Research on stress disorders is said to have begun with studies on hysteria in the late 19th century. Subsequently, the studies on “war neurosis” were actively conducted because many soldiers returning from wars such as World War I and the Vietnam War were found to suffer from psychiatric sequelae. In 1980, posttraumatic stress disorders (PTSD) was conceptualized as a disease by the American Psychiatric Association. In Japan, PTSD has become widely known as a result of natural disasters such as the Great Hanshin-Awaji Earthquake and the Great East Japan Earthquake, and criminal incidents such as the Sarin gas attack and the Akihabara street riots. Then, in 2018, the International Classification of Diseases 11th Revision recognized a new mental disorder, namely, complex post-traumatic stress disorder. Thus, in this special issue, we asked four doctors who specialize in PTSD and are active in the field to discuss the diagnosis, treatment, and support methods for PTSD based on their own research and clinical experiences. This special issue provides current information on the diagnosis, pharmacotherapy, and psychotherapy of PTSD, as well as the concept and approach to support for victims and survivors, and points to note. This special issue, that provides important insights into PTSD, will be of assistance to those engaged in the treatment of and support for PTSD.

Posttraumatic stress disorder (PTSD) is a common stress-related mental disorder that can occur after experiencing a traumatic event. In this review, I first summarize the concept, diagnosis, and epidemiology of PTSD. In diagnosing PTSD, it is important to ascertain traumatic events based on official diagnostic criteria. Then, the standard pharmacotherapy for PTSD is outlined by referring to the well-established evidence and treatment guidelines. There is currently a dearth of pharmacological treatment options for PTSD, with only two selective serotonin reuptake inhibitors (i.e., paroxetine and sertraline) being approved and covered by insurance, while trauma-focused psychotherapy such as prolonged exposure therapy is known to be highly effective and recommended as the first-line treatment for PTSD in several international guidelines. Still, there are many cases in which pharmacotherapy is important, such as in patients who are severely ill and those with comorbid psychiatric disorders. Since pharmacotherapy can be readily implemented in everyday practice, it is hoped that more effective medications that target the mechanisms underlying PTSD are developed and individuals with this disorder can enjoy the benefits of medical treatment. In addition, healthy lifestyles and dietary habits may also be beneficial for individuals with PTSD.

Clinical practice guidelines for posttraumatic stress disorder (PTSD) from various agencies recommend trauma-focused psychotherapies as the first-line treatment. Commonly recommended therapies include Prolonged Exposure Therapy, Cognitive Processing Therapy, and Eye Movement Desensitization and Reprocessing. After introducing the core elements of empirically supported psychotherapies for PTSD, this paper focuses first on Prolonged Exposure Therapy, which has been covered by health insurance in Japan since 2016, explaining its theoretical foundation and treatment details. The second half of the paper addresses therapeutic approaches for complex PTSD, newly adopted in the International Classification of Diseases, 11th Revision (ICD-11). Given the more pervasive and multifaceted nature of complex PTSD, treatment guidelines recommend integrating multiple therapeutic components to address these broader challenges. Trauma-focused therapies may need to be adapted to accommodate the specific needs of individuals with complex PTSD. In this context, the paper introduces Skills Training in Affective and Interpersonal Regulation (STAIR) Narrative Therapy, a multicomponent therapeutic model specifically designed for complex PTSD.

This study examines the challenges and approaches in providing mental health support to survivors with PTSD following the Great East Japan Earthquake, tsunami, and nuclear accident of 2011, based on clinical experience in Minamisoma City, Fukushima Prefecture. The paper first outlines the principles of disaster psychiatry and Psychological First Aid (PFA), emphasizing the importance of ensuring safety and security. Through case studies of elderly evacuees and disaster response workers, it illustrates how the disruption of community ties and prolonged evacuation significantly impacted mental health outcomes. Analysis of clinical records from a psychiatric clinic established in 2016 revealed high treatment discontinuation rates (58.5%) among PTSD patients and insufficient intervention for substance use disorders. The study also presents cases where Prolonged Exposure (PE) therapy was successfully implemented, demonstrating its effectiveness in treating complex trauma resulting from both disaster experiences and pre-existing conditions. The findings suggest that while standard psychiatric care should be consistently available in disaster-affected areas, specialized trauma-focused interventions should be introduced only after basic stability has been established. This staged approach aligns with current disaster mental health intervention frameworks.

Crimes have a significant impact on victims and their families, often leading to the development of post-traumatic stress disorder (PTSD). For professionals in victim support, it is essential to learn how to address PTSD effectively. This paper introduces the provision of trauma-focused cognitive behavioral therapy for crime victims by Victim support center of Tokyo. It also discusses the assessment perspectives necessary for implementing trauma-focused cognitive behavioral therapy, the psychological support provided through psychoeducation and self-management, and the systems that facilitate the implementation of trauma-focused cognitive behavioral therapy.

The insomnia symptom is a serious problem in Japan. Various cognitive factors have been shown to be involved in insomnia, and in Harvey’s (2002) model, dysfunctional beliefs about insomnia leads to negative cognitive activity, which keeps people awake at night and leads to sleep disturbances. It has been also pointed out that different types of rumination have different effects on insomnia symptoms. In this study, based on Harvey’s (2002) model, we examined the process in which two types of rumination, Brooding and Reflection, affect insomnia symptoms using Structural Equation Modeling. The results showed that Blooding is caused by dysfunctional beliefs about sleep, and that it leads to insomnia symptoms by promoting pre-sleep arousal. It was also shown that Reflection was not caused by dysfunctional beliefs about sleep, did not lead to pre-sleep arousal, and suppressed insomnia symptoms. In addition, the effects of depressive symptoms, fear of corona and sleep hygiene (frequency of alcohol consumption, smoking, caffeine use), and habits (time in bed, nap time) on insomnia symptoms and cognitive factors related to insomnia were also examined.

The purpose of this study was to investigate the relationships among the desirability of other person’s perspectives on assertions, the assertions and interpersonal stress in tate-yoko interpersonal relationships. A hypothetical model of the desirability of other person’s perspectives, assertions, and interpersonal stress was developed based on previous researches. The participants were 207 university students. We assumed tate (e.g., teachers or superiors person)-yoko (e.g., friends or colleagues) interpersonal relationships and assessed assertions and the desirability in other person’s perspectives in conflict scenes using questionnaires. In order to assess the interpersonal stress, we also administered an interpersonal stress event scale. The results of path analysis suggested that the desirability of other person’s perspectives in tate relationships was associated with assertions to tate relationships. Assertions to tate relationships contributed to the reduction of interpersonal stress. In contrast, assertions to yoko relationships contributed to the increase of interpersonal stress. These results indicate that assertions in conflict situations have the effect of decreasing or increasing interpersonal stress depending on the interpersonal relationship. These results were discussed the influence of the interpersonal relationship and other person’s perspectives to the assertions on the assertions and the interpersonal stress.

This study aimed to investigate the relationship between Psychological capital (PsyCap) and perceived stress, as well as the mediating effects of six different coping strategies at work. A web-based survey was conducted with 3,000 office workers—2,193 males, 804 females, and 3 unknown, ; the participants’ mean age was 47.38 (SD: 8.7; range: 18-59)—. The measures included the Japanese version of the PCQ24, the Japanese version of the Perceived Stress Scale (PSS), and the Brief Scales for Coping Profile (BSCP), which consists of six coping factors. Structural Equation Modeling (SEM) suggested that PsyCap had a direct negative effect on perceived stress, an indirect positive effect on perceived stress through “Active solution” coping, and an indirect negative effect on perceived stress through “Changing a point of view” and “Avoidance and suppression” coping. These findings indicate that PsyCap has the dual impact of either reducing or increasing perceived stress directly or indirectly through these coping styles. Also, increased perceived stress through “Active solution” coping may result in positive outcomes after overcoming the temporary increase in stress. Future research should investigate the relationship of PsyCap between positive outcomes in the context of stress science research.

In recent years, how to has developed measures to mental health of employees is a major challenge for enterprises. It is important to take organizational characteristics into account when people adopt measures to manage stress in the workplace. The purpose of this study was to investigate the effect of characteristics of organizational culture on “Sence of Coherence” (SOC) and Depression. Data from 654 respondents who were full-time, white-collar workers were used. Descriptive statistics of the scale scores of the data were calculated to check for differences in means by gender. Next, we conducted a correlation analysis between SOC and depression, gender, and organizational culture characteristics. Finally, multiple regression analysis (stepwise method) was performed. The results indicated that women were more likely to be depressed by gender and those with higher market culture were also more likely to be depressed; those with higher SOC and those with higher clan culture were less likely to be depressed; and those with higher SOC and those with higher clan culture were more likely to be depressed.

There is a need to prevent depression among part-time high school students. Thus far, a classroom-based depression prevention program using the cognitive restructuring method has been implemented. In this study, we developed and evaluated of a depression prevention program using the cognitive restructuring method for part-time high school students in a regular course schedule. Forty-one part-time high school students who were enrolled in a regular course were analyzed. Depression and cognitive distortions in interpersonal situations were measured before and after the program and at the 3-month follow-up. Immediately after the program, participants were asked to evaluate the program and describe their impressions. The results showed no improvement in depression, but improvement in cognitive distortions such as a lack of self-confidence, self-deprecation, and exclusion of others. Participants also indicated that they found the program useful and actively participated in it. Finally, through the analysis of the participants’ impressions using text mining, issues to be addressed in the implementation of this program were presented.

This study aimed to identify factors related to unmasking anxiety, with a focus on the aspect of physical appearance. In this study, body dysmorphic concern and appearance shame were addressed as factors related to unmasking appearance anxiety. In addition, social anxiety and the underlying public self-consciousness and desire to avoid rejection were also addressed. The results of the analysis revealed gender differences, where appearance-related factors were not found to be related to unmasking appearance anxiety for males, but public self-consciousness and social anxiety were related to it. On the other hand, for females, body dysmorphia concerns were found to be related to unmasking appearance anxiety.

This study examined the relationships between reappraisal as coping with future anxiety, and positive and negative anxiety among adolescents. We focused on two reappraisal sub-strategies: technical-analytic-problem solving and explicitly positive. The participants were 119 undergraduate and graduate students, and they completed an online survey. The results of the path analysis indicated that technical-analytic-problem solving was negatively related to negative anxiety and explicitly positive was positively related to positive anxiety, suggesting that the two reappraisal sub-strategies are effective as coping with future anxiety.

The purpose of this study was to investigate the factors that contribute to Post Traumatic Growth (PTG) following hurtful experiences, specifically focusing on self-disclosure and deliberate rumination. The mediation analysis was conducted using data from 205 undergraduate and graduate students who completed the online survey. The results showed that deliberate rumination had mediating effects on both the total and subscale scores of PTG, and that not only a mediating effect but also a direct influence of self-disclosure was significant for the relationships with others of PTG. These findings indicate that deliberate rumination is a critical factor in promoting PTG.

The authors conducted a questionnaire survey of prison staffs and found that burnout scores (Japanese Burnout Scale: JBS) were generally higher for prison officers and education, investigation, and work specialists (n = 91) than for nurses, care workers, and teachers. Among environmental factors, job autonomy was found to determine all three burnout factors, as well as to reduce the intention to leave the job through emotional exhaustion and personal accomplishment. Based on these results, we discussed the importance of focusing on the mental health of prison staff who support the Japanese penal institutions.

This research focuses on developing and validating self-report measures to assess aggressive behaviors via LINE and Twitter (X) platforms. The authors developed item pools for evaluating aggressive behaviors via LINE and Twitter based on existing scales or items assessing behaviors on the internet. Undergraduate students (N = 350) responded to these item pools, and measures of internet trolling, aggressive behaviors in real life, sadistic tendencies, and Big Five personality traits. Based on the results of exploratory factor analysis, the authors developed the Aggressive Behaviors via LINE Scale and the Aggressive Behaviors via Twitter Scale, each with a one-factor structure and high internal consistency. Further, correlations between the scales’ scores and validity measures indicated acceptable construct validity of the scales. These scales could be valuable tools for future research examining the determinants of aggressive behaviors via LINE and Twitter.