Research reportCoping behaviors in relation to depressive symptoms and suicidal ideation among middle-aged workers in Japan
Introduction
In Japan, the annual number of deaths by suicide markedly increased in 1998 and leveled off at approximately 30,000 per year thereafter (Ministry of Health, Labor and Welfare, Japan, 2005). During this period, the increase was especially remarkable among individuals in their 40 s to 60 s and became a grave public health issue (Kawakami, 2003). In particular, the increased incidence of suicide among the middle aged population in Japan caused the largest drop of average male life expectancy since the Second World War.
Both the degree and recency of stress have been shown to be significant predictors of suicidal ideation (Huff, 1999). Coping behaviors are potentially important as both moderators and mediators in the bidirectional relationship of psychosocial stress with depression and suicidal ideation (Seiffge-Krenke, 2004). Coping has been described as a process in which cognitive or behavioral strategies are developed to manage specific internal and/or external sources of psychological stress (Folkman and Lazarus, 1980, Folkman et al., 1986).
The most widely used categories of coping are problem-solving, emotional distraction, and avoidant strategies (Compas et al., 2001, Endler and Parker, 1990). A problem-solving strategy is one in which an individual takes action to change the circumstances that are causing stress; an emotional distraction strategy is one in which an individual works to alter their own experience of negative emotion that results from a stressful source; and an avoidant strategy is one in which an individual works to orient himself/herself away from the source of stress.
Previous studies have shown that although some coping behaviors are associated with successful outcomes, others are not (Kohn et al., 1994, Ravindran et al., 1996, Roy-Byrne et al., 1980, Whatley et al., 1998). Failure to cope with or adjust to stress may cause mental problems (Folkman et al., 1986). Further studies are needed to evaluate the relative contributions of coping behaviors to depressive symptoms and suicidal behaviors within clinical populations and the community in general. To the best of our knowledge, there have been no studies of the link between coping behaviors and suicidal tendencies among a middle-aged population in Japan.
The objectives of this investigation were (1) to evaluate the relationship of coping behaviors to depressive symptoms and suicidal ideation among middle-aged workers and (2) to examine the gender specific contributions of coping behaviors in the prediction of depressive symptoms and suicidal ideation.
Section snippets
Participants
The present study was a part of the survey conducted by the Aomori Occupational Health Promotion Center in 2004. The current study is a cross-sectional study of middle-aged workers (40–60 years of age) who were recruited from companies in the Aomori Prefecture. In total, 6762 workers (4119 men and 2643 women) from 764 randomly selected companies participated.
The investigation was approved by the Aomori Occupational Health Promotion Center and as part of the prefecture enterprise. Informed
Characteristics of participants
Using a score of 19, identified by Wada et al. (2007) as the optimal cut-off point for identifying possible cases of depression among working individuals, the frequency of probable clinical depression in the current sample was 24.2% in males (n=998) and 25.4% in females (n=671) (p>0.05). Overall, the mean CES-D score was 14.2±7.8 for males and 14.5±7.8 for females (p>0.05). Table 1 shows the responses to the item “Have you ever been severely depressed and thought about suicide?” among
Discussion
The present study assessed the relationship between coping behaviors and depressive symptoms as measured by the CES-D and suicidal ideation among middle-aged workers in Japan. We found various types of gender differences with respect to the prevalences of coping behaviors for each type of strategy. About the Problem-solving strategy, “Making plans to take time off” had a higher prevalence in males than in females. Among the emotion-focused strategies, “Engaging himself/herself in leisure
Role of funding source
Funding for this study was provided by the Hirosaki Research Institute for the neurosciences; the Hirosaki Research Institute for the neurosciences had no further role in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication.
Conflict of interest
All of the authors read and approved the manuscript. None of the authors had a conflict of interest.
Acknowledgments
We are grateful to all of the volunteers who participated in this study. The authors would also like to express their gratitude to Dr. Hiroichi Tasaki for his help with this study.
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