Psychiatry and Clinical Neurosciences 2015; 69: 210–219
doi:10.1111/pcn.12230
Regular Article
Significant factors in family difficulties for fathers and mothers who use support services for children with hikikomori Akiko Funakoshi,
PhD1*
and Yuki Miyamoto,
PhD2
1
Psychiatric and Mental Health Nursing, Mie Prefectural College of Nursing, Tsu and 2Department of Psychiatric Nursing, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
Aims: Hikikomori is a new psychosociological phenomenon among youth, of almost complete withdrawal from social interaction, and it has received considerable attention in community mental health in Japan. The aims of the present study were to identify the influential factors of family difficulties of parents who use support services for children with hikikomori, and compare them between fathers and mothers. Methods: Data were collected from 110 parents (55 couples) of children with hikikomori with regard to family difficulties, quality of life, and depression variables via self-report questionnaires. To assess the influential factors of Family Difficulties for parents with children with hikikomori, hierarchical multiple linear regression analysis was carried out for gender.
IKIKOMORI (SOCIAL WITHDRAWAL) has received considerable attention in community mental health in Japan since the 1990s. The definition of hikikomori according to Ministry of Health, Labour and Welfare in Japan1 is as follows: ‘Hikikomori is a psychosociological phenomenon, one of its characteristic features is withdrawal from social activities and staying at home almost all days for more than half a year (English translation cited by Kondo et al., 2013)2’. Hikikomori usually starts by the late teens,2 and it is estimated that 260 000
H
*Correspondence: Akiko Funakoshi, PhD, Psychiatric and Mental Health Nursing, Mie Prefectural College of Nursing, 1-1-1 Yumegaoka, Tsu Mie 514-0116, Japan. Email: [email protected] Received 29 November 2013; revised 11 June 2014; accepted 7 August 2014.
210
Results: While 94.5% of mothers received some kind of family support, only 61.9% of fathers received it. For both genders, the number of services that the fathers received was significantly correlated with marital cooperation, and the number of services that the mothers received was significantly correlated with support resource utilization. Conclusions: It is necessary for fathers to receive more support, and it is important for professionals to encourage parents to address their difficulties together. Key words: family difficulties, hikikomori, social withdrawal.
families in Japan have a child with hikikomori.3 Hikikomori has become an international concern and there are some cases reported to have occurred elsewhere,4–7 although it was considered a culturebound trait unique to Japan at first.7,8 Kato et al. noted that hikikomori is perceived as occurring across a variety of cultures by psychiatrists in multiple countries (Australia, Bangladesh, India, Iran, Japan, Korea, Taiwan, Thailand and the USA).9 Several studies found that psychiatric disorders are often comorbid with hikikomori. A Japanese largescale epidemiological study indicated that among people who have experienced hikikomori, 54.5% had also experienced a psychiatric disorder in their lifetime.3 In addition, another study also indicated that among people who have used services for hikikomori, 35.7% have had a psychiatric disorder diagnosed.10 Providing professional support for families – especially parents – with hikikomori children is impor-
© 2014 The Authors Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology
Psychiatry and Clinical Neurosciences 2015; 69: 210–219
Family difficulties in hikikomori 211
tant for the following reasons. First, professionals’ helping the parents leads to support of their withdrawn child indirectly. Some studies indicate that family support makes a positive impact on withdrawn children.11,12 Next, many parents themselves also need emotional support from mental health professionals. Parents with a hikikomori child often face many difficulties,13 and their psychological distress is stronger than in the general population.14 Family support eases the family’s anxiety, and helps the family to see their child with hikikomori positively.15 Last, the onset mechanism for hikikomori is not merely a problem of the withdrawn person themselves, but also includes the problems in family relationships. Some reports pointed to a possibility that hikikomori and family function are related.16,17 Family support prevents the parents from being socially isolated, and being excessively involved in the problems of their child with hikikomori. Consequently, there is a possibility that the relationship between service use and difficulties may differ between fathers and mothers, even though it is necessary to provide family support not only for the mother but also for the father in hikikomori cases. The aim of the present study was to identify the influential factors in family difficulties for parents who use support services for children with hikikomori, and compare them between fathers and mothers.
couples) of the 116 families, in which both father and mother participated, after excluding parents who had missing entries in their questionnaires, and also after excluding others who had more than one child with hikikomori.
METHODS Participants and data collection In the present study, hikikomori children were operationally defined as dependants whose parents have received support for hikikomori. Participants who have a child with hikikomori were recruited through the support organizations to which they belong. Mental and welfare centers from three adjoining prefectures in the Tokai region and four incorporated non-profit organizations conducting self-help groups for parents with socially withdrawn children participated in this investigation. Parents were asked to complete the questionnaires anonymously and mail them to the supervising the University.
Sample A total of 116 of 431 families to whom the questionnaires were distributed responded (response rate, 26.9%). The sample consisted of 110 parents (55
Measures The demographic information related to the families and their children with hikikomori, and the data on family difficulties, quality of life, and depression variables were collected via self-report questionnaires. The existence of mental disorders among the children with hikikomori was also reported by the parents. The parents’ difficulties with regard to children with hikikomori were assessed using the Family Difficulties Scale in Children with Hikikomori, which consists of 18 items, corresponding to difficulties in marital cooperation (five items), psychological conflict with the child (seven items), and difficulties in support resource utilization (six items). All items are scored on a 4-point Likert scale ranging from 1 (‘strongly agree’) to 4 (‘strongly disagree’). High scores are indicative of difficulty. Previous research has confirmed the validity and reliability of the scale.18 Quality of life was assessed with the short form of the Japanese version19 of the World Health Organization quality of Life scale (WHO/QOL-26).20 WHO/ QOL-26 includes four subscales: Physical Domain, Psychological Domain, Social Relationships, and Environment. All items are scored on a 5-point Likert scale. High scores are indicative of high QOL. Depression was assessed with the Japanese version21 of the Center for Epidemiologic Studies Depression Scale (CES-D).22 All items are scored on a 4-point Likert scale. Depression is suspected if the CES-D score is ≥16.
Statistical analysis This analysis compared fathers with mothers in terms of degree of family difficulty, QOL, depression, and amount of service use. Paired t-test and McNemar test were used to compare demographic variables; family difficulties; depression; QOL; and service use. To assess the influential factors of Family Difficulties for parents of children with hikikomori, hierarchical multiple linear regression analysis was carried
© 2014 The Authors Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology
212 A. Funakoshi and Y. Miyamoto
out for gender. The independent variables that correlated with dependent variables were entered into the equation in the following order. At step 1, the mental status and the current behavioral conditions of children with hikikomori (such as the period of suffering, the morbidity of any mental disorder, the number of problematic behaviors, and scope of activity) were entered simultaneously. At step 2, the parents’ QOL mean score was entered. At step 3, the parents’ number of services use was entered. All data analysis was conducted using SPSS (version 17.0; IBMJapan, Tokyo, Japan). Significance was set at P < 0.05.
Ethical considerations All participants were informed in writing about the study purpose and methods. They were assured that neither they nor their places of work would be identified. They were also informed that participation in the study was voluntary and that they could stop at any time if they were unhappy with any aspect. Consent from participants was confirmed by their filling out the questionnaires. The Ethics Committee, of the Graduate School of Medicine and Faculty of Medicine, of The University of Tokyo, approved the research protocol before starting the study (ID:1419, approval date: 22 May 2006).
Psychiatry and Clinical Neurosciences 2015; 69: 210–219
Sociodemographic characteristics of hikikomori children The sample consisted of a total of 55 dependants: 41 (76.4%) of the hikikomori children were male and the mean age was 30.8 ± 7.1 years. Although approximately 70% of the dependants did not have a mental disorder leading to hikikomori, they had been socially withdrawn for a mean of 9.8 ± 5.9 years each. It was inferred from parents’ information that the definition according to Ministry of Health, Labour and Welfare in Japan was fulfilled by 34 dependants (61.8%). Table 2 lists the condition of dependants with hikikomori for the month prior to this study. Nearly half (45.5%) of the children were able to go out freely but did not participate in any social activity. In their attitudes to their families, those with hikikomori who rejected at least one other member of their family comprised 36.3%. The study investigated the problematic behavior of those with hikikomori via a multiple answer questionnaire. Participants were given questions related to ‘authoritative attitude in the home’; ‘disorderly diet’; ‘compulsive behavior’; ‘destructive behavior’; ‘violence in the home’; ‘self-injury’, and ‘disrupted sleep pattern’. More than half (54.5%) of dependants had at least one problematic behavior; the most common was ‘disrupted sleep pattern’. A total of 41.8% had this.
Influential factors in family difficulties
RESULTS Participants Table 1 lists subject demographic characteristics; service use; QOL; family difficulties, and depression. The mean age of the fathers was 63.5 ± 7.1 years, and that of the mothers was 59.4 ± 6.4 years. Fathers were significantly older than mothers. The mean service use received during the past year was significantly lower among fathers than mothers. Significantly fewer fathers participated in family support than mothers. Although 94.5% of mothers received some kind of family support, only 61.9% of fathers received it. Mean psychological domain score for the WHO/QOL and CES-D were not significantly different between fathers and mothers, but in CES-D the mean score of mothers exceeded the cut-off-point and 47.3% of them scored higher than the cut-off-point.
Regarding the Family Difficulties Scale (Table 3), the total score was not significantly different between fathers and mothers. In three subscales, the mean score for difficulty in support resource utilization was significantly higher among fathers than mothers. Tables 4–7 list the results of hierarchical multiple linear regression analysis. In Table 4 (model III), the number of services that the fathers received marginally significantly correlated with the lower total score of the Family Difficulties Scale among fathers. In contrast, the period of hikikomori was significantly correlated with XX among mothers. In addition, for both genders, the higher score of their own QOL strongly correlated with the lower total score of the Family Difficulties Scale. Also for both genders, the number of services that the fathers received was significantly correlated with marital cooperation (Table 5, model III).
© 2014 The Authors Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology
Psychiatry and Clinical Neurosciences 2015; 69: 210–219
Family difficulties in hikikomori 213
Table 1. Hikikomori children demographic characteristics (n = 55) Mean (SD; range) Age (years) Age when Hikikomori started (years) Period of Hikikomori (years) Age when family first visited support organization (years) (n = 54)
Gender Male Female Geniture First child (No sibling) Second child Third child Fourth child Prevalence of mental disorder (n = 53) Fulfilling definition in guideline (n = 53) School refusal (n = 54) Problematic behaviors Disrupted sleep patterns Self-injury Violence in the home Destructive behavior Compulsive behavior Disorderly diet Authoritative attitude in the home No. problematic behaviors 0 1 2 3 4 5 Scope of activity for the past month (n = 54) Participating in social activities Going out freely, excluding social activities Going out with reservations Staying at home Staying in one’s room Attitude to family for the past month Not rejecting family members Rejecting some of the family members Rejecting all of the family members
In Table 6 (the best fit model II), psychological conflicts with children was not significantly correlated with parents’ service use. Parents’ service use had a marginally significant correlation with the number of problematic behaviors and the scope of activity of their child, and the QOL score for fathers,
30.8 20.9 9.8 23.0
(7.1; 14–49) (6.3; 13–37) (5.9; 0–26) (7.3;13–37)
n
%
41 13
76.4 23.6
20 (4) 30 4 1 16 34 31
36.4 (7.3) 54.5 7.3 1.8 29.1 61.8 56.4
23 0 1 2 10 13 6
41.8 0.0 1.8 3.6 18.2 23.6 10.9
25 13 11 5 0 1
45.5 23.6 20.0 9.1 0.0 1.8
2 25 15 9 3
3.6 45.5 27.3 16.4 5.5
35 13 7
63.6 23.6 12.7
whereas for the mothers their QOL was significantly and strongly correlated. In Table 7 (model III), shorter periods of hikikomori and the number of services that the mothers received was significantly correlated with support resource utilization among both the mothers and the fathers (model III).
© 2014 The Authors Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology
214 A. Funakoshi and Y. Miyamoto
Psychiatry and Clinical Neurosciences 2015; 69: 210–219
Table 2. Parent characteristics vs gender (n = 110)
Age in years No. services received in the last year
Working styles Not working Full-time job Part-time job Participated in family support in the last year No Yes Medical setting No Yes Home visiting care No Yes Ambulant counseling No Yes Self-help group No Yes Telephone counseling No Yes Email counseling No Yes Lecture meeting No Yes
Fathers (n = 55) Mean (SD; range)
Mothers (n = 55) Mean (SD; range)
t‡
P
63.5 (7.1; 43–81) 1.6 (1.6; 0–5)
59.4 (6.4; 43–76) 2.6 (1.5; 0–6)
10.119** −4.219**
doi:10.1111/pcn.12230
Regular Article
Significant factors in family difficulties for fathers and mothers who use support services for children with hikikomori Akiko Funakoshi,
PhD1*
and Yuki Miyamoto,
PhD2
1
Psychiatric and Mental Health Nursing, Mie Prefectural College of Nursing, Tsu and 2Department of Psychiatric Nursing, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
Aims: Hikikomori is a new psychosociological phenomenon among youth, of almost complete withdrawal from social interaction, and it has received considerable attention in community mental health in Japan. The aims of the present study were to identify the influential factors of family difficulties of parents who use support services for children with hikikomori, and compare them between fathers and mothers. Methods: Data were collected from 110 parents (55 couples) of children with hikikomori with regard to family difficulties, quality of life, and depression variables via self-report questionnaires. To assess the influential factors of Family Difficulties for parents with children with hikikomori, hierarchical multiple linear regression analysis was carried out for gender.
IKIKOMORI (SOCIAL WITHDRAWAL) has received considerable attention in community mental health in Japan since the 1990s. The definition of hikikomori according to Ministry of Health, Labour and Welfare in Japan1 is as follows: ‘Hikikomori is a psychosociological phenomenon, one of its characteristic features is withdrawal from social activities and staying at home almost all days for more than half a year (English translation cited by Kondo et al., 2013)2’. Hikikomori usually starts by the late teens,2 and it is estimated that 260 000
H
*Correspondence: Akiko Funakoshi, PhD, Psychiatric and Mental Health Nursing, Mie Prefectural College of Nursing, 1-1-1 Yumegaoka, Tsu Mie 514-0116, Japan. Email: [email protected] Received 29 November 2013; revised 11 June 2014; accepted 7 August 2014.
210
Results: While 94.5% of mothers received some kind of family support, only 61.9% of fathers received it. For both genders, the number of services that the fathers received was significantly correlated with marital cooperation, and the number of services that the mothers received was significantly correlated with support resource utilization. Conclusions: It is necessary for fathers to receive more support, and it is important for professionals to encourage parents to address their difficulties together. Key words: family difficulties, hikikomori, social withdrawal.
families in Japan have a child with hikikomori.3 Hikikomori has become an international concern and there are some cases reported to have occurred elsewhere,4–7 although it was considered a culturebound trait unique to Japan at first.7,8 Kato et al. noted that hikikomori is perceived as occurring across a variety of cultures by psychiatrists in multiple countries (Australia, Bangladesh, India, Iran, Japan, Korea, Taiwan, Thailand and the USA).9 Several studies found that psychiatric disorders are often comorbid with hikikomori. A Japanese largescale epidemiological study indicated that among people who have experienced hikikomori, 54.5% had also experienced a psychiatric disorder in their lifetime.3 In addition, another study also indicated that among people who have used services for hikikomori, 35.7% have had a psychiatric disorder diagnosed.10 Providing professional support for families – especially parents – with hikikomori children is impor-
© 2014 The Authors Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology
Psychiatry and Clinical Neurosciences 2015; 69: 210–219
Family difficulties in hikikomori 211
tant for the following reasons. First, professionals’ helping the parents leads to support of their withdrawn child indirectly. Some studies indicate that family support makes a positive impact on withdrawn children.11,12 Next, many parents themselves also need emotional support from mental health professionals. Parents with a hikikomori child often face many difficulties,13 and their psychological distress is stronger than in the general population.14 Family support eases the family’s anxiety, and helps the family to see their child with hikikomori positively.15 Last, the onset mechanism for hikikomori is not merely a problem of the withdrawn person themselves, but also includes the problems in family relationships. Some reports pointed to a possibility that hikikomori and family function are related.16,17 Family support prevents the parents from being socially isolated, and being excessively involved in the problems of their child with hikikomori. Consequently, there is a possibility that the relationship between service use and difficulties may differ between fathers and mothers, even though it is necessary to provide family support not only for the mother but also for the father in hikikomori cases. The aim of the present study was to identify the influential factors in family difficulties for parents who use support services for children with hikikomori, and compare them between fathers and mothers.
couples) of the 116 families, in which both father and mother participated, after excluding parents who had missing entries in their questionnaires, and also after excluding others who had more than one child with hikikomori.
METHODS Participants and data collection In the present study, hikikomori children were operationally defined as dependants whose parents have received support for hikikomori. Participants who have a child with hikikomori were recruited through the support organizations to which they belong. Mental and welfare centers from three adjoining prefectures in the Tokai region and four incorporated non-profit organizations conducting self-help groups for parents with socially withdrawn children participated in this investigation. Parents were asked to complete the questionnaires anonymously and mail them to the supervising the University.
Sample A total of 116 of 431 families to whom the questionnaires were distributed responded (response rate, 26.9%). The sample consisted of 110 parents (55
Measures The demographic information related to the families and their children with hikikomori, and the data on family difficulties, quality of life, and depression variables were collected via self-report questionnaires. The existence of mental disorders among the children with hikikomori was also reported by the parents. The parents’ difficulties with regard to children with hikikomori were assessed using the Family Difficulties Scale in Children with Hikikomori, which consists of 18 items, corresponding to difficulties in marital cooperation (five items), psychological conflict with the child (seven items), and difficulties in support resource utilization (six items). All items are scored on a 4-point Likert scale ranging from 1 (‘strongly agree’) to 4 (‘strongly disagree’). High scores are indicative of difficulty. Previous research has confirmed the validity and reliability of the scale.18 Quality of life was assessed with the short form of the Japanese version19 of the World Health Organization quality of Life scale (WHO/QOL-26).20 WHO/ QOL-26 includes four subscales: Physical Domain, Psychological Domain, Social Relationships, and Environment. All items are scored on a 5-point Likert scale. High scores are indicative of high QOL. Depression was assessed with the Japanese version21 of the Center for Epidemiologic Studies Depression Scale (CES-D).22 All items are scored on a 4-point Likert scale. Depression is suspected if the CES-D score is ≥16.
Statistical analysis This analysis compared fathers with mothers in terms of degree of family difficulty, QOL, depression, and amount of service use. Paired t-test and McNemar test were used to compare demographic variables; family difficulties; depression; QOL; and service use. To assess the influential factors of Family Difficulties for parents of children with hikikomori, hierarchical multiple linear regression analysis was carried
© 2014 The Authors Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology
212 A. Funakoshi and Y. Miyamoto
out for gender. The independent variables that correlated with dependent variables were entered into the equation in the following order. At step 1, the mental status and the current behavioral conditions of children with hikikomori (such as the period of suffering, the morbidity of any mental disorder, the number of problematic behaviors, and scope of activity) were entered simultaneously. At step 2, the parents’ QOL mean score was entered. At step 3, the parents’ number of services use was entered. All data analysis was conducted using SPSS (version 17.0; IBMJapan, Tokyo, Japan). Significance was set at P < 0.05.
Ethical considerations All participants were informed in writing about the study purpose and methods. They were assured that neither they nor their places of work would be identified. They were also informed that participation in the study was voluntary and that they could stop at any time if they were unhappy with any aspect. Consent from participants was confirmed by their filling out the questionnaires. The Ethics Committee, of the Graduate School of Medicine and Faculty of Medicine, of The University of Tokyo, approved the research protocol before starting the study (ID:1419, approval date: 22 May 2006).
Psychiatry and Clinical Neurosciences 2015; 69: 210–219
Sociodemographic characteristics of hikikomori children The sample consisted of a total of 55 dependants: 41 (76.4%) of the hikikomori children were male and the mean age was 30.8 ± 7.1 years. Although approximately 70% of the dependants did not have a mental disorder leading to hikikomori, they had been socially withdrawn for a mean of 9.8 ± 5.9 years each. It was inferred from parents’ information that the definition according to Ministry of Health, Labour and Welfare in Japan was fulfilled by 34 dependants (61.8%). Table 2 lists the condition of dependants with hikikomori for the month prior to this study. Nearly half (45.5%) of the children were able to go out freely but did not participate in any social activity. In their attitudes to their families, those with hikikomori who rejected at least one other member of their family comprised 36.3%. The study investigated the problematic behavior of those with hikikomori via a multiple answer questionnaire. Participants were given questions related to ‘authoritative attitude in the home’; ‘disorderly diet’; ‘compulsive behavior’; ‘destructive behavior’; ‘violence in the home’; ‘self-injury’, and ‘disrupted sleep pattern’. More than half (54.5%) of dependants had at least one problematic behavior; the most common was ‘disrupted sleep pattern’. A total of 41.8% had this.
Influential factors in family difficulties
RESULTS Participants Table 1 lists subject demographic characteristics; service use; QOL; family difficulties, and depression. The mean age of the fathers was 63.5 ± 7.1 years, and that of the mothers was 59.4 ± 6.4 years. Fathers were significantly older than mothers. The mean service use received during the past year was significantly lower among fathers than mothers. Significantly fewer fathers participated in family support than mothers. Although 94.5% of mothers received some kind of family support, only 61.9% of fathers received it. Mean psychological domain score for the WHO/QOL and CES-D were not significantly different between fathers and mothers, but in CES-D the mean score of mothers exceeded the cut-off-point and 47.3% of them scored higher than the cut-off-point.
Regarding the Family Difficulties Scale (Table 3), the total score was not significantly different between fathers and mothers. In three subscales, the mean score for difficulty in support resource utilization was significantly higher among fathers than mothers. Tables 4–7 list the results of hierarchical multiple linear regression analysis. In Table 4 (model III), the number of services that the fathers received marginally significantly correlated with the lower total score of the Family Difficulties Scale among fathers. In contrast, the period of hikikomori was significantly correlated with XX among mothers. In addition, for both genders, the higher score of their own QOL strongly correlated with the lower total score of the Family Difficulties Scale. Also for both genders, the number of services that the fathers received was significantly correlated with marital cooperation (Table 5, model III).
© 2014 The Authors Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology
Psychiatry and Clinical Neurosciences 2015; 69: 210–219
Family difficulties in hikikomori 213
Table 1. Hikikomori children demographic characteristics (n = 55) Mean (SD; range) Age (years) Age when Hikikomori started (years) Period of Hikikomori (years) Age when family first visited support organization (years) (n = 54)
Gender Male Female Geniture First child (No sibling) Second child Third child Fourth child Prevalence of mental disorder (n = 53) Fulfilling definition in guideline (n = 53) School refusal (n = 54) Problematic behaviors Disrupted sleep patterns Self-injury Violence in the home Destructive behavior Compulsive behavior Disorderly diet Authoritative attitude in the home No. problematic behaviors 0 1 2 3 4 5 Scope of activity for the past month (n = 54) Participating in social activities Going out freely, excluding social activities Going out with reservations Staying at home Staying in one’s room Attitude to family for the past month Not rejecting family members Rejecting some of the family members Rejecting all of the family members
In Table 6 (the best fit model II), psychological conflicts with children was not significantly correlated with parents’ service use. Parents’ service use had a marginally significant correlation with the number of problematic behaviors and the scope of activity of their child, and the QOL score for fathers,
30.8 20.9 9.8 23.0
(7.1; 14–49) (6.3; 13–37) (5.9; 0–26) (7.3;13–37)
n
%
41 13
76.4 23.6
20 (4) 30 4 1 16 34 31
36.4 (7.3) 54.5 7.3 1.8 29.1 61.8 56.4
23 0 1 2 10 13 6
41.8 0.0 1.8 3.6 18.2 23.6 10.9
25 13 11 5 0 1
45.5 23.6 20.0 9.1 0.0 1.8
2 25 15 9 3
3.6 45.5 27.3 16.4 5.5
35 13 7
63.6 23.6 12.7
whereas for the mothers their QOL was significantly and strongly correlated. In Table 7 (model III), shorter periods of hikikomori and the number of services that the mothers received was significantly correlated with support resource utilization among both the mothers and the fathers (model III).
© 2014 The Authors Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology
214 A. Funakoshi and Y. Miyamoto
Psychiatry and Clinical Neurosciences 2015; 69: 210–219
Table 2. Parent characteristics vs gender (n = 110)
Age in years No. services received in the last year
Working styles Not working Full-time job Part-time job Participated in family support in the last year No Yes Medical setting No Yes Home visiting care No Yes Ambulant counseling No Yes Self-help group No Yes Telephone counseling No Yes Email counseling No Yes Lecture meeting No Yes
Fathers (n = 55) Mean (SD; range)
Mothers (n = 55) Mean (SD; range)
t‡
P
63.5 (7.1; 43–81) 1.6 (1.6; 0–5)
59.4 (6.4; 43–76) 2.6 (1.5; 0–6)
10.119** −4.219**
