Summary: Although the percentage of women who initiate breast cancer screening is increasing, the rate of continued adherence is poor. The purpose of this article was to demonstrate the study to develop a model of behavioral change for breast cancer screening based on the trans-theoretical model, the theory of planned behavior, and cancer worry, and examine the predictive validity of audience segmentation based on the model and the effectiveness of a tailored message intervention compared with a non-tailored message intervention for psychological based segments increasing the breast cancer screening rate. Our model from a questionnaire survey completed by 641 women revealed that the stage of change for mammography adoption was significantly affected by goal intention, implementation intention and cancer worry, and the predictive validity of audience segmentation was confirmed. Tailored message intervention was conducted for 1859 participants from a Japanese urban community setting. A logistic regression model revealed that the odds of a woman who received a tailored message undergoing mammography was 4.02 times those of a women who had received a non-tailored message (95% confidence interval, 2.67–6.06). These studies show that behavioral change approach is effective and significant way to develop the model and intervention for the Japanese cancer screening behaviors.

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Summary: Educating people about nutrition may increase their knowledge of what to eat but understanding eating behaviors is necessary to develop a healthy eating lifestyle. However, there is little information on eating behavior in nutrition education due to a lack of evidence. Here, we examined coping strategies for dealing with temptations in weight management using a qualitative and scale development study. These studies identified five coping strategies such as “counter-conditioning”, “eating style”, “stimulus control”, “social support”, and “cognitive coping”. We then implemented a weight management program focused on these coping strategies in a company. The program increased the number of participants who were actively losing weight or in a maintenance stage and decreased those with a body mass index >25 kg/m². The five coping strategies were also used to develop educational material. The feasibility of this material was examined by health professionals and adults who attended a health program. The study using the material was widely regarded as fun, although some improvements were suggested and the material revised accordingly. The data gathered from these studies provides evidence on eating behavior that supports shifting nutrition education away from focusing on nutrition and towards promoting healthy eating behaviors.

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Summary: Because stress has a profound adverse effect on Japanese workers’ health, the government and companies have taken various provisions. Companies held workshops to promote stress-level checks and stress-management education. Currently, more workers participate in the checks and education sessions. However, it is a problem that participating in stress checks and education sessions is not related to subsequent implementation of self-care behavior. We hypothesized that workers’ stress-management behaviors are affected by individual differences in attitudes toward “stress.” In other words, self-evaluation of stress level is the first step required to produce stress-coping behavior. Even if people experience stress, those who underestimate their stress level and the importance of stress management might not implement adequate stress management. In this paper, we introduce a qualitative study of stress attitudes intended for acute myocardial infarction patients and quantitative studies of workers. Applying the factor of “stress underestimation tendency” is expected to enhance the effectiveness of stress-level checks or stress-management education in companies.

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Summary: There is increasing evidence that psychological factors (e.g., pain coping strategies) play an important role in older adults’ adjustment to musculoskeletal pain. Therefore, interest in the use of cognitive behavioral therapy (e.g., pain coping skills training) to help older adults manage musculoskeletal pain is growing. In the present article, the first section reviewed the background on the necessary of cognitive behavioral therapy for managing musculoskeletal pain. The second section highlighted five techniques mainly used in pain coping skills training for musculoskeletal pain: cognitive restructuring, relaxation, distraction, pleasant activity scheduling, and activity-rest cycling. The third section introduced two printed materials newly developed for pain coping skills training and exercise therapy among older Japanese with knee pain. The final section of the present paper discussed important future directions for working within this research area. The present review revealed that it is important to apply the cognitive behavioral therapy (pain coping skills training) in management of musculoskeletal pain.

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Summary: Recent studies on the psychological effects of emotional labor among hospital nurses have focused not only on aversive effects such as progression of burnout or depression but also on favorable effects, such as enhanced job satisfaction. However, few studies investigated these effects among Japanese hospital nurses. This study measured elements of emotional labor in detail and investigated the association of each element of emotional labor with work engagement and stress responses among 306 Japanese female hospital ward nurses in the Kanto region. In August–September 2011, they were surveyed using a self-administered questionnaire, measuring on emotional labor, work engagement, psychological and physical stress responses, and demographics. Multiple regression analyses were conducted to examine the association of each element of emotional labor (“Exploring and understanding”, “Expression of caring”, “Deep adjustment”, “Suppressed expression”, and “Surface adjustment”) with work engagement, and psychological and physical stress responses. The results showed that “Exploring and understanding” was positively associated with work engagement, whereas “Suppressed expression” was negatively associated with work engagement. “Deep adjustment” was positively associated with psychological and physical stress responses. These findings suggest that enhancing “Exploring and understanding” and reducing “Suppressed expression” and “Deep adjustment” have an effect on improving mental health among nurses.

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Summary: In this study, differences between two subtypes (Generalized type and Non-generalized type) of social anxiety were investigated in terms of individuals’ fluency in the formation of stimulus relations and physiological responses. Fifty-four university students completed the Japanese version of the Social Phobia Scale (SPS), which measures anxiety in performance situations; the Social Interaction Anxiety Scale (SIAS), which assesses anxiety in interaction situations; and the Go/No-go Association Task, which measures individuals’ fluency in the formation of stimulus relations between verbal stimuli representing social situations and emotions. In addition, their mental sweatings were recorded while they performed a speech task. The average and standard deviation criteria on the SPS and SIAS were used in group setting. Consequently, 30 individuals were subjected to analysis. Results indicated that individuals with generalized social anxiety were more fluent than those with low-level anxiety in forming stimulus relations between verbal stimuli representing performance situations and negative emotions. Further, individuals with low-level anxiety showed greater mental sweating in the speech task itself than they did in the preparation for the task. These results indicate that Relational Frame Theory may be efficiently applied to better understand the subtypes of social anxiety.

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Summary: Cognitive defusion strategies are a set of techniques that are used in Acceptance and Commitment Therapy to change the functions of verbal stimuli. The Word Repeating Technique (WRT) is a commonly used cognitive defusion technique. This study examined whether differences in verbal stimuli used in WRT have different effects on outcome measures. Further, we investigated whether the WRT have different effects on outcome measures from exposure to verbal stimuli. Forty-nine undergraduate and graduate students were randomly assigned to four groups: (a) the Neutral-Defusion condition, in which neutral verbal (e.g., lemon) stimuli were repeated; (b) the Negative-Defusion condition, in which uncomfortable verbal stimuli (e.g., failure) were repeated; (c) the Both-Defusion condition, in which both neutral and uncomfortable verbal stimuli were repeated; and (d) the Verbal-Exposure condition, in which participants were exposed to uncomfortable verbal stimuli. Results suggested that the WRT had different effects on outcome measures from the exposure to the verbal stimuli. Furthermore, the WRT using uncomfortable verbal stimuli did not have long-term effects on outcome measures, while the WRT using neutral verbal stimuli did, specifically in terms of avoidance of verbal stimuli and subjective measure results.

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