The association between post-traumatic stress disorder symptoms and the quality of life among Wenchuan earthquake survivors: the role of social support as a moderator

Study on the relationship between PTSD and academic control and academic emotion in primary and middle school students after flood disaster

Purpose

To explore the relationship between post-traumatic stress disorder (PTSD) and students' academic control and academic emotion in the aftermath of a flood disaster. The findings will offer educators and relevant departments valuable insights to understand and facilitate the restoration of learning capabilities among students affected by the disaster.

Methods

This study employed a combined approach of questionnaire surveys and longitudinal tracking. Students from Guangling Primary and Secondary School (Shouguang City, Weifang, Shandong Province) participated in surveys administered in September 2018, December 2018, and September 2019. The instruments utilized included the Post-Disaster Trauma Assessment Questionnaire, the Adolescent Academic Control Scale, and the mathematical version of the Achievement Emotions Questionnaire. Data analysis involved two-factor correlation and mediation effect testing.

Results

Significant differences were observed in overall PTSD scores and its three dimensions between the 1-week and 1-year post-disaster assessments. Both the average PTSD score and the detection rate were higher 1 year after the disaster compared to the first week. Students' academic control demonstrated a strong positive correlation with positive academic emotions and a significant negative correlation with anxiety-related academic emotions. Cross-lagged regression analysis indicated a predictive relationship: academic control measured 3 months post-disaster significantly predicted academic emotions at the 9-month assessment, and conversely, academic emotions at the 3-month point were predictive of academic control at 9 months. In addition, academic control appears to play a complete mediating role in the relationship between PTSD and academic emotions.

Conclusion

Students exhibited a range of PTSD symptoms following the disaster, with a higher prevalence noted in the first year compared to the initial week. PTSD negatively affects academic standing in these students, and is predictive of both their sense of academic control and their emotional responses to learning. Crucially, academic control and academic emotions exhibit a strong correlation and can mutually affect one another. Interventions aimed at reducing PTSD symptoms, cultivating positive academic emotions, and strengthening students' sense of academic control must therefore consider the relationship between these factors. This holistic approach will enhance psychological well-being and improve academic performance.

Lifelong traumatic events, social support, and health-related quality of life among older adults

BACKGROUND

The present study aimed to investigate the relation between lifelong exposure to traumatic life events, social support, and health-related quality of life (QOL) in a sample of older people.

METHOD

A sample of 172 participants (mean age = 68.81, SD = 7.15; 68.6% female and 31.4% male) was involved in this study. The participants completed scales measuring lifelong exposure to traumatic events, social support, and health-related QOL.

RESULTS

The results showed that lifelong exposure to traumatic events was negatively related to physical and mental health-related QOL. Moreover, social support moderated the relation between traumatic life events exposure and mental health-related QOL.

DISCUSSION

Geriatric services could identify and implement adequate measures to provide social support and to improve different dimensions of QOL among older adults.

The mediating role of self-efficacy, social support, and hope in the relation between mental health and resilience among 2023 Türkiye earthquake survivors

This research aims to investigate the mediating role of self-efficacy, social support, and hope in the relationship between depression, anxiety, stress, and resilience in 2023 Türkiye earthquake survivors (N = 491). The findings from a multi-mediation analysis showed the indirect effect of depression, anxiety, and stress on resilience through self-efficacy, social support, and hope. Thus, self-efficacy, social support, and hope may be protective factors for resilience in earthquake survivors. Strategies to improve self-efficacy and hope in earthquake survivors and social support may be necessary in reducing the stress factors caused by earthquakes.

Prevalence and risk for symptoms of PTSD among survivors of a COVID-19 infection

COVID-19 pandemic has profound psychological effects worldwide and the psychological sequelae will persist for a long time among COVID-19 survivors. This cross-sectional study aimed to explore the prevalence of PTSD and its associated risk factors in COVID-19 survivors of the first wave pandemic. Demographics questionnaire, the Impact of Events Scale-Revised, the Pittsburgh Sleep Quality Index, the Fatigue Scale-14, the Resilience Style Questionnaire, the Short Version of COVID-19 Stigma Scale, the Peace of Mind Scale, and the Perceived Social Support Questionnaire were used to collect relevant information of the participants. The propensity score-matching (PSM) method was employed to adjust covariate or confounding variables in order to derive more accurate conclusions. After PSM, adjusted odds ratios and 95% confidence intervals were determined by binary conditional logistic regression. A total of 1541 COVID-19 survivors were included firstly and 15.2% reported PTSD symptoms, 1108 participants left after PSM. Four risk factors were identified: higher severity of COVID-19 infection, fatigue, COVID-19 related stigma and poor sleep quality. When designing psychological interventions to alleviate PTSD symptoms of COVID-19 survivors, reducing stigma and fatigue, and improve their sleep quality are suggested.

Quality of life of children with neurodevelopmental disorders and their parents during the COVID-19 pandemic: a 1-year follow-up study

This study aimed to reveal changes in the quality of life (QOL) of children with neurodevelopmental disorders and their parents, and the interaction between their QOL and parental mental state during the coronavirus 2019 (COVID-19) pandemic. Eighty-nine school-aged children and parents participated in surveys in May 2020 (T1) and May 2021 (T2). The parents completed questionnaires that assessed their QOL, depression, parenting stress, and living conditions. Children's temporary mood status was evaluated using the self-reported visual analog scale (VAS). Children's QOL and VAS at T2 were higher than their QOL at T1. Parents' QOL at T2 was lower than their QOL at T1. Severe parental depression at T1 had a synergistic effect on severe parenting stress and severe depressive state at T2. Additionally, children's high QOL at T1 had a synergistic effect on low parenting stress and children's high QOL at T2. Furthermore, children's low VAS scores and parents' low QOL at T2 were associated with deterioration of family economic status. Children and parents' QOL changed during the prolonged COVID-19 pandemic. Improvement in children's QOL was influenced by reduced maternal depressive symptoms. Public support for parental mental health is important to avoid decreasing QOL.

Health-related quality of life among older adults who experienced the Pohang earthquake in South Korea: A cross-sectional survey

Background

Earthquakes are global natural disasters and can cause loss of property, livelihood and affect human health. A 5.4 magnitude earthquake, the Pohang earthquake, occurred in South Korea in 2017. In this study, based on a health-related quality of life (HRQOL) conceptual model, we examined the HRQOL and its associated factors among older adults who had experienced the earthquake.

Methods

A cross-sectional study was conducted with a quota sample of 312 older adults living in eight villages of a district that was the most damaged area during the Pohang earthquake. Data were collected from January 15–March 19, 2019, via face-to-face interviews using structured questionnaires. Structural equation modeling was performed to explore the associations among depression, posttraumatic stress symptoms, community resilience, social support, disaster preparedness, and HRQOL.

Results

The mean age of the participants was 77.93 ± 6.11 years. HRQOL scores were 49.85 ± 18.07 (physical health), 50.16 ± 18.75 (psychological health), 61.93 ± 19.20 (social relations), and 49.53 ± 16.37 (environment). The structural equation modeling analysis showed a good fit. Depression had direct (β =  − 2.21; p < 0.001), indirect (β =− 0.23; p < 0.001), and total effects on HRQOL (β =  − 2.44; p < 0.001). Community resilience (β = 6.05; p = 0.001) and social support (β = 0.12, p = 0.001) had direct and total effects on HRQOL. Disaster preparedness had indirect (β = 0.40; p = 0.001) and total (β = 0.69, p = 0.031) effects on HRQOL. In contrast, posttraumatic stress symptoms did not have significant effects on HRQOL.

Conclusions

Our findings indicated that lower depression, higher community resilience, social support, and disaster preparedness were associated with increased HRQOL. Thus, it is helpful to decrease depression and strengthen community resilience, social support, and disaster preparedness to promote HRQOL among older adults who have experienced earthquakes. These results can inform the development of HRQOL in socio-psychological improvement programs for older adults in community health centers and disaster-relief psychological support centers.

Subjective Wellbeing and Related Factors of Older Adults Nine and a Half Years after the Great East Japan Earthquake: A Cross-Sectional Study in the Coastal Area of Soma City

This study examined older adults’ subjective wellbeing and related factors in the coastal area of Soma City nine and a half years after the Great East Japan Earthquake (GEJE). Data were collected from 65- to 84-year-old residents and 1297 participants via a questionnaire from October to November 2020. The participants were divided into two groups: housing complexes and non-housing complexes. The dependent variable was subjective wellbeing assessed via Lawton’s Philadelphia Geriatric Center Morale Scale (PGCMS). Using multivariate regression analysis, the factors most strongly related to a low PGCMS score for both groups were poor health conditions, difficulties resting while asleep, poor financial wellbeing, inability to chew certain foods, and fear of solitary death. The GEJE experience was further distinguished in the housing complex group by the loss of an important non-family individual; for the other group, important factors were female gender, junior high school education level or lower, limited social networks, and deterioration of a family member’s health. Older adults’ subjective wellbeing in Soma City was low after nine and a half years following the GEJE. For disaster victims and their families in both groups, it is crucial to implement measures such as long-term, continuous physical and mental health support.

Health-related quality of life among survivors in minority area 2 years after Jiuzhaigou earthquake: A cross-sectional study

To investigate the health-related quality of life (HRQoL) and related factors, the symptoms of posttraumatic stress disorder (PTSD) among earthquake survivors in minority area 2 years after Jiuzhaigou earthquake.Two years after the Jiuzhaigou earthquake, a cross-sectional survey was conducted by a multi-stage sampling approach. HRQoL was measured by the short form 12 (SF-12), PTSD was measured by the PTSD Check List-Civilian Version (PCL-C), and social support was measured by the Multidimensional Scale of Perceived Social Support. Descriptive statistics, t-tests, ANOVA and multiple linear regression analysis were used for data analysis.Of the 561 participants, the mean scores on the physical component summary (PCS) and mental component summary (MCS) were 46.36 ± 12.79 and 55.03 ± 8.73, and 5.73% reported the symptoms of PTSD. Lower PCS and MCS after an earthquake were associated with elderly age, physical illness, and low level of social support (P < .05). Meanwhile, PTSD was significantly associated with MCS.These findings showed that physical disease and psychological symptoms can adversely affect the HRQoL of survivors. Moreover, providing higher social support to survivors should be considered as a way to improve the HRQoL outcomes of survivors.

Examining moderators of the relationship between social support and self-reported PTSD symptoms: A meta-analysis

Social support is one of the most robust predictors of posttraumatic stress disorder (PTSD). Yet, little is known about factors that moderate the relationship between social support and PTSD symptom severity. This meta-analysis estimated the overall effect size of the relationship between self-reported social support and PTSD severity and tested meaningful demographic, social support, and trauma characteristics that may moderate this association using both cross-sectional and longitudinal effect sizes. A comprehensive search identified 139 studies with 145 independent cross-sectional effect sizes representing 62,803 individuals and 37 studies with 38 independent longitudinal effect sizes representing 25,792 individuals. Study samples had to comprise trauma-exposed, nonclinical adult populations to be included in the analysis. Cross-sectional and longitudinal analyses revealed a near medium overall effect size (rcross = -.27; 95% CI [-.30, -.24]; rlong = -.25; 95% CI [-.28, -.21]) with a high degree of heterogeneity (cross-sectional I2 = 91.6, longitudinal I2 = 86.5). Both cross-sectional and longitudinal moderator analyses revealed that study samples exposed to natural disasters had a weaker effect size than samples exposed to other trauma types (e.g., combat, interpersonal violence), studies measuring negative social reactions had a larger effect size than studies assessing other types of social support, and veteran samples revealed larger effect sizes than civilian samples. Several other methodological and substantive moderators emerged that revealed a complex relationship between social support and PTSD severity. These findings have important clinical implications for the types of social support interventions that could mitigate PTSD severity. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Psychosocial Well-Being of School-Aged Children Born to Bereaved (Shidu) Families: Associations with Mothers' Quality of Life and Involvement Behaviors

Parents who lost their only child in the 12 May 2018 Wenchuan earthquake came to be known as the “shidu” (loss of an only child) parents. After the earthquake, they were beneficiaries of free reproductive health services, and most had another child. This study focuses on the psychosocial well-being of those children born to the shidu parents, and explores factors associated with mothers’ quality of life (QoL) and their involvement with their children. A cross-sectional survey was conducted in two primary schools in Wenchuan County. A sample of 192 families was analyzed (147 non-shidu and 45 shidu). The statistical analyses indicated that the children of shidu families had poorer peer relationships than children of non-shidu families. Moreover, shidu mothers’ expectations of their children’s achievements were significantly lower than for non-shidu mothers, but there was no statistically significant difference in the QoL between them. Additionally, a higher home-based involvement of mothers was found to be moderately associated with peer relationship problems of children in shidu families. Therefore, we suggest a future research focus on developing joint activities for parents and children that help to increase emotional communication for the psychosocial development of children in shidu families after disasters in China.

Associations among trauma exposure, post-traumatic stress disorder, and depression symptoms in adolescent survivors of the 2013 Lushan earthquake

BACKGROUND

Post-traumatic stress disorder (PTSD) frequently occurs in survivors of natural disasters, while symptom of depression is related mostly to interpersonal trauma. These conditions are highly correlated and strongly impact adolescent quality of life. This study aimed to explore the relationship among trauma exposure, PTSD symptoms, and/or depression symptoms in adolescent survivors of the 2013 Lushan (China) earthquake.

METHODS

A cross-sectional survey of 2921 adolescents in the Longmenshan seismic fault zone was conducted three years after the Lushan earthquake. Participants were evaluated using the Earthquake Experience Scale, the Adolescent Self-rating Life Events Checklist (ASLEC), the Children's Revised Impact of Event Scale (CRIES-13), and the Depression Self-Rating Scale (KADS-6). Stepwise regression was used to explore relationships between trauma exposure and PTSD or depression symptoms.

RESULTS

There was a strong correlation between PTSD and depression symptoms, with a 10.7% comorbidity. Earthquake-related exposure, negative life events, prior exposure to the 2008 Wenchuan (China) earthquake, and being left behind by parents all contributed to PTSD and depressive symptoms. Earthquake exposures contributed mainly to PTSD symptoms, while interpersonal traumas contributed mainly to depression symptoms.

CONCLUSION

PTSD and depression symptoms strongly correlate in adolescent survivors of the 2013 Lushan earthquake. The high comorbidity between PTSD and depression symptoms may reflect shared risk factors. Natural disasters are more likely to cause PTSD symptoms, while interpersonal traumas are more likely to cause depression symptoms.

Perceived social support functions as a resilience in buffering the impact of trauma exposure on PTSD symptoms via intrusive rumination and entrapment in firefighters

Resilience has been highlighted as a pivotal factor in overcoming the detrimental impact of trauma. The present study tests a resilience model of trauma using risk (rumination, emotion regulation, and entrapment) and protective (perceived social support) factors in a sample of firefighters who are at heightened risk for post-traumatic stress disorder, using a cross-sectional design. Specifically, the present study focuses on perceived social support as a resilience factor against PTSD symptoms, in response to trauma exposure. The sample included 545 firefighters from six large cities in Korea, who completed the following self-report questionnaires: Life Event Checklist, Event-related Rumination Inventory, Emotion Regulation Questionnaire, Entrapment scale, Impact of Event Scale-Revised, and Duke-UNC Functional Social Support Questionnaire. Exposure to traumatic events indirectly affected PTSD symptoms via intrusive rumination, emotional regulation, and perceptions of entrapment. Additionally, the mediating effects of intrusive rumination and perceptions of entrapment were moderated by perceived social support. That is, firefighters with high levels of perceived social support reported lower severity of rumination and PTSD symptoms. These findings suggest that perceptions of social support may operate as a resilience factor in buffering the effects of trauma on PTSD symptoms. Perceived social support interacts with intrusive rumination and perceptions of entrapment, thereby resisting the development of PTSD symptoms.

Scientific evidence on natural disasters and health emergency and disaster risk management in Asian rural-based area

INTRODUCTION

Disaster epidemiological studies indicate that Asia has the highest frequency of natural disasters. Rural communities are heavily impacted by natural disasters and have different healthcare needs to urban ones. Referencing Asian countries, this paper's objective is to provide an overview of health impacts and the current evidence for designing programmes and policies related to rural health emergency and disaster risk management (health-EDRM).

SOURCES OF DATA

This paper uses published English-only reports and papers retrieved from PubMed, Google Scholar, Embase, Medline and PsycINFO on rural disaster and emergency responses and relief, health impact and disease patterns in Asia (January 2000-January 2018).

AREAS OF AGREEMENT

Earthquakes are the most studied natural disasters in rural communities. The medical burden and health needs of rural communities were most commonly reported among populations of extreme age. Most of the existing research evidence for rural interventions was reported in China. There lacks published peer-reviewed reports of programme impacts on personal and community preparedness.

AREAS OF CONTROVERSY

There is a lack of evidence-based health-EDRM interventions to evaluate implementation effectiveness in rural areas despite vast volumes of health-related disaster literature.

GROWING POINTS

Climate change-related disasters are increasing in frequency and severity. Evidence is needed for disaster risk reduction interventions to address the health risks specific to rural populations.

AREAS TIMELY FOR DEVELOPING RESEARCH

To support global policy development, urgent evidence is needed on the intervention effectiveness, long-term health outcomes, local and cultural relevance as well as sustainability of health relief produced by Health-EDRM programmes in rural areas.

A senior high school-based survey on the long-term impact of the Wenchuan earthquake on survivors' quality of life: PTSD as a mediator

Previous earthquake-related studies mostly focused on the prevalence and risk factors of post-traumatic stress disorder (PTSD), and there are only a few articles on the subsequent long-term outcomes of earthquakes. This study aimed to investigate the long-term impact of the Wenchuan earthquake on the quality of life (QOL) of surviving senior high school students 2-3 years post-disaster and to clarify whether PTSD was a mediator in the relationship of earthquake-related exposure and QOL. The study collected 1031 survivors' self-report questionnaires on socio-demographic data, earthquake-related experiences, PTSD symptoms (PCL-C), and QOL (WHOQOL-BREF). The results showed that earthquake-related exposure experiences were negatively associated with QOL scores, and the severity of PTSD symptoms was significantly and negatively related to QOL scores. Structural equation model (SEM) analysis showed that earthquake-related exposure was directly related to the severity of PTSD symptoms, while insignificantly directly related to QOL. Therefore, earthquake-related exposure was indirectly related to QOL (totally mediated by severity of PTSD symptoms). PTSD was a mediator in the relationship between earthquake-related exposure and QOL among adolescents: earthquake-related exposure affected the survivors' QOL mainly mediated by the PTSD symptoms that developed. Therefore, to improve the QOL of the survivors after an earthquake, more attention should be paid to survivors who have PTSD symptoms.

Factors associated with social support in child-rearing among mothers in post-disaster communities

Background

Natural disasters have long-term negative impacts on the health and socioenvironmental conditions of a population, affecting the physical environment as well as the relationships within the community, including social networks. Mothers in post-disaster communities may have difficulty receiving social support not only from family members and relatives but also from members of their community, such as people in their neighborhoods. This study focused on mothers with infants and preschool-aged children in post-disaster communities. The associations of social support with sociodemographic characteristics and socioenvironmental conditions related to child-rearing among mothers in post-disaster communities were assessed.

Methods

An anonymous self-administered questionnaire survey was conducted in October 2015 in 988 households in areas affected by the Great East Japan Earthquake and Tsunami. The data collected on sociodemographic and socioenvironmental characteristics included the presence of pre-disaster acquaintances in the neighborhood and social support for child-rearing. The associations of sociodemographic and socioenvironmental characteristics with social support were examined.

Results

We analyzed 215 completed questionnaires from mothers living in different houses from those they lived in before the disaster to reflect continuous relationships with people from the pre-disaster communities. Social support was significantly associated with infant sex, extended family, support obtained from relatives not living together, pre-disaster acquaintances, use of child support resources, and no perceived difficulties in child-rearing. In addition, the presence of pre-disaster acquaintances was associated with categories of mental/physical place of comfort and child-rearing support, with adjusted odds ratios of 1.88 (95% CI 1.03–3.44) and 2.84 (95% CI 1.46–5.52) compared with mothers who did not have any pre-disaster acquaintances.

Conclusions

Factors associated with the obtainment of social support in child-rearing among mothers in post-disaster communities were attributed not only to mothers themselves and family members but also to socioenvironmental factors such as the presence of pre-disaster acquaintances. The presence of pre-disaster acquaintances promoted rich social support in child-rearing in post-disaster communities. When reconstructing a community following changes in residence location after a disaster, the pre-disaster relationships among the community dwellers should be considered from the viewpoint of child-rearing support.

Electronic supplementary material

The online version of this article (10.1186/s12199-018-0747-7) contains supplementary material, which is available to authorized users.

The prevalence of posttraumatic stress in adolescents eight years after the Wenchuan earthquake

In 2008, an 8.0 Richter scale earthquake devastated Wenchuan in China, which resulted in heavy casualties, and had wide-reaching psychological effects on survivors. To examine its impact on the survivors, this study aims to investigate the prevalence of posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG) in adolescents eight years after the earthquake. The cross-section survey was conducted in two different earthquake-affected areas, and data were collected from 4118 respondents. Instruments included the questionnaire on demographic information, the questionnaire on seismic exposure, PTSD Checklist-Civilian Version (PCL-C) questionnaire, Posttraumatic Growth Inventory (PTGI), Perceived Social Support Scale (PSSS) and Simple Coping Style Questionnaire (SCSQ). During the survey, there were 1998 valid questionnaires from the generally affected area and 2120 questionnaires from the severely affected area. The rate of PTSD is 1.9% in the generally affected area and 2.7% in the severely affected disaster area; there is no significant difference between the two differently affected areas. Occurrences of PTSD and PTG are significantly positively correlated in the generally affected area, nevertheless, there is a significant negative correlation between PTSD and PTG in most systems of the severely affected area. The results of this study help to expand our knowledge regarding posttraumatic stress in adolescents 8 years after the Wenchuan earthquake, and it provides suggestions for specific long-term health interventions in such populations. To prevent earthquake-related psychological issues among adolescent survivors, social support, psychological aid, and improvement of the living environment are necessary to buffer negative posttraumatic stress.

Effectiveness of cognitive-behavioural therapy for post-disaster distress in post-traumatic stress symptoms after Chilean earthquake and tsunami

OBJECTIVE

This is the first time that the effectiveness of cognitive-behavioural therapy for post-disaster stress (CBT-PD) in symptoms of posttraumatic stress disorder (PTSD) has been tested outside the United States of America.

DESIGN

Quasi-experiment with three groups. In the quasi-control group, complete CBT-PD was applied even though its members did not have PTSD; in quasi-experimental conditions, participants received complete treatment because they had this diagnosis; and in the third group, participants with PTSD received an abbreviated treatment (double sessions) due to organisational requirements.

LOCATION

Primary health care workers in Constitución (Chile), city exposed to earthquake and tsunami; public department workers in Talca (city exposed only to earthquake) and teachers from a school (Constitución).

PARTICIPANTS

A total of 13 of the 91 people diagnosed with PTSD participated. In addition, 16 people without diagnosis voluntarily participated. The treatment was completed by 29 participants. There were no dropouts. Only 1 of the 9 participants in the quasi-experimental group did not respond to treatment.

INTERVENTIONS

CBT-PD is a group therapy (10-12 sessions) that includes psychoeducation, breathing retraining, behavioural activation and cognitive restructuring. CBT-PD (complete and abbreviated) was applied between September and December 2010.

MEASUREMENTS

Short Posttraumatic Stress Disorder Rating Interview (SPRINT-E) was used to measure PTSD symptoms before and after treatment.

RESULTS

The group that received the complete treatment and was diagnosed with PTSD showed a significant decrease in the total symptoms to below dangerous levels (IGA_AB: 31.556; p<0.01; 95%CI: 0.21-2.01]; η²=0.709).

DISCUSSION

The effectiveness and benefits of incorporating CBT-PD in the health network after events like disasters were discussed.

Association Between Resilience and Quality of life in Wenchuan Earthquake Shidu parents: The Mediating Role of Social Support

Of the Wenchuan earthquake victims, there was a special group who lost their only child, known as the Shidu parents. The purpose of this paper is to examine social support as a moderator between resilience and quality of life (QOL) in Shidu parents. A cross-sectional sample survey was conducted to collect data from 22 earthquake-stricken counties in Sichuan province. Of the Shidu parents from the Wenchuan earthquake, being of Han ethnicity, receiving a high monthly income, having a high education, having lost a younger child (18-27), and having lost a male child were all risk factors for a lower QOL (p < 0.05). This study highlighted that different types of social support have different roles in building resilience and improving QOL. The results emphasized the importance of developing suitable social support strategies as mediators to improve resilience and the QOL in Shidu parents.

Mental health problems among survivors in hard-hit areas of the 5.12 Wenchuan and 4.20 Lushan earthquakes

BACKGROUND

Earthquake exposure has often been associated with psychological distress. However, little is known about the cumulative effect of exposure to two earthquakes on psychological distress and in particular, the effect on the development of post-traumatic stress disorder (PTSD), anxiety and depression disorders.

AIMS

This study explored the effect of exposure on mental health outcomes after a first earthquake and again after a second earthquake.

METHODS

A population-based mental health survey using self-report questionnaires was conducted on 278 people in the hard-hit areas of Lushan and Baoxing Counties 13-16 months after the Wenchuan earthquake (Sample 1). 191 of these respondents were evaluated again 8-9 months after the Lushan earthquake (Sample 2), which struck almost 5 years after the Wenchuan earthquake.

RESULTS

In Sample 1, the prevalence rates for PTSD, anxiety and depression disorders were 44.53, 54.25 and 51.82%, respectively, and in Sample 2 the corresponding rates were 27.27, 38.63 and 36.93%. Females, the middle-aged, those of Tibetan nationality, and people who reported fear during the earthquake were at an increased risk of experiencing post-traumatic symptoms.

CONCLUSIONS

Although the incidence of PTSD, anxiety and depression disorders decreased from Sample 1 to Sample 2, the cumulative effect of exposure to two earthquakes on mental health problems was serious in the hard-hit areas. Therefore, it is important that psychological counseling be provided for earthquake victims, and especially those exposed to multiple earthquakes.

The relationship between post-traumatic stress disorder and quality of life in infertile Shidu parents from the 2008 Sichuan earthquake: the moderating role of social support

WHAT IS KNOWN ON THE SUBJECT?: Since the promulgation of the one-child policy in 1979, most families have had only one child. Shidu parents, as a special group of Sichuan 2008 earthquake victims, are parents who lost their only child in the earthquake. WHAT DOES THIS PAPER ADDED TO EXISTING KNOWLEDGE?: Shidu parents are an especially vulnerable group in China. This study was the first systematic population-based investigation to explore quality of life (QOL) risk factors and to examine the moderating role of social support between post-traumatic stress disorder (PTSD) and QOL in Shidu parents. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The results found that further social support should be provided as a long-term mental health intervention strategy to promote QOL in Shidu parents suffering from PTSD. The research may provide information to assist psychologists in post-disaster mental health interventions with Shidu parents and to inspire decision makers who work with similar groups in other countries.

ABSTRACT

Introduction Because of the one-child policy in force in China from 1979 to 2015, most parents were only allowed to have a single child. Of all the Sichuan earthquake victims, there was a special group called the Shidu parents who lost their only child in the earthquake. Aim The aim of this study was to identify the related risk factors for the Shidu parents' quality of life (QOL) and to examine the role of social support as a moderator between post-traumatic stress disorder (PTSD) and QOL in Shidu parents. Method A cross-sectional sample survey was conducted to collect data from 10 heavily damaged counties in Sichuan province (n = 176). Discussion PTSD was found to be negatively associated with the Shidu parents' QOL, and social support had a major effect on moderating the association between the PTSD and QOL in Shidu parents. Implications for practice Developing suitable social support could be considered a key part of psychological intervention strategies to promote QOL in Shidu parents suffering from PTSD. This study could provide decision support for mental health professionals (e.g. nurses and psychiatrists) working on mental crisis interventions with Shidu parents.

Perceived Changes in Social Relations after Earthquake Trauma among Eastern Anatolian Women: Associated Factors and Mental Health Consequences

In this study, we examined social relations in women exposed to earthquake trauma in Eastern Anatolia, Turkey. We examined women's perceptions regarding the changes in their social relations within their neighbourhood, within their marriage and with their children; analysed the factors that were associated with these relations; and tested the hypothesis that an improvement in social relations will protect women's mental health from the negative impact of earthquake trauma. Participants consisted of a random selection of 1253 women, who were interviewed regarding their psychosocial needs and mental health status 1 year after earthquake. They reported trauma-related changes in their social relations; their mental health was evaluated using the Post Traumatic Stress Diagnostic Scale and Brief Symptom Inventory. Our study demonstrated severe earthquake trauma was associated with deteriorated social relations, especially neighbourhood and marital relations. Deteriorated marital and child relations were associated with increased levels of psychiatric distress; deteriorated neighbourhood relations were associated with intrusive posttraumatic stress symptoms. Improved neighbourhood relations, but not family relations, were able to protect women's mental health from the negative impact of trauma. The results are discussed regarding their relevance to gender effects and the provision of relation-specific and symptom-specific disaster relief. Copyright © 2014 John Wiley & Sons, Ltd.

The association between exposure and psychological health in earthquake survivors from the Longmen Shan Fault area: the mediating effect of risk perception

Background

In this study, exposure refers to survivors who suffered from life-changing situations, such as personal injuries, the deaths or injury of family members, relatives or friends or the loss of or damage to personal or family property, as a result of the earthquake. The mediating effect of risk perception on the exposure and psychological health in survivors from the Longmen Shan Fault area and the moderating effect of social support on the relationship between risk perception and psychological health were both examined.

Method

A cross-sectional survey was conducted in a local Longmen Shan Fault area near the epicenter of the 2008 Wenchuan earthquake. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), the standard Chinese 12-item Short Form (SF-12v2), and the Social Support Rating Scale (SSRS) were used to interview 2,080 earthquake survivors in the period one-year after the earthquake. Based on the environment and the characteristics of the Longmen Shan Fault area, a risk perception questionnaire was developed to evaluate survivor risk perception. Factor and regression analyses were conducted to determine the hypothetical relations.

Results

The analyses provided effective support for the hypothesized model. Survivor risk perception was classified into direct risk perception and indirect risk perception. Survivor direct risk perception was found to play a partial mediating role in the relationship between exposure and the two domains (Physical component summary (PCS) and the Mental component summary (MCS)) of psychological health. Survivor indirect risk perception was found to have a only partial mediating effect on the association between exposure and MCS. Social support was found to moderate the influence of risk perception on psychological health.

Conclusion

Risk communication should be considered in future post-earthquake psychological assistance programs and social support strategies could also be useful in improving psychological health.

Perceived Social Support in Multi-era Veterans With Posttraumatic Stress Disorder

Low social support is associated with greater prevalence and severity of posttraumatic stress disorder (PTSD). However, the factors that explain the association between social support and PTSD are not well understood. In the current study, 741 VA patients who presented to a PTSD clinic between 2005 and 2013 completed assessments of symptom severity and social support. Analysis of variance and linear regression tested the associations between social support, sociodemographic characteristics, and PTSD symptom severity. In adjusted analyses, social support was robustly associated with PTSD severity (β = -0.30, p < 0.001). After stratification by combat era, this association remained significant for all era veterans except veterans of the post-Vietnam/Desert Storm era. Other sociodemographic characteristics did not affect the association between social support and PTSD. Our findings suggest that the detrimental effects of poor social support pervade across sociodemographic groups and that efforts to improve social support in veterans with PTSD are needed.

Posttraumatic stress disorder and posttraumatic growth coexistence and the risk factors in Wenchuan earthquake survivors

Various studies have assessed the negative and/or positive changes in the aftermath of traumatic events. Yet few of these have addressed the factors associated with the coexistence of both negative and positive changes after a devastating earthquake. The aim of this study is to assess the relationship between the negative and positive changes and elucidate the risk factors of such changes one year after Wenchuan earthquake. A total of 2080 survivors from 19 counties participated in a self-report questionnaire survey which included the posttraumatic stress disorder (PTSD) Check list-Civilian, the posttraumatic growth PTG Inventory (PTGI). The prevalence of PTSD and moderate PTG was found to be 40.1% (95% CI [37.9% 42.3%]) and 51.1% (95% CI [48.9% 53.3%]). The PTSD and moderate PTG coexistence was 19.6% (95% CI [17.8% 21.4%]). PTSD symptom severity was significantly positively associated with the PTG score. Middle aged groups (31-40 and 41-50 years old, OR=2.323, 95% CI [1.059, 5.095] and OR=2.410, 95% CI [1.090, 5.329] respectively), those with lower income levels (OR=8.019, 95% CI [2.421, 26.558]), those living in temporary house (OR=1.946, 95% CI [1.280, 2.956]), and those who had had less social support (OR=1.109, 95% CI [1.076, 1.143]) had a significantly higher possibility for the presence of PTSD and moderate PTG coexistence. The results indicated the widespread positive changes in earthquake survivors. Better income levels and living conditions and higher social support were suggested to promote PTG in those with PTSD.

An evaluation of the buffering effects of types and sources of support on depressive symptoms among natural disaster exposed Chinese adults

OBJECTIVE

Social support is a key protective factor for people exposed to natural disasters. The effect of type and source of this support is not well documented. Investigations are needed to identify the specific modifying role of received and perceived support from family and friends on the association between disaster exposure and depressive symptoms.

METHODS

Face-to-face household interviews were conducted in 2014 with a random sample of 751 adults recruited from Yuexiu and Tianhe districts in Guangzhou, China. Sampling was accomplished through spatial epidemiological methods. Participants' exposure to disaster, depressive symptoms, and social support networks was recorded on tablet devices. Multiple regression analysis was used to test the potential moderating role of social support on depression symptoms.

RESULTS

A total of 30.24% reported natural disaster exposure. Disaster exposure and received family support were significantly and positively related to depressive symptoms. In contrast, perceived family support moderated the relationship between disaster exposure and depressive symptoms. No association was found between support from friends and depressive severity.

CONCLUSION

Perceived family support buffered the effect of disaster exposure in this sample, while received family support was associated with increased depression. Perceived family support is an important resource among those who experience disaster exposure and actual provision of family support may be harmful or miscarried. Natural disasters are becoming increasingly prevalent in Asia. According to the Economic and Social Commission for Asia and the Pacific (ESCAP, 2015a), a total of 119 disaster events, accounting for more than half of the total number of disasters occurred in the world, took place in Asia in 2014, affecting 79.6 million people, among whom 6050 died. The Chinese Mainland experienced several major natural disasters, including the earthquake in Wechuan, Sichuan Province, in 2008 and natural disasters affected more than 500,000 people causing 0.4% of GDP loss (roughly US$3 trillion; ESCAP, 2015b). The current study investigated the effect of social resources on mental health following natural disaster exposure.

Application of the eight-item modified medical outcomes study social support survey in Japan: a national representative cross-sectional study

PURPOSE

This study aimed to create a Japanese version of the eight-item version of modified medical outcomes study social support survey (mMOS-SS), investigate psychometric property, and determine the standard values for Japanese citizens by using a nationally representative sample from the general population.

METHODS

A stratified two-stage sampling was conducted with 4000 Japanese men and women who were in the age group of 25-74 as of January 01, 2014. From February to March 2014, placement method was conducted using self-administered questionnaire. Consequently, 2067 questionnaires were gathered (a collection rate of 51.7%). Thus, the target of analysis was 952 males and 1100 females.

RESULTS

The results of factor analysis showed that each of the samples exhibited two types of factors, i.e., emotional and instrumental, just as was the case with the original version. The Cronbach's alpha ranged from 0.90 to 0.95 for each of the samples for both total score and the subscales. On comparing the groups by married versus unmarried and living alone versus not living alone, those not living alone and married people had significantly higher scores (p < 0.05) for each group except for married females less than 50 years. There was a significant positive correlation among mental health, life satisfaction, and self-rated health.

CONCLUSION

This study revealed that the eight-item Japanese version of the mMOS-SS had the same psychometric properties as those found in the research results of the English version.

Happily Ever After? Pre-and-Post Disaster Determinants of Happiness Among Survivors of Hurricane Katrina

This study investigated pre- to post-disaster changes in happiness of 491 women affected by Hurricane Katrina, and identified factors that were associated with the survivors' happiness after the storm. Participants completed surveys approximately 1 year before and 1 and 4 years after the storm. The surveys collected information on the women's happiness, social support, household characteristics, and hurricane exposure. We found that happiness significantly decreased from pre-disaster to 1 year post-disaster but there were no significant differences in happiness between the pre-disaster and 4 years post-disaster assessments. An exception were 38 women who continued to have lower levels of happiness 4 years post-disaster than at pre-disaster. These women were more likely to be living on their own after the storm and reported consistently lower levels of perceived social support from the community both before and after the storm than the other women of the sample. Factors associated with the survivor's happiness after the storm included exposure to hurricane stressors and losing a loved one to the hurricane. These were predictive of lower happiness 1 year post-disaster. Four years after the hurricane only exposure to hurricane stressors was predictive of lower levels of happiness. In contrast, pre-disaster happiness and post-disaster social support were protective against the negative effect of the hurricane on survivors' happiness.

Factors associated with resilience of adult survivors five years after the 2008 Sichuan earthquake in China

Given the paucity of quantitative empirical research on survivors’ resilience and its predictors in the context of long-term recovery after disasters, we examined how resilience predictors differed by gender among adult survivors five years after the Sichuan earthquake. This was a cross-sectional survey study of adult survivors (N = 495; aged 18–60) living in reconstructed communities five years into the recovery process after the Wenchuan earthquake. The instruments we used included assessments of sociodemographic characteristics and earthquake exposure level, the Connor-Davidson Resilience Scale, and the Social Support Rating Scale. Support-seeking behaviors emerged as a significant predictor of male survivors’ resilience, while subjective support and marital status were found to be predictors of female survivors’ resilience. Annual household income and chronic disease were predictors for both male and female groups. The findings of this study can be used in devising methods to boost survivors’ resilience by promoting their satisfaction with social support and their ability to obtain effective support. Additionally, the results suggest how to assist survivors who may have relatively poor resilience.

Satisfaction With Economic and Social Rights and Quality of Life in a Post-Disaster Zone in China: Evidence From Earthquake-Prone Sichuan

Objective

This study explored the influence of satisfaction with economic and social rights (ESR) on the quality of life (QOL) of people in post-disaster zones in Sichuan, China.

Methods

Data from a survey conducted in 2013 in the 5 hardest hit counties in the earthquake-prone area of Sichuan were used. QOL was measured by use of the brief version of the World Health Organization Quality of Life questionnaire (WHOQOL-BREF). Structural equation models were developed to determine the specific features of the influence of satisfaction with ESR on QOL.

Results

The mean values of both the WHOQOL-BREF scale and the ESR satisfaction scale were lower than the midpoint of the scales. Satisfaction with ESR had a significant effect on psychological health, social relationships, and environment, apart from physical health. Satisfaction with the right to food had the greatest effect on QOL, followed by the rights to education, work, health, social security, and housing.

Conclusions

Satisfaction with ESR had a significant positive influence on the QOL of people in a post-disaster zone, particularly satisfaction with the right to food. Policies on food and education guarantees and mental health intervention are highlighted. (Disaster Med Public Health Preparedness. 2015;9:111-118)

HIV-related behaviors, social support and health-related quality of life among men who have sex with men and women (MSMW): a cross-sectional study in Chongqing, China

Background

Health-related quality of life (HRQOL) has become commonly used both as a concept and as a field of research. However, little is known about the HRQOL of men who have sex with men and women (MSMW). The aim of this study was to examine HIV-related behaviors, social support, and HRQOL status and explore its predictors among MSMW.

Methods

An anonymous cross-sectional study was conducted by snowball sampling method in 2013. A total of 563 Chinese MSM completed a structured questionnaire. The HRQOL and social support were measured with the Chinese version of the World Health Organization Quality of Life Scale (WHOQOL-BRFE) and the Social Support Rating Scale (SSRS), respectively.

Results

Of the 563 MSM analyzed, 77 (13.68%) were MSMW who had a higher proportion of in-marriage and preference for an insertive role as compared with the men who have sex with men only (MSMO) (P<0.05). As high as 70.13% of MSMW had no regular sex partners and 72.73% of MSMW reported engaging in unprotected anal sex in the last six months. 36.36% had tested for HIV, while only 12.99% had accepted HIV voluntary counseling and testing (VCT) services. The scores of objective support and subjective support in MSMW were significantly higher than that of MSMO (P<0.05). No statistically significant difference was found in scores of all the four domains of the HRQOL between MSMW and MSMO. When comparing the HRQOL scores of MSMW with the Chinese general population reference group, the scores of MSMW were significantly lower in physical health domain. In a multivariate regression model, age, monthly income, sexual role, VCT acceptability, subjective support were associated with variability in HRQOL.

Conclusions

To improve the HRQOL among MSMW, more attention needs to be paid to those with low social support, low-income, the old and those prefer a receptive role during anal sex populations.

Social support and mental health treatment among persons with PTSD: results of a nationally representative survey

OBJECTIVE

Despite continued outreach efforts, levels of mental health care utilization for posttraumatic stress disorder (PTSD) remain low. As such, it is important to identify factors that may promote or discourage treatment engagement. This study was designed to examine the association between perceived social support and utilization of several types of PTSD services.

METHODS

Data came from wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions, which was administered between 2004 and 2005. PTSD was assessed via structured interview, and perceived social support was assessed via the Interpersonal Support Evaluation List-12. Participants were asked about receipt of four modalities of PTSD-specific treatment: outpatient, hospitalization, emergency department visits, and psychiatric medication prescriptions. Weighted logistic regression modeling was performed to examine associations between social support scores and the odds of receiving treatment for PTSD, and the analyses were adjusted for sociodemographic characteristics and PTSD severity.

RESULTS

The final sample consisted of 2,811 individuals with PTSD. Social support was not associated with the odds of receiving any type of PTSD treatment.

CONCLUSIONS

Among individuals in the general population with PTSD, perceived social support may not be related to PTSD treatment utilization. Other factors, such as sociodemographic characteristics and symptom severity, may be more important predictors of receipt of PTSD-specific treatment.

Facebook, quality of life, and mental health outcomes in post-disaster urban environments: the l'aquila earthquake experience

Background: An understudied area of interest in post-disaster public health is individuals’ use of social networks as a potential determinant of quality of life (QOL) and mental health outcomes. A population-based cross-sectional study was carried out to examine whether continual use of online social networking (Facebook) in an adult population following a massive earthquake was correlated with prevalence of depression and post-traumatic stress disorders (PTSD) and QOL outcomes.

Methods: Participants were a sample of 890 adults aged 25–54 who had been exposed to the L’Aquila earthquake of 2009. Definition of “user” required a daily connection to the Facebook online social network for more than 1 h per day from at least 2 years. Depression and PTSD were assessed using the Screening Questionnaire for Disaster Mental Health. QOL outcomes were measured using the World Health Organisation Quality of Life BREF (WHOQOL-BREF) instrument. Logistic regression was carried out to calculate the prevalence odds ratios (POR) for social network use and other covariates.

Results: Two hundred and twenty one of 423 (52.2%) men, and 195 of 383 (50.9%) women, had been using Facebook as social network for at least 2 years prior to our assessment. Social network use correlated with both depression and PTSD, after adjusting for gender. A halved risk of depression was found in users vs. non-users (POR 0.50 ± 0.16). Similarly, a halved risk of PTSD in users vs. non-users (POR 0.47 ± 0.14) was found. Both men and women using online social networks had significantly higher QOL scores in the psychological and social domains of the WHOQOL-BREF.

Conclusion: Social network use among adults 25–54 years old has a positive impact on mental health and QOL outcomes in the years following a disaster. The use of social networks may be an important tool for coping with the mental health outcomes of disruptive natural disasters, helping to maintain, if not improve, QOL in terms of social relationships and psychological distress.

Well-being and perceived quality of life in elderly people displaced after the earthquake in L'Aquila, Italy

On 6 April 2009, the city of L’Aquila was hit by a violent earthquake that destroyed almost all of its medieval centre, and the surviving inhabitants were evacuated and relocated in temporary quarters or undamaged homes. The aim of this study was to investigate the perceived quality of life of the elderly population 3 years after the earthquake in relation to the social and logistic issues of new housing. The study was carried out between October 2011 and March 2012, and involved 571 subjects aged over 65 years living in the municipality of L’Aquila. The interviews took place in the surgeries of general practitioners and the city’s Department of Prevention and Vaccination in the anti-influenza immunisation period. The instrument used was a 36-item questionnaire with closed, multiple choice answers divided into the following sections: demographics, everyday activities, health and perceived health, and the quality of life in the city. The results show that, 3 years after the earthquake, the elderly population living in the new towns and temporary housing of L’Aquila have a worse perception of their quality of life than the others. They feel a certain social isolation and wish to live elsewhere. Governments faced with the problems arising from a natural calamity should take into account all of the elements making up a good quality of life and, before making choices whose impact cannot be changed, consider both their immediate and long-term social consequences.

Coping strategies as a mediator of posttraumatic growth among adult survivors of the Wenchuan earthquake

Objective

By testing the mediating effect of coping strategies on the relationship between social support (SS) and posttraumatic growth (PTG), the aim of this research was to develop a new approach for the study of post-disaster psychological intervention.

Methods

A mediating effect model analysis was conducted on 2080 adult survivors selected from 19 of the counties hardest-hit by the 2008 Wenchuan earthquake. The Social Support Rating Scale and the Coping Scale were used to predict the PTG.

Results

A bivariate correlation analysis showed that there was a correlation between posttraumatic growth, social support and coping strategies. The mediation analysis revealed that coping strategies played a mediating role between social support and posttraumatic growth in survivors after the earthquake.

Conclusion

The results demonstrated that mental health programs for survivors need to focus on the establishment of a good social support network, which was found to be conductive to maintaining and increasing mental health levels. At the same time, adequate social support is able to assist survivors in adopting mature coping strategies, such as problem solving and asking for help. Hence, social support was found to play a vital role in balancing and protecting mental health.

A longitudinal study of quality of life of earthquake survivors in L'Aquila, Italy

BACKGROUND

People's well-being after loss resulting from an earthquake is a concern in countries prone to natural disasters. Most studies on post-earthquake subjective quality of life (QOL) have focused on the effects of psychological impairment and post-traumatic stress disorder (PTSD) on the psychological dimension of QOL. However, there is a need for studies focusing on QOL in populations not affected by PTSD or psychological impairment. The aim of this study was to estimate QOL changes over an 18-month period in an adult population sample after the L'Aquila 2009 earthquake.

METHODS

The study was designed as a longitudinal survey with four repeated measurements performed at six monthly intervals. The setting was the general population of an urban environment after a disruptive earthquake. Participants included 397 healthy adult subjects. Exclusion criteria were comorbidities such as physical, psychological, psychiatric or neurodegenerative diseases at the beginning of the study. The primary outcome measure was QOL, as assessed by the WHOQOL-BREF instrument. A generalised estimating equation model was run for each WHOQOL-BREF domain.

RESULTS

Overall, QOL scores were observed to be significantly higher 18 months after the earthquake in all WHOQOL-BREF domains. The model detected an average increase in the physical QOL scores (from 66.6 ± 5.2 to 69.3 ± 4.7), indicating a better overall physical QOL for men. Psychological domain scores (from 64.9 ± 5.1 to 71.5 ± 6.5) were observed to be worse in men than in women. Levels at the WHOQOL domain for psychological health increased from the second assessment onwards in women, indicating higher resiliency. Men averaged higher scores than women in terms of social relationships and the environmental domain. Regarding the physical, psychological and social domains of QOL, scores in the elderly group (age > 60) were observed to be similar to each other regardless of the significant covariates used.

CONCLUSIONS

WHOQOL-BREF scores of the psychological domain displayed trends conditioned by age and education: older subjects experienced less satisfaction with psychological health on average. Less-educated subjects always demonstrated the worst QOL scores. Gender, age and education impacted the variability of QOL in the environmental dimension in the elderly.

Social support as a moderator of the relationship between anxiety and depression: an empirical study with adult survivors of Wenchuan earthquake

BACKGROUND

On May 12th 2008, an earthquake with a magnitude of 8.0 on the Richter scale struck China, causing a large number of casualties and significant economic losses. By interviewing 2080 survivors of Wenchuan earthquake, the objective of this study is to estimate the role of different types of social support as possible moderating factors between anxiety and depression.

METHODS

A stratified random sampling strategy about the cross-sectional study was adopted. The self-rating anxiety scale (SAS), Self-Rating Depression Scale (SDS) and Social Support Rating Scale (SSRS) were used. A total of 2080 adult survivors of the Wenchuan earthquake from 19 damaged countries participated in the survey. Correlation analysis and regression analysis were performed to evaluate the moderating role of social support on the relationship between anxiety and depression.

RESULTS

One year after the Wenchuan earthquake, anxiety and depression were found to be 37.6% and 40.7%, respectively. Demographic characteristics were seen as significant in the cases of depression, except for age (p=0.599), while age and education level were not found to be significant for anxiety. The results showed that social support, especially subjective support could moderate the association between anxiety and depression.

CONCLUSIONS

Social support should be particularly focused on female survivors, those of the Han ethnic group, and those with a lower level of education and a lower income. Psychological intervention and care for survivors should focus on those most disoriented by the disaster.

Social support as a moderator of the relationship between anxiety and depression: an empirical study with adult survivors of Wenchuan earthquake

Background

On May 12th 2008, an earthquake with a magnitude of 8.0 on the Richter scale struck China, causing a large number of casualties and significant economic losses. By interviewing 2080 survivors of Wenchuan earthquake, the objective of this study is to estimate the role of different types of social support as possible moderating factors between anxiety and depression.

Methods

A stratified random sampling strategy about the cross-sectional study was adopted. The self-rating anxiety scale (SAS), Self-Rating Depression Scale (SDS) and Social Support Rating Scale (SSRS) were used. A total of 2080 adult survivors of the Wenchuan earthquake from 19 damaged countries participated in the survey. Correlation analysis and regression analysis were performed to evaluate the moderating role of social support on the relationship between anxiety and depression.

Results

One year after the Wenchuan earthquake, anxiety and depression were found to be 37.6% and 40.7%, respectively. Demographic characteristics were seen as significant in the cases of depression, except for age (p=0.599), while age and education level were not found to be significant for anxiety. The results showed that social support, especially subjective support could moderate the association between anxiety and depression.

Conclusions

Social support should be particularly focused on female survivors, those of the Han ethnic group, and those with a lower level of education and a lower income. Psychological intervention and care for survivors should focus on those most disoriented by the disaster.