Social support following a natural disaster: A longitudinal study of survivors of the 2013 Lushan earthquake in China

Associations between housing and psychological damage by earthquake and modifiable risk factors for dementia in general older adults: Tohoku Medical Megabank community-based cohort study

AIM

To evaluate the association between housing and psychological damage caused by the Great East Japan Earthquake (GEJE) and modifiable risk factors (MRFs) of dementia for general population of older adults.

METHODS

This cross-sectional study enrolled 29 039 community-dwelling older adults (mean age 69.1 ± 2.9 years, 55.5% women). We evaluated disaster-related damage (by complete or not complete housing damage) and psychological damage (by post-traumatic stress reaction [PTSR]) after the GEJE using a self-report questionnaire. MRFs encompassed the presence of depression, social isolation, physical inactivity, smoking, and diabetes. We examined the association between disaster-related damage and MRFs using ordinary least squares and modified Poisson regression models adjusted for sociodemographic and health status variables.

RESULTS

Complete housing damage and PTSR were identified in 2704 (10.0%) and 855 (3.2%) individuals, respectively. The number of MRFs was significantly larger for the individuals with complete housing damage (β = 0.23; 95% confidence interval [CI]: 0.19-0.27) and PTSR (β = 0.60; 95% CI: 0.53-0.67). Prevalence ratios (PRs) for depression and physical inactivity were higher in individuals with complete housing damage. The PRs for all domains of the MRFs were significantly higher in individuals with PTSR.

CONCLUSIONS

Housing and psychological damage caused by the GEJE were associated with an increased risk factor of dementia. To attenuate the risk of dementia, especially among older victims who have experienced housing and psychological damage after a disaster, multidimensional support across various aspects of MRFs is required. Geriatr Gerontol Int 2024; 24: 509-516.

Prevalence and determinants of post-traumatic stress disorder in patients with schizophrenia 2 years after an earthquake in Turkey

OBJECTIVES

High rates of post-traumatic stress disorder (PTSD) have been observed in earthquake survivors many years after the event. However, its prevalence among patients with schizophrenia is largely unknown. This study, which was conducted two years after the 2020 Elazığ earthquake, sought to identify risk factors for earthquake-related PTSD among patients with schizophrenia and healthy subjects.

METHODS

Adult patients with schizophrenia (N = 103) and healthy subjects (N = 103) who had survived the earthquake were recruited from affected areas in the Eastern Anatolian Region of Turkey, Elazığ. A detailed questionnaire of earthquake-related risk factors, the Brief Coping Orientation to Problems Experienced (Brief COPE), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Clinician-Administered PTSD scale for DSM-V (CAPS-5) scale were administered to participants.

RESULTS

Twelve percent of the patients with schizophrenia and 25% of the healthy subjects had earthquake-related PTSD diagnoses two years after the 2020 Elazığ earthquake. Healthy subjects had a significantly higher rate of earthquake-related PTSD when compared to patients with schizophrenia. Religious coping, self-blaming, less emotional support seeking, and going to a safer place on the night of the earthquake were found to be associated with PTSD in patients with schizophrenia. History of traumatic events, self-blaming, and less social support from family were found to be associated with a PTSD diagnosis in healthy subjects.

CONCLUSIONS

The earthquake in Turkey created a situation such that significant symptoms of PTSD remained present at two years following the event in both patients diagnosed with schizophrenia and healthy subjects. Patients with schizophrenia have different risk factors for the development of PTSD when compared with healthy subjects. Clinical interventions should consider risk factors, coping strategies, and perceived social support when seeking to prevent earthquake-related PTSD.

Depression, anxiety, stress, and job performance among Turkish nurses in the early post-earthquake period

BACKGROUND

Individual and social concerns can negatively affect nurses' mental health during a large-scale earthquake's early stages, making it challenging to perform their professional responsibilities.

AIM

This cross-sectional correlational study aimed to examine the relationship between depression, anxiety, and stress levels Turkish nurses experienced during an earthquake's early period. The nurses participating in this study were not directly present in the earthquake-affected area.

METHODS

The study was conducted on 232 nurses between February 10 and 25, 2023. The data were collected using the Depression, Anxiety, Stress-21 Scale and the Job Performance Evaluation Form developed by the researchers through a literature review. These were used to investigate nurses' work motivation changes due to the earthquake. The study followed the STROBE checklist for cross-sectional studies.

RESULTS

The participants' depression levels were severe, anxiety levels were extremely severe, and stress levels were moderate following the earthquake. Nurses who felt exhausted experienced reduced energy levels toward their work and reported a decrease in their desire, effort, and work motivation to perform well. In addition, they had higher depression, anxiety, and stress scores (p < 0.005).

CONCLUSION

Psychological difficulties, including depression, anxiety, and stress experienced by nurses not directly present in an earthquake-affected area, reduced their professional efforts and motivation and negatively affected the patient care process. Further studies should focus on conducting comparative studies in different cultures affected by natural disasters on the longitudinal analysis of the impacts of nurses' psychological distress on their job performance.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Nursing policymakers should be aware of the negative psychological effects experienced by nurses during the early post-earthquake period, even if they are not directly present in the earthquake-affected area. The study recommended that nurses should be provided with psychological support to deal with the negative effects of natural disasters and maintain job performance, including the nursing care process.

Longitudinal associations between social support trajectories and quality of life mediated by depressive symptoms: A 10-year cohort study of Wenchuan earthquake

INTRODUCTION

Previous studies on associations between social support and quality of life (QoL) have usually employed a variable-centered approach, without considering individual variances in time-varying changes in social support. This study explores trajectories of social support and whether depressive symptoms mediate associations between social support trajectories and QoL 10 years after an earthquake.

METHODS

Seven hundred and forty-four Chinese adolescents exposed to the Wenchuan earthquake were surveyed on social support at 6-, 18-, and 24-months and depressive symptoms at 30-months postearthquake (T30m ). They provided valid data on QoL after 10 years of the earthquake (T10y ). The latent class growth analysis was used to estimate social support trajectories. Mediation analysis was then conducted to test whether depressive symptoms at T30m mediated associations between social support trajectories and QoL at T10y .

RESULTS

Three trajectories of social support were identified: low decreasing (31.6%), moderate decreasing (55.4%), and persistent high (13.0%) groups. Depressive symptoms significantly mediated the effects of social support trajectories (relative to the low support trajectory) on future QoL (95% CIs: 0.70-1.78 and 1.41-3.37 for moderate decreasing and persistent high groups, respectively).

CONCLUSIONS

Social support shows individual differences over time. Moderate and high social support trajectories improve 10-year QoL partly by reducing depressive symptoms. Therefore, interventions aimed at enhancing social support and reducing depressive symptoms may be more effective in enhancing QoL in the aftermath of disasters.

Improvements in Compassion and Fears of Compassion throughout the COVID-19 Pandemic: A Multinational Study

During large-scale disasters, social support, caring behaviours, and compassion are shown to protect against poor mental health outcomes. This multi-national study aimed to assess the fluctuations in compassion over time during the COVID-19 pandemic. Respondents (Time 1 n = 4156, Time 2 n = 980, Time 3 n = 825) from 23 countries completed online self-report questionnaires measuring the flows of compassion (i.e., Compassionate Engagement and Action Scales) and fears of compassion toward self and others and from others (i.e., Fears of Compassion Scales) and mental health at three time-points during a 10-month period. The results for the flows of compassion showed that self-compassion increased at Time 3. Compassion for others increased at Time 2 and 3 for the general population, but in contrast, it decreased in health professionals, possibly linked to burnout. Compassion from others did not change in Time 2, but it did increase significantly in Time 3. For fears of compassion, fears of self-compassion reduced over time, fears of compassion for others showed more variation, reducing for the general public but increasing for health professionals, whilst fears of compassion from others did not change over time. Health professionals, those with compassion training, older adults, and women showed greater flows of compassion and lower fears of compassion compared with the general population, those without compassion training, younger adults, and men. These findings highlight that, in a period of shared suffering, people from multiple countries and nationalities show a cumulative improvement in compassion and reduction in fears of compassion, suggesting that, when there is intense suffering, people become more compassionate to self and others and less afraid of, and resistant to, compassion.

Post-Traumatic Stress Disorder after the 6.1 Magnitude Earthquake in Piura, Peru: A Cross-Sectional Study

In Peru, major disasters like the 2007 Pisco earthquake have produced high rates of post-traumatic stress. However, evidence is still needed to strengthen interventions. In 2021, a major earthquake struck Piura, in northern Peru. In this context, we aimed to assess the prevalence of PTSD and its associated factors. A cross-sectional study was conducted during August-September 2021 in people who experienced the 6.1 Piura earthquake on 30 July 2021. The questionnaire included the PCL-C, CD-RISC, ISI, HFIAS, and additional demographic data. Generalized linear models were used. The prevalence of PTSD was 20.3%. Household income was between PEN 2001 and 3000 (PR = 4.26, 95% CI: 1.08-16.75), smoking (PR = 2.49, 95% CI: 1.03-6.01), experience of a nervous breakdown (PR = 1.83, 95% CI: 1.09-3.09), moderate food insecurity (PR = 2.91, 95% CI: 1.10-7.73), and severe insomnia (PR = 8.25, 95% CI: 2.22-30.71) increased the prevalence of PTSD. One out of five individuals experienced post-traumatic stress symptoms after the 2021 earthquake in Piura, which varies depending on socioeconomic, psychosocial, and individual factors. Further research should strengthen these findings to ensure a fair and early mental health intervention against new seismic events in this and other Peruvian regions.

Psychometric properties of the Perceived Social Support Questionnaire (PSSQ), a new measure of perceived social support among older adults

OBJECTIVE

Based on literature and available questionnaires, the present study aimed at creating and validating the Perceived Social Support Questionnaire (PSSQ): a 4-item scale assessing the perceived social support in older adults. Normative scores were also computed.

METHODS

Three hundred and two participants (mean age 87.68) selected from ongoing population-based studies completed a phone interview. Among these, 247 completed a second interview 4 months later allowing assessing the questionnaire fidelity over time.

RESULTS

The factor analysis evidenced two dimensions: availability of social support and satisfaction with it. Both dimensions had a satisfactory internal consistency but weak intraclass correlation coefficient. Univariate analyses revealed that age, number of calls per week and living environment marginally associated with the availability score. The satisfaction score was associated with perceived health status, sadness, depressive mood, feeling of loneliness, anxiety, and the perception of social support during the pandemic context. The norms computed were stratified on age.

CONCLUSIONS

The PSSQ is a short and easy-to-administer tool allowing assessing perceived social support in older population. Despite a weak fidelity that could actually be explained by changes in perceived social support over time, the questionnaire revealed good psychometric qualities and validity.

Survivors' experiences of informal social support in coping and recovering after the 2017 Manchester Arena bombing

BACKGROUND

Much of the psychosocial care people receive after major incidents and disasters is informal and is provided by families, friends, peer groups and wider social networks. Terrorist attacks have increased in recent years. Therefore, there is a need to better understand and facilitate the informal social support given to survivors.

AIMS

We addressed three questions. First, what is the nature of any informal support-seeking and provision for people who experienced the 2017 Manchester Arena terrorist attack? Second, who provided support, and what makes it helpful? Third, to what extent do support groups based on shared experience of the attack operate as springboards to recovery?

METHOD

Semi-structured interviews were carried out with a purposive sample of 18 physically non-injured survivors of the Manchester Arena bombing, registered at the NHS Manchester Resilience Hub. Interview transcripts were thematically analysed.

RESULTS

Participants often felt constrained from sharing their feelings with friends and families, who were perceived as unable to understand their experiences. They described a variety of forms of helpful informal social support, including social validation, which was a feature of support provided by others based on shared experience. For many participants, accessing groups based on shared experience was an important factor in their coping and recovery, and was a springboard to personal growth.

CONCLUSIONS

We recommend that people who respond to survivors' psychosocial and mental healthcare needs after emergencies and major incidents should facilitate interventions for survivors and their social networks that maximise the benefits of shared experience and social validation.

Stress-related psychopathology during the COVID-19 pandemic

The COVID-19 pandemic has introduced widespread societal changes that have required ongoing adaptation. Unsurprisingly, stress-related psychopathology has increased during the pandemic, in both children and adults. We review these patterns through the lens of several leading conceptual models of the link between stress and psychopathology. Some of these models focus on characteristics of environmental stressors-including cumulative risk, specific stressor types, and stress sensitization approaches. Understanding the specific aspects of environmental stressors that are most likely to lead to psychopathology can shed light on who may be in most need of clinical intervention. Other models center on factors that can buffer against the onset of psychopathology following stress and the mechanisms through which stressors contribute to emergent psychopathology. These models highlight specific psychosocial processes that may be most usefully targeted by interventions to reduce stress-related psychopathology. We review evidence for each of these stress models in the context of other widescale community-level disruptions, like natural disasters and terrorist attacks, alongside emerging evidence for these stress pathways from the COVID-19 pandemic. We discuss clinical implications for developing interventions to reduce stress-related psychopathology during the pandemic, with a focus on brief, digital interventions that may be more accessible than traditional clinical services.

Post-traumatic stress disorder (PTSD), anger and mental health of school students in Syria after nine years of conflict: a large-scale school-based study

BACKGROUND

The Syrian crisis has entered its ninth year with many being affected by the war. This is the largest-scale study that aims to evaluate the psychological profile of secondary school students in Syria.

METHODS

This is a cross-sectional study in schools in Damascus, Syria. The surveys assessed working habits, smoking, war exposure, grades, socioeconomic status (SES), social support, health-related quality of life (HRQL), post-traumatic stress disorder (PTSD), problematic anger, and other parameters.

RESULTS

This study included 1369 students of which 53% suffered from PTSD and 62% from problematic anger. Around 46% declared a fair or worse general health and 61% had moderate or severe mental health. Only 9.3% did not report exposure to any war-related variable. War exposure had an impact on PTSD, anger, and HRQL, but not on students' grades. Smoking, having consanguineous parents, and working did not have a clear association with grades or anger. Social support weakly reduced PTSD and anger scores. Interestingly, working was associatedwith lowerPTSD scores but was associated with a worse physical component of HRQL.

CONCLUSION

This is the largest study on school students in Syria that reports the psychological ramifications of war. Although the direct effects of war could not be precisely described, the high burden of PTSD and anger distress was a strong reflection of the chronic mental distress.

Disaster Resilience Differs between Survivors and Victims’ Families: A Semantic Network Analysis

The main purpose of this study is to clarify the difference in disaster resilience between survivors and victims’ families by analyzing the language used in popular literature on disaster cases. The results showed that there were differences in emotions, behaviors, attitudes, role perceptions, etc., between survivors and victims’ families in dealing with a disaster. In particular, survivors remember and think about the situation that occurred at the time of the disaster, which creates resilience to the incident, while victims’ families attempt to establish resilience to the incident by investigating the facts and government countermeasures. While survivors were focused on building their own resilience, victims’ families were more focused on improving government countermeasures to prevent such accidents from recurring. This can be considered as social or national resilience. Based on this comparative analysis, it is necessary to prepare various theoretical foundations for disaster preparedness and resilience, while further elaborating the theory.

Associations between adolescents' prosocial experiences and mental health during the COVID-19 pandemic

Natural disasters and times of crisis, such as the COVID-19 pandemic, are extremely stressful events, with severe mental health consequences. However, such events also provide opportunities for prosocial support between citizens, which may be related to mental health symptoms and interpersonal needs. We examined adolescents' prosocial experiences as both actors and recipients during the early stages of the COVID-19 pandemic and assessed whether these experiences were associated with indicators of mental health. Adolescents (N = 426; 78% female) aged 13 to 20 years (M age  = 16.43, SD = 1.10; 63.6% White, 12.9% Hispanic/Latinx, 8.5% Asian, 4.2% Black, 2.8% Native American) were recruited across the US in early April of 2020. Participants reported on their COVID-19 prosocial experiences (helping others, receiving help) and mental health (depressive symptoms, anxiety symptoms, burdensomeness, belongingness). Multiple regression models indicated greater engagement in COVID-19 prosocial behavior was associated with greater anxiety symptoms and greater burdensomeness. Receiving more COVID-19 help was associated with lower depressive symptoms and higher belongingness. Findings highlight the importance of furthering our understanding of the nuanced connections between prosocial experiences and adolescents' mental health to help inform post-pandemic recovery and relief efforts.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s12144-021-02670-y.

A Positive Legacy of Trauma? The Role of Perceived Social Support on Mental Health Among Earthquake Survivors During the COVID-19 Outbreak

BACKGROUND

People with prior experience of severe trauma may be particularly vulnerable in the face of the COVID-19 pandemic. However, little is known about mental health problems among prior trauma survivors during the pandemic outbreak.

METHODS

A total of 362 Wenchuan earthquake survivors were assessed using Patient Health Questionnaire, Generalized Anxiety Disorder Scale, as well as Multidimensional Scale of Perceived Social Support, as part of an online survey between February 3 and 10, 2020.

RESULTS

Our results showed that 6.6 and 4.7% of the participants experienced depression and anxiety during the COVID-19 outbreak, respectively. Perceived social support was negatively associated with depressive and anxiety symptoms. Earthquake exposure has no direct effect on current depressive and anxiety symptoms, but it would moderate the direct relationship between perceived social support and psychological symptoms.

CONCLUSIONS

Our findings suggested that trauma exposure may lead to salutogenic outcomes. The protective effect of perceived social support on psychological symptoms was greater in people with a higher level of trauma exposure than in a lower one.

The Experience and Perceived Consequences of the 2016 Fort McMurray Fires and Evacuation

Few studies have examined the scope of the subjective experience during and after a natural disaster. This qualitative study explored the perceptions of persons affected by the wildfires and evacuation of Fort McMurray in 2016. The objectives were to document (1) the experience of the evacuation, and (2) the biopsychosocial consequences of the wildfires as perceived by evacuees from Fort McMurray 3 months and 3 years after evacuation. This study included two data collections, one from 393 evacuees 3 months after evacuation using an online questionnaire, and the other from 31 participants (among those who participated in the 3-month evaluation) interviewed by telephone 3 years after evacuation. Eight themes describing the evacuation experience emerged from the qualitative analysis: the preparation for evacuation, the perceived traumatic nature of the evacuation, problems encountered while on the move, assistance received and provided, vulnerability conditions, presence of physical discomfort, relocation and no problem/no response. Seven categories of negative consequences emerged: material and financial loss, emotional/mental health disorders, cognitive impairments, behavioral changes, spiritual/existential reflections, social alterations, and physical conditions. Four categories of positive consequences emerged: posttraumatic growth, resilience/absence of consequences, altruism and community cohesion. This study showed a wide range of perceived consequences of fires and evacuations by Fort McMurray residents. The results highlight the importance of tailoring responses to the needs of evacuees and providing assistance to victims over a long period of time.

Received support in the aftermath of Hurricane Florence: reciprocal relations among perceived support, community solidarity, and PTSD

BACKGROUND AND OBJECTIVES

The social support deterioration model (SSDM) posits that individuals who do not receive adequate support following a disaster are vulnerable to losses in community solidarity and perceived support, as well as the development of persistent distress. However, limited longitudinal research has evaluated the relations among support and these outcomes among disaster-affected individuals. Design: The current study utilized random intercept cross-lagged panel modeling (RI-CLPM) to examine reciprocal relations among received support, community solidarity, perceived support, and posttraumatic stress disorder (PTSD) symptoms among rural Hurricane Florence survivors (n = 261) assessed 5-8 months post-hurricane (T1), and then at two more timepoints at three-month intervals (T2 and T3). Results: Results of the RI-CLPM supported that lower received support at T2 was associated with decreases in community solidarity at T3, and higher perceived support at T1 was associated with increases in received support at T2. In supplemental analyses, higher received support at T2 was associated with lower PTSD symptoms at T3. Conclusions: Consistent with the SSDM, individuals who receive less support post-disaster are vulnerable to losses in community solidarity and potentially persistent PTSD symptoms. Conversely, those with stronger support networks may be better able to access needed support in the longer-term.

Addressing the mental health needs of learners and nonlearners in an academic medical center during COVID-19

The coronavirus disease (COVID-19) has impacted life for people throughout the world, especially for those in health care who experience unique stressors. To support the psychological needs of staff, faculty, and learners at a biomedical sciences university, faculty at Baylor College of Medicine created a mental health and wellness support program consisting of multiple behavioral health care pathways, including phone support, a self-guided mental health app, a coping skills group, and individual therapy services. The authors present this program as a model for academic institutions to support the well-being of faculty, staff, and learners.

A longitudinal study on emotional distress among local government staff seven years after the 2008 Wenchuan earthquake in China

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.

The Cost of Impression Management to Life Satisfaction: Sense of Control and Loneliness as Mediators

Purpose

Impression management, or self-presentation, prevails in our daily lives. However, whether it enhances or reduces individuals’ well-being remains underexplored. To fill this gap, the research proposed and tested the following hypotheses. Impression management is negatively related to life satisfaction. Impression management is negatively related to sense of control. Impression management is positively related to loneliness. Sense of control and loneliness mediate the relationship between impression management and life satisfaction.

Methods

Data were collected from an online survey of 243 Chinese adults drawn from a national sampling frame. We used LISREL8.8 to perform a series of CFAs to verify the distinctiveness of variables and conducted SEM modeling to test hypotheses. To further test the mediation hypotheses, we used bootstrapping procedures that generated a sample size of 5000.

Results

We found a negative association between impression management and life satisfaction. In addition, the association was fully mediated by sense of control and loneliness.

Conclusion

These results reveal that impression management is a negative indicator of life satisfaction because impression management impedes personal sense of control and elevates loneliness.

The Collapse of the Morandi Bridge in Genoa on 14 August 2018: A Collective Traumatic Event and Its Emotional Impact Linked to the Place and Loss of a Symbol

The collapse of the Morandi bridge in Italy, which took place in the summer of 2018, has had enormous emotional, economic, and social consequences for the inhabitants of the area, which are felt throughout the world. As seen in the literature, collective traumatic events increase the experience of insecurity and paranoia, thus increasing the perception of vulnerability. The present work aims to bring out the emotions most experienced by the participants connected to the traumatic event in question, paying attention to the possible solutions to be proposed to local stakeholders from a sustainability perspective, this way favouring community empowerment. The research, carried out with the photovoice technique, involved 30 young adults residing in areas near the event. The results illustrate how the participants experienced mainly feelings of emptiness, vulnerability, and fear as well as anger, despair, and mistrust of the institutions. It was also stressed that the economic and structural hardships hit the inhabitants hard. There have been many concrete solutions identified by the participants: creating a support network, supporting the local economy, and keeping the memory alive. The research and application implications underline the importance of using photovoice within community interventions, a tool that facilitates awareness and active citizenship.

Social support, interpersonal, and community dynamics following disasters caused by natural hazards

The most essential, and possibly the most reliably present, characteristic of all disasters is that they exert strong impact on social relationships. Two very different, at times conflicting, dynamic processes emerge in their aftermath: the initial outpouring of immense mutual helping and solidarity, followed by a subsequent sense of loss in the quality of interpersonal and community relationships. This review of recent findings in the area of disaster mental health confirmed two major patterns of social support dynamics following disastrous events resulting from natural hazards: a mobilization of received social support and deterioration of perceived social support and sense of community. Social support is a critical resource helping people cope with natural disasters. Its psychologically and socially protective functions for survivors and their communities unfold in a complex matrix of benefits and liabilities.