The effect of a behavioral activation program on improving mental and physical health complaints associated with radiation stress among mothers in Fukushima: a randomized controlled trial.
Mothers living with small children in Fukushima prefecture may experience radiation anxiety and related symptoms after the Fukushima Dai'ich Nuclear Power Plant Accident. A behavioral activation (BA) program was developed to improve their psychosomatic symptoms. The purpose of this randomized controlled trial was to examine the effectiveness of a BA program for improving psychological distress and physical symptoms among mothers with preschool children in Fukushima-prefecture 3 years after the Fukushima Daiichi Nuclear Power Plant accident.



Participants were recruited from mothers living with a preschool child(ren) in Fukushima city and surrounding areas though a newspaper advertisement, posters, and flyers. Participants allocated to the intervention group received a newly developed group-based BA program, which consisted of two 90- min lessons with a 1-week interval. Psychological distress and physical symptoms as a primary outcome, and radiation anxiety and positive well-being (liveliness and life satisfaction) as a secondary outcome, were measured at baseline, 1- and 3-month follow-ups.



Participants were randomly allocated to either an intervention or a control group (18 and 19, respectively). The BA program showed a marginally significant intervention effect on psychological distress (p = 0.051) and physical symptoms (p = 0.07) at 1-month follow-up, while the effect became smaller at 3-month follow-up. The effect sizes at 1-month were medium to large (-0.72 and -0.56, respectively). There was a significant intervention effect on increasing liveliness at 3-month follow-up (p = 0.02); and there were marginally significant effects on life satisfaction at 1- and 3-month follow-ups (both p = 0.09).



This BA program may be effective for improving psychological distress, physical symptoms, and well-being, at least for a short duration, among mothers with preschool children after the nuclear power plant accident in Fukushima, while a further large-scale study is needed.



The UMIN Clinical Trials Registry (UMIN-CTR; ID =  UMIN000014081 ). Registered 27 May 2014.
Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
Kotaro
K
Imamura
Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
Yuki
Y
Sekiya
Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
Yumi
Y
Asai
Graduate School of Public Health Nursing, St Luke's International University, Tokyo, Japan.
Maki
M
Umeda
Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University School of Medicine, Fukushima, Japan.
Naoko
N
Horikoshi
Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University School of Medicine, Fukushima, Japan.|Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan.
Seiji
S
Yasumura
Department of Neuropsychiatry, Fukushima Medical University School of Medicine, Fukushima, Japan.
Hirooki
H
Yabe
Department of Neuropsychiatry and Department of Psychosomatic Medicine, Kanto Medical Center NTT EC, Tokyo, Japan.
Tsuyoshi
T
Akiyama
Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. nkawakami@m.u-tokyo.ac.jp.
Norito
N
Kawakami
D000328:Adult; D001007:Anxiety / Q000150:complications / Q000517:prevention & control*; D001521:Behavior Therapy / Q000379:methods*; D002675:Child, Preschool; D003863:Depression / Q000150:complications / Q000517:prevention & control*; D005260:Female; D062406:Fukushima Nuclear Accident; D006801:Humans; D007564:Japan; D008297:Male; D008603:Mental Health; D009035:Mothers / Q000523:psychology*; D010549:Personal Satisfaction; D011602:Psychophysiologic Disorders / Q000209:etiology / Q000517:prevention & control; D013315:Stress, Psychological / Q000150:complications / Q000517:prevention & control*
Behavioral activation; Physical symptoms; Psychological distress; Psychological well-being; Radiation anxiety