Development and validation of the 22‐item Tarumi's Modern‐Type Depression Trait Scale: Avoidance of Social Roles, Complaint, and Low Self‐Esteem (TACS‐22)

Abstract

Aim Understanding premorbid personality is important, especially when considering treatment selection. Historically, the premorbid personality of patients with major depression in Japan was described as Shuchaku‐kishitsu [similar to Typus melancholicus], as proposed by Shimoda in the 1930s. Since around 2000, there have been increased reports in Japan of young adults with depression who have had premorbid personality differing from the traditional type. In 2005, Tarumi termed this novel condition ‘dysthymic‐type depression,’ and more recently the condition has been called Shin‐gata/Gendai‐gata Utsu‐byo [modern‐type depression (MTD)]. We recently developed a semi‐structured diagnostic interview to evaluate MTD. Development of a tool that enables understanding of premorbid personality in a short time, especially at the early stage of treatment, is desirable. The object of this study was to develop a self‐report scale to evaluate the traits of MTD, and to assess the scale's psychometric properties, diagnostic accuracy, and biological validity. Methods A sample of 340 participants from clinical and community settings completed measures. Psychometric properties were assessed with factor analysis. Diagnostic accuracy of the MTD traits was compared against a semi‐structured interview. Results The questionnaire contained 22 items across three subscales, thus we termed it the 22‐item Tarumi's Modern‐Type Depression Trait Scale: Avoidance of Social Roles, Complaint, and Low Self‐Esteem (TACS‐22). Internal consistency, test–retest reliability, and convergent validity were all satisfactory. Among patients with major depression, the area under the curve was 0.757 (sensitivity of 63.1% and specificity of 82.9%) and the score was positively correlated with plasma tryptophan. Conclusion The TACS‐22 possessed adequate psychometric properties and diagnostic accuracy in an initial sample of Japanese adults. Additional research on its ability to support clinical assessment of MTD is warranted.

Hikikomori : Multidimensional understanding, assessment, and future international perspectives

“…The commonality between hikikomori and MTD is social evasion tendency and we have proposed that the prolongation of MTD may be an important factor in the occurrence of hikikomori . The premorbid characteristics of MTD are self‐centeredness, socially evasive and narcissistic tendencies, easy traumatization, and low resilience, which correspond to hikikomori features …”

Prototypes in psychiatry and the structure of clinical empathy

“…in this issue are welcome interventions from psychiatrists concerned about the recognition of distress and the structure of empathy, particularly for those whose ailment is treated dismissively. Kato et al . discuss Tarumi's concept of modern‐type depression, which illuminates the power of such prototypes in capturing the complexity of people's distress and the importance of cultivating understanding of the social forces behind their predicament.…”

“…This may be because the Japanese prototype of depression (Typus melancholicus) led to insufficient recognition of women's suffering. The recent rise of depression as a 'global burden'a problem of labor and an object of economic imperativehas brought gender equality to the diagnosing of depression, 2,3 while generating debates about how seemingly scientific psychiatry can also be profoundly moral.The papers by Kato et al 4 and Kashihara et al 5 in this issue are welcome interventions from psychiatrists concerned about the recognition of distress and the structure of empathy, particularly for those whose ailment is treated dismissively.Kato et al 4 discuss Tarumi's concept of modern-type depression, which illuminates the power of such prototypes in capturing the complexity of people's distress and the importance of cultivating understanding of the social forces behind their predicament. Kashihara et al 5 effectively employ a comparative perspective in investigating lay people's understandings of depression in Japan and the USA.…”

“…The papers by Kato et al 4 and Kashihara et al 5 in this issue are welcome interventions from psychiatrists concerned about the recognition of distress and the structure of empathy, particularly for those whose ailment is treated dismissively.…”

“…Kato et al 4 discuss Tarumi's concept of modern-type depression, which illuminates the power of such prototypes in capturing the complexity of people's distress and the importance of cultivating understanding of the social forces behind their predicament. Kashihara et al 5 effectively employ a comparative perspective in investigating lay people's understandings of depression in Japan and the USA.…”