Kyushu University [Toshihide Kuroki (Professor) Faculty of Human-Environment Studies, Department of Human Sciences]

1. Clinical Psychiatry
A. A historical review on the nosology of mental illness: the diagnostic criteria of psychiatric disorders and its social impact
B. A Study on treatment and support for neurodevelopment disorders in adulthood

2. Clinical Psychology
A. Morita therapy; application of Morita therapy to adolescent patients at an outpatient clinic today
B. Psychological aspects on the medication treatment with psychiatric patients
C. Psycho-social support to the variation of mood disorders
D. A study on clinical utility of standardized psychiatric diagnoses in the field of clinical psychology
E. A study on measurements of the effect of psychotherapy on mental disorders
F. Collaboration between nationally certified psychologists and medical care systems in Japan

Research

Research Interests

A study on the clinical utility and limitations of the spectrum model of mental disorders in psychological assessment
keyword : psychological assessment, psychiatric diagnosis, dimension, spectrum model, clinical utility
2021.04～2024.03.
An empirical study on the reliability, validity and clinical utility of the alternative DSM-5 model for personality disorder
keyword : DSM-5, Personality disorder, Big Five, Dimension
2017.04～2020.06.
An empirical study on the validity and utility of DSM diagnosis for psychological assessment
keyword : DSM, personality disorder, PDI-5, dimension, category
2017.04～2020.03.
Studies on a possible role of psychologists in medical care systems
keyword : psychologists, medical care, role, education and training
2014.06～2015.03.
Global meta-effects of DSM, classification of psychiatric disorders, and its historical review
keyword : DSM, psychiatric diagnosis, nosology, operational criteria, history of psychiatry
2013.04～2016.03.

Current and Past Project

The aim of this study is to elucidate historically "involuntary hospitalization based on family consent" in the postwar psychiatric care service systems, by investigating forced hospitalization based on family consent under the Law of Mental Hygiene (1950-1987), which is the institutional pre-history of current medical protection hospitalization.
The aim of this study is to elucidate the effect of the Humanitude training on BPSD of elderly people with dementia and emotional stress of care givers in Fukuoka city.

Academic Activities

Reports

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Papers

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1.	Hiroaki Kubo, Hiromi Urata, Motohiro Sakai, Shunsuke Nonaka, Kazuhiko Saito , Masaru Tateno, Keiji Kobara , Naoki Hashimoto, Daisuke Fujisawa, Yuriko Suzuki, Kotaro Otsuka, Hiroho Kamimae, Yuya Muto, Takashi Usami, Yoko Honda, Junji Kishimoto, Toshihide Kuroki, Shigenobu Kanba, Takahiro A Kato , Development of a 3-Day Intervention Program for Family Members of Hikikomori Sufferers, Japanese Psychological Research, 10.1111/jpr.12368, 2021.08, Hikikomori (a severe form of social withdrawal) is a serious mental health issue. A family approach is the initial step to support hikikomori; thus effective family intervention programs are warranted. We recently developed a 5-day family intervention program (120 min weekly) based on Mental Health First Aid (MHFA) and Community Reinforcement and Family Training (CRAFT). In the present study, we modified the 5-day program to a 3-day program (180 min fortnightly), and examined the effectiveness of the 3-day program using a single-arm procedure. Data of 23 parents (four fathers and 19 mothers; age = 62.0 9.1 years) were analyzed. Mental health conditions among participants themselves improved at the 4-month followup, but the confidence in hikikomori support declined and stigma toward mental health problems did not change. However, short-term improvements in perceived skills in approaching hikikomori sufferers were detected. Hikikomori sufferers’ actual behavioral changes, such as social participation or utilization of support, were also observed (six out of 20 hikikomori sufferers). Preliminary effectiveness was confirmed for the 3-day program. Further revision of the program and a validation study with controls are required..
2.	Nakashima M, Inada N, Tanigawa Y, Yamashita M, Maeda E, Kouguchi M, Sarad Y, Yano H, Ikari K, Kuga H, Oribe N, Kaname H, Harada T, Ueno T, Kuroki T, Efficacy of group cognitive behavior therapy targeting time management for adults with attention deficit/hyperactivity disorder in Japan: A randomized control pilot trial., Journal of Attention Disorders, 10.1177/1087054720986939, J Atten Disord, Jan 20; 1087054720986939, Online ahead of print., 2021.01, Objective: Time-processing disorders in adults is a priority area for intervention. Time management program, which has been demonstrated to be effective in children with ADHD, has not been examined in adults. We anticipate the need for the development of specialized programs for adults. This is because it has been reported that time processing disorders have different patterns in childhood and adulthood. This study aimed to evaluate the therapeutic effect of a gCBT program focusing on time management for adults with ADHD. Method: Adults with ADHD were randomly assigned to gCBT (n=24) or a treatment as usual group (n=24). Outcome measures were masked clinically rated, self-reported, and family-reported ADHD symptoms. Results: The gCBT group significantly reduced ADHD symptoms on all measures. Conclusion: Interventions focused on time management have been shown to be effective not only in children with ADHD but also in adult patients..
3.	Kubo H, Urata H, Sakai M, Nonaka S, Saito K, Tateno M, Kobara K, Hashimoto N, Fujisawa D, Suzuki Y, Otsuka K, Kamimae H, Muto Y, Usami T, Honda Y, Kishimoto J, Kuroki T, Kanba S, Kato TA, Development of 5-day hikikomori intervention program for family members: A single-arm pilot trial. , Helion, 6, 1, e03011, 2020.01, Backgrounds: Hikikomori, a severe form of social withdrawal, is increasingly a serious mental health issue worldwide. Hikikomori is comorbid with various psychiatric conditions including depression, social anxiety and suicidal behaviors. Family support is encouraged as a vital first step, however evidence-based programs have yet to be established. Mental Health First Aid (MHFA) is one of the most well-validated educational programs encouraging lay people such as family members, to support close persons suffering from various psychiatric conditions such as depression, anxiety and suicidal behaviors. Methods: We newly developed an educational program for family members of hikikomori sufferers mainly based on MHFA and 'Community Reinforcement and Family Training (CRAFT)' with role-play and homework. As a single-arm trial, 21 parents (7 fathers and 14 mothers) living with hikikomori sufferers participated in our program with five once-a-week sessions (2 h per session) and six monthly follow-ups, and its effectiveness was evaluated using various self-rated questionnaires. Results: Perceived skills toward a depressed hikikomori case vignette, stigma held by participants, and subscales of two problematic and one adaptive behaviors of hikikomori sufferers were improved throughout the sessions and follow-ups. In addition, positive behavioral changes of hikikomori sufferers such as improved social participation were reported by participants. Limitations: Single-arm design and evaluation using self-rated questionnaires are the main limitations of the present study. Conclusions: Our newly developed program has positive effects on family members in their contact and support of hikikomori sufferers. Future trials with control groups are required to validate the effectiveness of this program..
4.	＠本村啓介、黒木俊秀, カテゴリー対ディメンジョン, 精神科治療学, 34, 1115-1122, 2020.11.
5.	The end of the DSM era and the rise of pluralism in psychiatry.
6.	Aita C, Mizoguchi Y, Yamamoto M, SeguchI Y, Yatsuga C, Nishimura T, Sugimoto Y, Takahashi D, Nishihara R, Ueno T, Nakayama M, Kuroki T, Nabeta H, Imamura Y, Monji A., Oxytocin levels and sex differences in autism spectrum disorder with severe intellectual disabilities., Psychiatry Research, 10.1016/j.psychres.2018.12.139, 273, 67-74, 2018.12, There were few reports of oxytocin (OXT) concentrations of autism spectrum disorder (ASD) patients with severe intellectual disabilities. We measured serum OXT concentrations in 79 hospitalized patients with severe intellectual disabilities (16-60 years old, 50 males and 29 females, 54 ASD patients) and investigated the associations between serum OXT concentration, symptom scores, sex differences, and autism spectrum disorder. There were no significant effects of diagnosis, severity of intellectual disabilities, and total score of the Japanese version of the Aberrant Behavior Checklist (ABC-J), the Childhood Autism Rating Scale-Tokyo Version (CARS-TV), and the Japanese version of the Repetitive Behavior Scale-Revised (RBS-R). However, there were sex differences in the correlations between OXT concentrations and subscale scores in the ASD group. The male ASD group (n = 39) showed negative correlations between RBS-R Self-injurious and Sameness subscale scores and serum OXT concentrations. In the female ASD group(n = 15), CARS-TV Nonverbal communication subscale scores and RBS-R Compulsive subscale scores were seen to positively correlate with serum OXT concentrations. These findings suggest that OXT functions differ in males and females with severe intellectual disabilities and that OXT partly affects autism and related to some of the repetitive behaviors and nonverbal communication, in ASD patients with severe intellectual disabilities..
7.	Toshihide Kuroki, Current viewpoints on DSM-5 in Japan., Psychiatry and Clinical Neurosciences, 70, 9, 371-393, 2016.09.
8.	Yamada H, Kuroki T, Nakahara T, Hashimoto K, Tsutsumi T, Hirano M, Maeda H, The dopamine D1 receptor agonist, but not the D2 receptor agonist, induces gene expression of Homer 1a in rat striatum and nucleus accumbens, Brain Research, Vol. 1131, pp88-96, 2007.02.
9.	Nakahara T, Kuroki T, Hondo H, Tsutsumi T, Fukuda K, Yao H, et al, Effects of atypical antipsychotics versus haloperidol on expression of heat shock protein in the discrete brain regions of phencyclidine-treated rats, Mol Brain Res, 73: 193-197, 1999.01.
10.	Nakahara T, Kuroki T, Hashimoto K, Hondo H, Tsutsumi T, Motomura K, et al, Effect of atypical antipsychotics on phencyclidine-induced expression of arc in rat brain, Neuroreport, 11: 551-555, 2000.01.
11.	Kuroki T, Dai J, Meltzer HY, Ichikawa J, R(+)-8-OH-DPAT, a selective 5-HT1A receptor agonist, attenuated amphetamine-induced dopamine synthesis in rat striatum, but not nucleus accumbens or medial prefrontal cortex, Brain Research, 872: 204-207, 2000.01.
12.	Kuroki T, Meltzer HY, Ichikawa J, 5-HT2A receptor stimulation by DOI, a 5-HT2A/2C receptor agonist, potentiates amphetamine-induced dopamine release in rat medial prefrontal cortex and nucleus accumbens, Brain Research, 972: 216-221, 2003.01.

Presentations

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1.	Toshihide Kuroki, Ishu Ishiyama, Morita therapy and trauma care, The 10th International Congress of Morita Therapy, 2019.08, In contrast to how clinical practice and research on psychological trauma began in the West in response to the need for support for wounded soldiers and veterans, trauma care work and research has been developing in Japan since the 1990’s in response to each occurrence of a major natural disaster in the country. Shortly after the time when Dr. Masatake Morita had developed his unique psychotherapy, the Great Kanto Earthquake struck the Kanto area in 1923 and caused an enormous damage to the Japanese society. While he promoted the therapeutic principle of "obedience to nature" in his treatment and pointed out the futility of resisting nature, it should be noted that he was not promoting a passive way of living and being dictated by one’s fate. He considered that our agony and distress and even anxiety and fear were all part of nature and that our emotions were changeable and ephemeral like external nature. However, changing our way of thinking alone would not serve much of a practical purpose by itself. Rather, Morita encouraged us to move forward in life with bravery by leaving anxiety as it is; he recommended that we do what is needed here and now in a factual reality-based manner. Morita’s idea of obedience to nature was probably reflected in the way the people came to accept the tragedy of the Great Kanto Earthquake disaster as it was in an arugamama way and felt the need to act on their hope for recovery and regeneration. How can we apply such a Moritian perspective to our psychological care for people suffering various kinds of trauma? Morita therapy thus offers an interesting trauma care model in comparison to how trauma care is conceptualized and practiced in other cultures..
2.	黒木俊秀, Outcome research on traditional Morita Therapy and the notation of therapeutic recovery in Morita Therapy., The 9th International Congress of Morita Therapy, 2016.09, The efficacy of traditional Morita therapy has been discussed by Dr. Morita and his followers using a number of clinical case studies and case illustrations. Researchers have also used follow-up outcome survey data for both descriptive and non-inferential statistics for analysis. The researchers who have reported these studies are practitioners of Morita therapy themselves, and according to them, over 80% of residential clients became able to resume a normal and active life after the treatment. It should be noted that successful treatment of shinkeishitsu clients using traditional Morita therapy does not require the elimination or minimization of anxiety symptoms and other ego-threatening feelings and traits. Recovered clients may still experience anxiety from time to time, but they do not stay preoccupied with resisting anxiety and uncomfortable feelings any longer. One traditional Morita therapist has said: “A cure is achieved by a non-cure.” This notion of therapeutic recovery in traditional Morita therapy may not be compatible with the modern outcome research methodology for evaluating therapeutic effects of psychotherapy..
3.	Beyond evidence: Contemporary science of psychotherapy.
4.	Illness may be attributed to personality traits: The impact of personality psychology on the DSM-5 development..
5.	Forensic psychiatry and DSM: Debates on validity and utility of psychiatric diagnosis.

Educational

Educational Activities

Graduate programs of clinical psychology practice, human-environment studies

Other Educational Activities

2018.03, As Chairman of the Teaching Profession Course Committee (directing to the Dean of the Faculty of Education), I applied for accreditation for the teaching profession course revision and received approval from the Ministry of Education, Culture, Sports, Science and Technology by the end of May, 2019..
2017.03.

Social

Professional and Outreach Activities

Counselor of Clinical Research Division, National Hospital Organization Hizen Psychiatric Center.

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