Reseach project

Unlike survival time and objective examinations, patient-reported outcomes, such as quality of life (QOL) and pain from symptoms, are outcomes that should be reported by the patients themselves. We are conducting development of QOL/PRO scales, especially those for children.

Even though QOL/PRO measurement is imoortant, it is often difficult. Patients/children are often cognitively, physically and psychosyocially developing. Medical practitioners also seldom know how to implement and interpret the measurement. We are working to resolve these issues.

1-1. Research on IPV during pregnancy and its impacts on perinatal mental health and infant abuse

・Prevence of IPV during pregnancy and its risk factors15.9%
The prevalence of IPV during pregnancy was 15.9% and its risk factors were being over 30 years old, having had an abortion in the past, and having a partner under 30 years old.
Kita S, Kataoka Y, Porter SE. Prevalence and risk factors of intimate partner violence among pregnant women in Japan. Health Care for Women International, 35(4), 442-457, 2013.

・Development of a screening tool using two-item to measure IPV during pregnnancy
We developed the japanese version of the Woman Abuse Screen Tool (Japanese version of WAST) and its validity and reliabiity This scale using only two-item is less burdensome for pregnant women and can be safely used in prenatal check-ups.
Kita S, Haruna M, Hikita N, Matsuzaki M, Kamibeppu K. Development of the Japanese version of the Woman Abuse Screening Tool-Short. Nursing and Health Sciences, 19(1), 35-43, 2017.

●Impacts of IPV during pregnancy on postnatal depression, mother-to-infant bonding failure, and infant abuse and its psycho-social mechanisms
・IPV during pregnacy impacted on postnatal depression and mother-to-infant bonding failure and its relationships were mediated by prenatal depression.
Kita S, Haruna M, Matsuzaki M, Kamibeppu K. Associations between intimate partner violence (IPV) during pregnancy, mother-to-infant bonding failure, and postnatal depressive symptoms. Archives of Women’s Mental Health, 9(4), 623-634, 2016.

・IPV during pregnancy and postnatal periold impacted on infant abuse: Approximately 2 to 3 times higher for infant abuse among victims of IPV compared to non-victims.
Kita S, Chan KL, Tobe H, Hayashi M, Umeshita K, Matsunaga M, Uehara N, Kamibeppu K. A follow-up study on the continuity and spillover effects of intimate partner violence during pregnancy on postnatal child abuse. Journal of Interpersonal Violence, 2019 (Ahead of print; doi: 10.1177/0886260518821460)

・IPV during pregnancy impacted on postnatal deperssion and monther-to-infant bonding failure and its relationships were mediated by perceived social supports during pregnnacy.
Kita S, Hayashi M, Umeshita K, Tobe H, Uehara N, Matsunaga M, Kamibeppu K. Intimate partner violence and maternal child abuse: The mediating effects of mothers’ postnatal depression, mother-to-infant bonding failure, and hostile attributions to children’s behaviors. Psychology of Violence, 10(3), 279-289, 2020.

・The relationship between IPV during pregnancy and infant abuse was mediated by mother’s hostile attributions, not postanatal depression and mother-to-infant bonding failure.
Kita S, Haruna M, Matsuzaki M, Kamibeppu K. Does antenatal social support affect the relationships between intimate partner violence during pregnancy and perinatal mental health? Violence Against Women, 26(6-7), 573-589, 2020.

・IPV during pregnancy impacted on mother-to-fetus bonding failure and its relationship was mediated by negative feeligns towards pregnancy
Kita S. Umeshita K, Tobe H, Hayashi M, Kamibeppu K. Intimate partner violence, negative attitudes towards pregnancy, and mother-to-fetus bonding failure among Japanese pregnant woman. Violence and Victims, 34(3), 536-547, 2019.

1-2. Identifying family poly-victimization and development a scale to measure the phenomenon. 

・Family violence is defined as the co-occurence and intergenerational trasimission of violence, such as IPV, child abuse and elder abuse.

・Chiilhood abuse increased 1.7 times higher risk for infant abuse: IPV for 3.4 times higher; both of IPV and childhood abuse for 5.2 time higher.
Kita S, Tobe H, Umeshita K, Hayashi M, Kamibeppu K. Impact of intimate partner violence and childhood maltreatment on maternal-infant maltreatment: A longitudinal study. Japan Journal of Nursing Sciences, 18(1), e12373, 2021.

・Development of the Japanese version of the Family Polyvictimization Scale (FPS=J)

2-1. Research on health among victims of violence

・76%, 50% and 68% of mothers who had experienced IPV have experienced PTSD, depression, and anxiety and 63% and 48% of their children have experienced internal and exetrnal problems at averagely 7 years after terminting the victimization of violence. 

2-2. Research on trauma recovery among surviviors of violence

We have been conducting a mixed method study using a unique narrative interveiw method (Clinical Enthographic Narrative Interview：CENI）to identify the trauma recovery process among surviviors of IPV and develop effective interventions to enhance their holistic health and recovery.

3-1. Research on development of training program to prevent child abuse for citizens: Community Based Participatrory Resaearch: CBPR)

・We have developed the Training program for Child Abuse Prevention for Citizens (TCAP-C) in collaborations with citizens, admistrative staff, health professionals, and researchers and tested its effects and accepatibility.

3-2. Research on effective interventions on abused children

・The relationship between the exposure of IPV and child’s QOL were moderated by the use of childcare services such as daycare and nursery services.(Kita et al., 2020)

●Resilience is “the ability to bounce back in the face of adversity or major stress. Like the word “stress,” resilience was originally a physical term, but it came to be used as a psychological term in the 1960s when resilience research began to address the question of what differentiates children who experience serious adversity, such as war, poverty, or abuse, from those who do not develop normally. Today, resilience is an important focus in many areas, including organizations and environments. Resilience can be enhanced by anyone, at any age. Resilience of parents has a significant impact on the resilience of their children.

●Among these, we developed a program focusing on anger management, communication, positive outlook and self-esteem/self-efficacy, which have a significant impact on family relationships, and tested its effectiveness in a randomized controlled trial. The results showed that the intervention group, who attended the program four times, showed greater resilience, self-esteem, anger toward their children, and self-esteem/self-efficacy than the control group immediately after the intervention and two months later. The intervention group showed improvements in resilience, self-esteem, anger expression toward children, anger control toward children, positive attitudes toward children’s inappropriate behavior, parenting feelings, and problem-focused coping, immediately after the intervention and two months after the intervention.

●The collaborative activities in Mishima City in Shizuoka Prefecture over many years was reported in December, 2022 issue of Public Health Nurses Journal by Igakushoin Co. LTD.

https://www.igaku-shoin.co.jp/journal/detail/40256

● Based on the results, I have been invited to give lectures and workshops in various locations to mothers, fathers, and professionals in the field of child rearing. A guidebook for nursing professionals and supporters, as well as for couples and mothers to continue learning and training together, will be published by Igaku Shoin Co.Ltd. (2023)

● An increasing number of mothers are experiencing stress from child rearing, and the emotions they feel are more anger than anxiety after the child is 18 months old. In addition to physical abuse, psychological abuse also damages the child’s brain and increases the child’s risk of depression and borderline personality disorder. It can also increase developmental disorder-like symptoms and create a vicious cycle of further anger. Maltreatment, more broadly defined than abuse, has long-term, serious negative effects on the child. On the other hand, mothers are also increasingly concerned that they may be abusing their children or that others may think they are abusing them. Anger is also strongly associated with depression and has a negative impact on mothers themselves. Mothers’ anger toward fathers has also become a social problem, and it is said that seeing or hearing violent or abusive behavior between husband and wife is far more harmful to children than abuse of themselves. In addition, parents’ emotional regulation (emotional control) has a significant impact on their children’s emotional regulation. In order to help their children express their emotions appropriately, parents must first train themselves to do so.

● We developed a program to train both anger control methods (anger management) and parenting (parenting) skills, and had 50 mothers in Ibaraki and Chiba prefectures take the program to test its effectiveness in a before-and-after comparison test. Compared to pre-intervention, post-intervention and 2 months post-intervention, anger traits and anger expression toward children were statistically significantly reduced, and anger control was significantly improved. In addition, 90% of the respondents said, “I feel better now that I know that anger has meaning.” I praise my child’s small progress and efforts more often.” 80% said, “I now have more realistic expectations for my child’s personality and growth.”　80% of the respondents said, “I am now able to focus on what my child is doing well rather than what he or she is not doing well.” I am less likely to hit my child when I am angry. Tobe H, Soejima T

Tobe H, Soejima T, Kita S, Sato I, Morisaki-Nakamura M, Kamibeppu K, Ikeda M, Hart C, Emori Y. How participation in a group-based anger management program Mental Health & Prevention. 25, 200228

●A longitudinal study of anger and depression in women in the second trimester of pregnancy found that higher anger traits during pregnancy were significantly associated with lower resilience during pregnancy and higher postpartum depression. Resilience during pregnancy partially mediated higher anger during pregnancy and postpartum depression. The results suggest that for pregnant women with high anger traits, increased resilience may reduce postpartum depression.

Tobe, H., Kita, S., Hayashi, M., Umeshita, K., & Kamibeppu, K. (2020). Mediating effect of resilience during pregnancy on the association between maternal trait anger and postnatal depression, Comprehensive Psychiatry, 152190. 2020.

●Mindfulness is a psychological program that incorporates meditation into medicine and has been called “muscle training for the mind,” and its research has increased dramatically in recent years. By incorporating mindfulness into the most important and most difficult relationships of the family, individual mental health and family relationships can be improved.

●I have received training from Nancy Bardacke, who developed Mindful Birthing for Pregnancy and Childbirth for pregnant women and their partners, and invited her to Japan to hold a program. We are also testing the effectiveness of the program.

Special Feature: Mindfulness for Childbirth and Childcare that Midwives Want to Use,” Midwifery Magazine Vol. 74 No. 3, March 2020

●I have received Mindful Parenting Teachers’training from Professor Susan Bogels (University of Amsterdam), who developed Mindful Parenting to utilize mindfulness in child rearing. She was invited to The University of Tokyo in January 2019.　

●I have translated Professor Susan Bogels’ self-help book and published it from Kitaoji shobo publishing company in September, 2020.　I’m conducting research to test the effectiveness of mindful parenting program.

You can download the Mindful Parenting meditation guidance in Japanese on the Kitaoji Shobo website: https://www.kitaohji.com/book/b581662.html