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Sirotich AC, Camisasca E. PTSD risk factors in earthquake survivors and their families: a systematic review. Eur J Psychotraumatol 2024; 15:2365477. [PMID: 38919135 PMCID: PMC11210410 DOI: 10.1080/20008066.2024.2365477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 05/20/2024] [Indexed: 06/27/2024] Open
Abstract
Background: Exposure to earthquakes can cause adverse effects on the mental health of survivors, including an increased risk of PTSD.Objective: This systematic review aims to analyse the previous secondary studies to identify the risk factors for PTSD from children to elderly earthquake survivors. In addition, it aims to consider the complexity of the joint effects of the individual, relational, and contextual risk factors, to also detect the most at-risk families.Method: After reviewing and screening studies from the literature search through PubMed, Web of Science, Scopus, and EBSCO under the guidance of PRISMA guidelines, ten eligible secondary studies were identified that examine the risk factors for PTSD in individuals (from children to elderly) affected by worldwide earthquakes.Results: The analysis of the included studies allowed the identification of a series of socio-demographic, pre-traumatic, peri-traumatic, and post-traumatic PTSD risk factors in children, adolescents, youth, adults, and elderly survivors. The results represent the complexity of the joint effects of these risk factors at individual, relational, and contextual levels.Conclusions: The consideration of the PTSD risk factors highlights the importance of individual characteristics and the type of experiences and exposure in the period before, during, and after the earthquake. This knowledge could allow the early identification of at-risk individuals of different ages and families and the implementation of intervention programmes.
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Affiliation(s)
| | - Elena Camisasca
- Faculty of Psychology, Università Telematica eCampus, Novedrate, Italy
- C.R.I.d.e.e., Psychology Department, Catholic University of the Sacred Heart, Milano, Italy
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Çiftci N, Yildiz M, Uçar M. Relationship Between Posttraumatic Stress Disorder, Death Anxiety, and Insomnia in Adults After the Earthquake. OMEGA-JOURNAL OF DEATH AND DYING 2024:302228241256267. [PMID: 38785216 DOI: 10.1177/00302228241256267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
This study aimed to determine the relationship between posttraumatic stress disorder, death anxiety, and insomnia in adults after the earthquake. This study, designed in a relational-cross-sectional-descriptive model, was conducted with 624 adult individuals living in a province affected by the earthquake that occurred in Turkey on February 6, 2023. The study data were collected using a personal information form, Posttraumatic Stress Disorder Checklist, Turkish Death Anxiety Scale, and Bergen Insomnia Scale. The analysis of the study data was performed by using SPSS 25.0, AMOS 24.0, and G*Power 3.1 Statistical package software. A significant positive correlation was found between posttraumatic stress disorder and Insomnia and Death Anxiety (p < .05). There was a significant positive correlation between Death Anxiety and Insomnia (p < .05). It was determined that Death Anxiety has a mediating role in the impact of posttraumatic stress disorder on insomnia (95% Confidence Interval: 0.572/1.407) (p < .05). It was determined that the model created in line with the hypotheses was compatible and the model fit indices were within the desired limits, with x2/df = 1.795, RMSEA = 0.03, CFI = 0.95, GFI = 0.946, AGFI = 0.93, IFI = 0.95. It was determined that posttraumatic stress disorder increased death anxiety and insomnia after the earthquake. Conducting longitudinal studies on the post-earthquake period is recommended.
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Affiliation(s)
- Necmettin Çiftci
- Department of Nursing, Faculty of Health Sciences, Muş Alparslan University, Muş, Turkey
| | - Metin Yildiz
- Department of Midwifery, Faculty of Health Sciences, Sakarya University, Sakarya, Turkey
| | - Mehmet Uçar
- Department of Medical Services and Techniques, Varto Vocational School, Muş Alparslan University, Muş, Turkey
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Zhao Y, Sun X, Yuan GF, Jin J, Miao J. Joint developmental trajectories of depression and post-traumatic stress disorder symptoms among Chinese children during COVID-19. Arch Psychiatr Nurs 2024; 49:118-125. [PMID: 38734447 DOI: 10.1016/j.apnu.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 08/20/2023] [Accepted: 02/18/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND In early 2020, Chinese children started to demonstrate severe depression and post-traumatic stress disorder symptoms (PTSS) caused by lockdown and self-isolation (measures taken at the beginning of the COVID-19 pandemic). OBJECTIVES Concerning the significant impact of the pandemic on children's physical and mental development, the study aimed to explore children's depression and PTSS during the COVID-19 pandemic and the protective effects of family resilience on the trajectories. METHODS 883 children participated and completed three waves of online follow-up questionnaires. The latent growth mixture modeling (LGMM) analysis was used to explore the trajectories of children's depression and PTSS based on the individual approach. RESULTS Two types of depression trajectories were identified and defined as the resilient group (83.01 %) and the recovery group (16.99 %); Two types of PTSS trajectories were identified and defined as the resilient group (71.12 %) and the recovery group (28.88 %); Two types of the joint trajectories of depression and PTSS were identified and defined as the resilient group (83.47 %) and the chronic group (16.53 %). The results indicated that maintaining a positive outlook (a dimension of family resilience) was the potential predictor of PTSS trajectories. CONCLUSION The trajectories of depression and PTSS among Chinese children during the COVID-19 pandemic were heterogeneous, and there were similar evolving subtypes. Family resilience could be a critical protective factor for children and families.
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Affiliation(s)
- Yi Zhao
- School of Psychology, Nanjing Normal University, 122 Ninghai Road, Gulou District, Nanjing 210097, China
| | - Xun Sun
- School of Psychology, Nanjing Normal University, 122 Ninghai Road, Gulou District, Nanjing 210097, China
| | - Guangzhe Frank Yuan
- School of Education Science, Leshan Normal University, 778 Binhe road, Shizhong District, Leshan 614000, China
| | - Jialu Jin
- School of Psychology, Nanjing Normal University, 122 Ninghai Road, Gulou District, Nanjing 210097, China
| | - Jiandong Miao
- School of Education Science, Nanjing Normal University, 122 Ninghai Road, Gulou District, Nanjing 210097, China.
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Tomak L, Demirel T, Demir I. Evaluation of the demographic characteristics and general health status of earthquake survivors affected by the 2023 Kahramanmaraş earthquake; a section from Gaziantep Nurdağı district. BMC Public Health 2024; 24:937. [PMID: 38561730 PMCID: PMC10986009 DOI: 10.1186/s12889-024-18444-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 03/26/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND An earthquake with a magnitude of 7.7 occurred in Pazarcık District of Turkey at 04.17 on February 6, 2023 and another earthquake of 7.6 occurred at 13.24 on the same day. This is the second largest earthquake to have occurred in Turkey. The aim of this study is to investigate the earthquake-related level of knowledge, attitudes and behaviours, general health and psychological status of survivors who were affected by the 2023 Kahramanmaraş Earthquake and who were living in Nurdağı District of Gaziantep after the earthquake. METHODS Data of 2317 individuals older than 18 years of age who were living in earthquake neighbourhoods, tents and containers in Nurdağı District of Gaziantep were examined. Variables were evaluated to find out the demographic characteristics and general health status of earthquake victims. General Health Questionnaire (GHQ-12) was used to find out psychological states of earthquake victims. RESULTS The rate of injuries was 14.2% and leg and foot injuries were the most common with 44.2%. The relationship between injury status; and age, marital status, and being trapped under debris was revealed (p < 0.05). Mean GHQ-12 score of the survivors was 3.81 ± 2.81 and 51.9% experienced psychological distress. In the evaluation with logistic regression, it was found that female gender, being injured in the earthquake, loss of first degree and second degree relatives (with a higher rate in loss of first degree relative), having a severely damaged -to be demolished house and having a completely destroyed house were correlated with higher level of psychological distress (p < 0.05). CONCLUSION General characteristics, injury prevalence and affecting factors of earthquake survivors were evaluated in the present study. Psychological distress was found in victims. For this reason, providing protective and assistive services to fight the destructive effects of earthquake is vital. Accordingly, increasing the awareness of people residing in earthquake zones regarding earthquakes is exceptionally important.
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Affiliation(s)
- Leman Tomak
- School of Medicine, Department of Biostatistics and Medical Informatics, Ondokuz Mayis University, 55200, Samsun, Turkey.
| | - Tolga Demirel
- Turkish Statistical Institute, Gaziantep Recional Office, Degirmicem Mah. Sehit Murat Yasilak Sok. No:13/A, Gaziantep, Turkey
| | - Ibrahim Demir
- Turkish Statistical Institute, Devlet Mah. Necatibey Cad. No:114 Cankaya, Ankara, Turkey
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Yalniz Dilcen H, Çakır Koçak Y, Ada G, Demir Bozkurt F, Dülger H. Determinants of Psychosocial Health Status in Pregnant and Postpartum Women Experiencing Earthquake in Turkey. Disaster Med Public Health Prep 2024; 18:e16. [PMID: 38304943 DOI: 10.1017/dmp.2024.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
OBJECTIVE It is well known that natural disasters such as earthquakes negatively affect physical and mental health by exposing people to excessive stress. The aim of this study was to investigate determinants of psychosocial health status among the pregnant and postpartum women who experienced earthquake in Türkiye. METHODS Pregnant and postpartum women (n = 125) living in tent cities in the Kahramanmaraş region formed the study sample. Data were collected between February 20 and 26, 2023, through face-to-face interviews. The instruments used for data collection were the Introductory Form, the Depression Anxiety Stress Scale, the Traumatic Childbirth Perception Scale, and the Post-Traumatic Stress Disorder-Short Scale. RESULTS A moderate positive relationship was found between stress and posttraumatic stress and traumatic childbirth perception in pregnant and postpartum women, and a high positive relationship was found between anxiety and depression. A high level of relationship was found between anxiety and stress and depression. CONCLUSIONS It is seen that the psychosocial health of pregnant and postpartum women, who belong to the risk group in the earthquake zone, is at high risk. Psychological support is urgently needed to preserve and improve their psychosocial health.
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Affiliation(s)
- Hacer Yalniz Dilcen
- Department of Midwifery, Faculty of Health Science, Bartın University, Ağdacı Campus, Bartin, Turkey
| | - Yeliz Çakır Koçak
- Department of Midwifery, Faculty of Health Science, Bartın University, Ağdacı Campus, Bartin, Turkey
| | - Güleser Ada
- Department of Midwifery, Faculty of Health Science, Bartın University, Ağdacı Campus, Bartin, Turkey
| | - Feyza Demir Bozkurt
- Department of Nursing, Faculty of Health Science, Bartın University, Ağdacı Campus, Bartin, Turkey
| | - Hanifi Dülger
- Department of Midwifery, Faculty of Health Science, Bartın University, Ağdacı Campus, Bartin, Turkey
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Öztürk HIB, Dönmezler S. Chronotype influences on posttraumatic stress disorder induced by the twin earthquakes in Turkey: A cross-sectional study among medical students. Chronobiol Int 2024; 41:10-16. [PMID: 38108143 DOI: 10.1080/07420528.2023.2294052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 12/07/2023] [Indexed: 12/19/2023]
Abstract
This study aimed to investigate the correlation between chronotypes and posttraumatic stress disorder (PTSD) symptoms in medical students affected by earthquakes in Kahramanmaraş, Turkey, while elucidating if the PTSD manifestation varies among different chronotypes four months post-disaster. The study encompassed 193 medical students, subjected to the sociodemographic data form, the Morningness-Eveningness Questionnaire (MEQ) and the PTSD Checklist for DSM-5 (PCL-5). The results indicated that students identified as "evening types" reported significantly elevated PCL-5 scores (p < 0.001) relative to "morning" and "intermediate" types. According to PCL-5 scores, 43.5% of the participants exhibited PTSD, with a higher occurrence among the evening types. Multivariable linear regression analysis revealed that lower MEQ scores independently correlated with elevated PTSD symptoms (β = -0.1389 [95% CI = -0.273 - -0.0048], p = 0.042), suggesting the potential of eveningness as a risk factor for PTSD post-disaster. These findings could enhance our understanding of PTSD, aid the development of preventive strategies, and underscore the importance of considering chronotypes. Further expansive, population-based studies with a longitudinal design are necessary to better understand the relationship between PTSD and the circadian system.
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Affiliation(s)
| | - Süleyman Dönmezler
- School of Medicine, Department of Psychiatry, Sanko University, Gaziantep, Turkey
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Kim ES, Yeo J, Kim Y, Ha IH. The Impact of Moderate Earthquakes on Antidepressant Prescriptions in Ulsan, South Korea: A Controlled Interrupted Time Series Analysis. J Epidemiol 2023; 33:600-606. [PMID: 36372434 PMCID: PMC10635813 DOI: 10.2188/jea.je20220171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 10/18/2022] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND In 2016, two consecutive moderate magnitude earthquakes occurred in Ulsan, South Korea. Therefore, we aimed to investigate the impact of earthquakes on the mental health of residents in Ulsan. METHODS We used data from the 2015-2017 Korean Health Insurance Review & Assessment Service National Patient Sample. We conducted an interrupted time series analysis using location-based controls. Changes in the number of antidepressants, benzodiazepines, and zolpidem prescriptions in Ulsan were compared to controls. Overall changes in weekly prescriptions 1 year after the first earthquake, compared to a non-earthquake scenario, were estimated. RESULTS In antidepressant prescriptions, the increase in trend after an earthquake was significantly higher than controls. However, the changes in benzodiazepines and zolpidem prescribing were not significant. Overall, the impact of the earthquake on weekly antidepressant prescriptions at 1 year was estimated as a 1.32 (95% CI, 1.18-1.56) rate ratio compared to the non-earthquake scenario. This corresponded to an increase of 1,989.7 (95% CI, 1,202.1-3,063.0) in the number of prescriptions. Among subgroups, the increase was highest among males aged 20-39 years. CONCLUSION The moderate earthquake in Ulsan was associated with an increase in antidepressant prescriptions. The increase in the male group aged 20-39 was the highest. The impact may vary according to the context of the population.
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Affiliation(s)
- Eun-San Kim
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Jiyoon Yeo
- Department of Economics, Korea University, Seoul, Republic of Korea
| | - Yongjoo Kim
- College of Korean Medicine, Sangji University, Wonju, Republic of Korea
| | - In-Hyuk Ha
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
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Comorbidity of posttraumatic stress disorder and depression among adolescents following an earthquake: A longitudinal study based on network analysis. J Affect Disord 2023; 324:354-363. [PMID: 36586597 DOI: 10.1016/j.jad.2022.12.119] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 11/15/2022] [Accepted: 12/23/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND High comorbidity between posttraumatic stress disorder (PTSD) and depression among adolescents often follows severe traumatic events. Models on the pathway to comorbidity dispute greatly and how PTSD and depression get comorbidity, remain unclear. METHODS A follow-up investigation was conducted of 424 adolescent survivors of the Jiuzhaigou earthquake at 12 months (T1) and 27 months (T2). RESULTS Contemporaneous network analysis and cross-lagged panel network analysis showed that PTSD and depression are two separate disorders with strong associations via links between dysphoric symptoms of PTSD and somatic or non-somatic symptoms of depression. However, the association weakened from T1 to T2, and internal connections between symptoms within each disorder became stronger. LIMITATION We only measured the comorbidity of PTSD and depression at two time points following the earthquake, which may limit the long-term applicability of our findings following trauma. CONCLUSIONS The findings also showed that the centrality in contemporaneous networks may indicate node connectivity rather than the influence or potential causality among nodes. These results help to elucidate the relationship between PTSD and depression and could contribute to the development of appropriate therapies.
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Liang Y, Chen Y, Huang Q, Zhou Y, Liu Z. Network structure and temporal stability of depressive symptoms after a natural disaster among children and adolescents. Eur J Psychotraumatol 2023; 14:2179799. [PMID: 37052102 PMCID: PMC9970231 DOI: 10.1080/20008066.2023.2179799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/14/2023] Open
Abstract
Background: Previous studies have found that the postdisaster developmental course of depression is more stable than that of other mental disorders among children and adolescents. However, the network structure and temporal stability of depressive symptoms after natural disasters among children and adolescents remain unknown.Objective: This study aims to understand the depressive symptom network and evaluate its temporal stability among children and adolescents after natural disasters.Methods: Three-wave measurements were conducted among 1,466 children and adolescents at 3, 15, and 27 months following the Zhouqu debris flow. Depressive symptoms were evaluated by the Child Depression Inventory (CDI), which was dichotomised to signify the presence or absence of depressive symptoms. Depression networks were estimated with the Ising model, and expected influence was used to assess node centrality. A network comparison test was used to test the differences in the depression networks among the three temporal points.Results: Overall, the depressive symptom network was temporally stable regarding symptom centrality and global connectivity over the two-year study period. Self-hate, loneliness, and sleep disturbance were central symptoms and had low variability in the depressive networks at the three temporal points. Crying and self-deprecation had large temporal variability in centrality.Conclusion: The present study provides the first evidence for the temporal stability of the youth depressive symptom network postdisaster. The similar central symptoms and connectivity of depression symptoms at different temporal points after natural disasters may partially explain the stable prevalence and developmental trajectory of depression. Self-hate, loneliness, and sleep disturbance could be central characteristics, and sleep disturbance and reduced appetite, sadness and crying, and misbehaviour and disobedience could be key associations in the endurance of depression among children and adolescents after experiencing a natural disaster.
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Affiliation(s)
- Yiming Liang
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, School of Psychology and Cognitive Science, East China Normal University, Shanghai, People's Republic of China
| | - Yaru Chen
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, People's Republic of China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, People's Republic of China
| | - Qi Huang
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, School of Psychology and Cognitive Science, East China Normal University, Shanghai, People's Republic of China
| | - Yueyue Zhou
- Department of Psychology, Henan University, Kaifeng, People's Republic of China
| | - Zhengkui Liu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, People's Republic of China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, People's Republic of China
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Kwon HJ, Leem J, Kim DW, Kwon CY, Kim SH. Effect of acupuncture on patients with major psychiatric disorder and related symptoms caused by earthquake exposure: Protocol for a scoping review of clinical studies. PLoS One 2023; 18:e0281207. [PMID: 36706118 PMCID: PMC9882882 DOI: 10.1371/journal.pone.0281207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 01/11/2023] [Indexed: 01/28/2023] Open
Abstract
Earthquakes have the greatest destructive effect among all natural disasters. Posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and anxiety disorder (AD) are major psychiatric disorders (MPD) that can be triggered by exposure to earthquakes. Conventional treatments such as pharmacological treatments have several limitations. Acupuncture therapy as a complementary integrative medicine may be an effective alternative treatment for these limitations. This study aimed to identify the status of the clinical evidence regarding acupuncture therapy for earthquake survivors with MPD. We will follow the scoping review process as previously described. The study question is as follows: "Which types of clinical research designs, study types, study durations, adverse events, and clinical outcomes have been reported regarding acupuncture therapy for MPD in earthquake survivors?" Medline, Excerpta Medica dataBASE, Cochrane Central Register of Controlled Trials, Web of Science, Scopus, Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature, PsycArticles databases, and Chinese, Korean, and Japanese databases will be comprehensively searched electronically from their inception to November 2022. Data from the included studies will be collected and descriptively analyzed in relation to our research question. We will collate, synthesize, and summarize the extracted data according to the analytical framework of a scoping review. The protocol will conform with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extensions of Scoping Reviews to ensure the clarity and completeness of our reporting in the whole phase of the scoping review (Protocol registration: https://osf.io/wfru7/). The findings of this scoping review will provide fundamental data that will help researchers identify appropriate research questions and design further studies on the use of acupuncture for MPD management in earthquake survivors. These results will be helpful for developing disaster site-specific research protocols for future clinical trials on this topic.
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Affiliation(s)
- Hui-Ju Kwon
- College of Korean Medicine, Daegu Haany University, Gyeongsan-si, Gyeongsangbuk-do, Republic of Korea
| | - Jungtae Leem
- College of Korean Medicine, Wonkwang University, Iksan, Republic of Korea
| | - Da-Woon Kim
- Department of Neuropsychiatry of Korean Medicine, Pohang Korean Medicine Hospital Affiliated to Daegu Haany University, Pohang-si, Gyeongsangbuk-do, Republic of Korea
| | - Chan-Young Kwon
- Department of Oriental Neuropsychiatry, Dong-Eui University College of Korean Medicine, Busan, Korea
| | - Sang-Ho Kim
- Department of Neuropsychiatry of Korean Medicine, Pohang Korean Medicine Hospital Affiliated to Daegu Haany University, Pohang-si, Gyeongsangbuk-do, Republic of Korea
- * E-mail:
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Liang Y, Zhao Y, Zhou Y, Liu Z. How Maternal Trauma Exposure Contributed to Children's Depressive Symptoms following the Wenchuan Earthquake: A Multiple Mediation Model Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16881. [PMID: 36554761 PMCID: PMC9779171 DOI: 10.3390/ijerph192416881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/07/2022] [Accepted: 12/14/2022] [Indexed: 06/17/2023]
Abstract
Although well-established literature has indicated the burden of mental health among victims after the Wenchuan earthquake, no research has focused on the mental health of mothers and their children who experienced the earthquake and were pregnant during or shortly after it. This study investigates the relationship between maternal trauma exposure (TE) and children's depressive symptoms after the Wenchuan earthquake and explores the risk and protective factors underlying this relationship. A sample of 547 mother-child dyads, in which the mother experienced the Wenchuan earthquake, was used to assess maternal depressive symptoms, maternal TE, children's depressive symptoms, children's perceived impact of the earthquake and maternal posttraumatic growth (PTG). The results showed that maternal TE had two significant one-step indirect associations with children's depressive symptoms (through children's perceived impact of the earthquake and maternal PTG) and one two-step indirect association with children's depressive symptoms (through maternal depressive symptoms via children's perceived impact of the earthquake). The results indicated that maternal depressive symptoms, children's perceived impact of the earthquake and maternal PTG mediated the association between maternal TE and children's depressive symptoms. These findings highlight the importance of mothers in supporting the mental health of these children. Maternal depressive symptoms and PTG, two posttraumatic outcomes, played positive and negative roles in the intergenerational transmission of trauma. Thus, post-disaster interventions should reduce the maternal transmission of trauma-related information and improve maternal PTG to support children's mental health.
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Affiliation(s)
- Yiming Liang
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai 200062, China
| | - Yiming Zhao
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai 200062, China
| | - Yueyue Zhou
- School of Psychology, Henan University, Kaifeng 475004, China
| | - Zhengkui Liu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China
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Al Hariri M, Zgheib H, Abi Chebl K, Azar M, Hitti E, Bizri M, Rizk J, Kobeissy F, Mufarrij A. Assessing the psychological impact of Beirut Port blast: A cross-sectional study. Medicine (Baltimore) 2022; 101:e31117. [PMID: 36253992 PMCID: PMC9575829 DOI: 10.1097/md.0000000000031117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Beirut Port blast's magnitude is considered the third after Hiroshima and Nagasaki atomic bombings. This blast occurred in the densely populated section of Beirut, leaving more than six thousand injured patients. The psychological disturbances were assessed in the blast survivors who presented to the Emergency Department (ED) at the American University of Beirut Medical Center (AUBMC). This was a cross-sectional study at the ED of AUBMC. Identified patients were contacted and consented to participate in the study. Post-Traumatic Stress Disorder (PTSD) was selected as an outcome. Depression, PTSD, and concussion were assessed using patient health questionnaire (PHQ)-9, PTSD checklist for DSM-5 (PCL5), and brain injury symptoms (BISx) tools, respectively. The association of patients and injury characteristics with the study outcome was assessed using logistic regression. 145 participants completed the study procedures. The participants' average age was 39.8 ± 15.4 years, and 60% were males. Almost half of the participants showed depression on PHQ, and 2-thirds had PTSD. The participant's age was negatively associated with PTSD, whereas being a female, having depression, and having a concussion were positively associated with PTSD. The results of this study were in line with the previous literature report except for the association between younger age and PTSD, which warrants further investigations to delineate the reasons.
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Affiliation(s)
- Moustafa Al Hariri
- Vice President for Medical and Health Science Office, QU Health, Qatar University, Doha, Qatar
- Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Hady Zgheib
- Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Karen Abi Chebl
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Maria Azar
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Eveline Hitti
- Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Maya Bizri
- Department of Psychiatry, American University of Beirut Medical Center, Beirut, Lebanon
| | - Jennifer Rizk
- Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Firas Kobeissy
- Department of Biochemistry and Molecular Genetics, American University of Beirut, Beirut, Lebanon
| | - Afif Mufarrij
- Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- *Correspondence: Afif Mufarrij, Department of Emergency Medicine, American University of Beirut Medical Center, P.O. Box: 11-0236/ Riad El-Solh/ Beirut 1107 2020, Lebanon (e-mail: )
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13
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Six-year changes of posttraumatic stress symptoms and depressive symptoms among Chinese earthquake survivors: A network analysis. J Affect Disord 2022; 310:32-42. [PMID: 35525508 DOI: 10.1016/j.jad.2022.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 04/21/2022] [Accepted: 05/02/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND The risk factors of Posttraumatic Stress Symptoms (PTSS) and depressive symptoms have been well-established, but whether the network structure of their symptoms changes over time remains unclear. This study aims to examine the six-year changes of network structure of PTSS and depressive symptoms among Wenchuan earthquake adult survivors in China. METHODS In this pooled cross-sectional study, respondents were sampled from the same population at each of the five waves (N = 1343, 1205, 1177, 1376, and 1339). The network structure of them was investigated using network analyses. RESULTS The study shows network connections stable across waves were the positive connections between hyperarousal and intrusions, hyperarousal and somatic symptoms, and two dimensions of positive effects. Stable negative connections were those between depressed affects and positive effects, avoidance and depressed affects, avoidance with interpersonal symptoms and avoidance with somatic symptoms. Across waves, fearful emotion consistently was the strongest bridge symptom connecting with PTSS symptoms. However, for PTSS the strongest bridge symptom varied across time as it was avoidance in wave 1 but were hyperarousal in other four waves. LIMITATIONS This study was based on a pooled cross-sectional survey, which inhibits conclusions regarding causal influences between symptoms at the individual patient level. CONCLUSIONS The network structure of PTSS and depressive symptoms was partly stable, yet also varied across survey waves. Core symptom clusters for PTSS and depressive symptoms were avoidance and depressed affect, respectively. The central role of these clusters in PTSS and depressive symptoms has important implications to future psychiatric programs.
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Demirchyan A, Khachadourian V, Armenian HK, Goenjian AK. The course, trajectories and predictors of depression 23 years after the 1988 Spitak earthquake in Armenia: A prospective cohort study. Psychiatry Res 2022; 313:114640. [PMID: 35598565 DOI: 10.1016/j.psychres.2022.114640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 05/04/2022] [Accepted: 05/14/2022] [Indexed: 11/19/2022]
Abstract
There is a scarcity of long-term studies of depression after natural disasters. This prospective epidemiologic study evaluated the course of depression and factors associated with it among survivors 23-years post-earthquake. A geographically stratified subsample of 725 adults exposed to the Spitak earthquake was assessed for depression using DSM-III-R criteria in 1991 and 2012. Additionally, an adapted CES-D-16 scale was used to assess depressive symptoms in 2012. A fitted multi-nominal logistic regression model identified predictors of different trajectories of depression. For the whole group, the rate of clinical depression dropped from 51.5% in 1991 to 31.7% in 2012. Earthquake intensity and experiencing strong fear at baseline were strongly associated with chronic (depressed at both assessments, 18.1%) and recovered (depressed only in 1991, 33.5%) depression trajectories compared with the healthy group, with odds ratios (OR) over 4.0 and 3.0, respectively. Predictors distinguishing chronic depression included earthquake-related nuclear-family deaths (OR=3.79), chronic illnesses at baseline (OR=1.24), and social support (OR=0.91). Predictors of the late-onset trajectory (depressed only in 2012, 13.5% of the cohort) included post-earthquake trauma (OR=1.42), socioeconomic status (OR=0.45), and social support (OR=0.86). The factors associated with the different trajectories of depression provide guidance for planning more effective mental health interventions after disasters.
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Affiliation(s)
- Anahit Demirchyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia.
| | - Vahe Khachadourian
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Haroutune K Armenian
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Armen K Goenjian
- UCLA/Duke University National Center for Child Traumatic Stress, Department of Psychiatry and Biobehavioral Sciences, UCLA, CA, USA; Collaborative Neuroscience Network, CA, USA
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Using network analysis to explore the key bridge symptoms between posttraumatic stress symptoms and posttraumatic growth among survivors 10 years after the Wenchuan earthquake in China. J Psychiatr Res 2022; 150:173-179. [PMID: 35390697 DOI: 10.1016/j.jpsychires.2022.03.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 02/14/2022] [Accepted: 03/07/2022] [Indexed: 11/23/2022]
Abstract
Despite previous research has illustrated there is high-coexistence between posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG) in the aftermath of traumatic events, few studies have conceptualized the coexistence mechanism of the two psychological phenomena. Using the network analysis, this study aimed to identify the key bridge symptoms and compare sex differences between PTSD symptoms and PTG elements in survivors 10 years after the Wenchuan earthquake in China. A total of 744 survivors 10 years after the Wenchuan earthquake in China completed self-reported questionnaires on demographics, PTSD symptoms (4-item of Posttraumatic Stress Disorder Checklist), and PTG (10-item of Posttraumatic Growth Inventory). Network analysis was used to identify the network structure of PTSD symptoms and elements of PTG, along with bridge symptoms. Additionally, sex differences in the network structure were compared by the Network Comparison Test. Results revealed that the network of PTSD symptoms and elements of PTG was robust to stability and accuracy tests. The key bridge symptoms in the network were "Stronger religious faith", "Changed priorities", and "Easily startled". There were significant differences in network global strength across sex, and network structure across the severity of property loss other than house damage. Future interventions targeting the three key bridge symptoms are expected to relieve the severity of PTSD and promote growth following exposure to traumatic events.
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Ide-Okochi A, Samiso T, Kanamori Y, He M, Sakaguchi M, Fujimura K. Depression, Insomnia, and Probable Post-Traumatic Stress Disorder among Survivors of the 2016 Kumamoto Earthquake and Related Factors during the Recovery Period Amidst the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074403. [PMID: 35410082 PMCID: PMC8998281 DOI: 10.3390/ijerph19074403] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/25/2022] [Accepted: 04/04/2022] [Indexed: 11/28/2022]
Abstract
The aftereffects of the severe 2016 Kumamoto earthquake were complicated by the COVID-19 pandemic. This study aimed to identify mental health problems and related factors among survivors five years after the earthquake and clarify its long-term effects. A cross-sectional survey was conducted in 2020 among 19,212 survivors affected by the earthquake who moved from temporary to permanent housing. We analysed 8966 respondents (5135 women, 3831 men; mean age 62.25 ± 17.29 years). Logistic regression analysis was conducted to examine associations between mental health problems and socioeconomic factors. Prevalence rates of psychological distress, insomnia, and probable post-traumatic stress disorder were 11.9%, 35.2%, and 4.1%, respectively. Female gender (OR = 1.33, 95% CI = 1.13–1.57; OR = 1.21, 95% CI = 1.08–1.34; OR = 1.81, 95% CI = 1.41–2.32), public housing (OR = 2.14, 95% CI = 1.63–2.83; OR = 1.54, 95% CI = 1.26–1.88; OR = 2.41, 95% CI = 1.62–3.58), loneliness (OR = 9.08, 95% CI = 7.71–10.70; OR = 5.55, 95% CI = 4.90–6.30; OR = 3.52, 95% CI = 2.77–4.49), COVID-19-induced activity reduction (OR = 1.41, 95% CI = 1.19–1.66; OR = 1.86, 95% CI = 1.68–2.07; OR = 1.80, 95% CI = 1.40–2.31), and COVID-19-induced income reduction (OR = 1.33, 95% CI = 1.12–1.57; OR = 1.43, 95% CI = 1.28–1.59; OR = 1.92, 95% CI = 1.51–2.43) were significantly associated with mental health problems. These results suggest that gender, current housing, loneliness, and COVID-19 affected the survivors’ mental health during recovery.
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Affiliation(s)
- Ayako Ide-Okochi
- Graduate School of Health Sciences, Kumamoto University, Kumamoto City 862-0976, Japan; (Y.K.); (M.H.); (M.S.)
- Correspondence: ; Tel.: +81-96-373-5518
| | - Tomonori Samiso
- Health and Welfare Policy Division, Health and Welfare Bureau, Kumamoto City 860-0808, Japan;
| | - Yumie Kanamori
- Graduate School of Health Sciences, Kumamoto University, Kumamoto City 862-0976, Japan; (Y.K.); (M.H.); (M.S.)
| | - Mu He
- Graduate School of Health Sciences, Kumamoto University, Kumamoto City 862-0976, Japan; (Y.K.); (M.H.); (M.S.)
| | - Mika Sakaguchi
- Graduate School of Health Sciences, Kumamoto University, Kumamoto City 862-0976, Japan; (Y.K.); (M.H.); (M.S.)
| | - Kazumi Fujimura
- Department of Community Health Systems Nursing, Ehime University Graduate School of Medicine, Toon City 791-0295, Japan;
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Yang Y, Zeng W, Lu B, Wen J. The Contributing Factors of Delayed-Onset Post-traumatic Stress Disorder Symptoms: A Nested Case-Control Study Conducted After the 2008 Wenchuan Earthquake. Front Public Health 2022; 9:682714. [PMID: 35004555 PMCID: PMC8739781 DOI: 10.3389/fpubh.2021.682714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 11/09/2021] [Indexed: 02/05/2023] Open
Abstract
Background: Delayed-onset post-traumatic stress disorder after catastrophes is a major public health issue. However, good designs for identifying post-traumatic stress disorder (PTSD) among earthquake survivors are rare. This is the first nested case-control study to explore the possible factors associated with delayed-onset PTSD symptoms. Methods: A nested case-control study was conducted. The baseline (2011) and follow-up (2018) surveys were utilized to collect data. A total of 361 survivors of the Wenchuan earthquake were investigated and 340 survivors underwent follow-up. The survivors, from the hardest-hit areas, who met the criteria for PTSD were included in the case group, and PTSD-free survivors from the same area, matched for age, were included in the control group, with a ratio of one to four. Conditional logistic regression was used to evaluate the variables' odds ratio (OR). Results: The overall prevalence of delayed-onset PTSD symptoms in survivors of the Wenchuan earthquake was 9.7% (33/340). The unemployed earthquake survivors had a higher risk of developing delayed-onset PTSD symptoms (OR = 4.731, 95% CI = 1.408-15.901), while higher perceived social support was a protective factor against delayed-onset PTSD symptoms (OR = 0.172, 95% CI = 0.052-0.568). Conclusion: Delayed-onset PTSD symptoms, after a disaster, should not be ignored. Active social support and the provision of stable jobs can contribute to the earthquake survivors' mental health.
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Affiliation(s)
- Yanlin Yang
- Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu, China
| | - Wenqi Zeng
- Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu, China
| | - Bingqing Lu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jin Wen
- Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu, China
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Qi J, Sun R, Zhou X. Network analysis of comorbid posttraumatic stress disorder and depression in adolescents across COVID-19 epidemic and Typhoon Lekima. J Affect Disord 2021; 295:594-603. [PMID: 34509075 DOI: 10.1016/j.jad.2021.08.080] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 07/30/2021] [Accepted: 08/25/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Network analytic studies indicate that posttraumatic stress disorder (PTSD) may be comorbid with depression at the symptom level, but it remains unclear whether these findings are replicable and generalizable across trauma types. OBJECTIVE This study aim was to examine and compare PTSD-depression comorbidity networks of two types of trauma related to Typhoon Lekima and COVID-19 epidemic. METHODS Participants were 1605 and 601 adolescents recruited following Typhoon Lekima and the COVID-19 outbreak, respectively. RESULTS COVID-19 and Lekima PTSD-depression networks had considerable similarities, including adequate stability and accuracy, connected symptoms of PTSD and depression, symptoms with high centralities, and bridge symptoms. PTSD-depression comorbid symptoms were more complicated in the COVID-19 network but may show more persistence in the Lekima network. Distinct bridge symptoms contributed to the heterogeneity of PTSD-depression comorbidity characteristics between the two networks. Specifically, restricted affect and felt down and unhappy were two important bridge symptoms with high centrality unique to the COVID-19 network. CONCLUSIONS PTSD-depression comorbidity network has considerable replicability across trauma types, but specific symptom-level associations and some bridge symptoms may vary across trauma types. These findings also highlight the importance of negative emotions to comorbid PTSD and depression in adolescents following the COVID-19 outbreak compared with Typhoon Lekima.
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Affiliation(s)
- Junjun Qi
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou 310028, China
| | - Rui Sun
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou 310028, China
| | - Xiao Zhou
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou 310028, China.
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Amanda AR, Hidajah AC, Wahyuni CU. The Effect of Post-Traumatic Stress Disorder on Women After The Earthquake in Central Sulawesi. JURNAL BERKALA EPIDEMIOLOGI 2021. [DOI: 10.20473/jbe.v9i32021.303-309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background: Posttraumatic stress disorder (PTSD) is a psychological disorder caused by uncommon occurrences such as threats or catastrophic events. Women are particularly susceptible to developing PTSD, as they have a range of threat perceptions. Purpose: The aim of this study was to examine the effect of PTSD on women survivor of the earthquake in the Sigi Biromaru sub-district of Central Sulawesi. Methods: This was a descriptive study conducted using a cross-sectional design. The population for this study were housewives who have been displaced by the earthquake and are currently residing in temporary shelters (Huntara) in a village located in the Sigi Biromaru sub-district. The instrument used in this study was the PTSD measurement questionnaire sheet. It was conducted from March to April 2020 and included a total of 115 participants. Univariate analysis was used to determine the respondents’ characteristics, including their age, education, occupation, income, and a description of the PTSD condition. Results: The results show that the majority of respondents experienced severe PTSD (70.43%). Most of the respondents (35.65%) were between the ages of 37 and 46, were senior high school graduates (40%), were unemployed (74%), and had earnings of < 2,500,000 (85.22%). Three variables that affect PTSD are education with a p-value of 0.03 < 0.05, job/occupation with a p-value of 0.02 < 0.05, and income with a p-value of 0.03 < 0.05. Conclusion: Women who are elderly, have a low level of education, are unemployed, and have low income are more vulnerable to experiencing PTSD.
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Quality of Life in Lower-Limb Amputees 10 Years After the 2008 Sichuan Earthquake: A Cross-Sectional Study. Disaster Med Public Health Prep 2021; 16:1573-1579. [PMID: 34392861 DOI: 10.1017/dmp.2021.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The aim of this study was to investigate the long-term outcome of quality of life (QOL) in the lower-limb amputees 10 years after the 2008 Sichuan earthquake. METHODS In the cross-sectional study, 66 lower-limb amputees were recruited. The prosthetics-related QOL was assessed using the Prosthetic Evaluation Questionnaire (PEQ) in terms of the scales of utility, appearance, sounds, residual limb health, perceived response, frustration, social burden, ambulation, and well-being. The score of each PEQ subscale was calculated and compared among the cohorts with different demographic characteristics. RESULTS The PEQ scores showed that the scales of sounds, residual limb health, and frustration were still low in the lower-limb amputees 10 years after the 2008 Sichuan earthquake. The comparison of PEQ scales among cohorts with different demographic characteristics indicated that the potential demographic risk factors, namely, age, marital status, educational level, living independence, and comorbidity, were associated with prosthesis-related QOL. CONCLUSIONS The prosthesis-related QOL of the lower-limb amputees 10 years after the 2008 Sichuan earthquake has been partly documented in this study. The potential demographic risk factors associated with QOL of amputees were also identified. These findings could enhance the understanding of prosthesis-related QOL of lower-limb amputees sustained in an earthquake and facilitate the optimization of post-disaster rehabilitation strategies.
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21
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Zhang K, He F, Ma Y. Sex ratios and mental health: Evidence from China. ECONOMICS AND HUMAN BIOLOGY 2021; 42:101014. [PMID: 33984820 DOI: 10.1016/j.ehb.2021.101014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 01/27/2021] [Accepted: 04/28/2021] [Indexed: 06/12/2023]
Abstract
While sex ratios (i.e., relative numbers of men and women) have been linked to various economic and social outcomes, how sex ratios affect mental health is underexplored. Using nationally representative data from the China Family Panel studies (CFPS) and Population Census, we evaluate the impact of sex ratios on mental health among Chinese men and explore potential mechanisms. Employing the instrumental variables (IV) approach where the One-Child Policy's mandated fertility limits and implementation are used as exogenous variations in local sex ratios, we find that higher local sex ratios increase depressive symptoms and probability of depression among Chinese men. The impact is stronger for men with lower levels of education and living in rural areas. Analyses of potential mechanisms show that higher sex ratios increase the likelihood of marriage delay and unemployment for men, and prolong working hours for the employed men. The findings are of direct relevance to the health and population policy in China.
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Affiliation(s)
- Kezhong Zhang
- School of Management, Huazhong University of Science and Technology, China
| | - Fan He
- School of Management, Huazhong University of Science and Technology, China
| | - Yuanyuan Ma
- Wenlan School of Business, Zhongnan University of Economics and Law, China; The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Ireland.
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Fan Y, Guan L, Xiang H, Yang X, Huang G, Cheng W, Xie Y, Wang X, Liang G, He M, Wang R, Hu J, Liu M, Mou X, Wu B, Ma H, Yu X. A longitudinal study on emotional distress among local government staff seven years after the 2008 Wenchuan earthquake in China. BMC Public Health 2021; 21:702. [PMID: 33836705 PMCID: PMC8033268 DOI: 10.1186/s12889-021-10726-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 03/29/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND The current study examined the change in local government staff's emotional distress over 7 years after the 2008 Wenchuan earthquake, and the influence of earthquake exposure and professional quality of life (ProQOL) on emotional distress. METHODS This longitudinal study assessed 250 participants at 1 year after the earthquake; 162 (64.8%) were followed up at 7 years. Emotional distress was assessed with the Self-Reporting Questionnaire (SRQ) at both time points. We assessed ProQOL, including compassion satisfaction, burnout, and secondary traumatic stress, and earthquake exposure at 1 year. Wilcoxon signed-rank tests were performed to test longitudinal changes in emotional distress. Hierarchical multiple regression was conducted to examine the effect of earthquake exposure and ProQOL. RESULTS The positive screening rate of emotional distress (SRQ ≥ 8) was 37.6 and 15.4% at one and 7 years, respectively. Emotional distress scores declined over time (p < 0.001). Earthquake exposure and ProQOL predicted one-year (ps < 0.05) but not seven-year emotional distress, whereas burnout predicted both one-year (p = 0.018) and seven-year (p = 0.047) emotional distress. CONCLUSIONS Although emotional distress can recover over time, it persists even 7 years later. Actions to reduce burnout during the early stage of post-disaster rescue have long-term benefits to staff's psychological outcomes.
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Affiliation(s)
- Yunge Fan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Haidian District Huayuan North Road No. 51, Beijing, 100191, China
| | - Lili Guan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Haidian District Huayuan North Road No. 51, Beijing, 100191, China.
| | - Hu Xiang
- The Third People's Hospital of Mianyang, Mianyang, Sichuan, China
| | - Xianmei Yang
- The Third People's Hospital of Mianyang, Mianyang, Sichuan, China
| | - Guoping Huang
- The Third People's Hospital of Mianyang, Mianyang, Sichuan, China
| | | | - Yongbiao Xie
- Guangdong Mental Health Center, Guangzhou, Guangdong, China
| | - Xiuzhen Wang
- Shenyang Mental Health Center, Shenyang, Liaoning, China
| | | | - Ming He
- Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang, China
| | - Ruiru Wang
- Peking University Third Hospital, Beijing, China
| | - Jia Hu
- Shanghai Yangpu Mental Health Center, Shanghai, China
| | - Menglin Liu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Haidian District Huayuan North Road No. 51, Beijing, 100191, China
| | - Xiaojie Mou
- Wuhan Mental Health Center, Wuhan, Hubei, China
| | - Baoming Wu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Haidian District Huayuan North Road No. 51, Beijing, 100191, China
| | - Hong Ma
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Haidian District Huayuan North Road No. 51, Beijing, 100191, China
| | - Xin Yu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Haidian District Huayuan North Road No. 51, Beijing, 100191, China
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Lu B, Zeng W, Li Z, Wen J. Risk factors of post-traumatic stress disorder 10 years after Wenchuan earthquake: a population-based case-control study. Epidemiol Psychiatr Sci 2021; 30:e25. [PMID: 33729117 PMCID: PMC8061289 DOI: 10.1017/s2045796021000123] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 02/04/2021] [Accepted: 02/15/2021] [Indexed: 02/05/2023] Open
Abstract
AIMS To investigate the prevalence of post-traumatic stress disorder (PTSD) symptoms in the hard-hit areas 10 years after the Wenchuan earthquake, and explore the risk factors of long-term PTSD among Wenchuan earthquake survivors. METHODS A matched case-control study was conducted. The involving participants were from the hard-hit areas 10 years after the Wenchuan earthquake. The collected information includes demographic characteristics, socioeconomic status, behaviour habits, earthquake exposure, perceived social support, physical health and mental health. Mental health status was measured using the PTSD Checklist-Civilian Version (PCL-C). Respondents with PCL-C score ⩾38 were classified as cases, and then the cases and controls were matched based on age (±3 years) and community location according to a ratio of 1:3. RESULTS We obtained 86 cases and 258 controls. After controlling for confounding factors, it was found that lower income (OR 2.42; 95% CI 1.16-5.03), chronic diseases (OR 3.00; 95% CI 1.31-6.88) and death of immediate families in the earthquake (OR 7.30; 95% CI 2.36-22.57) were significantly associated with long-term PTSD symptoms. CONCLUSION Even 10 years after the Wenchuan earthquake, the survivors in the hard-hit areas still suffered from severe mental trauma. Low income, chronic diseases and death of immediate families in the earthquakes are significantly associated with long-term PTSD symptoms. Interventions by local governments and health institutions to address these risk factors should be undertaken to promote the health of survivors.
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Affiliation(s)
- Bingqing Lu
- Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu610041, China
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu610041, China
| | - Wenqi Zeng
- Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu610041, China
| | - Zhuyue Li
- West China Hospital/West China School of Nursing, Sichuan University, Chengdu610041, China
| | - Jin Wen
- Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu610041, China
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Liang Y, Zhou Y, Liu Z. Consistencies and differences in posttraumatic stress disorder and depression trajectories from the Wenchuan earthquake among children over a 4-year period. J Affect Disord 2021; 279:9-16. [PMID: 33035749 DOI: 10.1016/j.jad.2020.09.107] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 06/03/2020] [Accepted: 09/26/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) and depression are the most prevalent mental disorders following disasters, and they often co-occur. The current study investigated trajectories of PTSD and depression among children after exposure to the Wenchuan earthquake and identified factors associated with PTSD or depression trajectories. METHODS Three hundred children who were exposed to the Wenchuan earthquake reported PTSD and depression symptoms 4, 16, 29, 40 and 52 months after the disaster, and potential predictors (age, earthquake exposure, prequake trauma and parental relationship) were identified. The PTSD and depression trajectories were identified with latent growth mixture modeling (LGMM), and the predictors were explored with multinomial logistic regression. RESULTS Two depression trajectories emerged: resilient (66.2%) and chronic (33.8%). Three PTSD trajectories emerged: resilient (74.9%), recovery (7.5%) and relapsing (17.7%). Overall, 57.3% of the children had low depression and PTSD symptoms over four years. Depression trajectories were significantly predicted by age and parental relationship, while PTSD trajectories were significantly predicted by trauma exposure and prequake trauma experience. LIMITATIONS The children's prequake mental health statuses were unknown, and all assessments relied on self-report questionnaires. CONCLUSION The postdisaster developmental course of depression was more stable than that of PTSD, and PTSD and depression had different risk factors. Previous studies that focus only on PTSD or depression trajectories may overestimate children's resilient responses. Longer-term postdisaster intervention should pay more attention to depression than to PTSD.
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Affiliation(s)
- Yiming Liang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yueyue Zhou
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Zhengkui Liu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China.
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Paquin V, Elgbeili G, Laplante DP, Kildea S, King S. Positive cognitive appraisal "buffers" the long-term effect of peritraumatic distress on maternal anxiety: The Queensland Flood Study. J Affect Disord 2021; 278:5-12. [PMID: 32949873 DOI: 10.1016/j.jad.2020.09.041] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 07/21/2020] [Accepted: 09/07/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Limited research has evaluated distinct aspects of disaster experience as predictors of affective symptoms. In this study, we examined the extent to which maternal depression and anxiety over time were predicted by (1) objective hardship from a flood during pregnancy, (2) peritraumatic distress and (3) cognitive appraisal of the flood's consequences. METHODS Data were drawn from the 2011 Queensland Flood Study, a prospective, longitudinal study of pregnancy (n = 183). Mothers' disaster experience was measured within 1 year after the flood. Their levels of depression, anxiety and stress were measured at 16 months, 30 months, 4 years and 6 years after childbirth. Linear mixed models were employed to evaluate symptom trajectories. RESULTS There were no time-dependent effects of disaster-related variables. Objective hardship did not predict outcomes. Peritraumatic distress significantly predicted depression and anxiety symptoms when cognitive appraisal was negative. Conversely, when cognitive appraisal was neutral or positive, the effect of peritraumatic distress was "buffered". For anxiety, but not depression, this interaction survived Bonferroni correction. Neutral/positive cognitive appraisal similarly moderated the effect of peritraumatic dissociation. LIMITATIONS The generalizability of our findings is limited by overall low levels of depression and anxiety, along with a predominantly Caucasian, higher socioeconomic status sample. Potential confounders such as pre-disaster anxiety were not controlled for. CONCLUSION In line with previous evidence, this study supports the predictive validity of peritraumatic distress for post-disaster depression and anxiety. Our findings suggest that cognitive appraisal could be a relevant target for interventions aimed at fostering maternal resilience.
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Affiliation(s)
- Vincent Paquin
- Department of Psychiatry, McGill University, 1033 Avenue des Pins, Montreal QC Canada H3A 1A1; Douglas Institute Research Centre, 6875 Boulevard LaSalle, Verdun, QC Canada H4H 1R3
| | - Guillaume Elgbeili
- Douglas Institute Research Centre, 6875 Boulevard LaSalle, Verdun, QC Canada H4H 1R3
| | - David P Laplante
- Douglas Institute Research Centre, 6875 Boulevard LaSalle, Verdun, QC Canada H4H 1R3
| | - Sue Kildea
- Molly Wardaguga Research Centre, School of Nursing and Midwifery, Charles Darwin University, Level 11, East building, 410 Ann St Brisbane, 4000 QLD, Australia; Mater Research Institute, The University of Queensland, 39 Annerley Rd, South Brisbane QLD 4101 Australia; School of Nursing, Midwifery and Social Work, Chamberlain Building, The University of Queensland, St Lucia QLD 4072, Australia
| | - Suzanne King
- Department of Psychiatry, McGill University, 1033 Avenue des Pins, Montreal QC Canada H3A 1A1; Douglas Institute Research Centre, 6875 Boulevard LaSalle, Verdun, QC Canada H4H 1R3.
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Moore A, van Loenhout JAF, de Almeida MM, Smith P, Guha-Sapir D. Measuring mental health burden in humanitarian settings: a critical review of assessment tools. Glob Health Action 2020; 13:1783957. [PMID: 32657249 PMCID: PMC7480646 DOI: 10.1080/16549716.2020.1783957] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background The effects of disasters and conflicts are widespread and heavily studied. While attention to disasters’ impacts on mental health is growing, mental health effects are not well understood due to inconsistencies in measurement. Objective The purpose of this study is to review mental health assessment tools and their use in populations affected by disasters and conflicts. Method Tools that assess posttraumatic stress disorder, depression, substance use disorder, and general mental health were examined. This review began with a search for assessment tools in PubMed, PsycINFO, and Google Scholar. Next, validation studies for the tools were obtained through snowball sampling. A final search was conducted for scientific studies using the selected tools in humanitarian settings to collect the data for analysis. The benefits and limitations described for each tool were compiled into a complete table. Results Twelve assessment tools were included, with 88 studies using them. The primary findings indicate that half of the studies used the Impact of Events Scale-Revised. The most common limitation discussed is that self-report tools inaccurately estimate the prevalence of mental health problems. This inaccuracy is further exacerbated by a lack of cultural appropriateness of the tools, as many are developed for Western contexts. Conclusion It is recommended that researchers and humanitarian workers reflect on the effectiveness of the mental health assessment tool they use to accurately represent the populations under study in emergency settings. In addition, mental health assessment should be coupled with action.
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Affiliation(s)
- Ashley Moore
- Department of Social and Behavioral Sciences, Yale University School of Public Health , New Haven, CT, USA
| | - Joris Adriaan Frank van Loenhout
- Centre for Research on the Epidemiology of Disasters (CRED), Institute of Health and Society, Université Catholique de Louvain , Brussels, Belgium
| | - Maria Moitinho de Almeida
- Centre for Research on the Epidemiology of Disasters (CRED), Institute of Health and Society, Université Catholique de Louvain , Brussels, Belgium
| | - Pierre Smith
- Institute of Health and Society IRSS, Université Catholique de Louvain , Brussels, Belgium
| | - Debarati Guha-Sapir
- Centre for Research on the Epidemiology of Disasters (CRED), Institute of Health and Society, Université Catholique de Louvain , Brussels, Belgium
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Guo J, Fu M, Liu D, Zhang B, Wang X, van IJzendoorn MH. Is the psychological impact of exposure to COVID-19 stronger in adolescents with pre-pandemic maltreatment experiences? A survey of rural Chinese adolescents. CHILD ABUSE & NEGLECT 2020; 110:104667. [PMID: 32859393 PMCID: PMC7440157 DOI: 10.1016/j.chiabu.2020.104667] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 07/31/2020] [Accepted: 08/01/2020] [Indexed: 05/18/2023]
Abstract
BACKGROUND Since the COVID-19 outbreak at the end of 2019, it has evolved into a global pandemic with tremendous mental health impact besides the threats to people's physical health. OBJECTIVE The aims were to examine whether exposure to COVID-19 predicts elevated levels of anxiety and post-traumatic stress symptoms and whether pre-pandemic maltreatment experiences exacerbate this impact on mental health in adolescents. PARTICIPANTS AND SETTING The survey was conducted online from February 8 st to February 27th, 2020, and the questionnaires were distributed and retrieved through a web-based platform. This study includes a total of 6196 subjects, aged range from 11 to 18 years old. METHODS Several multivariable linear regressions were used to analyse the data. RESULTS The largest variance in PTSS and anxiety problems was explained by ACEs, with more pre-pandemic maltreatment experiences predicting more PTSS (effect size beta = 0.16∼0.27), and more anxiety (effect size beta = 0.32∼0.47). Experienced or subjective fear of exposure to COVID-19 predicted statistically significant variance in PTSS and anxiety, and standardized betas ranged from 0.04 to 0.09. Participants who had adverse childhood experiences and had experienced exposure to COVID-19 showed elevated PTSS. CONCLUSIONS After pre-pandemic maltreatment experiences the impact of exposure to COVID-19 on mental health may be stronger. Scars from the past seem to be vulnerabilities during societal upheaval. We therefore suggest that when exposed to COVID-19 rural adolescents should get prioritized professional family support and mental health counseling in particular when they have experienced family abuse and neglect in childhood, even though such support is more difficult to organize in rural areas.
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Affiliation(s)
- Jing Guo
- Department of Health Policy and Management, School of Public Health, Peking University, 100191, Beijing, China
| | - Mingqi Fu
- Center for Social Security Studies, Wuhan University, 430070, Wuhan, China
| | - Danxia Liu
- School of Sociology, Huazhong University of Science and Technology, 430074, Wuhan, China
| | - Bo Zhang
- Department of Neurology and ICCTR Biostatistics and Research Design Center, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA
| | - Xiaohua Wang
- School of Social Development and Public Policy, Beijing Normal University, 100875, Beijing, China.
| | - Marinus H van IJzendoorn
- Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, 3000 DR, Rotterdam, the Netherlands; School of Psychology, Capital Normal University, 100048, Beijing, China; School of Clinical Medicine, University of Cambridge, CB2 0SR, Cambridge, UK
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Kang E. Association between psychological morbidities and information provision, reliability, and satisfaction among disaster victims: A cross-sectional study. J Psychiatr Res 2020; 130:273-279. [PMID: 32861210 DOI: 10.1016/j.jpsychires.2020.08.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 08/08/2020] [Accepted: 08/11/2020] [Indexed: 11/19/2022]
Abstract
Providing information about disaster relief services and recovery processes reduces the damage from disasters and enables disaster victims to respond to disasters effectively. The present study aimed to clarify the associations between provision, reliability, satisfaction of information and satisfaction with media coverage and the risk of psychological morbidities (post-traumatic stress disorder [PTSD], depression, and anxiety). This was a cross-sectional survey - 1337 disaster victims who had experience of disasters within 2 years, such as earthquakes were enrolled in the 3rd Disaster Victims Panel Survey, 2018. Logistic regression analysis was used to investigate the associations between psychological morbidities and provision, reliability, and satisfaction of information. Reliability of information was assessed with a dichotomized variable and satisfaction with information or media was assessed 4 levels with 'neutral' by a single retrospective self-report item. The risks of depression (odds ratio [95% CI] = 1.478 [1.078-2.028]; p = 0.015) and anxiety (1.879 [1.262-2.798]; p = 0.002) were significantly higher in uninformed victims. Those who received reliable information were less likely to report depression (0.538 [0.381-0.758]; p < 0.001) and anxiety (0.362 [0.229-0.573]; p < 0.001), and those who received unreliable information were more likely to report PTSD (1.714 [1.045-2.810]; p = 0.033) and depression (1.742 [1.029-2.950]; p = 0.039). Satisfactory information was related to lower risks of depression (0.543 [0.380-0.778]; p = 0.001) and anxiety (0.352 [0.215-0.575]; p < 0.001). Disaster victims who were unsatisfied with media coverage had higher risks of PTSD (5.363 [3.672-7.833]; p < 0.001), depression (5.911 [3.377-10.347]; p < 0.001) and anxiety (5.840 [2.837-12.022]; p < 0.001). Providing information and providing reliable and satisfactory information might reduce the risk of psychological morbidities. Our results suggest that providing reliable and satisfactory information during disasters could reduce the psychiatric burden of disasters.
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Affiliation(s)
- Eunkyo Kang
- Public Healthcare Center, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea; Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
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Abstract
The purposes of this study was to assess the youth mental health after the coronavirus disease 19 (COVID-19) occurred in China two weeks later, and to investigate factors of mental health among youth groups. A cross-sectional study was conducted two weeks after the occurrence of COVID-19 in China. A total of 584 youth enrolled in this study and completed the question about cognitive status of COVID-19, the General Health Questionnaire(GHQ-12), the PTSD Checklist-Civilian Version (PCL-C) and the Negative coping styles scale. Univariate analysis and univariate logistic regression were used to evaluate the effect of COVID-19 on youth mental health. The results of this cross-sectional study suggest that nearly 40.4% the sampled youth were found to be prone to psychological problems and 14.4% the sampled youth with Post-traumatic stress disorder (PTSD) symptoms. Univariate logistic regression revealed that youth mental health was significantly related to being less educated (OR = 8.71, 95%CI:1.97-38.43), being the enterprise employee (OR = 2.36, 95%CI:1.09-5.09), suffering from the PTSD symptom (OR = 1.05, 95%CI:1.03-1.07) and using negative coping styles (OR = 1.03, 95%CI:1.00-1.07). Results of this study suggest that nearly 40.4% of the youth group had a tendency to have psychological problems. Thus, this was a remarkable evidence that infectious diseases, such as COVID-19, may have an immense influence on youth mental health. Therefor, local governments should develop effective psychological interventions for youth groups, moreover, it is important to consider the educational level and occupation of the youth during the interventions.
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Affiliation(s)
- Leilei Liang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, 130021, Jilin Province, China
| | - Hui Ren
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, 130021, Jilin Province, China.,Department of the First Hospital, Jilin University, No.71 Xinmin Street, Changchun, 130021, Jilin Province, China
| | - Ruilin Cao
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, 130021, Jilin Province, China
| | - Yueyang Hu
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, 130021, Jilin Province, China
| | - Zeying Qin
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, 130021, Jilin Province, China
| | - Chuanen Li
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, 130021, Jilin Province, China
| | - Songli Mei
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, No.1163 Xinmin Street, Changchun, 130021, Jilin Province, China.
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Wang Q, Chen C, Zhang S, Tang Y, Wang H, Zhou X, Wong MS. Pain issues in the victims with lower-limb amputation: 10 years after the 2008 Sichuan earthquake. Disabil Rehabil 2020; 44:1346-1353. [PMID: 32787698 DOI: 10.1080/09638288.2020.1803998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE To study the prevalence, intensity, and bothersomeness of amputation-related pain and further to identify the potential risk factors in the victims with lower-limb amputation 10 years after the 2008 Sichuan earthquake. METHODS In the cross-sectional study, 66 victims with lower-limb amputation were recruited. The Prostheses Evaluation Questionnaire was used to document the prevalence, intensity, and bothersomeness of amputation-related pain. The bivariate relationships between amputation-related pain and each of demographic characteristics were analyzed. RESULTS Majority of the enrolled lower-limb amputees (90.9%) reported to have one or more types of amputation-related pain. The intensity and bothersomeness of amputation-related pain were considered as severe in nearly 40% of these post-earthquake victims. The potential demographic risk factors associated with the prevalence, intensity, and bothersomeness of amputation-related pain were identified, including the age, lower level of education, marital status, employment, and comorbidity. CONCLUSIONS The pain coming from phantom limb, residual limb, non-amputated limb, and back was found persistent in the lower-limb amputees 10 years after the 2008 Sichuan earthquake. The findings of this study could provide useful reference for optimization of post-disaster rehabilitation strategies to alleviate chronic pain in the victims following lower-limb amputation.Implications for RehabilitationThe pain coming from phantom limb, residual limb, non-amputated limb, and back was found persistent in the victims with lower-limb amputation 10 years after the 2008 Sichuan earthquake.Continuous post-earthquake assessment and management of amputation-related pain should be taken into consideration for the victims with lower-limb amputation.The comorbidity should be effectively and efficiently controlled for the victims with lower-limb amputation due to its association with the intensity and bothersomeness of amputation-related pain.
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Affiliation(s)
- Qian Wang
- Center of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China.,Department of Biomedical Engineering, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Caiyun Chen
- Center of Comprehensive Service of Disabled, Deyang, China
| | - Sheng Zhang
- Center of Comprehensive Service of Disabled, Deyang, China
| | - Yiming Tang
- Center of Comprehensive Service of Disabled, Deyang, China
| | - Hongxia Wang
- Center of Comprehensive Service of Disabled, Deyang, China
| | - Xue Zhou
- Center of Comprehensive Service of Disabled, Deyang, China
| | - Man-Sang Wong
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Kowloon, Hong Kong
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Fukasawa M, Kawakami N, Umeda M, Akiyama T, Horikoshi N, Yasumura S, Yabe H, Suzuki Y, Bromet EJ. Long-lasting effects of distrust in government and science on mental health eight years after the Fukushima nuclear power plant disaster. Soc Sci Med 2020; 258:113108. [DOI: 10.1016/j.socscimed.2020.113108] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/21/2020] [Accepted: 06/02/2020] [Indexed: 11/26/2022]
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Koirala R, Søegaard EGI, Ojha SP, Hauff E, Thapa SB. Trauma related psychiatric disorders and their correlates in a clinical sample: A cross-sectional study in trauma affected patients visiting a psychiatric clinic in Nepal. PLoS One 2020; 15:e0234203. [PMID: 32541999 PMCID: PMC7295578 DOI: 10.1371/journal.pone.0234203] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 05/20/2020] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Nepal, like many other low-income countries, has a great burden of mental health issues but few resources to meet them. In addition, Nepal has endured several traumatic events in recent decades but the impact on mental health has not been studied in clinical settings. This study explores trauma-related psychiatric disorders and their correlates. METHODS 100 patients with a history of trauma who visited the outpatient psychiatry clinic at a University hospital in Kathmandu were assessed. The Composite International Diagnostic Interview 2.1 (CIDI) was used to evaluate lifetime and current depressive disorder, generalized anxiety disorder (GAD) and lifetime post-traumatic stress disorder (PTSD). Current PTSD was evaluated using PSTD Checklist-Civilian Version (PCL-C). RESULTS The median number of lifetime traumatic events was two. Natural disaster was the most common trauma type (84%) compared to other types of trauma. Rape was reported as the most traumatizing. Current PTSD was found in 15%, depression in 33% and GAD in 38% of the patients. The lifetime rates were PTSD 83%, depression 45% and GAD 40%. There was high comorbidity between the disorders. The 31 to 45 years age group, above high school education level and trauma types other than earthquake were independently associated with current PTSD. Marital status and upper socioeconomic status (SES) compared to upper-middle SES were independently associated with lifetime PTSD. Both lifetime and current depression rates were independently associated with the upper SES compared to upper-middle SES. Place of living, education above high school and lower-middle SES were significantly associated with lifetime and current GAD. CONCLUSION PTSD, depression and GAD were prevalent in a trauma exposed patient population visiting a psychiatric clinic in Nepal. High rates of comorbidities and several risk factors were identified. Our findings highlight the need for addressing trauma related disorders in clinical settings in developing countries.
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Affiliation(s)
- Rishav Koirala
- Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Brain and Neuroscience Center, Kathmandu, Nepal
- * E-mail:
| | - Erik Ganesh Iyer Søegaard
- Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Saroj Prasad Ojha
- Department of Psychiatry and Mental Health, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | - Edvard Hauff
- Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Suraj B. Thapa
- Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Psychiatry and Mental Health, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
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Tang W, Xu D, Xu J. The mediating role of alexithymia between earthquake exposure and psychopathology among adolescents 8.5 years after the wenchuan earthquake. PERSONALITY AND INDIVIDUAL DIFFERENCES 2020. [DOI: 10.1016/j.paid.2020.109881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Ear acupuncture for posttraumatic symptoms among long-term evacuees following the 2017 Pohang earthquake: a retrospective case series study. Integr Med Res 2020; 9:100415. [PMID: 32435584 PMCID: PMC7231849 DOI: 10.1016/j.imr.2020.100415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Indexed: 11/21/2022] Open
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Li Y, Shi X, McReynolds LS, Tang H, Chen H, Wang T, Zhang Y, Geng F, Fan F, Hoven CW. Depressive symptoms between parent and adolescent survivors: A longitudinal actor-partner interdependence model. J Affect Disord 2020; 265:139-145. [PMID: 32090735 DOI: 10.1016/j.jad.2020.01.038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 12/04/2019] [Accepted: 01/11/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND The association between parent-child depression following disasters has been well documented. However, longitudinal studies of posttraumatic depression using parent-child dyadic are scarce. This study aimed to investigate inter-related effects between parent and child depression, as well as predictors of depressive symptoms, in a large sample of Wenchuan earthquake survivors. METHODS Data are from the Wenchuan Earthquake Adolescent Health Cohort (WEAHC) Study that included 685 parent-child dyads exposed to the earthquake. Depression was assessed with the Self-Rating Depression Scale (for parents) and Depression Self-Rating Scale for Children, at 12 (T12m) and 18 months (T18m) post-earthquake. Longitudinal actor-partner interdependence models (APIMs) were employed to examine depression within dyads. Predictors of depressive symptoms were assessed by the cart algorithm throughout the 6-month follow-up. RESULTS Adjusting for earthquake exposure and previous depressive symptoms, parents' depression at 12 months predicted children's depressive symptoms at 18 months, and vice versa (β = 0.14 for parents and β = 0.12 for children). Psychomotor retardation in parents, and dysphoria/social isolation and positive affect in children were identified as crucial screening indicators identifying parents and children at increased risk for depression. CONCLUSION A bidirectional association was found between parent and child depression following a mass disaster. Both parent and child depression status should be examined when implementing interventions to identify and treat depression in earthquake survivors.
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Affiliation(s)
- Yuanyuan Li
- School of Psychology, Center for Studies of Psychological Application, and Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Shipai Road, Guangdong 510631, China
| | - Xuliang Shi
- College of education, Hebei University, Baoding, China
| | - Larkin S McReynolds
- Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, USA
| | - Huilan Tang
- Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, USA
| | - Huilin Chen
- Department of Psychology, University of Bath, Bath, Somerset, UK
| | - Tong Wang
- School of Psychology, Center for Studies of Psychological Application, and Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Shipai Road, Guangdong 510631, China
| | - Yuechu Zhang
- School of Psychology, Center for Studies of Psychological Application, and Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Shipai Road, Guangdong 510631, China
| | - Fulei Geng
- School of Psychology, Center for Studies of Psychological Application, and Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Shipai Road, Guangdong 510631, China
| | - Fang Fan
- School of Psychology, Center for Studies of Psychological Application, and Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Shipai Road, Guangdong 510631, China.
| | - C W Hoven
- Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, USA
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Li L, Reinhardt JD, Van Dyke C, Wang H, Liu M, Yamamoto A, Chen Q, Hu X. Prevalence and risk factors of post-traumatic stress disorder among elderly survivors six months after the 2008 Wenchuan earthquake in China. BMC Psychiatry 2020; 20:78. [PMID: 32087728 PMCID: PMC7036222 DOI: 10.1186/s12888-020-2474-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 01/31/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Several studies indicate that older age is a risk factor for probable post-traumatic stress disorder (PTSD). However, evidence on the prevalence and risk factors for elderly disaster survivors is limited. METHODS Multi-stage stratified sampling was applied in this cross-sectional study. The Revised Version of the Impact of Event Scale (IES-R) was used to evaluate symptoms of PTSD. Chi-squared test was used for univariable analysis of prevalence of probable PTSD by possible determinants. Multivariable logistic regression analysis was utilized to further explore risk factors for PTSD. RESULTS 427 elderly survivors age 60 or older participated. The prevalence of probable PTSD was 40.5, 36.3, and 21.5% according to a cut off score of the IES-R of 33, 35, and 2 points on average across items, respectively. In multivariable logistic regression, elderly survivors with a higher number of diagnosed chronic illnesses were more likely to be screened positive for PTSD and those with a greater number of family members living in the same home were less likely to be classified as having probable PTSD for all cut off scores. Elderly survivors with improved economic status and those with primary school or lower education were more often estimated to have probable PTSD with a cut off score of 35 and 2 points on average. CONCLUSIONS Elderly survivors in a high impact area following a major earthquake are at high risk for developing PTSD. Those who live alone and report pre-existing chronic illness are particularly vulnerable.
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Affiliation(s)
- Lan Li
- grid.13291.380000 0001 0807 1581Department of Nursing, West China Hospital, Sichuan University, Chengdu, China ,grid.410578.fDepartment of Nursing, Southwest Medical University, Luzhou, China ,Institute for Disaster Management and Reconstruction of Sichuan University and Hong Kong Polytechnic University, Chengdu, China
| | - Jan D. Reinhardt
- Institute for Disaster Management and Reconstruction of Sichuan University and Hong Kong Polytechnic University, Chengdu, China ,grid.419770.cSwiss Paraplegic Research, Nottwil, Switzerland ,grid.449852.6Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Craig Van Dyke
- grid.13291.380000 0001 0807 1581Department of Nursing, West China Hospital, Sichuan University, Chengdu, China ,grid.266102.10000 0001 2297 6811Department of Psychiatry, University of California San Francisco, San Francisco, CA USA
| | - Heng Wang
- grid.13291.380000 0001 0807 1581Department of Anesthesiology, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, China
| | - Maoqiong Liu
- Department of Nursing, Dujiangyan Second People’s Hospital, Dujiangyan, China
| | - Aiko Yamamoto
- grid.502988.eResearch Institute for Nursing Care, Information Engineering National Institute of Technology, Nara College, Nara, Japan
| | - Qian Chen
- Center of Gerontology and Geriatrics, National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu, 610041, Sichuan Province, China.
| | - Xiuying Hu
- Innovation Center for Nursing Research, West China School of Medicine/West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu, 610041, Sichuan Province, China.
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Ma Z, Lin Z. The impact of exposure to memorial reports on the 5.12 Wenchuan earthquake on sleep quality among adult survivors ten years after the disaster: Evidence for nonlinear associations. Compr Psychiatry 2020; 97:152150. [PMID: 31864220 DOI: 10.1016/j.comppsych.2019.152150] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 10/16/2019] [Accepted: 11/29/2019] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Very few studies have explored the effect of exposure to disaster memorial reports in the media on long-term sleep quality during the recovery period and post-disaster era. This study investigated the relationship between exposure to memorial reports and adult survivors' long-term sleep quality 10 years after the 5.12 Wenchuan earthquake in 2008, and determined whether exposure to memorial reports are associated with poor sleep quality. METHOD Using a cross-sectional methodology, we surveyed participants (N = 1000) recruited from six disaster-affected counties. We measured sleep quality using the Pittsburgh Sleep Quality Index questionnaire (PSQI). RESULTS After controlling for the effects of demographic factors, socioeconomic status, and earthquake exposure factors, exposure to memorial reports and the PSQI global score had a strong inverted U-shaped relationship. Relationships among three sub-scores of PSQI (subjective sleep quality, sleep latency, daytime dysfunction) were also found to have similar relationships with memorial report exposure. That is, survivors who were exposed to low or high degrees of memorial reports had better sleep quality than those who were exposed to intermediate memorial reports. DISCUSSION The curvilinear relationship between media exposure and sleep quality in the post-disaster era reveals that media exposure could be used to identify victims at risk of poor sleep quality. Clinicians and practitioners may consider adopting psychological intervention programs to enhance victims' psychological controllability to overcome mental disorders caused by media exposure.
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Affiliation(s)
- Zhihao Ma
- Computational Communication Collaboratory, School of Journalism and Communication, Nanjing University, Nanjing 210093, PR China
| | - Zhongxuan Lin
- School of Journalism and Communication, Jinan University, Guangzhou 510632, PR China.
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Lu B, Zeng W, Li Z, Wen J. Prevalence and Influencing Factors of Post-Traumatic Stress Disorder Among Survivors in the Hard-Hit Areas Ten Years After the Wenchuan Earthquake: A Cross-Sectional Study. Neuropsychiatr Dis Treat 2020; 16:933-941. [PMID: 32308397 PMCID: PMC7152546 DOI: 10.2147/ndt.s247527] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 03/25/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) is common psychological distress after natural disasters, which is persistent. Chronic PTSD leads to a heavy disease burden. The purpose of this study is to explore the prevalence and influencing factors of chronic PTSD among survivors in the hard-hit areas ten years after the Wenchuan earthquake. MATERIALS AND METHODS A cross-sectional survey was conducted on residents aged 16 or above in hard-hit areas through a multi-stage sampling approach ten years after the Wenchuan earthquake. The items of the questionnaire included demographic characteristics and earthquake exposure factors, and the PTSD Checklist-Civilian Version (PCL-C) was used to evaluate the PTSD of the respondents. RESULTS A total of 1039 complete questionnaires were obtained. The median age of 1039 respondents was 60 years, 63.2% of whom were female, 70.2% were illiterate or had received primary education, and 58% had an annual household income of less than 20,000 yuan (US$ 2871.3). The rate of PTSD was 9.1% (95/1039). After controlling for confounding factors, it was found that higher income level and education level, and moving to concentrated rural settlement (CRS) after the earthquake might be protective factors for the long-term mental health of survivors in the hard-hit areas, and the loss of immediate families in the earthquake was an important risk factor. CONCLUSION Even though ten years have passed since the Wenchuan earthquake, the survivors in the hard-hit areas still have a serious mental disorder. The local government and health-care institutions should take appropriate measures to improve the mental health of residents.
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Affiliation(s)
- Bingqing Lu
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China
| | - Wenqi Zeng
- Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China
| | - Zhuyue Li
- West China Hospital/West China School of Nursing, Sichuan University, Chengdu 610041, People's Republic of China
| | - Jin Wen
- Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China
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Fukasawa M, Kawakami N, Umeda M, Akiyama T, Horikoshi N, Yasumura S, Yabe H, Suzuki Y, Bromet EJ. Longitudinal associations of radiation risk perceptions and mental health among non-evacuee residents of Fukushima prefecture seven years after the nuclear power plant disaster. SSM Popul Health 2019; 10:100523. [PMID: 31872039 PMCID: PMC6909055 DOI: 10.1016/j.ssmph.2019.100523] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 10/29/2019] [Accepted: 11/25/2019] [Indexed: 11/30/2022] Open
Abstract
We aimed to explore the effects of prolonged radiation risk perceptions on mental health after the Fukushima nuclear power plant accident occurred in 2011. We investigated the longitudinal associations of radiation risk perceptions five years after the accident with psychological distress and posttraumatic stress symptoms two years later among non-evacuee community residents of Fukushima prefecture. A two-wave questionnaire survey was administered for 4,900 randomly sampled residents in 49 municipalities of Fukushima prefecture excluding the evacuation area designated by the Japanese government. Radiation risk perceptions were assessed with a seven-item scale. Psychological distress and posttraumatic stress symptoms were measured by the K6 and the six-item abbreviated version of the Posttraumatic Stress Disorder Checklist-Specific version, respectively. We investigated the associations of radiation risk perceptions in the first survey conducted in 2016 with psychological distress and posttraumatic stress symptoms in the follow-up survey conducted in 2017–18, controlling for the baseline level of distress or symptoms using multivariate logistic regression analyses. Valid responses were obtained from 1,148 residents (23.4%). Higher risk perceptions of radiation exposure in the first survey predicted later posttraumatic stress symptoms but not psychological distress after controlling for baseline symptoms or distress. High risk perceptions of radiation exposure after nuclear power plant accidents can lead to posttraumatic stress symptoms. Radiation anxiety predicted later posttraumatic stress symptoms. Radiation anxiety did not predict later psychological distress. Radiation anxiety affected later mental health status among non-evacuee residents.
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Affiliation(s)
- Maiko Fukasawa
- Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Norito Kawakami
- Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Maki Umeda
- Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Tsuyoshi Akiyama
- Department of Neuropsychiatry, NTT Medical Center Tokyo, 5-9-22 Higashi-Gotanda, Shinagawa-ku, Tokyo, 141-8625, Japan
| | - Naoko Horikoshi
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima City, Fukushima, 960-1295, Japan
| | - Seiji Yasumura
- Department of Public Health, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima City, Fukushima, 960-1295, Japan
| | - Hirooki Yabe
- Department of Neuropsychiatry, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima City, Fukushima, 960-1295, Japan
| | - Yuriko Suzuki
- Department of Mental Health Policy, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-higashi, Kodaira, Tokyo, 187-8553, Japan
| | - Evelyn J Bromet
- Stony Brook University, 100 Nicolls Road, Stony Brook, NY, 11794, USA
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Zhang Y, Zhang J, Ren R, Tang X. Bidirectional associations of insomnia symptoms with somatic complaints and posttraumatic stress disorder in child and adolescent earthquake survivors: a longitudinal study. Sleep Breath 2019; 24:311-320. [DOI: 10.1007/s11325-019-01955-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 09/18/2019] [Accepted: 09/29/2019] [Indexed: 12/14/2022]
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School-based psychoeducation and storytelling: Associations with long-term mental health in adolescent survivors of the Wenchuan earthquake. Epidemiol Psychiatr Sci 2019; 29:e65. [PMID: 31640825 PMCID: PMC8061163 DOI: 10.1017/s2045796019000611] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
AIMS We explored the factors promoting long-term mental health among adolescent survivors of the 2008 Wenchuan earthquake in China. We examined the associations of their long-term mental health with disaster-related storytelling and school-based psychoeducation, and of school-based psychoeducation with disaster-related storytelling. METHODS A secondary school-based cross-sectional survey was conducted 6 years after the disaster. Participants with traumatic experiences such as injury, loss, witnessing someone's death/injury and home destruction (N = 1028, mean age 15, standard deviation 1.38, male 51%) were eligible. Mental health/disaster education (MHE/DE) was defined as taking one or more lessons in MHE and/or DE at school since the earthquake. Experiences of storytelling about the disaster involved expressing distressing memories and feelings regarding the earthquake since the disaster happened, according to four groups: never expressed distressing memories and feelings, expressed them through writing/drawing, expressed them through talking to lay supporters and expressed them through talking to health professionals. Analysis of covariance was used to compare mean scores on five selected subscales of the Symptom Checklist-90 (SCL-90), the Athens Insomnia Scale (AIS) and the Psychotic-Like Experiences (PLEs) scale among the four storytelling groups. Linear regression analysis was used to identify the relationships between MHE/DE and current mental health as measured by the SCL-90, AIS and PLEs. The relationship between education and storytelling was probed by χ2 test. RESULTS The talked-to-lay-supporters group showed better mental health on the SCL-90 (p ⩽ 0.001), AIS (p < 0.001) and PLEs (p = 0.004), while the consulted-health-professionals group showed worse mental health on the three dimensions of the SCL-90: depression (p = 0.05), anxiety (p = 0.02) and fear (p = 0.04), and on PLEs (p = 0.02) compared with the never-expressed group. MHE and DE were inversely associated with SCL-90, AIS and PLE scores. Participants who received these forms of education talked about their disaster experiences to lay supporters more than those who did not. CONCLUSIONS MHE and DE at school may promote adolescents' mental health after a disaster. Experience of storytelling about the disaster to lay supporters may be helpful for long-term psychological recovery, and may be a potential mediating factor for school-based education and better mental health. Because of the cross-sectional nature of this study, causality cannot be inferred; therefore, further prospective intervention studies are needed to elucidate the effect of these factors on adolescent survivors' mental health.
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Gao X, Leng Y, Guo Y, Yang J, Cui Q, Geng B, Hu H, Zhou Y. Association between earthquake experience and depression 37 years after the Tangshan earthquake: a cross-sectional study. BMJ Open 2019; 9:e026110. [PMID: 31434762 PMCID: PMC6707697 DOI: 10.1136/bmjopen-2018-026110] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE To investigate the association between the Tangshan earthquake and depression after 37 years. DESIGN AND SETTING A cross-sectional study conducted in Tangshan from 2013 to 2014. PARTICIPANTS The sample included 5024 participants born before 28 July 1976 the date of the Tangshan earthquake, with available data on their earthquake experiences and depression 37 years post-earthquake. OUTCOMES AND VARIABLES The outcome was depression measured using the Center for Epidemiological Study and Depression Scale. The independent variable was earthquake experience, which was classified into three groups: no earthquake experience, earthquake experience without bereavement and earthquake experience with bereavement. Multivariable logistic regression analysis was used to evaluate the association between earthquake experience and depression after adjusting for gender, age at the time of the earthquake, smoking status, drinking status, education, income, residence in Tangshan 1 to 2 years post-earthquake, hypertension, diabetes and dyslipidaemia. RESULTS Of the 5024 participants, 641 experienced the Tangshan earthquake, and 98 experienced bereavement due to the earthquake. 37 years after the earthquake, survivors who had lost relatives during the earthquake were nearly three times (OR 2.82, 95% CI 1.24 to 6.39) as likely to have depression as those who had not experienced the earthquake, while those who had not lost relatives were 1.69 times as likely (OR 1.69, 95% CI 0.93 to 3.08). Stratified analyses showed that earthquake was significantly associated with depression in women with (OR 3.51, 95% CI 1.21 to 10.16) or without bereavement (OR 3.07, 95% CI 1.44 to 6.56) but not in men; this association was also significant in individuals over 18 years old at the time of the earthquake with (OR 13.16, 95% CI 3.08 to 56.3) or without bereavement (OR 3.39, 95% CI 1.31 to 8.87) but not in individuals less than 18 years old. CONCLUSIONS 37 years after the Tangshan earthquake, earthquake experience was associated with depression among bereaved survivors, women and individuals over 18 years old at the time of the earthquake.
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Affiliation(s)
- Xing Gao
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yue Leng
- Global Brain Health Institute, Department of Psychiatry, University of California, San Francisco, California, USA
| | - Yuchen Guo
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jichun Yang
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences Key Laboratory of Molecular Cardiovascular Science of the Ministry of Education Center for Non-coding RNA Medicine, Peking University Health Science Center, Beijing, China
| | - Qinghua Cui
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences Key Laboratory of Molecular Cardiovascular Science of the Ministry of Education Center for Non-coding RNA Medicine, Peking University Health Science Center, Beijing, China
| | - Bin Geng
- Hypertension Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, State Key Laboratory of Cardiovascular Disease, Beijing, China
| | - Hongpu Hu
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yong Zhou
- Sanbo Brain Institute, Sanbo Brain Hospital, Capital Medical University, Beijing, China
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Negative life events and post-traumatic stress disorder symptoms: a moderated mediation model of only-child status and depressive symptoms. Public Health 2019; 172:31-39. [DOI: 10.1016/j.puhe.2019.04.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 03/29/2019] [Accepted: 04/05/2019] [Indexed: 10/26/2022]
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Temporal Transitions in Patterns of Posttraumatic Stress Disorder and Depression Among Adolescents Following the Wenchuan Earthquake. Child Psychiatry Hum Dev 2019; 50:494-504. [PMID: 30600421 DOI: 10.1007/s10578-018-0859-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Posttramatic stress disorder (PTSD) and depression are persistent disorders with heterogeneous comorbidity. Cross-sectional design limitations have prevented previous studies from examining symptom pattern transitions, which limits the understanding on the change of mental health over time since trauma. This study examined transition patterns of PTSD and depression comorbidity and assessed the role of personality. PTSD, depression, and personality scales were used to assess 619 adolescents 1 year after the Wenchuan earthquake and then to longitudinally assess 332 adolescents 2 years post-earthquake. Data were analyzed using latent transition analysis and logistic regression. Four PTSD and depression comorbidity patterns were identified at both times: moderate comorbidity, high comorbidity, no symptoms, and depression. Patterns of PTSD and depression changed in 23.4% of adolescents: 4.4% and 7.1% transitioned from no symptoms to depression and from depression to moderate comorbidity, respectively; 7.5% transitioned from moderate comorbidity to depression. Extraversion and conscientiousness were more likely and openness was less likely to be associated with moderate comorbidity symptoms transitioned to depression symptoms. These findings indicated that patterns of PTSD and depression in adolescents are heterogeneous and show temporal change.
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Zhou X, Zhen R, Wu X. Trajectories of sleep problems among adolescents after the Wenchuan earthquake: the role of posttraumatic stress disorder symptoms. Psychol Health 2019; 34:811-827. [DOI: 10.1080/08870446.2019.1574348] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Xiao Zhou
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, China
| | - Rui Zhen
- Institute of Psychological Science, Hangzhou Normal University, Hangzhou, China
| | - Xinchun Wu
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Faculty of Psychology, Beijing Normal University, Beijing, China
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Posttraumatic stress disorder following the 2008 Wenchuan earthquake: A 10-year systematic review among highly exposed populations in China. J Affect Disord 2019; 243:327-339. [PMID: 30261448 DOI: 10.1016/j.jad.2018.09.047] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 08/27/2018] [Accepted: 09/15/2018] [Indexed: 01/10/2023]
Abstract
BACKGROUND The 2008 Wenchuan earthquake was unprecedented in Chinese history both in terms of the magnitude of the quake itself and the scale of human suffering. Following the disaster, researchers reported on a wide range of mental health outcomes, especially posttraumatic stress disorder (PTSD). In this review, we assess the cumulative body of research evidence about PTSD across the first 10 years following the earthquake. METHODS We searched the literature in the PubMed, Web of Science, and China National Knowledge Infrastructure (CNKI) databases (from May 2008 to February 2018) using Wenchuan earthquake and PTSD as keywords. RESULTS We selected 58 relevant studies. Published findings from the selected period suggested a substantial burden of PTSD on highly exposed survivors. Studies have found that symptoms of PTSD have been associated with a range of risk factors, including sociodemographic factors, trauma exposure characteristics, post-disaster cognitive and emotional states, and social support. Studies have explored the factor structure of PTSD in the affected Chinese population, and researchers have developed a Chinese self-report measure of PTSD symptoms. Several treatments for PTSD have been evaluated, including some indigenous intervention methods. LIMITATIONS Only a relatively small number of the studies used longitudinal assessments, and the consistency and effectiveness of measurement tools for PTSD require further exploration. More rigorous investigations of the effectiveness of interventions for the prevention and treatment of PTSD are needed. CONCLUSION The 10-year body of literature is important for the future deployment of disaster relief and an increased understanding of PTSD in China.
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Liang Y, Cheng J, Zhou Y, Liu Z. Trajectories of posttraumatic stress disorders among children after the Wenchuan earthquake: a four-year longitudinal study. Eur J Psychotraumatol 2019; 10:1586266. [PMID: 30911361 PMCID: PMC6427502 DOI: 10.1080/20008198.2019.1586266] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 01/30/2019] [Accepted: 02/12/2019] [Indexed: 11/17/2022] Open
Abstract
Background: Previous research has demonstrated heterogeneous patterns of posttraumatic stress disorder (PTSD) among children following disasters. However, no clear consensus has been reached regarding the postdisaster trajectories of PTSD among children. Objective: The current study examined the trajectories of PTSD among children after exposure to the Wenchuan earthquake and explored potential predictors of distinct PTSD trajectories. Methods: A four-year longitudinal study was conducted to follow 301 children who were evaluated for PTSD symptoms following the Wenchuan earthquake. Trauma exposure and some pre-existing characteristics were measured at four months after the disaster, and PTSD symptoms were measured at 4, 16, 29, 40 and 52 months after the disaster. The trajectories were identified with Latent Growth Mixture Modelling, and the predictors were explored with multinomial logistic regression. Results: The following three latent PTSD trajectories were found among children: resilient (74.9%), relapsing (17.7%) and recovery (7.5%). Trauma exposure was more likely to be related to a more severe trajectory of PTSD, having experienced prequake trauma was more likely to be related to the recovery trajectory and school 2 was more likely to be related to the relapsing trajectory. Conclusion: These findings provide novel insights into children's postdisaster response patterns. Individual heterogeneity existed in posttraumatic reactions. This longer-term longitudinal study captured more detailed and accurate information about the development of these trajectories. Trauma exposure and previous traumatic experience were linked to malignant development of PTSD.
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Affiliation(s)
- Yiming Liang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Jin Cheng
- School of Psychology, Beijing Sport University, Beijing, China
| | - Yueyue Zhou
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Zhengkui Liu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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Yin Q, Wu L, Yu X, Liu W. Neuroticism Predicts a Long-Term PTSD After Earthquake Trauma: The Moderating Effects of Personality. Front Psychiatry 2019; 10:657. [PMID: 31616324 PMCID: PMC6763688 DOI: 10.3389/fpsyt.2019.00657] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 08/14/2019] [Indexed: 11/13/2022] Open
Abstract
Background: The heartache from the devastating 8.0 magnitude Wenchuan earthquake, which killed nearly 90,000 people in western China, is still felt despite the large-scale recovery and reconstruction of the affected areas. This study investigated the relationships of earthquake-trauma exposures and personality with posttraumatic stress disorder (PTSD), to identify the long-term consequences of the Wenchuan earthquake on the survivors and the risk factors related to chronic PTSD. We hope the findings can contribute to developing new health care prevention and interventions for the survivors. Methods: We collected a sample of 490 people over 3 years after the Wenchuan earthquake, using questionnaires about demographic information and the traumatic experience in earthquake, the Impact of Event Scale-Revised (IES-R), and the Eysenck Personality Questionnaires (EPQ), to find the consequences of the Wenchuan earthquake on the survivors and the potential factors related to the long-term morbidity of PTSD. Result: Traumatic experiences, such as witnessing someone being seriously injured, having your house seriously damaged, and having close relatives severely injured, were associated with developing PTSD. Personality measured by EPQ was also closely related to PTSD. Regression analyses indicated that a potential linear model characterized the relationship between PTSD, neuroticism and psychoticism, yet extraversion/introversion were not significant factors. In the multivariate logistic regression, neuroticism (a continuous variable measured by EPQ) was of more significance in predicting the morbidity of long-term PTSD, compared with other variables [odds ratio (OR) = 1.113, 95% confidence interval (CI) = 1.081-1.146, Wald Value = 50.467, P < 0.001]. The final path diagram built a model indicated the moderating role of personality in the relationship between traumatic experiences and PTSD (CMIN/DF = 2.324, P < 0.001; CFI = 0.879 < 0.8; RMSEA = 0.05 < 0.08). Conclusion: This study demonstrated the role of personality traits and subjective exposure experiences regarding the vulnerability associated with PTSD after earthquake. Among all personality traits, neuroticism is considered a vulnerability factor of PTSD, and other personality traits also moderate the effects of traumatic experiences associated with PTSD. These findings might be useful for psychologists to develop intervention strategies for people suffered natural disasters, and to help individuals with PTSD to heal fully.
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Affiliation(s)
- Qianlan Yin
- The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Second Military Medical University, Shanghai, China
| | - Lili Wu
- The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Second Military Medical University, Shanghai, China
| | - Xiaoqian Yu
- Department of Psychology, University of South Florida, Tampa, FL, United States
| | - Weizhi Liu
- The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Second Military Medical University, Shanghai, China
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Zhou X, Zhen R, Wu X. How does parental attachment contribute to post-traumatic growth among adolescents following an earthquake? Testing a multiple mediation model. Eur J Psychotraumatol 2019; 10:1605280. [PMID: 31105903 PMCID: PMC6507859 DOI: 10.1080/20008198.2019.1605280] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 03/11/2019] [Accepted: 03/28/2019] [Indexed: 11/22/2022] Open
Abstract
This study aimed to elucidate the mechanism underlying the effect of parental attachment on post-traumatic growth (PTG) among adolescents. Nine and a half years after the Wenchuan earthquake, 872 adolescents in China were assessed using self-reported questionnaires. The results showed that parental attachment had a direct association with PTG, two significant one-step indirect associations with PTG (through justice beliefs and cognitive reappraisal), two significant two-step indirect associations (through feelings of safety via justice beliefs and justice beliefs via cognitive reappraisal), and one significant three-step indirect association (through feelings of safety via justice beliefs by cognitive reappraisal). The results indicated that feelings of safety, justice beliefs, and cognitive reappraisal mediated the association between parental attachment and PTG. These findings highlight the importance of a family perspective and may help clinical psychologists to improve adolescents' PTG by helping them to build positive parental attachments.
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Affiliation(s)
- Xiao Zhou
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, China
| | - Rui Zhen
- Institute of Psychological Science, Hangzhou Normal University, Hangzhou, China
| | - Xinchun Wu
- Beijing Key Laboratory of Applied Experimental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
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50
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Zhou X, Zhen R, Wu X. Trajectories of academic burnout in adolescents after the Wenchuan earthquake: A latent growth mixture model analysis. SCHOOL PSYCHOLOGY INTERNATIONAL 2018. [DOI: 10.1177/0143034318810318] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Changes in academic burnout in adolescents have attracted much research attention; however, most studies assume that adolescent academic burnout is characterized by overall homogenous change and overlook the heterogeneity of burnout change. To address this issue, this study examined distinct latent trajectories of academic burnout in adolescents following the Wenchuan earthquake, China. Adolescents were surveyed at 1 (T1), 1.5 (T2), 2 (T3), and 2.5 years (T4) after the earthquake. Self-reported questionnaires were administered to 391 participants aged 12- to 19-years-old. The results identified three academic burnout trajectories: Increasing (3.9%), low (85.4%), and decreasing (10.7%). Additionally, intrusive post-traumatic stress disorder (PTSD) symptoms were more likely in the increasing group, avoidance PTSD symptoms were more likely in the decreasing group, and PTSD hyperarousal symptoms were more likely in the decreasing group, but less likely in the increasing group. These findings indicate that adolescents experienced heterogeneous academic burnout changes following the earthquake.
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Affiliation(s)
| | - Rui Zhen
- Hangzhou Normal University, China
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