The authors studied effects of sex, mood states, and psychosocial stress on somatic symptoms in patients attending a mind/body medicine clinic. The subjects consisted of 1,280 Japanese outpatients and 971 U.S. outpatients. Japanese patients completed the Profile of Mood States (POMS). Psychosocial stress was assessed along DSM-III-R axis IV. Patients in the U.S. completed the Symptom Checklist 90 Revised (SCL-90R) and Stress Perception Scale. With respect to the 16 major somatic symptoms, symptom-positive patients (Japan 16/16; U.S. 10/16) had significantly higher scores on the POMS/SCL-90R anxiety, depression, and hostility scales than symptom-negative patients. Multiple regression analysis indicated that sex, POMS/SCL-90R anxiety, and psychosocial stress predicted the number of total somatic symptoms in both clinics. The findings suggest that sex differences, anxiety, and psychosocial stress are significantly associated with somatic symptoms across cultures.

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Characteristics of 1,012 outpatients completing a 10-week behavioral medicine intervention were compared with 300 dropout outpatients. The Symptom Checklist 90 Revised (SCL-90R) was administered before and after the program.
Compared to dropouts, patients completing treatment tended to be highly educated, married, and gainfully employed; they had significantly lower pre-treatment scores on the SCL-90R somatization, depression, and obsessive-compulsive scales and global severity index. Depression and education significantly discriminated between the two groups through multiple logistic regression analysis. The intervention significantly decreased all the SCL-90R scores among patients completing treatment, but degrees of treatment effects did not significantly differ between education levels. Less educated patients might benefit from preparatory interventions, or from a modified approach to their treatment.

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The purpose of this study was to investigate the relationships between anger dimensions and cardiovascular reactivity. 202 university students were asked to complete Buss-Perry Aggression Questionnaire (BAQ) and 32 of them (13 male and 19 female) were asked to take part in the experiment.
After the rest period, the subjects executed mirror-drawing task two times: they performed the task normally (control condition) and they were harassed during their task performing (interpersonal stress condition).
Factor analysis for BAQ revealed 3 factors: “anger expression”, “anger experience”, and “assertiveness”. Correlation coefficient between 3 factors and cardiovascular changes from control condition to interpersonal stress condition indicated that “anger expression” were related to increasing systolic blood pressure significantly.
These results are in agreement with recent cross-sectional studies in Japan, suggesting that “anger expression” may be related to coronary heart disease. There is a possibility that episodic anger expression with interpersonal conflict can cause coronary heart disease.

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The transtheoretical model (TTM) of behavior change is increasingly being applied to studies on physical activity and exercise promotion in Japan. The present study developed the decisional balance for exercise scale to measure the benefits (pros) and costs (cons) of exercising. In addition, we examined the prevalence of stages of change for exercise behavior and their relationship to decisional balance for exercise. A total of 608 middle-aged adults answered a 30-item questionnaire consisting of statements on the benefits and costs of exercising. Stepwise exploratory factor analysis identified the following two factors: One a 10-item component representing positive perceptions of exercise (pros), the other a 10-item component representing avoidance of exercise (cons). Psychometric analyses showed that the decisional balance for exercise scale had high reliability and validity. On the basis of their responses to the stages of change measure, 203 were in precontemplation (33.4%), 123 in contemplation (20.2%), 114 in preparation (18.8%), 48 in action (7.9%), and 120 in maintenance (19.7%). Significant differences were found for pros, cons, and decisional balance (pros minus cons) mean scores across the five stages of change. In contrast with those who exercised regularly, participants who had not yet begun to exercise saw exercising as having nearly as many costs as it had benefits. In Japan, continued work at understanding modifiable factors associated with physical inactivity and intervention trial would yield important information for promoting physical activity and exercise effectively.

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[in Japanese]

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