Evidence suggests that insomnia persists for many depressive patients after their other symptoms have responded to pharmacotherapy. The present case study reports an attempt to use a behavioral intervention based on functional assessment with a retired 69-year-old man who had residual insomnia despite having taken several types of sleep medication. The functional assessment suggested that his tendency to perform various activities daily had been functioning as a coping mechanism for avoiding the anxiety and discomfort that he felt from not being able to sleep. These avoidance behaviors were provoked by various discriminative stimuli, including his own verbal behaviors. After conducting the functional assessment in five 50-minute sessions, 11 booster sessions were held in order to discontinue his consumption of sleep medications. The results showed that his sleep onset latency (SOL) was reduced from 60 to 10 minutes, and his wake after sleep onset (WASO), from 180 to 33 minutes after the second session. Furthermore, the man's Insomnia Severity Index (ISI) scores decreased from 24 (severe) to 7 (in remission) after discontinuation of the sleep medications. The present results suggest that this functional-assessment-based intervention may be effective in treating individuals who have residual insomnia after remission of their major depressive disorder.

View full abstract

Empirical evidence from experimental, cross-sectional, and longitudinal studies has suggested that depressive ruminations prolong and intensify depression. Previous published research has suggested that rumination contributes to the development of stressors, and that the experience of stressors enhances the level of rumination. The purpose of the present 2-wave longitudinal study was to investigate how the reciprocal relationship between rumination and stressors is associated with depression. Adults (N=111; mean age 44.30±11.34 years) completed instruments that assessed rumination and depression at baseline (T1). Then, rumination, depression and stressors were assessed 7 months later (T2). Structural equation modeling indicated that rumination at baseline was not directly associated with depression 7 months later, but stressors that had been experienced during the intervening 7 months fully mediated the effects of rumination on depression. Moreover, the level of rumination and depression at baseline was associated with greater stressor, which in turn intensified rumination and depression 7 months later.

View full abstract

The aim of the present research was to examine how reinforcement histories with different instructions affect behavioral variability. The participants, 53 undergraduate students, were divided into 2 groups: a group scoring high on the General Health Questionnaire (High GHQ group) and a group scoring low on that instrument (Low GHQ group). Each of these groups was randomly divided into 4 groups: an other-instruction group, a self-instruction group, a choice-instruction group, and a control group. After the participants' responses were reinforced under each instructional condition, their behavioral variability was recorded and compared to that of participants in the control group. A significant difference between the scores of the Low GHQ group and the control group was not observed, whereas a significant difference from the control group's scores was observed for the scores of the other-instruction group and the self-instruction group in the High GHQ group. These results suggest that the overall variability of the behavior of those participants with few mental health problems was not decreased by the instructions. On the other hand, it is possible that, for those with mental health problems, the variability of their behavior decreased as a result of effects of the other-instructions and self-instructions. Those participants' behavioral variability did not, however, decrease in the choice-instruction condition, in spite of their mental health problems. These results suggest that adopting choice-instruction may be an effective measure for maintaining clients' response variability in clinical settings.

View full abstract

Cognitive models of social anxiety suggest that negative and distorted self-imagery may have an important role in maintaining anxiety. The present study investigated whether emotionally valenced (negative, positive, control) self-imagery affects performance in social situations. Volunteers who scored high and low of social anxiety participated in a speech task. They were allocated to one of three imagery conditions in which participants rehearsed a negative self-image, a positive self-image, or a control self-image prior to giving a speech. The results showed that the participant who had scored high on social anxiety and had rehearsed negative self-imagery rated their anxiety symptoms as being more visible than those who had rehearsed the control self-image. Also, independent assessors rated as poor the speech performance of the participants in the negative self-image condition. Participants who had scored high on social anxiety and had rehearsed a positive self-image reported feeling more anxious as well as holding more negative self-imagery, although they had an adaptive evaluation of their appearance. These results suggest that negative self-imagery has a more negative effect for socially anxious people. Positive self-imagery has different effects from negative self-imagery.

View full abstract

The purpose of the present study was to examine factor structures and estimate the internal consistency and validity of the Personal Values Questionnaire II (PVQ-II; Blackledge et al., 2010), which evaluates value. The instrument has been adopted in Acceptance and Commitment Therapy (Hayes et al., 1999) from various aspects, in order to elaborate on the PVQ-II. The participants were Japanese college students and adults (N=388). Item-analysis and exploratory factor analysis indicated that the PVQ-II had 3 factor structures (8 items), and that it had good validity and reliability. Confirmatory factor analysis (N=413) supported the 3-factor model of the PVQ-II. The present study has added to the data from the standardization of the PVQ-II. The present data indicate that the PVQ-II can be applied in a Japanese cultural context. Future research should examine the specificity of the PVQ-II in Japan.

View full abstract

Pregnancy and childbirth are well-known risk factors for the onset or worsening of obsessive-compulsive disorders. However, there are few reports of behavioral approaches to these cases, especially in Japan. In the present study, a 28-year-old pregnant woman with obsessive-compulsive disorder was successfully treated by behavior therapy consisting primarily of exposure and response prevention without medication. After marriage, the woman came to have an obsessive-compulsive disorder which worsened after pregnancy. At her first medical examination, the present authors observed that she disinfected the soles of her feet and the floor of the lavatory, took photographs and made detailed notes of her own actions, and checked her actions when she went to the lavatory. In addition, she related that her obsessions interfered with housework including cooking: "I must spread dirt and germs." She was given behavior therapy consisting primarily of exposure and response prevention once a week for 12 weeks. Her obsessive-compulsive symptoms gradually decreased. No obsessive-compulsive symptoms were observed at the time of childbirth, and she was able to do housework and take care of her baby. At a half-year follow-up medical examination, the improvement was observed to have been maintained.

View full abstract