BackgroundCoping, the cognitive and behavioral effort required to manage the effects of stressors, is important in determining psychological stress responses (ie, the emotional, behavioral, and cognitive responses to stressors). Coping was classified into categories of emotional expression (eg, negative feelings and thoughts), emotional support seeking (eg, approaching loved ones to request encouragement), cognitive reinterpretation (eg, reframing a problem positively), and problem solving (eg, working to solve the problem). Stress mindset refers to the belief that stress has enhancing (stress-is-enhancing mindset) or debilitating consequences (stress-is-debilitating mindset). This study examined whether coping mediated the relationship between stress mindset and psychological stress responses. Psychological stress responses were conceptualized as depression-anxiety, irritability-anger, and helplessness. The following two hypotheses were tested: 1) a stronger stress-is-enhancing mindset is associated with less frequent use of emotional expression, emotional support seeking, and problem solving, which in turn is associated with lower levels of depression-anxiety, irritability-anger, and helplessness; 2) a stronger stress-is-debilitating mindset is associated with more frequent use of these coping strategies, which in turn is associated with higher levels of these psychological stress responses.Materials and methodsThe participants were 30 male and 94 female undergraduate and graduate students (mean age =20.4 years). Stress mindset, coping, and psychological stress responses were measured using self-report questionnaires. Six mediation analyses were performed with stress-is-enhancing mindset or stress-is-debilitating mindset as the independent variable, one of the psychological stress responses as the dependent variable, and the four coping strategies as mediators.ResultsEmotional expression partially mediated the relationship between a strong stress-is-debilitating mindset and higher irritability-anger levels. The other three coping strategies did not exhibit mediating effects. None of the coping strategies mediated the relationship between a stress-is-enhancing mindset and psychological stress responses.ConclusionThese results provide initial evidence that stress mindset is associated with psychological stress responses, through coping strategies.

BackgroundThere are many different skill components used in cognitive behavioural therapy (CBT). However, there is currently no comprehensive way of measuring these skills in patients.ObjectiveTo develop a comprehensive and brief measure of five main CBT skills: self-monitoring, behavioural activation, cognitive restructuring, assertiveness training and problem-solving.MethodsUniversity students (N=847) who participated in a fully factorial randomised controlled trial of smartphone CBT were assessed with the CBT Skills Scale, the Patient Health Questionnaire-9 (PHQ-9), the Generalised Anxiety Disorder-7 (GAD-7) and the short form of the Japanese Big Five Scale. Structural validity was estimated with exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), and internal consistency evaluated with Cronbach’s α coefficients. Construct validity was evaluated with the correlations between each factor of the CBT Skills Scale, the PHQ-9, the GAD-7 and the Big Five Scale.FindingsThe EFA supported a five-factor solution based on the original instruments assessing each CBT skill component. The CFA showed sufficient goodness-of-fit indices for the five-factor structure. The Cronbach’s α of each factor was 0.75–0.81. Each CBT skills factor was specifically correlated to the PHQ-9, GAD-7, and the Big Five Scale.ConclusionsThe CBT Skills Scale has a stable structural validity and internal consistency with a five-factor solution and appropriate content validity concerning the relationship with depression, anxiety and personality.Clinical implicationsThe CBT Skills Scale will be potential predictor and effect modifier in studying the optimisation of CBT interventions.Trial registrationCTR-000031307.

BackgroundPositivity refers to “a general tendency to view life and experiences with a positive outlook”. Enhanced positivity has been linked with decreased negative affect and increased positive affect, but rather little is known about the factors that mediate these relationships. One potential such factor is perceived stress, which refers to how one appraises life situations as stressful. This study examined the mediating effects of perceived stress on the associations of positivity with negative and positive affect. Two hypotheses were tested: 1) positivity is negatively associated with perceived stress, which in turn is positively associated with negative affect, and 2) positivity is negatively associated with perceived stress, which in turn is negatively associated with positive affect.MethodsAn online survey was conducted with 100 Japanese men and 100 Japanese women who were members of a survey company in January 2018. They completed questionnaires on positivity, perceived stress, and negative and positive affect. All survey procedures were managed and conducted by a web-survey company.ResultsMediation analyses indicated that perceived stress was a mediator in the relationship between positivity and negative affect. Perceived stress was also found to be a mediator in the relationship between positivity and positive affect.ConclusionPositivity was found to be associated with negative affect and positive affect via perceived stress.

BackgroundDysfunctional attitudes are beliefs and attitudes that induce negative thoughts about the self, others, and the future, leading to depression. Perfectionistic dysfunctional attitudes are beliefs and attitudes about achievement and excessive fear of failure, while dependent dysfunctional attitudes are beliefs and attitudes about dependency on, and approval from, others. Subthreshold depression refers to a depressive state that does not meet the diagnostic criteria for a major depressive episode. This study examined whether the difference in perfectionistic dysfunctional attitudes between college students with subthreshold depression and those with no depression would be greater than that of dependent dysfunctional attitudes.MethodsParticipants were defined as having subthreshold depression if they scored 16 or higher on the Japanese version of the Center for Epidemiologic Studies Depression Scale but did not meet the diagnostic criteria for a major depressive episode, as assessed by the major depressive episode module of the Mini-International Neuropsychiatric Interview. The participants included 21 male and 87 female college students, with a mean age of 20.3 years. Dysfunctional attitudes were evaluated with the Japanese version of the 24-item Dysfunctional Attitude Scale.ResultsOf the 108 students, 34 had subthreshold depression while 74 had no depression. The magnitudes of the differences in perfectionistic and dependent dysfunctional attitudes between the students with subthreshold depression and those with no depression were large (Cohen’s d=0.83) and small (Cohen’s d=0.25).ConclusionThe results of this study provide the first evidence that the difference in perfectionistic dysfunctional attitudes between college students with subthreshold depression and those with no depression is greater than that of dependent dysfunctional attitudes.

Background Sleep problems interfere with work performance. Decreased work productivity due to health problems is defined as presenteeism. Although empirical data on the improvement of presenteeism by sleep interventions have been published, a systematic review elucidating whether there is a difference in the improvement of presenteeism across various types of sleep interventions has not yet been published. This systematic review of studies aimed to clarify which sleep interventions are more likely to be effective in improving presenteeism. Methods The electronic databases PubMed, PsycINFO, and MEDLINE were used to perform a literature search (the start and end search dates were October 20, 2019, and March 11, 2020, respectively). A combination of terms such as “employee*,” “sleep,” “insomnia,” and “presenteeism” was used for the search. Both randomized and non-randomized control trials were included in this systematic review. Results Six types of sleep interventions were identified, including cognitive behavioral therapy for insomnia (CBT-I), sleep hygiene education, yoga, mindfulness, weight loss program, and changing the color temperature of fluorescent lights in the workplace. Only CBT-I improved both sleep problems and presenteeism compared with a control group. The results of this review also show that there is heterogeneity in the measurement of presenteeism. Conclusions The results of this systematic review suggested that CBT-I could be adapted for workers with sleep problems and presenteeism. We discussed whether CBT-I improved both sleep problems and presenteeism compared with other interventions. In addition, methods for measuring presenteeism in future research are proposed.