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Background: The novel corona virus infection (COVID-19) has immediately become a pandemic. Identifying characteristics of possible “super spreaders,” who are assumed to be a dominant cause of rapid transmission, will help in designing proper prevention strategies. Methods: We conducted a nation-wide online survey to investigate the relationship of understanding and anxiety levels about COVID-19 to possible risk behaviors for spreading the virus in Japan. In total, 4,000 citizens responded to our questionnaire during March 27 and 28, 2020. The questionnaire included several questions covering the level of fear and anxiety about COVID-19, infection preventive behaviors, access to media, level of trust in information about the virus, as well as participants’ demographic characteristics. Findings: In total, 13·7% of participants reported that they have a very low understanding of COVID-19. This study defined those participants as “indifferent individuals.” In addition, 10·6% and 12·2% of them indicated that they have no anxiety of being infected and transmission to others, respectively. We also found that 11·2% showed no worry about symptomatic aggravation, and 8·5% had no concern about spreading the infection. Indifferent individuals were less likely to access information sources than others, and do not trust the information they obtained about the virus. They were less anxious about their own health, and less likely to engage in precautionary behaviors (e.g., washing hands and avoiding crowded spaces) than other participants. Interpretation: The present study suggests it is highly important to educate those who have no concerns about COVID-19, and help them to stop their risk behaviors in order to prevent and control this viral pandemic. Funding Statement: This study was funded by a management grant provided by the Ministry of Education, Culture, Sport, Science and Technology to Chiba University Graduate School of Medicine. Declaration of Interests: The authors declare no conflict of interests regarding this study. Ethics Approval Statement: This study protocol was approved by the Ethics Committee of Chiba University Graduate School of Medicine and the Ethics Committee of the International University of Health and Welfare before implementation. Participants were informed that their participation was voluntary.

Background:Homework assignments are generally viewed as an important factor of cognitive behaviour therapy (CBT).Aim:This study examined whether perfectionists procrastinate homework assignments.Method:Thirty-eight university students attended two sessions, 7 days apart from each other. After completing perfectionism scales at the first session, they were asked to complete homework tasks from a self-help wellbeing booklet and return the booklet at session 2.Results:Only maladaptive facets of perfectionism correlated with most of the behavioural measures of procrastination. Moreover, those high in maladaptive perfectionism set and completed fewer planned activities to improve their mood.Conclusions:These findings suggest that perfectionism may affect how clients set their homework, and perfectionism may interfere with the homework assignments of CBT.

Background:It has been proposed that both positive and negative metacognitive beliefs sustain engagement in post-event processing (PEP). However, it is unknown: (1) whether individuals with social anxiety disorder (SAD) actually derive the benefits from PEP that they expect; (2) if this is not the case, how their positive beliefs are maintained; and (3) if they are aware of the counterproductive effects of PEP, why they still perform PEP.Aims:To explore the phenomenology of the processes involved in PEP from the perspective of SADs, in order to address the research questions above.Method:Twenty-one participants suffering from SAD received individual semi-structured interviews. Transcripts were analysed using thematic analysis.Results:Analysis revealed three main themes: (1) ‘Only, safe and useful way to improve myself’: SADs feel the need to improve their social performance, and they believe that PEP is the only, safe, and private way to do so, which is an underlying motive for them to do PEP; (2) ‘It hurts more than helps me’: however, through PEP, they do not seem to obtain the benefit that they expect, or only find a variety of counterproductive outcomes; (3) ‘Better safe than sorry’: they sometimes find makeshift solutions to improve their social performance during PEP, which may maintain their PEP as a form of intermittent reinforcement. They weigh up such costs and benefits, and choose to perform PEP while feeling conflicted about PEP.Conclusions:The results suggest that: (1) SADs rarely obtain the benefits from PEP that they expect; (2) their positive metacognitive beliefs are maintained by solutions they sometimes find during PEP; and (3) SADs choose to perform PEP while feeling conflicted; while PEP ironically maintains and exacerbates negative self-beliefs/images, it is the only safe and useful way to improve their social performance. These findings support and expand on the theories of PEP.

Background and objectives The perception of threat and associated feelings of anxiety typically prompt people to seek safety; reassurance seeking is an interpersonal strategy almost universally used to reduce the immediate perception of risk. Excessive Reassurance Seeking (ERS) is considered to be particularly prominent and unequivocally counter-productive in people suffering from anxiety disorders in general and OCD in particular, producing short term relief but a longer term return and worsening of the original anxiety. We evaluated the extent and specificity of the effects of ERS in OCD and mechanisms involved in both anxiety relief and the hypothesized later return of anxiety.. Method Self rated effects of reassurance seeking were investigated in 153 individuals with OCD, 50 with panic disorder, and 52 healthy controls, evaluating reactions to the provision and non-provision of reassurance. Results Reassurance is associated with short term relief then longer term return of both discomfort and the urge to seek further reassurance in both anxious groups; healthy controls do not experience significant resurgence. Greater return of anxiety and urge to seek more reassurance were associated with higher levels of overall reassurance seeking.. Limitations The findings were based on retrospective self-report of naturally occurring episodes of ERS; prospective studies and induced behaviours are now needed. Conclusions Not only is reassurance a quick fix for people experiencing OCD, but in the absence of treatment the only fix! The findings explain why reassurance seeking continues despite advice that it will worsen anxiety problems. Such advice is potentially harmful to patients and their loved ones..

Background The novel corona virus infection (COVID-19) quickly became a pandemic state. Identifying characteristics of “possible super spreaders”, suggested as a dominant cause of rapid spreading transmission, will help us to design proper prevention strategies. Methods We conducted a nation-wide online survey to investigate the relationship of perception and anxiety levels about COVID-19 to the possible risk behaviors for spread of the virus in Japan. We recruited a total of 4,000 citizens, who responded to the questionnaire including several questions regarding the level of fear and anxiety about COVID-19, infection preventive behaviors and access to media with trust level about the virus as well as some demographic and socioeconomic data during March 27th and 28th, 2020. Findings Thirteen-point-three percent of the participants rated “1” on a nine-point Likert with respect to the knowledge about COVID-19. Ten-point-one percent and 11.7% presented no anxiety of being infected and transmission to others. Ten-point-eight percent showed no worry about symptomatic aggravation. Eight-point-one percent had no serious concern about expanding infection. The distribution of these items was highly correlated with each other. Participants with the low level of knowledge about COVID-19 were likely to less frequently access any information sources and neither trust them. They were less anxious about their health status, and less likely to put precautionary behaviors such as washing hands and avoiding crowded spaces, suggested by statistical analyses. Interpretation The present study suggests that it is greatly important to enlighten those have no concerns about this crisis of COVID-19 and modify their risk behavior via various ways, in order to prevent and control this viral pandemic. Funding This study was funded by the management grand provided to Chiba University Graduate School of Medicine and the Japan Society for the Promotion of Science KAKENHI grants., Highlights ● The lack of knowledge about COVID-19 is the core cognitive trait of potential super spreaders who occupy more than 10% of citizens. ● Super spreaders may be in a vicious circle of cognitive indifference, lack of exact information, and recurrent risky behaviors. ● To stop the deterioration of pandemic of COVID-19, we should give proper knowledge to indifferent individuals with any means.

Substance Use Risk Profile Scale (SURPS; Conrod & Woicik, 2002) measures four risk personality dimensions related to substance use; anxiety sensitivity (AS), hopelessness (H), sensation seeking (SS), impulsivity (IMP). The aim of this study is to develop the Japanese version of Substance Use Risk Profile Scale (SURPS-J) and to probe the reliability and validity of this scale to the Japanese context. This study consists of the test of the factor analysis (Study 1; N = 462), the reliability (Study 2; N = 64), and the validity (Study 3; N = 182). Our findings are as below; Study 1 showed the conformed factorial structure of SURPS-J and Study 2 revealed the good test–retest reliability. Additionally, Study 3 demonstrated the adequate validity of SURPS-J and its sensitivity in identifying risky drinking motivations and lifetime tobacco and alcohol use. Results showed that high H individuals are likely to experience smoking under the personal and collective situations, while high SS and IMP individuals are prone to drink alcohol under the collective situation. Additionally, high AS individuals are prone to drink by virtue of negative reinforcement motives and high SS and IMP drink by reason of all drinking reinforcement motives.

The purpose of the present study was to explore the experience of being asked for reassurance from the perspective of carers of obsessive compulsive disorder (OCD) sufferers, and to examine its relationship to sufferers’ reassurance seeking by a direct comparison with data obtained from the person they normally offer reassurance to. Forty-two individuals with OCD and their carers completed alternate versions of the Reassurance Seeking Questionnaire. Result suggest that carers report most commonly providing reassurance when asked to do so, and the frequency of their reassurance provision is associated with how carefully sufferers seek reassurance, rather than their OCD symptom severity. The carer's perspectives on the impact of reassurance provision was accurate; both sufferers and carers perceive that reassurance works only temporarily, but even if the anxiety-relieving effect of reassurance decreases in the medium term, it is likely to be perceived as beneficial because carers accurately perceived that sufferers would feel much worse if they refused to provide reassurance. The present study is the first to quantitatively investigate carer's experiences of reassurance provision, and elucidate why carers feel the need to provide it.

Background and objectives Mental contamination is the experience of feelings of dirtiness without direct physical contact with a contaminant. Imagining a non-consensual kiss from an immoral man (Dirty Kiss task) can evoke feelings of mental contamination in non-clinical female participants. We investigated whether feelings of mental contamination evoked by the Dirty Kiss task are reduced by washing behaviours. Methods Forty-eight female participants were split into two groups: washing (n=24; asked to wash their hands and mouth after the Dirty Kiss task) and non-washing (n=24; asked to wait without engaging in any behaviour after the Dirty Kiss task). Indices of mental contamination were administered before, immediately after, 5 min after, and 20 min after the task. Results Mental contamination scores did not significantly differ between the groups at any point. However, in both groups, scores immediately after the Dirty Kiss task were significantly higher than those 5 or 20 min later. Limitations The long-term effects of washing behaviour on mental contamination were not clarified. Conclusions Mental contamination can be reduced by washing behaviour, although no more effectively than waiting without washing.

Social anxiety disorder (SAD) is characterized by significant distress regarding social performance situations. Patients experience strong embarrassment about how they are perceived by others due to increased self-focused attention. This case report presents two cases of SAD and the effects of cognitive behavioural therapy (CBT) on ‘picturing of self’ (e.g. self-picturing and self-projection). The goal was to demonstrate the changes in ‘picturing of self’ using brief video feedback (VF) as a treatment and projective drawing as an assessment method of CBT, especially with SAD. The CBT consisted of psychoeducation and case formulation, cognitive restructuring, and behavioural experiments. In one case VF was used to provide additional means by showing the patient's own actual moving figure, the self-picture. For the other case, the patient was instructed to ‘draw a person’ and the changes in drawing style were assessed. Through the course of CBT, Liebowitz Social Anxiety Scale scores reduced significantly in both cases. ‘Picturing of self’ changed as a result of the use of CBT. Brief VF and projective drawing would be useful for individuals to see the change in themselves.

Past research indicates that Self-Oriented Perfectionism (SOP: P. L. Hewitt & G. L. Flett, 1991) has been linked to psychopathology but can have both positive and negative elements. The purpose of the present study is to examine whether the relationship of SOP to positive and negative affect would be mediated by the presence of specific cognitions regarding “Personal Standards (PS),” and “Concern over Mistakes (CM)” as well as goal motivations. Two mediations involved in SOP were hypothesized: (1) in the presence of approach goals, the cognition of PS emerges from activated SOP and leads to positive affect; and (2) in the presence of avoidant goals, the cognition of CM emerges from activated SOP and leads to negative affect. In Study 1, 358 college students completed the research questionnaire, and structural equation modeling was used to test the mediation model. In Study 2, 60 participants, 30 rated high and 30 rated low in SOP, were presented with either an approach or an avoidant goal for an experimental task, and asked to rate their perfectionism cognitions and affects. The findings provided partial support for the hypotheses.

Mental contamination is the experience of contamination-related feelings of dirtiness despite the absence of direct physical contact with a contaminant. These feelings of dirtiness may be evoked by unwanted thoughts and memories of negative events such as ill treatment or sexual assault. This paper is composed of two related studies. The aim of Study 1 (n = 202 for factor analysis; n = 81 for test–retest reliability) was to develop a Japanese version of the Mental Pollution Questionnaire (MPQ–J), an instrument for measuring mental contamination. The aim of Study 2 (n = 236) was to confirm this instrument’s psychometric properties and to test the hypothesis that cognitions related to responsibility and morality predict feelings of mental contamination. After conducting factor analyses, the final version of the MPQ–J yielded eight items and two subscales. The psychometric properties of the MPQ–J were verified by examining correlations with general psychopathology measures. Hierarchical regression analyses s...

Obsessive–compulsive disorder (OCD) affects roughly 2.5% of the general population [1]. An anxiety–based disorder, OCD is characterized by persistent, intrusive, and distressing obsessions (thoughts, impulses, or images) or compulsions (repetitive, excessive behaviours or mental acts) [1]. Similar to the U.S., nationwide prevalence of OCD in Japan is approximately 2% [2]. In one study, researchers administered the Yale–Brown Obsessive Compulsive Scale (Y–BOCS) symptom checklist [3] to 343 Japanese patients with OCD to examine whether symptom dimensions were stable across cultures. They found that the OCD symptom structure has substantial transcultural stability across Western and Eastern cultures [4]. Fear of contamination features prominently in approximately half of all cases of OCD [5] e.g., ‘I avoid using public toilets because I am afraid of disease or contamination’). In generally, these feelings of dirtiness may be evoked by contact with a contaminant or dirt. However, there is also another type of contamination that may be experienced without physical contact with a contaminant [6,7]. This phenomenon, first identified by Rachman [8], is called mental contamination

Regarding self–conscious emotions, studies have shown that different forms of perfectionism show different relationships with pride, shame, and embarrassment depending on success and failure. What is unknown is whether these relationships also show cultural variations. Therefore, we conducted a study investigating how self–oriented and socially prescribed perfectionism predicted pride and embarrassment after success and failure by comparing 363 British and 352 Japanese students. Students were asked to respond to a set of scenarios where they imagined achieving either perfect (success) or flawed (failure) results. In both British and Japanese students, self–oriented perfectionism positively predicted pride after success and embarrassment after failure, whereas socially prescribed perfectionism predicted embarrassment after success and failure. Moreover, in Japanese students, socially prescribed perfectionism positively predicted pride after success and self–oriented perfectionism negatively predicted pride after failure. The findings have implications for our understanding of perfectionism, indicating that the perfectionism–pride relationship not only varies between perfectionism dimensions but may also show cultural variations. Copyright © 2012 John Wiley & Sons, Ltd.

Background: Mental contamination is a psychological sense of contamination that involves an internal, emotional feeling of dirtiness that may be evoked by unwanted thoughts and images, such as sexual assaults. Aims: This study aimed to investigate which types of unwanted sexual experiences evoke the strongest mental contamination, and to test the hypothesis that cognitive appraisals of an unwanted sexual experience predict indices of mental contamination (i.e. feeling of dirtiness, urge to wash, internal negative emotions, and external negative emotions). Method: 148 female participants were asked to recall their most distressing unwanted sexual experiences. Indices of mental contamination and cognitive appraisals of the experience were then assessed. Results: Our findings indicated that individuals recalling experiences related to rape felt more intense feelings of dirtiness than individuals recalling other types of unwanted sexual experience, such as verbal sexual assault, visual sexual assault, and forcible touching/frottage. In addition, hierarchical regression analyses demonstrated that a cognitive appraisal of perceived violation predicted all of the indices of mental contamination after controlling anxiety, depression, and fear of contact contamination. Conclusions: The present study demonstrated that an individual is at greatest risk of mental contamination if she has experienced rape/attempted rape, and if she makes a cognitive appraisal of violation regarding the incident.

Reassurance seeking is a common problem in clinically anxious populations, and is particularly obvious in obsessive–compulsive disorder (OCD). This study seeks to examine the way individuals with OCD try to seek reassurance and the perceived consequences of such reassurance seeking using a qualitative analysis of the perspectives of individuals with OCD who seek reassurance from other people. A semi-structured interview was employed to ask individuals with OCD to reflect on occasions when they sought reassurance, and its impact on themselves and others. Ten interviews were conducted, transcribed, and analysed in detail using thematic analysis. Four overarching themes were identified in terms of reassurance seeking; interrogating feelings to achieve a sense of certainty, ceaseless and careful effort, reluctance to seek reassurance, and interpersonal concern. A thematic map was produced to understand the relationship between themes and sub-themes.

The Multidimensional Perfectionism Cognitions Inventory (MPCI; Kobori & Tanno, 2004) is a promising new instrument developed in Japan to assess perfectionism cognitions regarding personal standards, pursuit of perfection, and concern over mistakes. In this study, we examined reliability and validity of the English version of the MPCI, the MPCI-E (Kobori, 2006), in a sample of 371 native English speakers. A confirmatory factor analysis confirmed the MPCI-E's 3-factorial oblique structure. Moreover, correlations with measures of dispositional perfectionism and past-week positive and negative affect provided initial evidence of the MPCI-E's convergent and differential validity. Finally, hierarchical multiple regressions indicated that the MPCI-E showed incremental validity in explaining variance in positive and negative affect above variance explained by dispositional perfectionism. Overall, the findings provide initial evidence for the reliability and validity of the MPCI-E as a multidimensional measure of perfectionism cognitions that has the potential to further the understanding of positive and negative cognitions in perfectionism.

Setting high standards is one of the core aspects of perfectionism. Shafran, Cooper, and Fairburn (2002) proposed that individuals with self-imposed perfectionism raise their standards after they successfully meet them. This study examines whether individuals with self-imposed perfectionism raise their goal after the feedback of success. Fifty-three college students, whose self-oriented perfectionism (SOP; Hewitt & Flett, 1991) was assessed, performed a task with a goal, and received feedback of success. Following the feedback, they were asked to choose (a) the same goal or (b) a more difficult goal for the next task. The logistic regression analysis revealed that the greater the SOP, the more likely the participants were to choose the difficult goal. The theoretical and clinical implications for the standard setting of perfectionism were discussed.

Individual temperamental factors that contribute to the development of two perfectionism traits were studied in 428 Japanese undergraduate students using the Multidimensional Perfectionism Scale (MPS) and Temperament and Character Inventory (TCI). The results showed that self-oriented perfectionism is associated with the temperamental characteristics of low novelty seeking, high reward dependence, and high persistence. In contrast, socially prescribed perfectionism is associated with low novelty seeking and high harm avoidance. Hierarchical regression analysis revealed that these temperaments primarily predicted self-oriented perfectionism, controlling for socially prescribed perfectionism. These temperamental characteristics did not predict socially prescribed perfectionism when self-oriented perfectionism was controlled.