Adolescence is marked by significant life stress. Recently, school refusal and dropouts as well as suicide among Japanese adolescents have increased. Sense of coherence (SOC) is recognized as a competency that helps people deal with stress. The purpose of this study was to examine the factors influencing SOC in male and female high school students. We conducted a survey with 203 pairs of high school students and their mothers, in Tokyo, to explore their SOC, family relationships, school belonging, and autistic traits. Analysis of the data revealed a weak relationship between female students’ SOC and that of their mothers, and no relationship between male students’ SOC and their mothers’ SOC. Feelings of acceptance and recognition from teachers improved students’ SOC, irrespective of gender. Low SOC in mothers had a negative impact on female students’ SOC, and children’s lack of imagination (an autism spectrum tendency) had a negative impact on male students’ SOC. This study revealed the importance of support at home and school according to the needs of both genders.

Spouses of individuals with autism spectrum disorder (ASD) may struggle with self-stigma and may require attention and care; however, no scale exists to measure the stigma of spouses of persons with ASD. This study created and investigated the construct validity of the Couples Stigma Scale. This scale consists of 14 items and it was designed based on prior literature, interviews, and the self-stigma theory to assess the self-stigma experienced by spouses of people with ASD. A survey was conducted with spouses of persons with ASD who participated in a self-help group. Responses were obtained from 259 people, of which 253 women were included in the analysis. Exploratory factor analysis was performed separately with two independent groups, indicating a four-factor structure, to determine structural validity. The factor loadings of the items constituting the four factors were 0.39 or greater. Regarding external validity, the correlation coefficient between the Couples Stigma Scale and the World Health Organization Quality of Life (WHOQOL) score was −0.341 (p < 0.001), and the domain correlation coefficient was significant for all relevant WHOQOL domains. Our results suggest that the Japanese version of the Couples Stigma Scale is a valid instrument for assessing self-stigma in the spouses of persons with ASD.

The decline in mental health among workers in Japan has become a serious concern. Autism spectrum disorder (ASD) traits are increasingly recognized as a potential risk factor for mental health issues, yet few individuals receive a formal ASD diagnosis. This study aims to examine whether undiagnosed but working individuals with strong ASD characteristics differ in factors related to presenteeism (low productivity) compared to their counterparts with fewer ASD traits. In particular, we investigated the impact of social camouflaging—the behavioral adaptation used to mask ASD traits—especially on workers with strong ASD characteristics. An online survey was conducted among white-collar workers aged 20 to 60. The survey included items collecting demographic information (gender, age, marital status, highest level of education completed, employment status, job title, length of employment, and working hours) and included the Japanese versions of four validated instruments to measure aspects of autism traits, social camouflaging, work functioning, and occupational stress. Of the 543 respondents, 139 (25.6%) exhibited strong ASD characteristics. These individuals reported lower productivity than their counterparts. While social camouflaging was observed across all ASD trait levels, it was specifically linked to poorer mental health and reduced productivity among workers with strong ASD characteristics. To support workplace well-being and productivity, it is crucial to increase awareness and understanding of ASD traits in professional settings and create an environment that accommodates diverse work styles.

The concept of "treatment engagement" has been used in many research articles to describe the behavior and process by which patients engage in treatment and medication. However, the term "treatment engagement" is often undefined and used ambiguously, with each researcher using the term, with a different, vague, or broad meaning. Given that many studies have shown that treatment engagement is directly related to clinical outcomes, the concept, should be defined more concretely. This study, therefore, aims to conduct a concept analysis of treatment engagement using Rodgers' evolutionary method of concept analysis. The antecedents of the concept of "treatment engagement" consisted of three elements: individual (i.e., knowledge regarding the disease and treatment, attitudes toward disease and treatment, and acceptance of the disease), situational (i.e., negative experiences in the past and conditions and circumstances that allow patients to focus on treatment), and environmental (i.e., connection with providers, social support, and adaptive treatment system). The attributes of treatment engagement had two elements: behavioral (i.e., initiation of treatment, continuation of treatment, and adherence to recommendations in treatment) and psychosocial (i.e., attitudes that indicate value and expectations toward treatment, cooperation with peers, and collaboration between patient and providers). Consequences of treatment engagement were treatment retention, better clinical outcomes, and coping with disease and treatment. Through this study, we developed the theoretical definition of treatment engagement as the process of initiating and continuing treatment, and adhering to treatment recommendations, in cooperation with peers and in collaboration with supporters, accompanied by a positive attitude toward treatment.

Certain individuals are clinically undiagnosed for Autism Spectrum Disorder (ASD) but exhibit strong ASD characteristics. This study examined the differences between a control group and a “high autistic traits” group involving individuals who scored 9 or higher on the Autism-Spectrum Quotient-16 Japanese Version, based on their sense of belonging, help-seeking style, and relationship with mental health. The participants were 608 Japanese public high school students. Of them, 129 (21.2%) and 479 (78.8%) were in the high autistic traits and control groups, respectively. A multiple regression analysis was performed using the General Health Questionnaire (GHQ) as the dependent variable for the groups. The analysis revealed no differences between the two groups regarding grade, gender, physical illness, insomnia, or mental health status; however, they differed regarding avoidant help-seeking style and teacher acceptance. Moreover, avoidant help-seeking scores in the high autistic traits group and teacher acceptance showed a significantly positive and significantly negative association with GHQ, respectively. The results indicated that children with autistic traits internally suppress them, experiencing distress. Teachers are aware that these students seek support from them, but the students seem reluctant to ask them for help. This can negatively impact the mental health of children with high autistic traits.