This study is on whether the occupation of computer operators was related to technostress tendency. The data were collected from questionnaires given to 273 computer operators (male 241,female 32). There were two kinds of questionnaires 1) a questionnaire to valuate technostress tendency, 2) a questionnaire to identify occupations. The questionnaire to evaluate technostress tendency had been based on report 1. It consisted of 31 questions (22 questions on techno-centered tendency, 9 questions on techno-anxious tendency). There were six categories for the occupation of computer operators ; 1) software developer, 2) hardware developer, 3) software analyst using completed software, 4) word-processor operator, 5) system engineer, 6) others (simple work for ofiice automation). The subjects chose one of these. Each question about technostress tendency was given a point according to the answer-Yes= 1 point, Unknown=0.5 point, NO=0 point. The total points were used as the score to judge technostress tendency in each subject. Subjects whose scores were ≧ mean+SD were identified to be in the high tendency group and subjects whose scores were≦ mean-SD were identified to be in the low tendency group. Regarding to occupation, category numbers 1 and 2 (software and hardware developer) were put in group A. Numbers 3 and 5 (software analyst using completed software and system engineer) were put in group B. And numbers 4 and 6 (operator of word-processor and others) were put in group C. Group A was regarded as occupations which people well trained in computers would take. Group B was regarded as one which people not trained in computers would take. And group C could include both. Chi-square test was used to examine the relation between occupation groups and technostress tendency. Distribution of occupations was significantly different between high and low techno-centered tendencies (p<0.01). It was shown that occupation group A was found more in the high technocentered tendency group than in the low one, and that occupation group C was on the contrary.With regard to techno-anxious tendency, no significant relationship in distribution of occupations was found.

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The purpose of this study is to evaluate psychological and physiological effects of photic feedback system (αFB) which had been developed in order to facilitate relaxation response comparing with autogenic traming (AT). The subjects were 13 healthy individuals (8 AT practiced and 5 unpracticed). All subjects experienced αFB session and AT session in turn with their eyes closed. Each αFB session consisted of a sweep period of 3 min, a rest period of 7 min, an αFB period of 10 min, a rest period of 10 min. Each AT session consisted of a rest period of 10 min, an AT period of 10 min, a rest period of 10 min. Physiological monitoring of blood pressure, heart rate (HR) and respiratory rate (RR) was performed during the sessions. As psychological measures, State trait anxiety inventoryState form (STAI-S) and Profile of mood states (POMS) were administered before and after the sessions, and post-trial subjective feeling-state reports were requested after them. The mean value and the standard deviation (SD) of systolic blood pressure (SBP), diastolic blood pressure (DBP). HR, RR and the coefficient of variance of R-R interval (CVR-R) were calculated on each of three following periods ; 7〜9 min (pre), 17〜19 min (mid), 27〜29 min (post). The data were statistically analyzed with analyses of variance by General Linear Models (GLM) procedure of Statistical Analysis System (SAS). The results were as follows ; 1) According to the results of psychological measures, almost all measures were significantly decreased, and αFB was equally effective for calming mood as AT. 2) SBP-mean and CVR-R Significantly increased, HR-mean significantly decreased. 3) SBP-SD and DBP-SD significantly increased during αFB and AT period. 4) CVR-R increased in the αFB sessions more than in the AT sessions. It is concluded that αFB was equally effective for calming mood as AT and that αFB was prone to increase parasympathetic measures such as CVR-R more than AT.

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The habit of smoking and drinking is well known to play an important role from the viewpoint of stress management. However, it also has an unfavorable aspect that tobacco and alcohol are closely associated with various diseases. In order to investigate the causative effect of smoking on psychosomatic diseases, we studied relations between the habit and alexithymia. Alexithymic traits which are supposed to contribute to the progress of psychosomatic diseases were assessed by means of MMPI-alexithymia scale. It was revealed that non-smokers were more alexithymic than smokers. Among smokers, those who did not give precise reasons why they tend to smoke were more alexithymic than those who were aware of reasons. There was no significant correlation between the habit of drinking and alexithymic trait. In addition, subjects under treatment for chronic diseases were more alexithy-mic than those who had completed treatment.

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Psychosomatic study of 13 patients with acute myocardial infarction under 40 years of age was performed. The results were as follows. 1) Various traditional risk factors. Smoking and hypercholesterolemia were commonly risk factors. Smoking was found in 12 cases, hypercholesterolemia in 10 cases, hypertension in 6 cases and diabetes mellitus in 3 cases. 2) Coronary angiographic findings. One case had double vessel disease and 9 cases had single vessel disease. Three cases had normal coronary angiograms. Patients with normal coronary angiograms were considered that their myocardial infarction were caused by vasospasms or thrombotic occlusion with complete recanalization. 3) Psychosocial factors associated with myocardial infarction. Psychosocial stress, mainly occupational stress (time urgency, work-overload, hard-driving and workaholic tendencies, etc.) were found in 10 cases. Type A behavior pattern evaluated by JAS (Jenkins Activity Survey translated into Japanese by Department of Psychosomatic Medicine of Tohoku University) was found in 11 cases. With regard to incidence of type A behavior pattern, there was no difference between young myocardial infarction and old (above 60 years of age) myocardial infarction patients, but psychosocial stress was found significantly higher in young patients, Severe type A patients seemed to have less feeling of fatigue than mild type As and type Bs. Lack of feeling of fatigue found in type A patients was probably caused by their overadaptation to environmental surroundings, and partially by their alexisomic tendency. Japanese type A behavior pattern is characterized by lower hostility and higher workaholic tendency. In young myocardial infarction patients, these characteristics can be seen clearly. So author supposed that by not feeling much fatigue, type A patients engage themselves in occupational stressful situations, and continued their hardworking style until they lead themselves to the onset of myocardial infarction. From these results author considered that psychosocial stress and type A behavior pattern played an important role as coronary risk factors and precipitating factors especially in myocardial infarction at a young age.

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The case is a 15-year old boy with intractable asthma whose first attack came at the age of one, who first visited our hospital at the age of nine and afterwards repeatedly received institutional therapies. Just after remission of his asthma as a result of institutional therapy at the age of 15,symptoms of Morita neurosis appeared. He began to wonder if he had a psychosis and he wanted us to change his personality. His strong inferiority complex was accompanied by psychosomatic complaints. None of the attempted treatments, including autogenic training, sandplay technique, pharmacotherapy and psychiatric therapy, worked. It is now thought that the decision to have the boy live on a regular basis in accordance with the Morita therapeutic approach, together with counseling and bibliotherapy, has proven to be successful in treating the patient. The neurotic personality of our case, however, has not been overcome yet ; nevertheless. I think that the Morita therapeutic approach in this case should be continued and refined.

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A case of psychogenic generalized convulsion, which was considered to be related to the sense of guilt, is reported in this paper. The patient was a 48 year old female, when she was first seen by the therapist. About a half year before the initial interview, she began to have the attacks of convulsion. These attacks went through 3 stages as follows ; (1) generalized convulsion for about 3 minutes, (2) confused state for about 15 minutes, (3) sleeping for about l-2 hours. On awakening, she had no memories of the attacks. She was admitted to our hospital (department of internal medicine), with the tentative diagnosis epilepsy. But no abnormality was found on EEG (done 2 times) and brain CT. She complained of insomnia and psychological difficulty, and was referred to our department for psychiatric interview. At the initial interview, she spontaneously talked about her unhappy life history and the sense of guilt concerning her recent situation. These can be summarized as follows ; She was born in a very poor family, father being an alcoholic, and there being incessant parental quarrels. She married when she was 21 years old, with the hope of getting a better family. But her husband was a terrible man, with the tendency of excessive gambling and extra-marital relationships, making a lot of debt, and beating her frequently. She finally left her husband when she was 46 years old. Then she began to live with 'the uncle', who helped her when she was at a loss. 'The uncle' had a wife, who was bedridden due to apoplexy. The patient was to take care of this woman, but she couldn't, because her physical condition began to deteriorate when she tried to do this. 'The uncle' put his wife into hospital, where she died about 3 months before the initial interview. The actual relationship between the patient and 'the uncle' was that of lovers. The patient felt strong sense of guilt toward his wife, especially because she did not take care of this woman. She also talked about the dream. In this dream, 2 red eye-balls flew in the air, attacking her. She recognized these eye-balls to be the wife of 'the uncle', and declared to the eye-balls that from then on the patient would take care of 'the uncle'. On hearing this, the eye-balls came just in front of her, and crushed themselves. After hearig these, the therapist assured the patient that she had done nothing wrong, and had the every right to her own happiness. There were no more attacks observed after this interview. In this case, the sense of guilt was considered to be the main causative factor of her conversion hysteria. It was possible to interpret it in the Oedipal context, 'the uncle' being father, and his wife being mother in her fantasy. But the therapist tried to alleviate this sense of guilt by means of supportive psychotherapy and prescribing anti-anxiety agents, with the result of good and stable recovery.

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Recently, many diseases are considered as psychosomatic diseases, however, few cases present the manifest correlation of clinical and psychological findings. We reported a case of coronary artery disease whose clinical manifestations varied depending on emotional stresses. A local physician referred to us a 76-year-old female patient complaining of severe headache and hypertension. Before then, she had been definitive in diagnosing coronary artery disease on the basis of coronary angiography, and had undergone A-C bypass operation. But after the operation, she came to experience attacks of severe headache accompanied by the elevation of blood pressure. Physical examinations showed no abnormalities causing the headache, so a diagnosis of psychogenic headache was suspected. After the admission to our hospital, her subjective symptoms and blood pressure varied depending on emotional stresses on three different occasions. These stresses were brought on by the therapist when he interpreted her conflict and just before her expectated date of leaving the hospital. When the interpretation was given, the emotional stress brought about the elevation of blood pressure and acute heart failure. A case of coronary artery disease with fluctuating blood pressure was documented and the etiology of the disease was discussed. This case clearly presents that emotional stress significantly impairs the fluctuations of blood pressure.

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A 27-year-old woman came to our hospital because of binge eating, self-induced vomiting, and loss of self-esteem. Her diagnosis of Bulimia nervosa was made in accordance with DSM-iiiR. When she was administered fasting therapy with Naikan procedure at first, we found out cognitive triad like depressed patients in her cognition, which is negative view of her past, presence, and future. Furthermore we found out she had severe cognitive distortions and she was insufficient to assert herself. Therefore we introduced her psycho-educational approach edited by Katzman et al. from the latter part of fasting period. The purposes of this therapy are as follows ; (1) Eating behaviors are thought as coping behaviors against stressors. Therefore we get patients to make sure of stressful conditions when they write down about their binge eating, selfinduced vomiting, and feelings and thoughts prior to eating. And we also get them to develop their coping skills except for eating behaviors. Then they are tried to correct their thoughts prior to binge and vomiting. (2) Patients modify their problems on their personality and behavior, for example, Iow self-esteem and insufficiency of assertiveness. In our outpatient department, she took self-monitoring used "weekly binge diary". She experienced that she could control her eating behavior because she paid attention to her feelings accompanied with eating behaviors and her cognitive distortions, and she practiced coping behaviors not to binge. In addition, she tried to organize her time by developing to nourish herself as coping behaviors. By the way, she took other cognitive behavioral approaches ; "three columns" and "graded task assignment". Finally, her binge eating and self-induced vomiting diminished after she had developed her sense of control and sense of self-efficacy. After 8 months from beginning of therapy, the Rorschach Test revealed that her emotional and interpersonal aspects improved more than immediately after fasting therapy. Therefore cognitive behavioral approach is effective in this case. We consider that cognitive behavioral approach administered in this case made up for fasting therapy because the followings contributed to maturity of her ego ; (1) similarity to Morita's therapy that gets newer adjustment patterns in the face of reality, (2) patient's experiences of sense of self-efficacy and sense of control in the process of this therapy, (3) modification of cognitive distortions by cognitive interventions and verification of its propriety.

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