“…We also used the Japanese version of the Patient Health Questionnaire-9 (PHQ-9) 21 to collect basic information on the mental health of participants; the PHQ-9 consists of nine questions. Depressive symptoms during the past four weeks were reported by the participants, with a score of 0 (not at all) to 3 (nearly every day) 22 .…”
Section: Methodsmentioning
confidence: 99%
“…Depressive symptoms during the past four weeks were reported by the participants, with a score of 0 (not at all) to 3 (nearly every day) 22 . We defined a score of ≥10, as recommended by previous studies 21 , as a cutoff point, meaning that a person is more likely to have major depression. The PHQ-9 has been widely used internationally as a screening scale for depression 23 and is highly reliable and valid 21 .…”
To deter the spread of the coronavirus disease 2019 (COVID-19), many countries have imposed a lockdown with restrictions. On 7 April 2020, the Japanese government declared a state of emergency over the COVID-19 outbreak. Japan was in “mild lockdown” which was not enforceable and non-punitive with the declaration. We conducted an online survey to investigate factors associated with psychological distress in the “mild lockdown” under a declared state of emergency for COVID-19. We collected data on 11,333 inhabitants (52.4% women, 46.3 ± 14.6 years) living in the seven prefectures where the declaration was first applied. The investigation dates of this study, 11 and 12 May 2020, were in the final phase of the state of emergency. The survey was conducted in real-time to minimize participants’ recall bias. In addition to psychological inventories often used worldwide, the questionnaires used in this survey included lifestyle and stress management items related to COVID-19 and various socio-demographic items including occupation (e.g. healthcare worker) or income.
“…We also used the Japanese version of the Patient Health Questionnaire-9 (PHQ-9) 21 to collect basic information on the mental health of participants; the PHQ-9 consists of nine questions. Depressive symptoms during the past four weeks were reported by the participants, with a score of 0 (not at all) to 3 (nearly every day) 22 .…”
Section: Methodsmentioning
confidence: 99%
“…Depressive symptoms during the past four weeks were reported by the participants, with a score of 0 (not at all) to 3 (nearly every day) 22 . We defined a score of ≥10, as recommended by previous studies 21 , as a cutoff point, meaning that a person is more likely to have major depression. The PHQ-9 has been widely used internationally as a screening scale for depression 23 and is highly reliable and valid 21 .…”
To deter the spread of the coronavirus disease 2019 (COVID-19), many countries have imposed a lockdown with restrictions. On 7 April 2020, the Japanese government declared a state of emergency over the COVID-19 outbreak. Japan was in “mild lockdown” which was not enforceable and non-punitive with the declaration. We conducted an online survey to investigate factors associated with psychological distress in the “mild lockdown” under a declared state of emergency for COVID-19. We collected data on 11,333 inhabitants (52.4% women, 46.3 ± 14.6 years) living in the seven prefectures where the declaration was first applied. The investigation dates of this study, 11 and 12 May 2020, were in the final phase of the state of emergency. The survey was conducted in real-time to minimize participants’ recall bias. In addition to psychological inventories often used worldwide, the questionnaires used in this survey included lifestyle and stress management items related to COVID-19 and various socio-demographic items including occupation (e.g. healthcare worker) or income.
“…Each item is rated from 0 = Not at all through 3 = Nearly every day , with the total score ranging therefore between 0 and 27. The reliability and the validity of the original PHQ-9 and its Japanese version are well established [ 45 , 46 ]. We used this scale successfully in our previous trial of the smartphone CBT [ 18 ].…”
BackgroundYouth in general and college life in particular are characterized by new educational, vocational, and interpersonal challenges, opportunities, and substantial stress. It is estimated that 30–50% of university students meet criteria for some mental disorder, especially depression, in any given year. The university has traditionally provided many channels to promote students’ mental health, but until now only a minority have sought such help, possibly owing to lack of time and/or to stigma related to mental illness. Smartphone-delivered cognitive behavioral therapy (CBT) shows promise for its accessibility and effectiveness. However, its most effective components and for whom it is more (or less) effective are not known.Methods/designBased on the multiphase optimization strategy framework, this study is a parallel-group, multicenter, open, fully factorial trial examining five smartphone-delivered CBT components (self-monitoring, cognitive restructuring, behavioral activation, assertion training, and problem solving) among university students with elevated distress, defined as scoring 5 or more on the Patient Health Questionnaire-9 (PHQ-9). The primary outcome is change in PHQ-9 scores from baseline to week 8. We will estimate specific efficacy of the five components and their interactions through the mixed-effects repeated-measures analysis and propose the most effective and efficacious combinations of components. Effect modification by selected baseline characteristics will be examined in exploratory analyses.DiscussionThe highly efficient experimental design will allow identification of the most effective components and the most efficient combinations thereof among the five components of smartphone CBT for university students. Pragmatically, the findings will help make the most efficacious CBT package accessible to a large number of distressed university students at reduced cost; theoretically, they will shed light on the underlying mechanisms of CBT and help further advance CBT for depression.Trial registrationUMIN, CTR-000031307. Registered on February 14, 2018.
“…The PHQ-9 uses 9 items of diagnostic criteria for major depressive episode (MDE) in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), and is rated from 0 = not at all to 3 = nearly every day. The Japanese version of the PHQ-9 has been shown to be valid and reliable in primary care patients [21] and the university students [22].…”
Section: Mood and Personalitymentioning
confidence: 99%
“…Participants (N = 847) were a mean age of 22.0 (SD=3.0, range = 18-39) and mostly female (53.4%). Most participants were undergraduates (70.1%), with 21.7% in master's programs, 7.8% in doctoral programs, and 0.4% in junior college programs.…”
Background: There are many different skill components used in cognitive-behavioral therapy (CBT). However, there is currently no comprehensive way of measuring these skills in patients. Assessing pretreatment CBT skills will contribute to prediction of treatment responses in the context of CBT for depression.Methods: We developed the CBT Skills Scale from five pre-existing instruments measuring major CBT components: self-monitoring, behavioral activation, cognitive restructuring, assertiveness training, and problem-solving. University students (N = 847) who participated in a fully factorial randomized controlled trial of smartphone CBT were assessed with the CBT Skills Scale, the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder 7 (GAD-7), and the short form of the Japanese Big Five Scale. Structural validity was estimated with exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), and internal consistency evaluated with Cronbach’s α coefficients. Construct validity was evaluated with the correlations between each factor of the CBT Skills Scale, the PHQ-9, the GAD-7, and the Big Five Scale.Results: The EFA supported a five-factor solution based on the original instruments assessing each CBT skill component. The CFA showed sufficient goodness-of-fit indices for the five-factor structure. The Cronbach’s α of each factor was 0.75-0.81. Each CBT skills factor was specifically correlated to the PHQ-9, GAD-7, and the Big Five Scale.Conclusions: The CBT Skills Scale has a stable structural validity and internal consistency with a five-factor solution and appropriate content validity concerning the relationship with depression, anxiety, and personality. Trial registration: UMIN, CTR-000031307. Retrospectively registered on February 14, 2018.
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