Background: Self-focused attention (SFA) is a major maintenance factor of social anxiety disorder. The two types of SFA, the observer perspective and self-focus on body sensation, increase anxiety in individuals with high levels of social anxiety. However, the triggers of each SFA remain unclear. This study used ecological momentary assessment to identify the factors that elicit SFA in real-life social scenarios. Methods: The study obtained 316 samples from 22 Japanese university students (4 male:18 female) with high social anxiety who completed momentary measures of stimulus perception and two types of SFA for 10 days. Links to online questionnaires were sent to the participants via e-mails 3 times a day. First, multilevel single regression analyses were used to identify the stimuli that induced the two types of SFA. Between-level interaction with gender was done to determine the effect of gender biasing on the female participants. Next, for the variables that were significantly predictive in these analyses, multilevel multiple regression analyses were conducted with fear of each stimulus as a control variable. Results: Perception of gaze, evaluation, and authority predicted SFA from the observer perspective. Perception of gaze also predicted self-focus on body sensation. In addition, the perception of positive response and that of stranger predicted self-focus on body sensation depended on gender, implying that the positive response perception of female participants predicted self-focus on body sensation. After controlling for corresponding fear, gaze perception predicted both SFAs, and the perception of authority predicted SFA from the observer perspective. In addition, after controlling for relevant fear, the perception of positive response of female participants predicted self-focus on body sensation. In contrast, the fear of evaluation but not the perception of evaluation predicted SFA from the observer perspective. Conclusions: The perception of gaze is the most powerful trigger of the two types of SFA, even after controlling for fear of gaze in real-life social scenarios for individuals with social anxiety. SFA from the observer perspective is also triggered by the perception of authority and fear of evaluation. The role of perception of positive responses or strangers should be re-evaluated after correcting for gender imbalance. (350 words / 350 words).

Self-compassion is regarded as a mediating or moderating variable in mindfulness-based interventions (MBI). However, few studies have investigated the role of self-compassion on MBI. Therefore, we conducted a randomized controlled trial to examine whether (1) MBI decreases depression and trait anxiety, while increasing trait mindfulness, trait self-compassion, self-compassionate behaviors (SC behaviors), and behaviors, along with improving mood; and (2) SC behaviors moderate the effect of mindful behaviors on mood in daily life. Participants were patients with depression and/or anxiety ( N=19) in Japan. Of the 27 participants recruited, 19 participated in the study. Using stratified randomization, we allocated 10 participants to the intervention group, with an 8-week standard MBI, and nine to the waitlist control group. Depression, trait anxiety, trait mindfulness, and trait self-compassion were assessed using questionnaires, while SC behaviors, mindful behaviors, and mood were measured using an ecological momentary assessment—a method used to repeatedly record events and behaviors in daily life. The results revealed that depression, trait anxiety, trait mindfulness, and trait self-compassion did not significantly change. However, SC behaviors, mindful behaviors, and mood significantly improved with MBI. Moreover, the interaction between SC behaviors and mindful behaviors was significantly shown in the pre-intervention, suggesting that SC behaviors moderate the effect of mindful behaviors on mood in daily life.

Background A brief measure of dispositional mindfulness is important for applied research on mindfulness. Although short forms of the Five Facet Mindfulness Questionnaire (FFMQ), which measures the five aspects of mindfulness (i.e., observing, describing, acting with awareness, non-judging, and non-reactivity), have been developed worldwide, the validity and reliability of the Japanese version has not been examined. This study aims to examine the validity and reliability of the 24-item and 15-item versions of the FFMQ in Japan, which are the most widely used versions worldwide. Methods Online surveys were conducted for 889 adults in Japan through an online survey company using self-reported questionnaires including the FFMQ to confirm the factor structure and validity. To examine construct validity, we examined the relationship between the short form of FFMQ and mind wandering, interoceptive awareness, experiential avoidance, cognitive fusion, openness, neuroticism, self-compassion, depression, and anxiety, which have been theoretically or empirically shown to be related to mindfulness. In addition, 137 adults responded to the FFMQ again, after four weeks, for the test-retest reliability. Results The correlated five-factor and four-factor (excluding observing) models and the higher-order factor hierarchical model did not show sufficient goodness of fit, while the 24-item version showed acceptable fit when uncorrelated method factors loaded on by the positive and negative (reverse-scored) items were added. However, the 15-item version did not show acceptable fits for any of the models. Regarding reliability, the 24-item version showed acceptable values. In terms of the relationship between the original and the shortened version of the FFMQ, the 24-item version shared approximately 80% of the variance with the original one. In addition, although the wording effects of positive and negative items seemed to affect the correlations between the FFMQ and the other scales, the associations with related concepts were as predicted generally, supporting the construct validity of the short form of the FFMQ. Conclusion In Japan, the 24-item version of FFMQ showed acceptable validity and reliability similar to the original version, and we recommend that the 24-item version be used.

Background: The Acceptance and Commitment Therapy (ACT) model of human functioning uses the behavioral processes of acceptance, mindfulness, and values, which together compose psychological flexibility, the ability to contact the present moment more fully as a conscious human being and to either change or persist when doing so serves valued ends. To increase the effectiveness of interventions in the medical treatment of diabetes, it is important to examine the effects on patients with type 2 diabetes of promoting the active component patterns of ACT. This study explores these points. Methods: Questionnaires were administered to type 2 diabetes patients who were registered in the database of a research service provider, and data was collected and analyzed from a total of 211 patients (mean age ± SD was 58.84 years old ±10.25, 14.69% were females). Results: Cluster analysis yielded four clusters: "Average" (average levels of acceptance, mindfulness, and values), "Flexibility" (high levels of acceptance, mindfulness, and values), "Values/low" (average levels of acceptance and mindfulness, and a low level of values), "Values/high" (average levels of acceptance and mindfulness and a high level of values). Patients in the "Flexibility" and "Values/high" clusters had significantly fewer depressive symptoms than the other clusters. However, members of the "Values/high" cluster demonstrated significantly higher glycated hemoglobin levels than those in the other clusters. Conclusions: The results above indicate that each part of the ACT model is necessary for managing diabetes treatment while improving quality of life. The importance of values is emphasized in ACT for diabetes patients, but we argue, given our results, that acceptance and mindfulness are very important for Japanese patients with type 2 diabetes. This study is limited to Japanese patients with type 2 diabetes. In further research, the subject population must be expanded to people from other areas and of different racial backgrounds.

Self-focused attention (SFA) and other-focused attention (OFA) are central maintenance factors of social anxiety. Tomita et al., Cognitive Therapy and Research 44:511–525, 2020 investigated brain activities when manipulating SFA and OFA during speech tasks, after controlling for social anxiety, using near-infrared spectroscopy (NIRS) and eye-tracking. Compared with the control condition, the SFA condition demonstrated greater activity in the right frontopolar area (rFPA) and right dorsolateral prefrontal cortex. In the OFA condition, relative to controls, activity was greater in the left superior temporal gyrus. We investigated whether the activity in these brain areas increased in healthy individuals in proportion to their social anxiety tendency without manipulating SFA and OFA. Thirty-nine participants performed speech tasks under a no attentional manipulation (no-instruction) condition and a control (looking at various places) condition. Brain activity was measured using NIRS (oxy-Hb responses), and eye movements were tracked. We found that higher social anxiety was associated with higher rFPA activity in the no-instruction condition compared to the control condition and that higher subjective SFA during the no-instruction condition with higher social anxiety was associated with increased rFPA between the no-instruction and control conditions. These results suggest that greater activity in the rFPA is a useful objective measure of SFA related to social anxiety during speech tasks.