Symptoms of PTSD Among Adolescents and Young Adult Survivors Six Years after the 2010 Haiti Earthquake

Intimate partner violence and posttraumatic stress disorder among adolescents and young adults in Haiti

Although the high prevalence of intimate partner violence (IPV) in Haiti is well-documented, its association with post-traumatic stress disorder (PTSD) symptoms among adolescents and young adults remains unexplored. Using a representative sample of adolescents and young adults from rural and urban areas across the 10 geographical regions of Haiti, this study investigates the association between IPV and PTSD symptoms. It explores the role of social support, emotion regulation, other traumatic events, and sociodemographic factors. The sample consisted of 3,586 participants, of whom 43.21 % (1,538) reported being in a dating relationship in the past year (56.04 % women). Overall, 25.53 % of the participants were categorized as having probable PTSD. Results showed that participants who experienced at least one episode of IPV victimization presented a higher prevalence of PTSD (32.28 %) compared to those who did not have any experience (16.29 %), χ2 (1) = 44.83, p < .001. The logistic regression model showed that emotional IPV, sexual IPV, traumatic life events, emotional dysregulation, and social support were associated with PTSD symptoms. This study highlights a strong association between IPV and PTSD symptoms, as well as factors that can contribute to the development and implementation of prevention and intervention programs among adolescents and young adults in Haiti.

PTSD risk factors in earthquake survivors and their families: a systematic review

Background: Exposure to earthquakes can cause adverse effects on the mental health of survivors, including an increased risk of PTSD.Objective: This systematic review aims to analyse the previous secondary studies to identify the risk factors for PTSD from children to elderly earthquake survivors. In addition, it aims to consider the complexity of the joint effects of the individual, relational, and contextual risk factors, to also detect the most at-risk families.Method: After reviewing and screening studies from the literature search through PubMed, Web of Science, Scopus, and EBSCO under the guidance of PRISMA guidelines, ten eligible secondary studies were identified that examine the risk factors for PTSD in individuals (from children to elderly) affected by worldwide earthquakes.Results: The analysis of the included studies allowed the identification of a series of socio-demographic, pre-traumatic, peri-traumatic, and post-traumatic PTSD risk factors in children, adolescents, youth, adults, and elderly survivors. The results represent the complexity of the joint effects of these risk factors at individual, relational, and contextual levels.Conclusions: The consideration of the PTSD risk factors highlights the importance of individual characteristics and the type of experiences and exposure in the period before, during, and after the earthquake. This knowledge could allow the early identification of at-risk individuals of different ages and families and the implementation of intervention programmes.

Determinants of mental illness and care seeking behaviours in Northern Haiti: an assessment of demographic, social, and religio-cultural factors among patients at the first mental health clinic in the region

Populations in countries such as Haiti demonstrate a high level of need for mental health care despite a lack of services and trained professionals. In addition to the dearth of biomedical services, local belief systems and explanatory models contribute to a majority of the population relying on traditional medicine as their first option for care. Using a mixed-methods approach, we aim to characterise mental illness at the first mental health clinic in the region - Sant Sante Mantal Mòn Pele (SSMMP) - by interviewing 96 patients with a demographic questionnaire as well as Anxiety, Depression, and Functionality Scales. Multivariate logistic and linear regression models were conducted examining the impact of demographic variables on whether patients believed their illness was caused by sent spirits or previously visited a Vodou priest for treatment, as well as Depression, Anxiety, and Functionality Scale scores. Factors associated with mental illness in this sample included sex, number of traumatic events, physical health status, and number of sessions attended at SSMMP. Factors which impacted traditional beliefs or practices related to mental illness included sex, age, and income.

Change patterns of sleep problems predict mental health problems among adolescents: a 10-year cohort study of Chinese Wenchuan earthquake

BACKGROUND

The predictive effects of change patterns of sleep problems on mental health after a long-term disaster remain poorly known. We examined the change patterns of sleep problems after the Wenchuan earthquake, and tested whether specific sleep-related change patterns could predict mental health problems (posttraumatic stress disorder [PTSD], anxiety, and depression) in the 10 years after Wenchuan earthquake.

METHODS

1357 adolescents exposed to the Wenchuan earthquake were surveyed on potential sleep problems at 18 months (T_18m) and 30 months (T_30m) post-earthquake. Among them, 799 participants completed the followed-up survey online 10 years after the earthquake (T_10y). Since some participants did not provide sleep problems data at both T_18m and T_30m, 707 samples were included in final analyses. Linear regression analysis was performed.

RESULTS

Four different patterns of sleep problems were identified: stable-low pattern (61.1%), stable-high pattern (15.3%), decreasing pattern (13.2%), and increasing pattern (10.5%). Additionally, we found that individuals in stable-high and increasing patterns were more likely to experience PTSD, anxiety, and depression at T_10y in the crude model. After controlling for confounders (e.g., earthquake exposure), these patterns were strongly predictive of depression at T_10y.

LIMITATIONS

Only two waves of sleep problems were collected and subjective sleep outcomes methods were used to collect data instead of objective methods.

CONCLUSIONS

Sleep problems had heterogeneity after a deadly earthquake. Individuals in stable-high and increasing patterns should be given more attention. Timely assessment and targeted interventions on specific sleep problems are necessary for preventing an escalation of adverse mental health outcomes.

Psychological outcomes for young adults after disastrous events: A mixed-methods scoping review

RATIONALE

Young adulthood (18 to 34) is a time of transitional change where individuals can be highly susceptible to mental health concerns. Despite similar vulnerabilities to their adolescent counterparts, the psychological outcomes for young adults following disasters are not well understood.

OBJECTIVE

This scoping review aimed to explore the literature on the psychological outcomes for young adults after disaster events.

METHODS

A systematic search of the literature was conducted in seven electronic databases, including PsycINFO, Medline, CINAHL, PILOTS, EMBASE, Scopus, and ProQuest dissertations and theses global. In total, 91 reports from 15 countries were included.

RESULTS

Findings suggested that young adults experience a range of psychological consequences after disasters, including posttraumatic stress symptoms, depression, anxiety, and other psychological outcomes, such as general/non-specific psychological distress. Pre-disaster, peri-disaster, and post-disaster factors were also found to influence the degree of psychological outcomes experienced by young adults, including prior psychological functioning and disaster exposure, among a host of other factors.

CONCLUSION

Future research is recommended to better understand young adults' psychological outcomes, experiences, and service needs following disasters.

Prevalence and risk factors of posttraumatic stress disorder among Chinese shidu parents: A systemic review and meta-analysis

BACKGROUND

Losing the only child is an extremely distressful life event for parents. Previous studies indicated that shidu parents were more vulnerable to develop posttraumatic stress disorder (PTSD). This study aims to calculate the pooled prevalence of PTSD and identify its risk factors.

METHOD

We conducted a systematic literature search in PubMed, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), Wanfang databases, Vip databases. We performed a meta-analysis using random effects models to calculate the pooled PTSD in shidu parents. Associated factors for PTSD was evaluated by determining standardized mean difference (SMD) with 95% CIs. All analyses were performed using the Stata 16.0.

RESULTS

Eight articles (covering 2,722 shidu parents) were included in this study. The pooled prevalence of PTSD was 46.8% (95%CI: 33.2%-60.3%) among Chinese shidu parents. Female (SMD[95%CI]: 0.41[0.20, 0.62]), higher education level (SMD[95%CI]: 0.15[0.03, 0.28]), lower income (SMD[95%CI]: 0.33[0.13, 0.53]), losing a daughter (SMD[95%CI]: 0.16[0.03, 0.28]) and shorter time since loss (SMD[95%CI]: 0.24[0.07, 0.40]) were significantly associated with a higher PTSD prevalence. Registered residence, cause of death, age of the child, and having a grandchild were not associated with PTSD.

LIMITATIONS

Some variables included in this meta-analysis were only measured twice, which limited the conclusions to some extent.

CONCLUSION

This meta-analysis indicated that nearly half of shidu parents experienced PTSD and provided evidence of risk factors for PTSD in shidu parents. Further research is suggested to determine how these factors interact. Effective interventions should be conducted to shidu parents with PTSD.

Prevalence and correlates of depression during the COVID-19 pandemic and the major role of stigmatization in low- and middle-income countries: A multinational cross-sectional study

OBJECTIVES

Currently, there is little data on the mental health consequences of the COVID-19 pandemic in low- and middle-income countries (LMICs). This study aims to examine the pooled and separate prevalence and determinants of depression during the pandemic in samples from four LMICs.

METHODS

Participants (N= 1267, 40.9% women) were recruited from the Democratic Republic of the Congo (DRC), Haiti, Rwanda, and Togo. They completed an online cross-sectional survey on sociodemographics, exposure and stigmatization related to COVID-19, the Hopkins Symptom Checklist depression subscale, and the Connor-Davidson Resilience Scale-2.

RESULTS

The pooled prevalence for depression symptoms was 24.3% (95% CI: 22.08-26.79%), with significant differences across countries. Younger age, gender (women), and high levels of exposure and stigmatization related to COVIID-19, and resilience were associated with depression in the pooled data. There were significant variations at the country level. Stigmatization (but not exposure to COVID-19 and resilience) was a strong predictor among the four countries.

CONCLUSIONS

The prevalence of depression symptoms in the LMICs are similar to those reported in China and in most high-income countries during the pandemic. The findings emphasize the need for implementing non-fear-based education programs during epidemics to reduce stigmatization.

Post-traumatic Stress Symptoms in Adolescents Exposed to the Earthquake in Lombok, Indonesia: Prevalence and Association With Maladaptive Trauma-Related Cognition and Resilience

Background: Natural disasters may physically and psychologically affect individuals and their surrounding community. This study determines the prevalence of post-traumatic stress (PTS) symptoms and its association with maladaptive trauma-related cognition and resilience among adolescents post-earthquake. Materials and Methods: Data were collected, in this cross-sectional study, during an intervention program post-earthquake held in a state high school located at Lombok, Indonesia. The study sample engaged students 14-19 years of age using the purposive sampling method. The questionnaires used to measure PTS symptoms, maladaptive trauma-related cognition, and resilience were Children's Revised Impact of Event Scale-13 (CRIES-13), Child Post-Traumatic Cognitions Inventory (CPTCI), and Child and Youth Resilience Measure-Revised (CYRM-R), respectively. Results: The prevalence of PTS symptoms was 69.9%. Among the respondents, 61.37% were female and 56.48% had mothers with lower educational levels. Using multiple linear regression, the final predictors of PTS symptoms were excessive reactions (e.g., wailing loudly, miserable shrieking) of proxy during earthquake (β = 3.283, p = 0.005), maladaptive trauma-related cognition (β = 0.224, p = 0.002), and resilience (β = 0.192, p < 0.001) with female gender (β = 7.350, p < 0.001) as a control variable. Through simple linear regression, victims who witnessed injury or death during the earthquake (p = 0.003), had a proxy died during the earthquake (p = 0.01), and trapped victims or those who had difficulty escaping (p = 0.01) were identified to potentially predict the occurrence of PTS symptoms, warranting further study. Conclusion: The presence of excessive proxy reactions during the earthquake, maladaptive trauma-related cognition, and resilience in adolescents exposed to a natural disaster are worth targeting and prioritizing in future post-disaster interventions.

Measuring mental health burden in humanitarian settings: a critical review of assessment tools

Background

The effects of disasters and conflicts are widespread and heavily studied. While attention to disasters’ impacts on mental health is growing, mental health effects are not well understood due to inconsistencies in measurement.

Objective

The purpose of this study is to review mental health assessment tools and their use in populations affected by disasters and conflicts.

Method

Tools that assess posttraumatic stress disorder, depression, substance use disorder, and general mental health were examined. This review began with a search for assessment tools in PubMed, PsycINFO, and Google Scholar. Next, validation studies for the tools were obtained through snowball sampling. A final search was conducted for scientific studies using the selected tools in humanitarian settings to collect the data for analysis. The benefits and limitations described for each tool were compiled into a complete table.

Results

Twelve assessment tools were included, with 88 studies using them. The primary findings indicate that half of the studies used the Impact of Events Scale-Revised. The most common limitation discussed is that self-report tools inaccurately estimate the prevalence of mental health problems. This inaccuracy is further exacerbated by a lack of cultural appropriateness of the tools, as many are developed for Western contexts.

Conclusion

It is recommended that researchers and humanitarian workers reflect on the effectiveness of the mental health assessment tool they use to accurately represent the populations under study in emergency settings. In addition, mental health assessment should be coupled with action.

Psychological effects of the COVID-19 pandemic on Wuhan's high school students

OBJECTIVE

This study explored the protective mechanisms of resilience and positive emotion regulation against psychological trauma among Wuhan's high school students during the COVID-19 outbreak.

METHOD

We obtained 286 valid samples from four high schools in Wuhan, China. To construct a measurement model and a structural model, structural equation models using four measurement scales with valid items were adopted, including a scale of psychological trauma, a scale of resilience, a scale of positive emotional regulation, and a scale of mental health. Participants reported their answers to items on a 5-point Likert-like scale.

RESULTS

The results revealed that psychological trauma was a negative predictor of mental health, and resilience and positive emotion regulation mediated the relationship between psychological trauma and mental health.

CONCLUSIONS

Accordingly, we concluded that resilience and positive emotion regulation interrupted the direct impact of psychological trauma on mental health, thereby greatly protecting the mental health of Wuhan's high school students during the COVID-19 outbreak.

Sexual victimization, PTSD, depression, and social support among women survivors of the 2010 earthquake in Haiti: a moderated moderation model

BACKGROUND

In 2010, an important earthquake devastated Haiti and caused thousands of deaths. In a social context where women are particularly vulnerable, this cross-sectional study examined the associations between sexual assaults experienced by women before the earthquake, the earthquake exposure, the traumatic consequences, and their satisfaction of social support received.

METHODS

A total of 660 women aged 18 to 86 completed questionnaires assessing exposure to the earthquake, sexual assault victimization, peritraumatic distress, Posttraumatic stress disorder (PTSD), depression, and social support. A moderated moderation model was computed to examine associations between exposure to the earthquake, sexual assault, social support, and traumatic consequences.

RESULTS

Results showed that 31.06% of women were victims of sexual assault before the earthquake. They presented higher prevalence of peritraumatic distress, PTSD, and depression symptoms, compared to non-victims. The moderated-moderation model showed that sexual assault and exposure to the earthquake were positively associated with traumatic consequences (respectively, B = 0.560, p < 0.001; B = 0.196, p < 0.001), while social support was negatively associated with them (B = -0.095, p < 0.05). Results showed a triple interaction: women victim of sexual assault who were satisfied with received social support are less likely to develop traumatic consequences after being exposed to the earthquake(B = -0.141, p < 0.01).

CONCLUSIONS

By demonstrating the role of sexual assault in the development of mental health problems after the Haitian earthquake, this study shows the importance for clinicians to investigate interpersonal trauma experienced before or following natural disasters among survivors. Results also indicate the key role of family and communities to help survivors build resilience and coping strategies with their social support.

Mental Health Among Children Older than 10 Years Exposed to the Haiti 2010 Earthquake: a Critical Review

PURPOSE OF REVIEW

There is evidence that the exposure to a major natural disaster such as the 2010 earthquake in Haiti may have devastating short- and long-term effects on children's mental health and overall development. This review summarizes what has been reported in the past 3 years (2017-2020) regarding emotional, psychological, and behavioral effects of exposure to this particular earthquake on children 10 years and older.

RECENT FINDINGS

Twenty-six articles were screened, of which twenty-one were selected for final analysis. The main themes addressed in the literature over the 3 years concerned prevalence of post-traumatic stress disorder (PTSD), depression, determinants of resilience factors, prevalence of sexual violence as well as prenatal exposure, and subsequent autism behaviors/symptoms. The majority of the findings analyzed in this review on mental health in young Haitian survivors of the 2010 earthquake came from cross-sectional studies conducted in West region of Haiti, spefically Port-au-Prince. There was a paucity of longitudinal and translational data available. The results of this critical review can be used to inform disaster preparedness programs with the aim of protecting children's development and mental health, which are much needed on this disaster-prone island.

Symptoms of posttraumatic stress disorder, depression, anxiety and other mental health problems following the 2010 earthquake in Haiti: A systematic review and meta-analysis

BACKGROUND

The 2010 earthquake in Haiti caused significant human and material damages, thousands of deaths and injuries, and 1.5 million homeless. This systematic review and meta-analysis aims to synthesize research on the prevalence and factors associated with PTSD, depression, anxiety symptoms, and other mental health problems among survivors.

METHODS

We searched six databases and retained 50 articles for the systematic review, 28 of which were included in three random effects meta-analyses on the prevalence of PTSD, depression, and anxiety symptoms in survivors.

RESULTS

Following the earthquake, more than one out of four individuals (28.44%,CI 95%,17.68%-42.37%; k = 24) reported severe symptoms of PTSD, one out of three reported severe symptoms of depression (32.16%,CI 95%,23.60%-42.11%; K=14), and one out of five reported severe symptoms of anxiety (20.49%,CI 95%,15.74%-26.24%;k=5). Studies revealed important rates of other mental health problems (including psychological distress and disturbance, suicidal ideations, and increased alcohol consumption) in survivors. Females were 41.38% more likely than males to experience severe symptoms of PTSD (OR = 1.41,CI 95%,1.22-1.64). Time was a moderator for depression and anxiety but not for PTSD, while the average age of participants only moderated depression.

LIMITATIONS

The studies included are observational and most used self-reported measures.

CONCLUSIONS

In a global context where natural disasters tripled since 1980, this first systematic review showed that human and material damages associated with the earthquake were sufficiently traumatic to induce severe symptoms of PTSD, depression, anxiety, and other mental health problems. Clinical and research implications are discussed.

PROSPERO REGISTRATION NUMBER

CRD42018115430.

Prevalence and predictors of posttraumatic stress disorder and depression among adolescents over 1 year after the Jiuzhaigou earthquake

BACKGROUND

On August 8, 2017, a 7-magtitude earthquake struck Jiuzhaigou County in Sichuan, China. This was the third devastating earthquake in that province. The prevalence and predictors of posttraumatic stress disorder (PTSD), depression, and comorbid PTSD/depression among adolescents were unclear after the Jiuzhaigou earthquake.

METHODS

Participants were 1241 adolescent survivors in Jiuzhaigou. Data were collected using the PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and the Chinese version of the Center for Epidemiologic Studies Depression Scale for Children.

RESULTS

In total, 46.3% of participants reported PTSD, 64.5% reported depression, and 39.2% reported comorbid PTSD/depression symptoms. Risk factors for symptoms of these disorders were being female, having been injured or trapped, and intrusive rumination. High school students were less likely to report PTSD and comorbid PTSD/depression than middle school students. Participants with family members/friends that were injured or trapped reported more PTSD and comorbid symptoms than those without this experience. Loss of property also predicted PTSD. However, deliberate rumination was a protective factor for depression.

LIMITATIONS

This study did not cover all adolescents in Jiuzhaigou and all potential predictors. As we used a cross-sectional design, this study could not assess the trajectory of PTSD, depression, and comorbid symptoms after the earthquake.

CONCLUSION

The findings are meaningful for mental health care among adolescents after natural disasters such as an earthquake.

Prevalence of stressful life events and their association with post-traumatic stress disorder among youth attending secondary school in Haiti

The association between earthquakes and youth post-traumatic stress disorder (PTSD) has been well described, but little is known about the relationship between other stressful life events (SLEs) and PTSD among earthquake-affected youth. This study examines a variety of SLEs, including earthquake, and their association with PTSD among school-going Haitian youth following a major earthquake in 2010. In 2013, we assessed 120 students ages 18-22 for PTSD and other SLEs using a modified Structured Clinical Interview for DSM-IV (SCID)-based interview and the Stressful Life Events Checklist (SLE Checklist). Only 51.7% of participants on the SLE Checklist and 31.7% in the interview endorsed being affected by the earthquake or another disaster. Sexual assault showed the strongest association with PTSD in multivariable logistic regression. Contrary to our hypothesis, exposure to earthquake or another disaster was not significantly associated with current PTSD. In this population, exposure to interpersonal violence may have had a greater impact on PTSD risk than exposure to natural disaster. These data underscore the need to examine and reduce both acute and chronic stressors among disaster-affected youth.