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Okuzono SS, Slopen N, Shiba K, Yazawa A, Kondo K, Kawachi I. Do Adverse Childhood Experiences Modify the Association Between Disaster-Related Trauma and Cognitive Disability? Am J Epidemiol 2024; 193:36-46. [PMID: 37442811 PMCID: PMC10773476 DOI: 10.1093/aje/kwad158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/17/2023] [Accepted: 07/07/2023] [Indexed: 07/15/2023] Open
Abstract
Identifying subpopulations that are particularly vulnerable to long-term adverse health consequences of disaster-related trauma is needed. We examined whether adverse childhood experiences (ACEs) potentiate the association between disaster-related trauma and subsequent cognitive disability among older adult disaster survivors. Data were from a prospective cohort study of older adults who survived the 2011 Great East Japan Earthquake. The baseline survey pre-dated the disaster by 7 months. We included participants who completed follow-up surveys (2013 and 2016) and did not have a cognitive disability before the disaster (n = 602). Disaster-related traumas (i.e., home loss, loss of friends or pets) and ACEs were retrospectively assessed in 2013. Cognitive disability levels in 2016 were objectively assessed. After adjusting for pre-disaster characteristics using a machine learning-based estimation approach, home loss (0.19, 95% confidence interval (CI): 0.09, 0.28) was, on average, associated with greater cognitive disability. Among individuals with ACEs, home loss was associated with even higher cognitive disability levels (0.64, 95% CI: 0.24, 1.03). Losses of friends (0.18, 95% CI: 0.05, 0.32) and pets (0.13, 95% CI: 0.02, 0.25) were associated with higher cognitive disability levels only among those with ACEs. Our findings suggest that individuals with a history of ACEs may be particularly vulnerable to adverse health consequences related to disasters.
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Affiliation(s)
- Sakurako S Okuzono
- Correspondence to Sakurako S. Okuzono, Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115 (e-mail: )
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Ashida T, Fujiwara T, Kondo K. Association between adverse childhood experiences and social integration among older people in Japan: Results from the JAGES study. Arch Gerontol Geriatr 2023; 114:105099. [PMID: 37329767 DOI: 10.1016/j.archger.2023.105099] [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: 02/26/2023] [Revised: 05/30/2023] [Accepted: 06/07/2023] [Indexed: 06/19/2023]
Abstract
Social integration, network, and support are beneficial to health. However, there is little evidence of the association between adverse childhood experiences (ACEs) and social integration in later life. This study investigates the association between ACE history and social integration in older people. We used data from the Japan Gerontological Evaluation Study (JAGES) 2013, which conducted a self-reported survey of functionally independent people aged ≥ 65 years from 30 municipalities across Japan and yielded information on ACE history. We conducted a Poisson regression analysis with robust error variances to assess the association between ACE history and social integration, adjusting for sex, age, childhood economic hardship, adult socioeconomic status, health status, living status, and trust in others. The number of respondents with at least one incident of ACE was approximately 36.8%. The prevalence ratios for those who reported a history of ACEs were as follows: housebound 1.495 (95% confidence interval [CI]: 1.19-1.88), small network size 1.146 (95% CI: 1.10-1.19), low network contact 1.059 (95% CI: 1.00-1.059), non-membership sports group 1.038 (95% CI: 1.00-1.07), and non-membership hobby group 1.06 (95% CI: 1.03-1.09). Among older people in Japan, a history of ACEs is inversely associated with social integration. These findings support the life course approach and suggest that adverse events in early life may have an impact on social life in old age. In order to promote healthy aging, it is important to recognize the significant impact of early-life adversities that can extend into later life.
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Affiliation(s)
- Toyo Ashida
- Faculty of Economics, Keio University, Tokyo, Japan.
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan; Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
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Fujiwara T, Koyama Y, Isumi A, Matsuyama Y, Tani Y, Ichida Y, Kondo K, Kawachi I. " What Did You Do in the War, Daddy?": Paternal Military Conscription During WWII, Economic Hardship and Family Violence in Childhood, and Health in Late Life in Japan. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:8114-8135. [PMID: 36794857 DOI: 10.1177/08862605231153889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Childhood adversity is a risk factor for poor health in late life and includes economic hardship and family violence, whose prevalence is high among offspring of military conscripted father. We assessed the association between paternal military conscription (PMC) and paternal war death (PWD) during Second World War and self-rated health (SRH) among older adults in Japan. Data were obtained from a population-based cohort of functionally independent people aged 65 years or older from 39 municipalities across Japan in 2016. Information on PMC and SRH was obtained through a self-report questionnaire. A total of 20,286 participants were analyzed with multivariate logistic regression to investigate the association between PMC, PWD, and poor health. Causal mediation analysis was performed to see whether childhood economic hardship and family violence mediated the association. Among participants, 19.7% reported PMC (including 3.3% PWD). In the age- and sex-adjusted model, older people with PMC showed higher risk of poor health (odds ratio [OR]: 1.16, 95% confidence interval [CI] [1.06, 1.28]), while those with PWD were not associated (OR: 0.96, 95% CI [0.77, 1.20]). Causal mediation showed a mediation effect of childhood family violence exposure on the association between PMC and poor health (proportion mediated: 6.9%). Economic hardship did not mediate the association. PMC, but not PWD, increased the risk of poor health in older age, which was partially explained by the exposure to family violence in childhood. There appears to be a transgenerational health impact of war which continues to affect the health of offspring as they age.
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Affiliation(s)
- Takeo Fujiwara
- Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yuna Koyama
- Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Aya Isumi
- Tokyo Medical and Dental University (TMDU), Tokyo, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
| | | | - Yukako Tani
- Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yukinobu Ichida
- Doctoral Institute for Evidence Based Policy, Inc., Tokyo, Japan
| | - Katsunori Kondo
- Chiba University, Chiba, Japan
- Department of Gerontological Evaluation, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu City, Aichi, Japan
| | - Ichiro Kawachi
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Wilson-Genderson M, Heid AR, Cartwright F, Pruchno R. Adverse childhood experiences, adult trauma, and depressive symptom trajectories. Aging Ment Health 2022; 26:2170-2178. [PMID: 34541986 DOI: 10.1080/13607863.2021.1978926] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Associations among adverse childhood experiences prior to age 18 (ACEs), subjective reports of trauma during Hurricane Sandy, and trajectories of depressive symptoms reported by community-dwelling older people were examined. METHODS We analyzed 6 waves of data from 5,688 people aged 50-74 recruited in 2006 and followed for 12-years using multilevel mixed effects models. RESULTS We found that: (1) people who experienced ACEs had trajectories of depressive symptoms in late life that were higher than people not having these experiences, (2) people experiencing two or more ACEs were more likely to report fear and distress when Hurricane Sandy hit than people experiencing either one or no adverse childhood experiences, and (3) while both ACE exposure and peri-traumatic stress were associated with trajectories having higher levels of depressive symptoms, the risk associated with ACEs (especially multiple ACEs) was greater. CONCLUSION Findings support life course stress theories including the cumulative inequality theory and stress proliferation theory, suggesting that inequalities are manifested over the life course and that people experiencing adversity during childhood are at increased risk of experiencing adversity in late life. By studying the relationship between adverse childhood experiences and response to Hurricane Sandy our findings demonstrate that adverse childhood experiences can alter the way traumatic events in adulthood are experienced. This finding in turn, has important implications for clinical practice, as it identifies a group of people likely to be at risk for adult trauma.
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Affiliation(s)
| | | | - Francine Cartwright
- New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA
| | - Rachel Pruchno
- New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA
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Chen H, Ma Q, Du B, Huang Y, Zhu SG, Li SL, Geng DQ, Xu XS. Psychotherapy and Follow-Up in Health Care Workers After the COVID-19 Epidemic: A Single Center's Experience. Psychol Res Behav Manag 2022; 15:2245-2258. [PMID: 36003831 PMCID: PMC9394520 DOI: 10.2147/prbm.s371787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 07/26/2022] [Indexed: 11/23/2022] Open
Abstract
Objective The present study aims to analysis the mental health of high-risk health care workers (HHCWs) and low-risk HCWs (LHCWs) who were respectively exposed to COVID-19 wards and non-COVID-19 wards by following up on mental disorders in HCWs in China for 6 months. Methods A multi-psychological assessment questionnaire was used to follow up on the psychological status of HCWs in the Affiliated Hospital of Xuzhou Medical University in Xuzhou City (a non-core epidemic area) at 6 months after the first evaluation conducted during the COVID-19 epidemic. Based on the risk of exposure to COVID-19 patients, the HCWs were divided into two groups: high-risk HCWs, who worked in COVID-19 wards, and low-risk HCWs, who worked in non-COVID-19 wards. Results A total of 198 HCWs participated in the study, and 168 questionnaires were selected for evaluation. Among them, 93 (55.4%) were in the HHCW group and 75 (44.5%) were in the LHCW group. Significant differences were observed in salary, profession, and altruistic behavior between the two groups (P < 0.05). There were no significant differences in the anxiety, depression, insomnia, or posttraumatic stress disorder (PTSD) scores between the two groups. Logistic regression revealed that work stress was a major joint risk factor for mental disorders in HCWs. Among all the HCWs, a total of 58 voluntarily participated in psychotherapy; the analysis showed a significant decrease in anxiety, depression, PTSD, work stress, and work risk after attending psychotherapy. There were also significant differences in positive and negative coping styles before and after psychotherapy. Conclusion In the present follow-up, work stress was the major contributing factor to mental disorders in HCWs. Psychotherapy is helpful in terms of stress management and should be provided to first-line COVID-19 HCWs.
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Affiliation(s)
- Hao Chen
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, People's Republic of China.,Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, 215000, People's Republic of China
| | - Qing Ma
- Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, People's Republic of China
| | - Bo Du
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, People's Republic of China
| | - Yan Huang
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, People's Republic of China
| | - Shi-Guang Zhu
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, People's Republic of China
| | - Sheng-Li Li
- Department of Medical Records and Statistics, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, People's Republic of China
| | - De-Qin Geng
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, People's Republic of China
| | - Xing-Shun Xu
- Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, 215000, People's Republic of China.,Institute of Neuroscience, Soochow University, Suzhou, 215000, People's Republic of China.,Jiangsu Key Laboratory of Neuropsychiatric Diseases, Soochow University, Suzhou, 215000, People's Republic of China
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Bai Y, Fu M, Wang X, Liu D, Zhang Y, Liu C, Zhang B, Guo J. Relationship among Child Maltreatment, Parental Conflict, and Mental Health of Children during the COVID-19 Lockdown in China. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 16:1-10. [PMID: 36043150 PMCID: PMC9411843 DOI: 10.1007/s40653-022-00478-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/04/2022] [Indexed: 06/15/2023]
Abstract
Children are more likely to experience maltreatment and parental conflict in a pandemic context, which can exacerbate their vulnerability to psychological disorders. The purpose of the present study was to examine mental health symptoms in children aged 0 to 10 years and consider related factors from the perspectives of maltreatment and parental conflict during the COVID-19 lockdown. Participants were 1286 parents aged 18 years and over with children aged 0 to 10 years were included. Several multivariable linear regressions were used to analyze the data. The largest variance in child mental health was explained by child maltreatment, as more maltreatment predicted higher reported psychological problems (standardized beta = 0.49, P < 0.001). Comparatively, parental conflict predicted less variance in mental health problems than maltreatment (standardized beta = 0.18, P < 0.001). Children who experienced more maltreatment experience and exposure to COVID-19 showed elevated levels of mental health symptoms (standardized beta = 0.06, p < 0.05), as did those who experienced parental conflict and pandemic exposure (standardized beta = 0.06, p < 0.05). The findings highlight that tailored programs that focus on a healthy family environment and strategic parental support services may be particularly effective in reducing children's mental health problems due to COVID-19 exposure.
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Affiliation(s)
- Yashuang Bai
- 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
| | - Xiaohua Wang
- School of Social Development and Public Policy, Beijing Normal University, 100875 Beijing, China
| | - Danxia Liu
- School of Sociology, Huazhong University of Science and Technology, 430074 Wuhan, China
| | - Yanjun Zhang
- School of Sociology, Huazhong University of Science and Technology, 430074 Wuhan, China
| | - Chengbin 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, Harvard Medical School, 02115 Boston, MA USA
| | - Jing Guo
- Department of Health Policy and Management, School of Public Health, Peking University, 100191 Beijing, China
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7
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Gewirtz-Meydan A, Lassri D. A profile analysis of COVID-19 stress-related reactions: The importance of early childhood abuse, psychopathology, and interpersonal relationships. CHILD ABUSE & NEGLECT 2022; 130:105442. [PMID: 34920898 PMCID: PMC8666322 DOI: 10.1016/j.chiabu.2021.105442] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 12/01/2021] [Accepted: 12/07/2021] [Indexed: 05/03/2023]
Abstract
BACKGROUND There is little argument that COVID-19 is potentially highly stressful for many people, however, little research has broken down COVID-19-related distress into different aspects clustering together, and how these clusters differ in terms of the vulnerability of the individuals. OBJECTIVE The primary aim of the present study was to identify distinct profiles of individuals' reactions to COVID-19-related stress, and analyze potential differences and risk and protective factors associated with these profiles in relation to childhood abuse, psychopathology, and interpersonal relationships. PARTICIPANTS AND SETTING Data was collected online among a convenience sample of 914 men and women in Israel. METHODS A Latent Profile Analysis (LPA) for estimating distinct profiles in people's COVID-19-related distress was applied. Next, profiles were compared in childhood abuse, psychopathology, perceived social support and relationship satisfaction. RESULTS Five distinct profiles were identified: The distressed (23.75%), the worried (38.96%), the financially and socially distressed (15.20%), the caregivers (13.65%), and the untroubled (8.44Profiles in which individuals had more COVID-19 related distress are characterized by more childhood abuse, psychopathology, and less social support and relationship satisfaction. CONCLUSION An assessment of the psychological implications of COVID-19 (when screening the population and creating prevention/intervention programs) should take into account the different responses individuals have when facing COVID-19, and their vulnerability, including their history of abuse, psychopathology, social support and relationship satisfaction, so that these programs will be better tailored to each type of distress experienced.
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Affiliation(s)
- Ateret Gewirtz-Meydan
- School of Social Work, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel. agewirtz-@univ.haifa.ac.il
| | - Dana Lassri
- The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Israel.
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Kunii Y, Usukura H, Otsuka K, Maeda M, Yabe H, Takahashi S, Tachikawa H, Tomita H. Lessons learned from psychosocial support and mental health surveys during the 10 years since the Great East Japan Earthquake: Establishing evidence-based disaster psychiatry. Psychiatry Clin Neurosci 2022; 76:212-221. [PMID: 35137504 PMCID: PMC9314661 DOI: 10.1111/pcn.13339] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 01/30/2022] [Indexed: 11/27/2022]
Abstract
Post-disaster mental health and psychosocial support have drawn attention in Japan after the 1995 Great Hanshin-Awaji Earthquake, with mental health care centers for the affected communities being organized. After the catastrophe, a reconstruction budget was allocated to organize mental health care centers to provide psychosocial support for communities affected by the 2007 Chūetsu offshore earthquake, the 2011 Great East Japan Earthquake, and the 2016 Kumamoto Earthquake. There were several major improvements in post-disaster mental health measures after the Great East Japan Earthquake. The Disaster Psychiatric Assistance Team system was organized after the earthquake to orchestrate disaster response related to the psychiatric health system and mental health of the affected communities. Special mental health care efforts were drawn to the communities affected by the nuclear power plant accident through Chemical, Biological, Radiological, Nuclear, and high yield Explosives, being succeeded by measures against the coronavirus pandemic. As another new movement after the Great East Japan Earthquake, the number of surveys involving communities affected by disasters has soared. More than 10 times the number of scientific publications were made in English during the decade following the Great East Japan Earthquake, compared with the previous decades. In this review, we examined the results and issues acquired in the 10 years since the Great East Japan Earthquake, proposing evidence-based disaster psychiatry as the direction of future mental health measures related to emergency preparedness and response.
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Affiliation(s)
- Yasuto Kunii
- Department of Disaster Psychiatry, International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
| | - Hitomi Usukura
- Department of Disaster Psychiatry, International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
| | - Kotaro Otsuka
- Department of Neuropsychiatry, School of Medicine, Iwate Medical University, Iwate, Japan.,Department of Disaster and Community Psychiatry, School of Medicine, Iwate Medical University, Iwate, Japan
| | - Masaharu Maeda
- Department of Disaster Psychiatry, School of Medicine, Fukushima Medical University, Fukushima, Japan.,Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Hirooki Yabe
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of Neuropsychiatry, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Sho Takahashi
- Department of Disaster and Community Psychiatry, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Hirokazu Tachikawa
- Department of Disaster and Community Psychiatry, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Hiroaki Tomita
- Department of Disaster Psychiatry, International Research Institute of Disaster Science, Tohoku University, Sendai, Japan.,Department of Psychiatry, Tohoku University Hospital, Sendai, Japan.,Department of Psychiatry, Graduate School of Medicine, Tohoku University, Sendai, Japan
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Children and adolescents' emotional problems during the COVID-19 pandemic in Brazil. Eur Child Adolesc Psychiatry 2022; 32:1083-1095. [PMID: 35618973 PMCID: PMC9135594 DOI: 10.1007/s00787-022-02006-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 05/04/2022] [Indexed: 11/21/2022]
Abstract
Brazil has been severely affected by the COVID-19 pandemic with one of the largest numbers of youth impacted by school closure globally. This longitudinal online survey assessed emotional problems in children and adolescents aged 5-17 years living in Brazil during the COVID-19 pandemic. Recruitment occurred between June to November 2020 and participants were invited for follow-up assessments every 15 days until June 2021. Participants were 5795 children and adolescents living across the country with mean age of 10.7 (SD 3.63) years at recruitment; 50.5% were boys and 69% of white ethnicity. Weighted prevalence rates of anxiety, depressive and total emotional symptoms at baseline were 29.7%, 36.1% and 36%, respectively. Longitudinal analysis included 3221 (55.6%) participants and revealed fluctuations in anxiety and depressive symptoms during one year follow-up, associated with periods of social mobility and mortality. Emotional problems significantly increased in July and September 2020 and decreased from December 2020 to February 2021 and then significantly increased in May 2021 relative to June 2020. Older age, feeling lonely, previous diagnosis of mental or neurodevelopmental disorder, previous exposure to traumatic events or psychological aggression, parental psychopathology, and sleeping less than 8/h a day were associated with increased rates of anxiety and depressive symptoms at baseline and over time. Food insecurity and less social contact with family and peers were associated with baseline anxiety and depressive symptoms, and lowest socio-economic strata, chronic disease requiring treatment and family members physically ill due to COVID-19 were associated with increasing rates over time. The pandemic severely affected youth, particularly those from vulnerable populations and in moments of increased mortality and decreased social mobility. Results underscore the need for allocation of resources to services and the continuous monitoring of mental health problems among children and adolescents.
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Inoue Y, Stickley A, Yazawa A, Aida J, Koyanagi A, Kondo N. Childhood adversities, late-life stressors and the onset of depressive symptoms in community-dwelling older adults. Aging Ment Health 2022; 26:828-833. [PMID: 33522286 DOI: 10.1080/13607863.2021.1875190] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objective: Depression is common in older individuals though many factors associated with its occurrence remain under-researched. We examined whether childhood adversities (CAs) and late-life stressors are associated with the onset of depressive symptoms in adults aged ≥ 65 and if these early- and late-life stressors interact in the prediction of depressive symptoms. Methods: Data came from the 2010 and 2013 waves of the Japan Gerontological Evaluation Study (JAGES) (N = 8701). The Geriatric Depression Scale (GDS-15) was used to assess the presence of depressive symptoms (GDS ≥ 5). A Poisson regression analysis was used to examine associations. Results: Both CAs (1 event: incidence rate ratio [IRR] = 1.59, 95% confidence interval [CI]: 1.41-1.79; ≥ 2 events: IRR = 2.36, 95% CI = 1.80-3.10) and late-life stressful events (1 event: IRR = 1.13, 95% CI: 1.02-1.25; ≥ 2 events: IRR = 1.25, 95% CI = 1.05-1.50) were significantly associated with the onset of depressive symptoms. Borderline significant interactions between CAs and late-life stressors (e.g. ≥ 2 CAs and ≥ 2 late-life events: IRR = 0.61, p = 0.087) suggest that late-life stressors may be important in predicting the onset of depressive symptoms especially among individuals with no or fewer CAs compared to those with ≥ 2 CAs. Conclusions: Stressful events in childhood and late adulthood were independently associated with the onset of depressive symptoms in older adults. In addition, stressful experiences in childhood might affect how individuals respond to stressful events in later life.
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Affiliation(s)
- Yosuke Inoue
- Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan
| | - Andrew Stickley
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.,Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
| | - Aki Yazawa
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA.,Research Center for Child Mental Development, University of Fukui, Fukui, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,Division for Regional Community Development, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Sendai, Japan
| | - Ai Koyanagi
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, Cibersam, Madrid, Spain
| | - Naoki Kondo
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan.,Department of Health and Social Behavior, School of Public Health, The University of Tokyo, Tokyo, Japan
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11
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Hu W, Su L, Li D, Zhou Y, Zhu J. Risk of First-Episode Schizophrenia in Aged Adults Increased During COVID-19 Outbreak. Int J Ment Health Addict 2021; 21:1-11. [PMID: 34658681 PMCID: PMC8508402 DOI: 10.1007/s11469-021-00671-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/01/2021] [Indexed: 01/08/2023] Open
Abstract
We noticed an unusual increase of aged adults in first-episode schizophrenia in January and February 2020 since the outbreak of COVID-19. This retrospective study aims to statistically validate this observation and find potential risk factors, if applicable. The demographics of schizophrenia in outpatients (both first-episode and follow-up) from January to March 2020 (36,624 records) and similar periods of 2017-2019 (114,141 records) were analyzed and compared to minimize seasonal influence. Limited personal information (age, gender, approximate residence) was investigated to find risk factors. After considering seasonal factors such as the Spring festival, the age of the first-episode schizophrenia was significantly increased in January (46.60 ± 15.14) and February (51.53 ± 14.74) but went back to normal in March 2020 (38.89 ± 14.59), compared with similar periods from 2017 to 2019 (Jan., 40.77 ± 15.26; Feb., 39.69 ± 15.10; Mar., 42.04 ± 15.83). Meanwhile, a slight but not significant change was found in the distribution of gender and approximate residence (urban/suburb). Our data supported that risk of first-episode schizophrenia in aged adults increased during the COVID-19 outbreak, which is consistent with the fact that COVID-19 is more lethal to elders. Public healthcare should prepare in advance for potential risks in public mental health, especially for elders.
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Affiliation(s)
- Wei Hu
- The Affiliated Xuzhou Eastern Hospital of Xuzhou Medical University, Xuzhou, Jiangsu China
| | - Li Su
- CAS Key Laboratory of Behavior Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Deyong Li
- The Affiliated Xuzhou Eastern Hospital of Xuzhou Medical University, Xuzhou, Jiangsu China
| | - Yi Zhou
- Department of Neurobiology, Army Medical University, Chongqing, China
- Chongqing Key Laboratory of Neuroscience, Chongqing, China
| | - Jing Zhu
- The Affiliated Xuzhou Eastern Hospital of Xuzhou Medical University, Xuzhou, Jiangsu China
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Kino S, Aida J, Kondo K, Kawachi I. Persistent mental health impacts of disaster. Five-year follow-up after the 2011 great east Japan earthquake and tsunami: Iwanuma Study. J Psychiatr Res 2021; 136:452-459. [PMID: 32948310 PMCID: PMC7443179 DOI: 10.1016/j.jpsychires.2020.08.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 08/10/2020] [Accepted: 08/14/2020] [Indexed: 11/06/2022]
Abstract
Few studies have tracked the long-term mental health outcomes following major disaster. We sought to document the trajectories of depressive symptoms and post-traumatic stress symptoms (PTSS) in the aftermath of the 2011 Great East Japan earthquake and tsunami. A cohort of community-dwelling older adults were followed for 5.5 years after the disaster at 3 waves (2010, 2013 and 2016). Depressive symptoms were measured by the Geriatric Depression Scale Short Form, while PTSS was assessed by the Screening Questionnaire for Disaster Mental Health. We examined the trajectories of mental illness symptoms based on the probabilities of persistence, recovery, and delayed onset. Among people without pre-disaster depressive symptoms, 13.6% had developed depressive symptoms 2.5 years after the disaster. Of these, half of those had recovered and half had persisted at the 5.5 year follow-up. 11.1% of survivors reported post-traumatic stress symptoms in 2013; of these, 58% recovered by 2016, while 4.8% experienced delayed onset. Job loss was associated with persistent PTSS (OR 2.03; 95%CI 1.01-4.12) while a drop in subjective economic status predicted delayed onset of PTSS (OR 2.13; 1.34-3.39). However, disaster-related experiences were unrelated to the trajectory of depressive symptoms at 5.5 years. The probabilities of remission (58%) and delayed onset (5%) of PTSS are consistent with prior disaster research. The experience of job loss and drop in subjective economic status appeared to exert a lingering influence on the persistence or delayed onset of PTSS. Depressive symptoms after the disaster had remitted in roughly half of the survivors after 5.5 years.
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Affiliation(s)
- Shiho Kino
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, USA; Department of Health Education and Health Sociology, The University of Tokyo, Tokyo, Japan.
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan,Division for Regional Community Development, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Sendai, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Chiba University, Center for Preventive Medical Sciences, Chiba, Japan,Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, USA
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Johnson CC, Aldea MA. Ethical Considerations for Telepsychotherapy and the Management of High-Risk Patients During Coronavirus 2019 (COVID-19): Challenges and Practice Considerations. ETHICS & BEHAVIOR 2021. [DOI: 10.1080/10508422.2020.1870979] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Candice C. Johnson
- Department of Veterans Affairs, C. W. Bill Young Veterans Affairs Healthcare System
| | - Mirela A. Aldea
- Department of Veterans Affairs, C. W. Bill Young Veterans Affairs Healthcare System
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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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Kino S, Aida J, Kondo K, Kawachi I. Long-term Trends in Mental Health Disorders After the 2011 Great East Japan Earthquake and Tsunami. JAMA Netw Open 2020; 3:e2013437. [PMID: 32797173 PMCID: PMC7428812 DOI: 10.1001/jamanetworkopen.2020.13437] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Posttraumatic stress symptoms (PTSS) and depressive symptoms are common among survivors of a major disaster, yet few longitudinal studies have documented their long-term persistence at the community level. OBJECTIVE To examine the trajectories of PTSS and depressive symptoms for as long as 5.5 years after the 2011 Great East Japan earthquake and tsunami. DESIGN, SETTING, AND PARTICIPANTS This cohort study used data from 2781 participants in 3 waves of the Iwanuma Study (2010, 2013, and 2016), a cohort of community-dwelling older adults (≥65 years in August 2010) in Iwanuma, Japan, who were directly affected by the 2011 disaster. The baseline assessment of mental health predated the disaster by 7 months, and survivors were followed up for 5.5 years after the disaster. Data analysis was performed from October 2019 to February 2020. EXPOSURES The March 11, 2011, Great East Japan earthquake and tsunami. MAIN OUTCOMES AND MEASURES PTSS were measured by 9 questions on the Screening Questionnaire for Disaster Mental Health, while depressive symptoms were measured by 15 items on the Geriatric Depression Scale short form. RESULTS The analytic samples for trajectories of PTSS and depressive symptoms included 2275 and 1735 respondents, respectively. In the study population at baseline, there were slightly more women (1262 of 2275 [55.5%] and 882 of 1735 [50.8%]), and most participants were aged 65 to 74 years (1533 [67.4%] and 1224 [70.5%]) and married (1664 [76.2%] and 1319 [77.7%]). Overall, there was a 13.6% (95% CI, 11.7%-15.6%) incidence of depression among individuals who did not have depression before the disaster, while a further 11.1% (95% CI, 9.8%-12.4%) reported PTSS after the disaster. By 5.5 years of follow-up, approximately half of the survivors with new depressive symptoms in 2013 (85 of 168 [50.6%]) and PTSS (147 of 253 [58.1%]) had recovered. The prevalence of depression in the community remained remarkably stable (between 504 participants [29.0%] and 506 participants [29.2%]) comparing predisaster and postdisaster data. CONCLUSIONS AND RELEVANCE In this study, mental illness symptoms persisted for more than 5 years among half of disaster survivors, but the community-wide prevalence of depression remained stable, suggesting that the community itself was resilient.
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Affiliation(s)
- Shiho Kino
- Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, Boston, Massachusetts
| | - Jun Aida
- Tohoku University Graduate School of Dentistry, Department of International and Community Oral Health, Sendai, Japan
| | - Katsunori Kondo
- Chiba University, Center for Preventive Medical Sciences, Chiba, Japan
- Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Ichiro Kawachi
- Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, Boston, Massachusetts
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Yanagi N, Inoue Y, Fujiwara T, Stickley A, Ojima T, Hata A, Kondo K. Adverse childhood experiences and fruit and vegetable intake among older adults in Japan. Eat Behav 2020; 38:101404. [PMID: 32674012 DOI: 10.1016/j.eatbeh.2020.101404] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 05/30/2020] [Accepted: 06/05/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Although adverse childhood experiences (ACEs) have been linked to negative health behaviors in adulthood, few studies have investigated if the impact continues until late adulthood. We examined the association between ACEs and fruit and vegetable intake (FVI) among older adults in Japan. METHODS Data came from the Japan Gerontological Evaluation Study (JAGES), 2013 in which 24,271 individuals aged ≥65 years participated. The number of ACEs was calculated (0, 1 and ≥2) while low FVI was defined as consuming fruit and vegetables less than once a day. A sex-stratified multilevel Poisson regression analysis was used to investigate the association between ACEs and low FVI. RESULTS Among men, 35.4% reported at least one ACE while the corresponding figure for women was 30.6%. Compared to those without ACEs, the prevalence ratios for low FVI among those who reported ≥2 ACEs were 1.51 (95% confidence interval [CI] = 1.30-1.75) for women and 1.28 (95% CI = 1.14-1.44) for men after adjusting for age and childhood economic hardship. Although these associations were attenuated after adjusting for socio-demographic and health-related variables, the link between ACEs and low FVI remained statistically significant among women. Of the seven individual forms of ACE, psychological neglect was significantly associated with low FVI (PR = 1.16, 95% CI = 1.03-1.31) among women in the final model. CONCLUSIONS ACEs are associated with low FVI among older Japanese adults. Our results suggest that the detrimental effect of ACEs on health behavior may stretch across the life course.
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Affiliation(s)
- Natsuyo Yanagi
- Department of Public Health, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yosuke Inoue
- Carolina Population Center, The University of North Carolina at Chapel Hill, NC, USA; Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - Andrew Stickley
- Department of Health Education and Health Sociology, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Toshiyuki Ojima
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Akira Hata
- Department of Public Health, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan; National Center for Geriatrics and Gerontology, Aichi, Japan
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Family Socioeconomic Status and Exposure to Childhood Trauma: Racial Differences. CHILDREN (BASEL, SWITZERLAND) 2020; 7:children7060057. [PMID: 32503310 PMCID: PMC7346200 DOI: 10.3390/children7060057] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/08/2020] [Accepted: 06/01/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Minorities' diminished returns (MDRs) refer to weaker effects of socioeconomic status (SES) indicators such as parental educational attainment and family income in generating tangible childhood outcomes for racial and ethnic minorities compared to the majority group, a pattern prevalent in the US. Our existing knowledge is minimal, however, about diminished returns of family SES on reducing exposure to childhood trauma. AIM To determine if there was a difference between non-Hispanic whites (NHW) and non-Hispanic blacks (NHB) in the effect of SES on exposure to childhood trauma among children ages 8-11 years old. MATERIALS AND METHODS In this cross-sectional study, we analyzed data from 4696 NHW or NHB American 8-11-year-old children who were participants in the Adolescent Brain Cognitive Development (ABCD) Study. The independent variables were parental educational attainment and family income. The primary outcome was exposure to 1 or 2+ childhood traumas, measured by the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) semi-structured interview. Polynomial regression was used for data analysis. RESULTS Parental education and family income had statistically significant protective (negative) effects on childhood trauma, indicating children from high income and highly educated families were exposed to a lower level of childhood trauma. However, race/ethnicity showed statistically significant interactions with parental education and family income on exposure to childhood trauma, indicating weaker protective effects of parental education and family income on reducing exposure to trauma for NHB compared to NHW children. Race-specific models showed protective effects of parental education and family income on exposure to childhood trauma for NHW but not NHB children. CONCLUSION The protective effects of parental education and family income against exposure to childhood trauma are systematically diminished for NHBs compared to NHWs. To minimize the racial/ethnic health gaps, diminished returns of parental education and family income should be addressed. There is a need for programs and interventions that equalize not only SES but also the marginal returns of SES for ethnic groups. Such efforts require addressing structural and societal barriers that hinder NHB families from translating their SES resources into tangible outcomes. There is a need for studies that can minimize MDRs for NHB families, such that SES can similarly secure tangible outcomes in the presence of SES resources.
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Tanaka E, Tennichi H, Kameoka S, Kato H. Long-term psychological recovery process and its associated factors among survivors of the Great Hanshin-Awaji Earthquake in Japan: a qualitative study. BMJ Open 2019; 9:e030250. [PMID: 31434779 PMCID: PMC6707693 DOI: 10.1136/bmjopen-2019-030250] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES The 1995 Great Hanshin-Awaji Earthquake had an enormous negative impact on survivors' health. Many survivors experienced psychological distress and their long-term psychological recovery process remains unclear. Our objective was thus to explore this long-term psychological recovery process. DESIGN Qualitative study. SETTING From January to December 2015, face-to-face interviews were conducted in Kobe, Japan. PARTICIPANTS 20 affected survivors (55% female; ages ranged from 7 to 60 at the time of the disaster)-10 volunteer storytellers, six first responders (firefighters/public health nurses) and four post-traumatic stress disorder patients. OUTCOME MEASURES We asked participants about their experiences and psychological distress relating to the earthquake and what facilitated or hindered their psychological recovery. We analysed interview data using constructivist grounded theory. RESULTS Participants experienced diverse emotional reactions immediately after the disaster and often hyperfocused on what they should do now. This hyperfocused state led to both mental and physical health problems several months after the disaster. Months, and sometimes years, after the disaster, guilt and earthquake narratives (ie, expressing thoughts and feelings about the earthquake) played key roles in survivors' psychological recovery: guilt suppressed their earthquake narrative; conversely, the narrative alleviated feelings of distress about the earthquake. In time, participants reconsidered their earthquake experiences both alone and through social interaction. This alleviated their emotional reactions; however, participants still experienced attenuated emotional reactions, and some hid their feelings of distress even 20 years postdisaster. Interpersonal relationships modified this psychological process both positively and negatively. CONCLUSIONS Future psychosocial support plans for disaster survivors may need to (1) include both mental and physical care in the transition from the acute phase to the recovery phase; (2) facilitate supportive interpersonal relationships for survivors during the mid-term recovery phase and (3) provide long-term psychological support to the most traumatised survivors, even if they appear to be functioning normally.
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Affiliation(s)
- Eizaburo Tanaka
- Research Department, Hyogo Institute for Traumatic Stress, Kobe, Japan
| | - Honami Tennichi
- Research Department, Hyogo Institute for Traumatic Stress, Kobe, Japan
| | - Satomi Kameoka
- Research Department, Hyogo Institute for Traumatic Stress, Kobe, Japan
| | - Hiroshi Kato
- Research Department, Hyogo Institute for Traumatic Stress, Kobe, Japan
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Imai Y, Sanada T, Tachi M. The Birth Prevalence of Cleft Lip and/or Cleft Palate After the 2011 Tōhoku Earthquake and Tsunami. Cleft Palate Craniofac J 2019; 56:1133-1138. [DOI: 10.1177/1055665619843409] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Objective: This study examined whether the 2011 Tōhoku earthquake and tsunami affected the birth prevalence of cleft lip and/or cleft palate (CL/P) in Miyagi Prefecture, where the earthquake and tsunami caused severe damage. Design: This was a retrospective cohort study. Setting: The study was conducted at university and children’s hospitals in Miyagi Prefecture. Participants: The annual and monthly numbers of infants born with CL/P were obtained from medical records. The affected period of birth was defined as 1 year from December 1, 2011, to November 30, 2012. The control period was 5 years from January 1, 2006, to December 31, 2010. The annual and monthly numbers of births in Miyagi Prefecture were obtained using e-Stat, which is a portal for Japanese government statistics. Main Outcome Measures: Main outcome measures were birth prevalence of CL/P during the control and affected periods. Results: There were no significant differences between the control and affected periods in the prevalence (per 10 000 live births) of cleft lip with or without palate (13.8 vs 16.7; P = .342), isolated cleft palate (5.2 vs 3.2; P = .267), or overall CL/P (19.0 vs 19.9; P = .799). Conclusions: We did not observe that the 2011 Tōhoku earthquake and tsunami affected the birth prevalence of CL/P in Miyagi Prefecture, even though it severely impacted human health in the area.
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Affiliation(s)
- Yoshimichi Imai
- Department of Plastic and Reconstructive Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | - Masahiro Tachi
- Department of Plastic and Reconstructive Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
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Tang W, Xu D, Li B, Lu Y, Xu J. The relationship between the frequency of suicidal ideation and sleep disturbance factors among adolescent earthquake victims in China. Gen Hosp Psychiatry 2018; 55:90-97. [PMID: 30448743 DOI: 10.1016/j.genhosppsych.2018.09.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 09/27/2018] [Accepted: 09/27/2018] [Indexed: 01/19/2023]
Abstract
OBJECTIVE This study aimed to examine the frequency of suicidal ideation (SI) and identify exposure variables, mental health, and sleep-related risk factors of SI among adolescents following the 2013 Ya'an earthquake. METHODS Participants consisted of 5563 adolescent students selected through random sampling from 11 primary and high schools in the counties most severely affected by the earthquake. They were asked to complete the Pittsburgh Sleep Quality Index, Children's Revised Impact of Event Scale-13, Short Mood and Feelings Questionnaire, and Screen for Child Anxiety-Related Emotional Disorders. Multinomial logistic analysis was used to identify possible relationships between SI and psychopathology, sleep problems, earthquake exposures or demographic characteristics. The mediation analysis was used to identify direct and indirect effects among sleep problems, psychopathology, earthquake exposures and SI. RESULTS Our findings suggest that 29.5% of the sample experienced SI during the past year (12.9% once, 11.9% twice, 2.6% on 3-4 occasions and 2.1% on at least 5 occasions). Multiple sleeping problems, including trouble falling asleep, shorter sleep duration, and daytime dysfunction, showed independent associations with SI. The mediation analysis suggested that depression and anxiety mainly mediated the association of sleep with SI. LIMITATIONS This study was cross-sectional and did not include controls. No baseline data were collected prior to the earthquake. CONCLUSION SI can be a serious problem among adolescents following a major earthquake, especially those who are older, who live in one-child households, or who are female. Years after a disaster, we found that exposure severity, psychopathology and sleep impairment all contributed to SI, and that earthquake exposure may have disrupted sleep and worsened mood, which in turn may have impacted SI. By enhancing teenagers' sleep management and shaping their activities, post-disaster intervention programs may help prevent SI among Chinese adolescents.
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Affiliation(s)
- Wanjie Tang
- Institute of Emergency Management and Post-disaster Reconstruction, Sichuan University, Chengdu, China; Centre for Educational and Health Psychology, Sichuan University, Chengdu, China; Mental Health Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Dun Xu
- Institute of Emergency Management and Post-disaster Reconstruction, Sichuan University, Chengdu, China
| | - Bin Li
- Mental Health Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Yi Lu
- Institute of Emergency Management and Post-disaster Reconstruction, Sichuan University, Chengdu, China
| | - Jiuping Xu
- Institute of Emergency Management and Post-disaster Reconstruction, Sichuan University, Chengdu, China.
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