD in this era . Based on the reports of S. Tarumi and our clinical observations, persons with MTD tend to express depressive mood just after stressful events and also have a tendency towards avoidance and social evasion in school and work environments.…”

Development and validation of the 22‐item Tarumi's Modern‐Type Depression Trait Scale: Avoidance of Social Roles, Complaint, and Low Self‐Esteem (TACS‐22)

“…In 2005, Tarumi termed this novel condition ‘dysthymic‐type depression’ in contrast to the melancholic‐type depression proposed by Shimoda, and Tarumi also proposed its premorbid personality . This syndrome is currently called Shin‐gata / Gendai‐gata utsu‐byo [new‐type depression or modern‐type depression (MTD)] and is characterized by a tendency for the presentation of depressive symptoms mainly in stressful workplace or school settings, with the rapid decrease or disappearance of these symptoms once patients leave these stressful situations …”

“…10,11 This syndrome is currently called Shin-gata/Gendai-gata utsu-byo [new-type depression or modern-type depression (MTD)] and is characterized by a tendency for the presentation of depressive symptoms mainly in stressful workplace or school settings, with the rapid decrease or disappearance of these symptoms once patients leave these stressful situations. [12][13][14][15][16] Tarumi pointed out that the premorbid personality and symptomatological characteristics of MTD include avoidant narcissistic personality ('attachment to himself/herself without roles,' 'negative feeling about social order,' and 'vague omnipotent thoughts'), extrapunitive feeling ('criticism of others'), and stress related to social norms, including social rules and social expectations. 10,11 Based on Tarumi's notes, we temporarily developed our original diagnostic criteria of MTD and a semi-structured diagnostic interview to evaluate the condition.…”

Prototypes in psychiatry and the structure of clinical empathy

“…The papers by Kato et al . and Kashihara et al . in this issue are welcome interventions from psychiatrists concerned about the recognition of distress and the structure of empathy, particularly for those whose ailment is treated dismissively.…”

“…discuss Tarumi's concept of modern‐type depression, which illuminates the power of such prototypes in capturing the complexity of people's distress and the importance of cultivating understanding of the social forces behind their predicament. Kashihara et al . effectively employ a comparative perspective in investigating lay people's understandings of depression in Japan and the USA.…”