This study attempts to idetntify and examine characteristics of a typical Japanese mother or motherhood. Using a questionnaire, 521 subjects (male 39.0%, age : 10-7O years) who took part in the lecture entitled "Health Education" were asked to list various images of motherhood with a short word. The same questions were also conducted to them on images of wowanhood, fatherhood and manhood Approximately) twenty images were obtained. Statistical analyses were performed by chi-square test. ANOVA, and Spearman's rank correlation coefficient. Major findings were as follows : 1) while images of fatherhood and manhood shared 7 out of, 10 words mentioned, those of motherhood and womanhood shared only 4,2) there existed little differences between males and females regarding their perception of images of motherhood, and 3) in image of motherhood the elder group ( >50 years old) answered "strick" and "patient" more often than the younger group ( <30 years old) , and "warm" and "lenient" Iess than the ) younger one

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This study aims to detect characteristics of images of motherhood in patients with psychosomatic diseases and to develop a screening method for patients with psychosomatic symptoms induced by the unusual relationship between mother and child. Using a questionnaire, 114 patients with psychosomatic diseases (males 40.4%, age : l0-70 years) and a control group of 521 people (males 39.0%, age : 10-7O years) who took part in the lecture entitled "Health Education" were asked to list short words which indicated various images of motherhood. The subjects were also asked to make similar lists with womanhood, fatherhood and manhood. Approximately twenty images were incorporated. Statistical analyses were performed by chi-square test and Spearman's rank correlation coefncient. Images of psychosomatic patients were compared with those of the control group, and some important implications were observed as follows : 1) the patient group mentioned the word "strong" for the images of motherhood and womanhood, and "tender" for the images of fatherhood and manhood more frequent than control, 2) while images of fatherhood and manhood shared 7 out of 10 words, those of motherhood and womanhood shared only 4 out of 10 words, which was the same as control groups, 3) no significant differences in the images of motherhood was found between males and females and between elder and younger respondents in the patient group, and 4) a higher correlation between male and female respondents was obtained with the control group than the patients. These data suggest that patients with psychosomatic diseases have reversed perception of the gender roles as compared to the control group.

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This study was conducted to examine the self-management of technostress using a questionnaire to evaluate technostress tendency. Technostress self-management was motivated by awareness of technostress tendency based on the results of a questionnaire and was practiced by following advice on how to mitigate technostress tendency. Two hundred and eight subjects were asked to complete a questionnaire designed to evaluate technostress tendency. Using these data, subjects who had high technostress tendency were chosen and were given the following information and guidance : 1)brief explanation of technostress, 2)results of questionnaire, 3) advice on how to mitigate technostress tendency. After 2 months, a second survey was conducted to evaluate any change in technostress tendency and to obtain reports from subjects on their activities during the previous 2 months. The Wilcoxon 2-sample test was used to compare the technostress tendency scores of the tow surveys. Of 190 subjects who responded to the 1 st survey, 57 subjects had high technostress tendency. Among these, 48 subjects (23 showing a techno-centered tendency, 25 showing a techno-anxious tendency) replied the second survey. Results showed mitigation of techno-centered tendency in 21 subjects (91%) and that of techno-anxious tendency in 21 subjects (84%)・ Based on the reports- of those subjects, efforts to change activities and thoughts in order to mitigate technostress tendency were investigated. Analysis showed that the technostress tendency scores of the 2 nd survey were significantly lower than those of the 1 st survey for both techno-centered tendency and techno-anxious tendency (p<0. O1,p < O. O1) . This indicates that awareness of one's own technostress tendency can encourage individuals to pay increased attention to technostress and to recognize the importance of self-management of technostress tendency. It also indicates that self-management of technostress tendency based on such motives had a noticeable effect. In addition, it suggests that self-management encouraged by self-awareness of technostress tendency was especially effective in mitigating techno-centered tendency with less self-consciousness.

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Stress reaction is caused by stressor but the form and intensity of the reaction caused by the same stressor are various individually influenced by one's character, circumstance and many other factors. These elements are concerned in the formation of one's mode of control recognition, coping, judgment, will etc. in regard to the stressor. The mode of control which has given tendency and individual difference is considered stress tolerance. It takes much time to suspect of stress tolerance, for it needs for specialist to ask in details a circumstance, a growing history or subjective symptom etc. and needs complicated psychological test. The Stress Tolerance Check List (STCL) was made with the aim of suspecting stress tolerance as facilitative and correct as possible in 1988. In this study, the reliability analysis of STCL was performed. The subjective people were 539 men and 250 women who took health check in human dry dock. The Cronbach alpha of STCL was 0.8016,and it can be considered to own a sufficient reliability. According to the factor analysis, it contained 5 factors in STCL, cheerfulness and positive thinking, Iiberality and consideration in social relations, self-unreliability, objectivity, and enough time. But the reliability of the 5 th factor, enough time, was not high. Shortened STCL of 13 items which is formed to own the highest Cronbach alpha, O . 8243,contained 3 factors, cheerfulness and positive thinking, Iiberality and consideration in social relations, objectivity. The coefficient of correlation between STCL and SDS was -0.5906 (p<0.001) . From these results, STCL is considered to be reliable and reasonable to suspect the stress tolerance to a certain extent, but to make more reliable and proper, the questions of STCL should be investigated and changed, especially so far as the questions related to the 5 th factor.

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The purposes of this study were to develop the scale of self-efflcacy on health behavior which influences on health promotion in chronic disease patients, and to examine the relationship between self-efficacy on health behavior and psychological stress responses. In study I, items relating to self-efficacy on the prevention of disease and on motivation to promote health were collected. As a result of factor analysis of self-efficacy based on data from 220 normal subjects over the age of 30,it was revealed that the self-efficacy scale on health behavior in chronic disease patients has following two main factors : 'Active coping behavior with disease' and 'Controllability for health.' As results of t-tests between clinical subjects with chronic disease and healthy control, it was revealed that scores of self-efficacy scale on health behavior in the clinical group were significantly higher than ones in the normal group. As results of analyses, 24-item self-efficacy scale of health behavior In chronic disease patients was developed. In study II, the relationship between self-efficacy on health behavior and stress responses was investigated. As a result of analysis, subjects with high self-efficacy showed low scores in subscales in stress responses. Finally, significance of measuring self-efficacy on health behavior, and the applicaction of the selfefficacy scale on health behavior in clinical settings were discussed.

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lrritable bowel syndrome (IBS) and non-ulcer dyspepsia (NUD) are considered to be typical stressinduced diseases of the digestive system. These two diseases are considered to be caused by dysfunctions in the digestive system. We experienced a case in which the IBS seemed to change over time to NUD during the patient's long clinical course. We herein report the clinical course of the changes in the motility function of the gallbladder for this patient. The patient was a 21-year-old female. Three years ago she first complained of severe constipation and lower abdominal pain. She was admitted to our hospital with a diagnosis of IBS, and her gallbladder dilated after caerulein injection paradoxically. Because her symptoms improved after psychosomatic therapy, she was eventually discharged. The stress-induced by job-hunting caused her to develop strong upper abdominal pain. She was later diagnosed as having NUD and thus was hospitalized for the second time. Her gallbladder contracted after caerulein injection weakly but definitely, which differs apparently from the response observed during the initial admission. During the clinical course her symptoms also change along with the gallbladder motility. According to these findings, it is presumed that a generalized abnormality of the smooth muscle of the digestive tract is basically exsisted in both IBS and NUD, which can possibly cause overlapping or syndrome shift to each other.

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A case of fourteen-year-old girl with postprandial abdominal pain, nausea and vomiting is presented. Gastroscopy and abdominal ultrasonogram did not reveal any major abnormalities, although the fecal hemoglobin concentration was increased. She was referred to the Dept. of Psychosomatic Medicine because anorexia nervosa was suspected. She was quite emaciated and had not entered menarche, but was without phobia of weight gain or distortion of body image. Low grade fever and tachycardia persisted and blood test showed an inflammtory reaction. Further studies, however, including barium enema and CT of the abdomen were non contributory. Almost one year after the initial consultation, she was hospitalized and superior mesenteric artery syndrome was noted on an upper GI series and abdominal ultrasonogram. As obstruction of duodenum at the superior mesenteric artery was severe, Iaparotomy was performed. At surgery, Iongitudinal ulceration of the terminal ileum was incidentally found. Histological examination confirmed Crohn's disease. Post-operatively, the gastrointestinal symptoms settled, and her weight increased from 23 kg to 42 kg over one and half years and regular menstruation has begun. To our knowledge, there has been no previously reported case of Crohn's disease associated with superior mesenteric artery syndrome, in which the combination presented as anorexia nervosa. This paper emphasizes that each of the disorders should be considered during the differential diagnosis of anorexia nervosa.

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A 48-year old female with adrenocorticotropin (ACTH) /luteinizing hormone (LH) deficiency associated with primary hypothyroidism was found. Since the age of 32,she had been complaining of general fatigue, dizziness, nausea, anxiety and sorrow. She was diagnosed as having anxiety neurosis by her family physician and was subsequently administered anti-anxiety drugs, but her complaints did not disappear. Then, she was referred to our associated hospital. "N", at 38 years of age. The physician at "N" diagnosed her as vegetative syndrome associated with anxietyand depressive state caused by the marital problems. The psychoeducational approach to her and her husband was applied. However, since her complaints had been continued over about a 10 year period and she had been admitted several times a year, the authors were consulted by her physician. We supposed that she might be suffering from endocrine disorders, especially pituitary disorders, because of various longstanding physical and psychiatric complaints. Pituitary function was evaluated and revealed that she was suffering from ACTH/LH deficiency associated with primary hypothyroidism. Hydrocortisone and thyroid hormone replacement therapy was started, and her complaints disappeared.

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Here, we report a case of bulimia nervosa who responded positively to transactional analysis after taking Mazindol. A 20-year-old woman, who started dieting at the age of 18,consulted our hospital complaining of binge eating, cathartic drug abuse, and depressive moods. She was diagnosed as having bulimia nervosa according to DSM-III-R and admitted to our hospital. She underwent transactional analysis, behavior therapy and antipsychotic drug therapy, but she resisted and her eating behavior and depressive moods worsened. Only Mazindol, which has an appetite-suppressive effect, stopped her binge eating. Her depressive moods gradually improved after she underwent transactional analysis with the cooperation of her parent and her boyfriend. We discuss the mechanism of onset and pathology of this case from the viewpoint of transactional analysis. That the appetite-suppressive effect of Mazindol may contribute to the therapy of bulimia nervosa is suggested.

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