Post-traumatic psychological changes among survivors of the Lushan earthquake living in the most affected areas

Post-traumatic positive and negative psychological changes experienced by child and adolescent earthquake survivors in remote rural western China: a cross-sectional study six years after the Yushu earthquake

Background: Yushu, Qinghai province is located in remote Tibetan plateau in Western China, struck by a disastrous earthquake in 2010. The study aimed to find out the positive and negative psychological changes and related risk factors of children and adolescents who had experienced Yushu earthquake, 6 years after it occurred. Methods: A cross-sectional research was adopted in the capital of Yushu Autonomous Prefecture in August 2016. The short form of the Changes in Outlook Questionnaire (CiOQ-S) was used, which is a 10-item self-report instrument consists of two subscales. A total of 591 valid questionnaires completed by local junior students were finally included in our study. Results: The mean scores of the positive and negative psychological changes were 19.28 and 13.08, respectively. The factors associated with positive psychological changes included high level of education, male gender, and uninjured in the earthquake. The factors associated with negative psychological changes included living in a pasture instead of downtown, injured during the earthquake, and not receiving psychological counselling. Conclusions: The current analysis tries to investigate the long-term psychological effects of earthquakes among children and adolescents, which aims to improve the psychological health status for child and adolescent survivors of similar events.

Identifying predictors of probable posttraumatic stress disorder in children and adolescents with earthquake exposure: A longitudinal study using a machine learning approach

BACKGROUND

Evidence has identified risk factors associated with individuals with trauma exposure who develop posttraumatic stress disorder (PTSD). How to combine risk factors to predict probable PTSD in young survivors using machine learning is limited. The study aimed to integrated multiple measures at 2 weeks after the earthquake using machine learning for the prediction of probable PTSD at 3 months after earthquake.

METHODS

A total of 2099 young survivors with earthquake exposure were included. We integrated multiple domains of variables to 'train' a machine learning algorithm (XGBoost). Thirty-one combination types were implemented and evaluated. The resulting XGBoost was utilized in identifying individual participants as either probable PTSD or no PTSD.

RESULTS

Any combination type predicted young survivor probable PTSD, with prediction accuracies ranging between 66%-80% (p < 0.05). In particular, the combination of earthquake experience, everyday functioning, somatic symptoms and sleeping correctly predicted 683 out of 802 cases of probable PTSD, translating to a classical accuracy of 74.476% (85.156% sensitivity and 60.366% specificity) and an area under the curve of 0.80. The most relevant variables (e.g. age, sex, property loss and a sedentary lifestyle) revealed in the present study.

LIMITATIONS

Participants from a specific district might limit the generalizability of our results. Self-report questionnaires and non-standardized measures were used to assess symptoms.

CONCLUSION

Detection of probable PTSD according to self-reported measurement data is feasible, may improve operational efficiencies via enabling targeted intervention, before manifestation of symptoms.

Factors associated with injuries among tornado victims in Yancheng and Chifeng, China

BACKGROUND

As extremely violent meteorological disasters, tornadoes often cause serious casualties. The study aims to analyze the characteristics and causes of tornado injuries in China under certain humanistic and geographical conditions.

METHODS

A random sampling questionnaire survey was developed and distributed to tornado victims from two separate occurrences: an Enhanced Fujita 4 tornado in Yancheng, and a Fujita 3 tornado in Chifeng. The information of demographic characteristics, disaster environment, and individual behaviors in victims was collected. Chi-square test and binary logistic regression were used to analyze influencing factor of injuries.

RESULTS

A total of 94 valid questionnaires (participation rate 95.9%) were finally collected in Yancheng tornado and 67 valid questionnaires (participation rate 93.1%) in Chifeng tornado. Residents' annual income (OR = 0.10, 95% CI 0.02-0.50, P = 0.005), degree of house collapse (OR = 183.12, 95% CI 8.04-4173.34, P = 0.001) have a significant impact on the probability of injury. Differences in tornado disaster drill awareness (P = 0.009), individual behaviors (P = 0.011) and fear level (P = 0.011) significantly affected the incidence of trauma. Whether victims were indoors or not has no statistical difference on injuries in China.

CONCLUSIONS

Our study clarifies risk factors and is conducive to the expansion of the investigation in tornado casualties. The government should improve the wind-resistance of residential buildings. Victims should participate in disaster prevention drills to take effective disaster avoidance actions.

Risk Factors of Post-traumatic Stress and Depressive Disorders in Longmenshan Adolescents After the 2013 Lushan Earthquake

This study examined the severity of post-traumatic stress and depressive disorders in Longmenshan adolescents after the 2013 Lushan earthquake, as well as relationships among earthquake-related exposure, post-earthquake negative factors, previous exposure to the 2008 Wenchuan earthquake, and level of earthquake impact (city). A cross-sectional survey was conducted among adolescents in Lushan (n = 1416), Baoxing (n = 1102) and Tianquan (n = 1265) at 3 years after the Lushan earthquake. Respondents were evaluated using the Earthquake Experience Scale, the Adolescent Self-rating Life Events Checklist (ASLEC), the Children's Revised Impact of Event Scale (CRIES-13), and the Depression Self-Rating Scale (KADS-6). High levels of post-traumatic stress and depression symptoms were found among adolescents in the most heavily affected cities, and these symptoms were more severe in respondents exposed to the 2008 earthquake. PTSD correlated most strongly with earthquake exposure, whereas depression correlated most strongly with psychosocial stressors following the event.

Investigating Lushan Earthquake Victims' Individual Behavior Response and Rescue Organization

Research concerning the impact of earthquake victims’ individual behavior and its association with earthquake-related injuries is lacking. This study examined this relationship along with effectiveness of earthquake rescue measures. The six most severely destroyed townships during the Lushan earthquake were examined; 28 villages and three earthquake victims’ settlement camp areas were selected as research areas. Inclusion criteria comprised living in Lushan county for a longtime, living in Lushan county during the 2013 Lushan earthquake, and having one’s home destroyed. Earthquake victims with an intellectual disability or communication problems were excluded. The earthquake victims (N (number) = 5165, male = 2396) completed a questionnaire (response rate: 94.7%). Among them, 209 were injured (5.61%). Teachers (p < 0.0001, OR (odds ratios) = 3.33) and medical staff (p = 0.001, OR = 4.35) were more vulnerable to the earthquake than were farmers. Individual behavior was directly related to injuries, such as the first reaction after earthquake and fear. There is an obvious connection between earthquake-related injury and individual behavior characteristics. It is strongly suggested that victims receive mental health support from medical practitioners and the government to minimize negative effects. The initial reaction after an earthquake also played a vital role in victims’ trauma; therefore, earthquake-related experience and education may prevent injuries. Self-aid and mutual help played key roles in emergency, medical rescue efforts.

Prevalence of probable posttraumatic stress disorder and determination of its relationship with everyday functioning in children and adolescents by using generalized estimating equations

INTRODUCTION

We investigated the prevalence rates for probable PTSD and used generalized estimating equations to identify risk factors for probable PTSD in children and adolescents exposed to the Lushan earthquake.

METHODS

A total of 1623 participants completed 3 assessments, including the Children's Revised Impact of Event Scale, at 2 weeks, 3, and 6 months after experiencing the Lushan earthquake. Additionally, demographic variables and variables related to everyday functioning were evaluated at 2 weeks after the earthquake via a self-constructed questionnaire.

RESULTS

The percentages of children and adolescents who changed from having no PTSD to probable PTSD and probable PTSD to no PTSD at each time point were approximately 8% and 20% of the sample, respectively. The percentage of participants without PTSD increased from 41.1% at the 2-week to 3-month time point to 54.3% at the 3-month to 6-month time point, and the percentage with persistent probable PTSD decreased from 29.6% to 16.4% at the 2 time points, respectively. Female gender, a sedentary lifestyle, and actively helping others were significant risk factors for probable PTSD, whereas initiating communications with others, actively playing with classmates and friends, and the ability to concentrate on academic studies after resuming class were factors that helped protect against probable PTSD.

DISCUSSION

Resistance to PTSD and persistent PTSD symptoms were both common occurrences in child and adolescent survivors. Specific variables related to everyday functioning may be risk factors for probable PTSD. These findings have implications for agencies that provide mental health services after an earthquake.

Prevalence and risk factors of posttraumatic stress disorder among teachers 3 months after the Lushan earthquake: A cross-sectional study

Teachers and students often suffer from the same disaster. The prevalence of PTSD in students has been given great attention. However, in acting as mentors to students and their families, teachers are more likely to have vicarious and indirect exposure via hearing stories of their aftermath and witnessing the consequences of traumatic events. There are limited data pertaining to the prevalence of PTSD and its risk factors among teachers. A total of 316 teachers from 21 primary and secondary schools in Baoxing County were administered a project-developed questionnaire which included the items regarding demographic characteristics, earthquake-related experiences, somatic discomforts, emotional reactions, support status, and everyday functioning 2 weeks after the Lushan earthquake, and they finished a 1-to-1 telephone interview for addressing the PTSD criteria of the Mini International Neuropsychiatric Interview (MINI) 3 months after the earthquake. The prevalence of PTSD was 24.4% among teachers. Somatic discomforts (odds ratio [OR] 1.89, 95% confidence interval [CI] 1.06-3.37) were positive risk factors of PTSD. Perceived social support (OR 0.30, 95% CI 0.14-0.62) and being able to calm down (OR 0.25, 95% CI 0.09-0.75) in teaching were negative risk factors. PTSD is commonly seen among teachers after an earthquake, and risk factors of PTSD were identified. These findings may help those providing psychological health programs to find the teachers who are at high risk of PTSD in schools after an earthquake in China.

Prevalence and Predictors of Somatic Symptoms among Child and Adolescents with Probable Posttraumatic Stress Disorder: A Cross-Sectional Study Conducted in 21 Primary and Secondary Schools after an Earthquake

PURPOSE

To explore the prevalence rates and predictors of somatic symptoms among child and adolescent survivors with probable posttraumatic stress disorder (PTSD) after an earthquake.

METHODS

A total of 3053 students from 21 primary and secondary schools in Baoxing County were administered the Patient Health Questionnaire-13 (PHQ-13), a short version of PHQ-15 without the two items about sexuality and menstruation, the Children's Revised Impact of Event Scale (CRIES), and the self-made Earthquake-Related Experience Questionnaire 3 months after the Lushan earthquake.

RESULTS

Among child and adolescent survivors, the prevalence rates of all somatic symptoms were higher in the probable PTSD group compared with the controls. The most frequent somatic symptoms were trouble sleeping (83.2%), feeling tired or having low energy (74.4%), stomach pain (63.2%), dizziness (58.1%), and headache (57.7%) in the probable PTSD group. Older age, having lost family members, having witnessed someone get seriously injured, and having witnessed someone get buried were predictors for somatic symptoms among child and adolescent survivors with probable PTSD.

CONCLUSIONS

Somatic symptoms among child and adolescent earthquake survivors with probable PTSD in schools were common, and predictors of these somatic symptoms were identified. These findings may help those providing psychological health programs to find the child and adolescent students with probable PTSD who are at high risk of somatic symptoms in schools after an earthquake in China.

Posttraumatic stress disorder and somatic symptoms among child and adolescent survivors following the Lushan earthquake in China: A six-month longitudinal study

OBJECTIVE

To explore somatic conditions in a sample of 2299 child and adolescent survivors of an earthquake and their relationship to posttraumatic stress disorder (PTSD) symptoms.

METHODS

The Children's Revised Impact of Event Scale, the Patient Health Questionnaire (PHQ)-13 scale, a short version of PHQ-15 scale that omits two items involving sexual pain/problems and menstrual problems, and a project-developed questionnaire were administered to participants three and six months after the earthquake.

RESULTS

Among child and adolescent survivors, the prevalence rates of probable PTSD were 37.4 and 24.2% three and six months, respectively, after the earthquake. The most common somatic symptoms were trouble sleeping (58.4 and 48.4%), feeling tired or having low energy (52.0 and 46.1%), and stomach pain (45.8 and 45.4%) after three and six months, respectively. Several specific somatic symptoms evaluated three months after the earthquake including trouble sleeping, headache, and shortness of breath were predictors of the overall PTSD symptoms evaluated six months after the earthquake. Additionally, the symptom of hyperarousal evaluated after three months could predict the overall somatic symptoms evaluated after six months.

CONCLUSIONS

PTSD and somatic symptoms were common after the earthquake, and a longitudinal association between PTSD and somatic symptoms was detected among child and adolescent survivors. These findings have implications in China and possibly elsewhere.