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Yamazaki M, Nagamine M, Kitano M, Waki F, Edo N, Koga M, Tachimori H, Toda H. Identifying factors related to stigma toward psychiatric illness and mental health services and attitudes of help-seeking among Japan Ground Self-Defense Force members. J Psychiatr Res 2023; 165:241-247. [PMID: 37523976 DOI: 10.1016/j.jpsychires.2023.07.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 06/09/2023] [Accepted: 07/20/2023] [Indexed: 08/02/2023]
Abstract
The stigma that military personnel feel toward mental illness and mental healthcare hinders their access to mental health services. Stigma is influenced by culture-specifically, that held by military personnel is closely related to military culture. To our knowledge, this is the first large-scale investigation aimed at identifying the factors, including demographic factors and elements of military culture, related to stigma among members of the Japan Ground Self-Defense Force. An anonymous questionnaire was administered to 4754 members. The questionnaire included items regarding demographic factors, history of psychiatric visits, military rank, overseas deployment experience, disaster relief experience, supervisor leadership, unit cohesion, general psychological distress, stigma toward perceived mental illness, and attitudes toward help-seeking. Multiple regression analysis was used to identify the various factors related to stigma. Responses were obtained from 4305 (90.5%) participants, among which 3723 (78.3%) were valid. Multiple regression analyses revealed that a variety of factors including age, psychiatric consultation, leadership, and cohesiveness were markedly associated with stigma and attitudes toward help-seeking. This study revealed that various factors including demographic factors and military culture factors such as supervisor leadership and unit cohesion are related to stigma and attitudes toward mental health services among Japan Ground Self-Defense Force personnel. Further studies are needed to examine the results in depth.
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Affiliation(s)
- Masayuki Yamazaki
- Department of Psychiatry, School of Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa City, Saitama, 359-8513, Japan.
| | - Masanori Nagamine
- Department of Behavioral Health, National Defense Medical College Research Institute, 3-2 Namiki, Tokorozawa City, Saitama, 359-8513, Japan.
| | - Masato Kitano
- Department of Behavioral Health, National Defense Medical College Research Institute, 3-2 Namiki, Tokorozawa City, Saitama, 359-8513, Japan.
| | - Fumiko Waki
- Department of Behavioral Health, National Defense Medical College Research Institute, 3-2 Namiki, Tokorozawa City, Saitama, 359-8513, Japan.
| | - Naoki Edo
- Department of Behavioral Health, National Defense Medical College Research Institute, 3-2 Namiki, Tokorozawa City, Saitama, 359-8513, Japan.
| | - Minori Koga
- Department of Psychiatry, School of Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa City, Saitama, 359-8513, Japan.
| | - Hisateru Tachimori
- Endowed Course for Health System Innovation, School of Medicine, Keio University, 35, Shinano-machi, Shinjuku Ward, Tokyo, 160-0016, Japan.
| | - Hiroyuki Toda
- Department of Psychiatry, School of Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa City, Saitama, 359-8513, Japan.
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Holton MJ, Snodgrass JL. A Theoretical and Theological Reframing of Trauma. PASTORAL PSYCHOLOGY 2023; 72:337-351. [PMID: 37313006 PMCID: PMC10077305 DOI: 10.1007/s11089-023-01063-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/22/2023] [Indexed: 06/15/2023]
Abstract
Racism, eco-violence, and myriad sociopolitical and interpersonal injustices continuously injure individuals, communities, and the globe, thereby challenging the human capacity to endure. The prevailing biomedical model of trauma, with its emphasis on pathology, fails to acknowledge the traumatic nature of these diffuse and pervasive injuries. The disciplines of spiritual and pastoral psychology are uniquely poised to reconceptualize trauma and reframe it as part of a stress-trauma continuum, given the way trauma can engender great suffering as well as resistance and the possibility of transformation. This perspective eschews the sentiment, ubiquitous in popular culture, that everything stressful is traumatic as well as the notion that "true" trauma is delimited by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). This article posits a strength-based approach to trauma that contextualizes our societal negativity bias within spiritual values of hope, (post-traumatic) growth, and (possibly) resilience while not diminishing the very real suffering, even despair, that emerge from trauma of all kinds.
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Affiliation(s)
- M. Jan Holton
- Duke Divinity School, Duke University, Box 90965, Durham, NC 27708-0965 United States of America
| | - Jill L. Snodgrass
- Loyola University Maryland, 4501 N. Charles Street, Baltimore, MD 21210 United States of America
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Gao R, Chan SKW, Zhang BZ, Lin JX, Peng SR, Yang CG, Tian GJ, Bai JZ, Xu LX, Li YH, Zheng ZJ, Pu DS, Chan CLW, Ran MS. An epidemiological survey of mental disorders 5 years after the Lushan earthquake in Ya'an, China. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1263-1272. [PMID: 33146858 DOI: 10.1007/s00127-020-01974-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 10/24/2020] [Indexed: 12/20/2022]
Abstract
PURPOSE This study aimed to (1) explore the prevalence and relevant influencing factors of different mental disorders 5 years after the Lushan earthquake in Ya'an, China. METHODS An epidemiological mental health survey was conducted to identify the prevalence of mental disorders in general population in Ya'an. A multi-stage, group-matching random sampling method was adopted. Face-to-face interviews were done with a two-stage design by trained interviewers and psychiatrists. The 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) was used for the diagnosis. RESULTS There were 8876 participants who were interviewed in this study. The total 12-month and lifetime prevalence of all mental disorders were 12.5% and 14.7%, respectively. There was a significant difference between males and females in the prevalence patterns of several mental disorders. Han ethnic group had higher prevalence of anxiety disorders (2.7%), and the Tibetan group had higher prevalence of alcohol-related disorders (5.0%). Logistic regression analysis showed that the areas severely affected by the earthquake had significantly higher prevalence of depressive disorders, and the extremely severe affected areas had significantly higher prevalence of trauma- and stressor-related disorders. CONCLUSION Our findings show that the prevalence of a range of mental disorders 5 years after the earthquake in Ya'an are high, and the prevalence of depressive and trauma- and stressor-related disorders may be influenced differently by the various severity of earthquake impact. This study may be crucial for the health policy-making, cultural-specific mental health services and long-term mental recovery after the earthquake.
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Affiliation(s)
- Ru Gao
- Ya'an Fourth People's Hospital, Ya'an, 625000, Sichuan, China
| | | | - Bing-Zhi Zhang
- Ya'an Fourth People's Hospital, Ya'an, 625000, Sichuan, China
| | - Jing-Xia Lin
- School of Nursing, University of Hong Kong, Hong Kong SAR, China
| | - Shu-Rong Peng
- Ya'an Fourth People's Hospital, Ya'an, 625000, Sichuan, China
| | - Chuan-Gang Yang
- Ya'an Fourth People's Hospital, Ya'an, 625000, Sichuan, China
| | - Guo-Jiao Tian
- Ya'an Fourth People's Hospital, Ya'an, 625000, Sichuan, China
| | - Jing-Zhen Bai
- Ya'an Fourth People's Hospital, Ya'an, 625000, Sichuan, China
| | - Liu-Xiu Xu
- Ya'an Fourth People's Hospital, Ya'an, 625000, Sichuan, China
| | - Yu-Hui Li
- Ya'an Fourth People's Hospital, Ya'an, 625000, Sichuan, China
| | - Zai-Jiang Zheng
- Ya'an Fourth People's Hospital, Ya'an, 625000, Sichuan, China
| | - Dao-Sheng Pu
- Ya'an Fourth People's Hospital, Ya'an, 625000, Sichuan, China
| | - Cecilia Lai-Wan Chan
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR, China
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR, China.
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Abstract
What happens when temporary shelters become permanent homes? What are the psychosocial impacts of prolonged dislocation, and how might these effects be mitigated through grassroots community activities? Based on fieldwork and interviews with residents in temporary housing and volunteer support groups in northeastern Japan conducted from 2014-2018, this article analyzes the ongoing challenges of delayed recovery, chronic dislocation, and social isolation among survivors of the March 11, 2011 disaster in Japan, with a particular focus on the residents of temporary facilities in Natori City, Miyagi Prefecture. I examine how the complexity of the disaster-recovery process within the local politics of the region has produced new tensions, creating a particular "zoned liminality" for displaced residents while undermining the social nexus of community relations. Then I reflect on certain challenges in treating the psychosocial trauma among survivors, and how their particular needs are addressed through new citizen-based volunteer movements offering holistic activities. These grassroots activities do not necessarily solve the breakdown of social bonds nor improve residents' prospects of returning home. However, by alleviating survivors' sense of social isolation and loneliness, this "humanistic" approach highlights the possibilities of participatory-style psychosocial support that goes beyond conventional biomedical services and top-down, state-driven policies. .
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Affiliation(s)
- Isaac Gagné
- German Institute for Japanese Studies (DIJ-Tokyo), Japan
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5
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Nagamine M, Giltay EJ, Shigemura J, van der Wee NJ, Yamamoto T, Takahashi Y, Saito T, Tanichi M, Koga M, Toda H, Shimizu K, Yoshino A, Vermetten E. Assessment of Factors Associated With Long-term Posttraumatic Stress Symptoms Among 56 388 First Responders After the 2011 Great East Japan Earthquake. JAMA Netw Open 2020; 3:e2018339. [PMID: 32990742 PMCID: PMC7525349 DOI: 10.1001/jamanetworkopen.2020.18339] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
IMPORTANCE First responders are at risk for developing symptoms of posttraumatic stress disorder (PTSD). Little is known about the risk factors for developing PTSD during a years-long period after complex mass disasters. OBJECTIVE To explore the long-term course of PTSD symptoms and to identify risk factors and their relative association with PTSD among first responders dispatched to the 2011 Japanese earthquake, tsunami, and nuclear disaster. DESIGN, SETTING, AND PARTICIPANTS This 6-year, large, prospective cohort study was part of a continuous longitudinal study of Japan Ground Self-Defense Force first responders. The data were collected at 1, 6, 12, 24, 36, 48, 60, and 72 months after mission completion from 2011 to 2017. Of approximately 70 000 eligible participants, 56 388 were enrolled in this study. Data were analyzed from 2017 to 2020. EXPOSURES Stress exposures owing to personal or professional disaster experience (eg, duties with body recovery or radiation exposure risk) and working conditions (eg, deployment length, postdeployment overtime work). MAIN OUTCOMES AND MEASURES The Impact of Event Scale-Revised score assessed PTSD symptoms; scores of at least 25 were defined as probable PTSD. Cox proportional hazards regression models assessed the risk factors for incidence of probable PTSD. RESULTS Among the 56 388 participants, 97.1% were men, and the median age at enrollment was 34 (range, 18-63) years. A probable PTSD rate was 2.7% at 1 month and showed a downward trend in the first year and a subsequent plateau. The cumulative incidence of probable PTSD was 6.75%. The severity of PTSD symptoms demonstrated a high degree of rank-order stability over time. Rather than professional disaster experience, sociodemographic factors and working conditions were independently associated with the incidence of probable PTSD: personal experience of the disaster (hazard ratio [HR], 1.96; 95% CI, 1.72-2.24), deployment length of at least 3 months (HR vs <1 month, 1.75; 95% CI, 1.52-2.02), increased age (HR for ≥46 vs ≤25 years, 2.28; 95% CI, 1.79-2.92), and postdeployment overtime work of at least 3 months (HR vs little to none, 1.61; 95% CI, 1.39-1.87). CONCLUSIONS AND RELEVANCE Given these findings, in the future, first responders' PTSD symptoms might be mitigated by shortening deployment length, avoiding postdeployment overtime work, and paying special attention to the needs of personnel with personal experience of the disaster or older age. Efforts to alleviate responders' initial symptoms will be required.
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Affiliation(s)
- Masanori Nagamine
- Division of Behavioral Science, National Defense Medical College Research Institute, Tokorozawa City, Japan
| | - Erik J. Giltay
- Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands
| | - Jun Shigemura
- Department of Psychiatry, School of Medicine, National Defense Medical College, Saitama, Japan
| | - Nic J. van der Wee
- Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands
| | - Taisuke Yamamoto
- Division of Behavioral Science, National Defense Medical College Research Institute, Tokorozawa City, Japan
| | - Yoshitomo Takahashi
- Division of Behavioral Science, National Defense Medical College Research Institute, Tokorozawa City, Japan
| | - Taku Saito
- Department of Psychiatry, School of Medicine, National Defense Medical College, Saitama, Japan
| | - Masaaki Tanichi
- Department of Psychiatry, School of Medicine, National Defense Medical College, Saitama, Japan
| | - Minori Koga
- Department of Psychiatry, School of Medicine, National Defense Medical College, Saitama, Japan
| | - Hiroyuki Toda
- Department of Psychiatry, School of Medicine, National Defense Medical College, Saitama, Japan
| | - Kunio Shimizu
- Division of Behavioral Science, National Defense Medical College Research Institute, Tokorozawa City, Japan
| | - Aihide Yoshino
- Department of Psychiatry, School of Medicine, National Defense Medical College, Saitama, Japan
| | - Eric Vermetten
- Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands
- ARQ National Psychotrauma Center, Diemen, the Netherlands
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Sakuma A, Ueda I, Shoji W, Tomita H, Matsuoka H, Matsumoto K. Trajectories for Post-traumatic Stress Disorder Symptoms Among Local Disaster Recovery Workers Following the Great East Japan Earthquake: Group-based Trajectory Modeling. J Affect Disord 2020; 274:742-751. [PMID: 32664010 PMCID: PMC7261355 DOI: 10.1016/j.jad.2020.05.152] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 05/18/2020] [Accepted: 05/22/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND As many local municipality and medical workers were involved in disaster recovery duties following the Great East Japan Earthquake (GEJE) on March 11, 2011, the aim of this work was to elucidate the distinct trajectories for post-traumatic stress disorder (PTSD) symptoms and associated factors among these personnel. They confronted a diverse range of stressors both as survivors and as relief workers; however, little is known about their longitudinal PTSD symptoms. METHODS The participants were 745 local municipality and hospital medical workers [average age: 43.6 ± 9.5 years, range: 20 - 66 years; 306 (59%) women] involved in disaster recovery duties following the GEJE. PTSD symptoms were measured using the Japanese version of the PTSD Checklist Specific Version (PCL-S) at four time points: 14, 30, 43, and 54 months after the GEJE. Using group-based trajectory modeling, distinct trajectories were elucidated. RESULTS We identified five distinct PTSD symptoms profiles: resistance (n = 467, 62.7%), subsyndromal (n = 181, 24.3%), recovery (n = 47, 6.3%), fluctuating (n = 26, 3.5%), and chronic (n = 24, 3.2%). The trajectories differed according to the post-disaster working conditions and personal disaster experiences. LIMITATIONS Potential selection bias resulting from the limited number of participants who completed all waves. The survey was conducted in one region of the disaster area. CONCLUSIONS The majority of participants remained stable, with a relatively small group classified as chronic and fluctuating. Our results highlight the importance of improved working conditions and sustained monitoring of workers responding to natural disasters.
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Affiliation(s)
- Atsushi Sakuma
- Department of Psychiatry, Tohoku University Hospital; Miyagi Disaster Mental Health Care Center.
| | - Ikki Ueda
- Department of Psychiatry, Tohoku University Hospital,Miyagi Disaster Mental Health Care Center
| | - Wataru Shoji
- Department of Human Science, Faculty of Liberal Arts, Tohoku Gakuin University,Department of Preventive Psychiatry, Tohoku University Graduate School of Medicine
| | - Hiroaki Tomita
- Miyagi Disaster Mental Health Care Center,Department of Preventive Psychiatry, Tohoku University Graduate School of Medicine,Department of Psychiatry, Tohoku University Graduate School of Medicine
| | - Hiroo Matsuoka
- Department of Preventive Psychiatry, Tohoku University Graduate School of Medicine
| | - Kazunori Matsumoto
- Miyagi Disaster Mental Health Care Center,Department of Preventive Psychiatry, Tohoku University Graduate School of Medicine,Department of Psychiatry, Tohoku University Graduate School of Medicine
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Bavafa A, Khazaie H, Khaledi-Paveh B, Rezaie L. The relationship of severity of symptoms of depression, anxiety, and stress with sleep quality in earthquake survivors in Kermanshah. J Inj Violence Res 2019; 11:225-232. [PMID: 31263090 PMCID: PMC6646827 DOI: 10.5249/jivr.v11i2.1203] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Accepted: 06/26/2019] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Earthquake is one of the most common natural disasters. A 7.3" Richter earthquake happened at 5km from the town of Ezgeleh in Kermanshah province in 2017, which caused several physical and mental injuries. The present study was conducted to investigate the sleep quality and mental health difficulties of those affected by earthquake and predict sleep quality according to severity of symptoms of depression, anxiety, and stress in the township of Sarpol-e Zahab, which suffered the most damage. METHODS A total of 999 earthquake survivors living in temporary tents and camps were assessed in terms of sleep quality and pattern using Pittsburgh Sleep Quality Index, and severity of psychological symptoms using Depression, Anxiety, and Stress scale 10 days after the disaster. RESULTS According to the results, poor sleep quality was experienced by 20.61% of survivors, severe stress by 60.5%, and severe depression by 41.5%, and moderate anxiety by 74%. The subjective quality, efficiency, daily dysfunction, use of hypnotics, and total sleep quality had a positive and significant relation with severity of experienced depression, anxiety, and stress. Sleep latency had a positive and significant relation only with stress, and sleep disturbance with depression and stress. CONCLUSIONS Severity of depression, anxiety, and stress can predict changes in total sleep quality of those affected by earthquake. Stress can be considered as the sole predictor of total sleep quality and the only factor that can explain components of sleep quality. The implications of the present study are debatable.
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Affiliation(s)
| | | | - Behnam Khaledi-Paveh
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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8
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Tanichi M, Nagamine M, Shigemura J, Yamamoto T, Sawamura T, Takahashi Y, Obara A, Saito T, Toda H, Yoshino A, Shimizu K. General psychological distress among Japan Self-Defense Forces personnel dispatched on United Nations peacekeeping operations and their spouses. Psychiatry Clin Neurosci 2019; 73:77-83. [PMID: 30506835 PMCID: PMC6849727 DOI: 10.1111/pcn.12806] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 10/10/2018] [Accepted: 11/20/2018] [Indexed: 11/30/2022]
Abstract
AIM The importance of family care during international deployment is emphasized within military organizations, but mental health interactions between deployed personnel and their spouses have not yet been assessed. This study addressed this gap by examining couples' mental health throughout a deployment period. METHODS The mental health of 324 spousal dyads of Japan Self-Defense Forces personnel dispatched for a half-year United Nations Disengagement Observer Force mission was examined, using longitudinal data derived from a survey at four time points: one-month pre-deployment, initial deployment, middle deployment, and immediately after homecoming. The 30-item General Health Questionnaire was used to evaluate general psychological distress, with high scores (≥7) indicating adverse mental health. RESULTS The spouses' general psychological distress was significantly higher compared with the deployed personnel (P < 0.001). The high general psychological distress of personnel was significantly related to that of their spouses (odds ratio = 2.24; 95% confidence interval, 1.32-3.80), and vice versa (odds ratio = 2.38; 95% confidence interval 1.39-4.08). CONCLUSION Mental health care will be beneficial for not only deployed personnel but also their spouses.
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Affiliation(s)
- Masaaki Tanichi
- Department of Psychiatry, School of Medicine, National Defense Medical College, Tokorozawa, Japan
| | - Masanori Nagamine
- Division of Behavioral Science, National Defense Medical College Research Institute, Tokorozawa, Japan
| | - Jun Shigemura
- Department of Psychiatry, School of Medicine, National Defense Medical College, Tokorozawa, Japan
| | - Taisuke Yamamoto
- Division of Behavioral Science, National Defense Medical College Research Institute, Tokorozawa, Japan
| | - Takehito Sawamura
- Division of Behavioral Science, National Defense Medical College Research Institute, Tokorozawa, Japan
| | - Yoshitomo Takahashi
- Division of Behavioral Science, National Defense Medical College Research Institute, Tokorozawa, Japan
| | - Asuka Obara
- Division of Behavioral Science, National Defense Medical College Research Institute, Tokorozawa, Japan
| | - Taku Saito
- Department of Psychiatry, School of Medicine, National Defense Medical College, Tokorozawa, Japan
| | - Hiroyuki Toda
- Department of Psychiatry, School of Medicine, National Defense Medical College, Tokorozawa, Japan
| | - Aihide Yoshino
- Department of Psychiatry, School of Medicine, National Defense Medical College, Tokorozawa, Japan
| | - Kunio Shimizu
- Division of Behavioral Science, National Defense Medical College Research Institute, Tokorozawa, Japan
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Allard CB, Straus E, Ra MI, Thomas KB, Kawamura R, Tosaka Y. Japanese Students Do See the Value of Asking About Child Abuse and Trauma in the Research Setting. J Empir Res Hum Res Ethics 2019; 14:141-151. [PMID: 30616432 DOI: 10.1177/1556264618821799] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Despite evidence regarding the impact of childhood abuse perpetrated by close others, or high betrayal trauma, a number of barriers continue to impede research efforts, including concerns that research may do more harm than good. Research conducted with Western samples has indicated that contrary to such concerns, participants rate the benefit of participating in trauma research as outweighing costs, even when they have a history of high betrayal trauma. Certain non-Western values, such as interpersonal harmony, could play a role in perceptions regarding trauma research participation. The current study evaluated perceptions of 79 Japanese undergraduate students who participated in an online study of child abuse. Japanese students rated the importance of participating in trauma research as greater than any immediate distress it caused. Interpersonal harmony was not related to perceptions of participating in trauma research, nor was a history of high betrayal child trauma. Taken together, these findings support continued research on childhood abuse in non-Western samples.
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Affiliation(s)
- Carolyn B Allard
- 1 University of California, San Diego, CA, USA.,2 VA San Diego Healthcare System, San Diego, CA, USA.,3 Alliant International University, San Diego, CA, USA
| | - Elizabeth Straus
- 1 University of California, San Diego, CA, USA.,2 VA San Diego Healthcare System, San Diego, CA, USA
| | - Mai I Ra
- 3 Alliant International University, San Diego, CA, USA
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10
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Nagamine M, Shigemura J, Fujiwara T, Waki F, Tanichi M, Saito T, Toda H, Yoshino A, Shimizu K. The relationship between dispositional empathy, psychological distress, and posttraumatic stress responses among Japanese uniformed disaster workers: a cross-sectional study. BMC Psychiatry 2018; 18:328. [PMID: 30309334 PMCID: PMC6182790 DOI: 10.1186/s12888-018-1915-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 09/27/2018] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Disaster workers suffer from psychological distress not only through the direct experience of traumatic situations but also through the indirect process of aiding disaster victims. This distress, called secondary traumatic stress, is linked to dispositional empathy, which is the tendency for individuals to imagine and experience the feelings and experiences of others. However, the association between secondary traumatic stress and dispositional empathy remains understudied. METHODS To examine the relationship between dispositional empathy and mental health among disaster workers, we collected data from 227 Japan Ground Self-Defense Force personnel who engaged in international disaster relief activities in the Philippines following Typhoon Yolanda in 2013. The Impact of Event Scale-Revised and the Kessler Psychological Distress Scale were used to evaluate posttraumatic stress responses (PTSR) and general psychological distress (GPD), respectively. Dispositional empathy was evaluated through the Interpersonal Reactivity Index, which consists of four subscales: Perspective Taking, Fantasy, Empathic Concern, and Personal Distress. Hierarchial linear regression analyses were performed to identify the variables related to PTSR and GPD. RESULTS High PTSR was significantly associated with high Fantasy (identification tendency, β = 0.21, p < .01), high Personal Distress (the self-oriented emotional disposition of empathy, β = 0.18, p < .05), and no experience of disaster relief activities (β = 0.15, p < .05). High GPD was associated with high Personal Distress (β = 0.28, p < .001), marital status (married, β = 0.22, p < .01), being female (β = 0.18, p < .01), medical unit (β = 0.18, p < .05), and no experience of disaster relief activities (β = 0.13, p < .05). CONCLUSIONS Among Japanese uniformed disaster workers, high PTSR was associated with two subtypes of dispositional empathy: the self-oriented emotional disposition of empathy and high identification tendency, whereas high GPD was associated with high identification tendency. Educational interventions that aim to mitigate these tendencies might be able to relieve the psychological distress of disaster workers.
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Affiliation(s)
- Masanori Nagamine
- Division of Behavioral Science, National Defense Medical College Research Institute, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan.
| | - Jun Shigemura
- 0000 0004 0374 0880grid.416614.0Department of Psychiatry, School of Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama Japan
| | - Toshimichi Fujiwara
- Japan Ground Self-Defense Force Medical School, 1-2-24, Ikejiri, Setagaya-ku, Tokyo, Japan
| | - Fumiko Waki
- Japan Ground Self-Defense Force Medical School, 1-2-24, Ikejiri, Setagaya-ku, Tokyo, Japan
| | - Masaaki Tanichi
- 0000 0004 0374 0880grid.416614.0Department of Psychiatry, School of Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama Japan
| | - Taku Saito
- 0000 0004 0374 0880grid.416614.0Department of Psychiatry, School of Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama Japan
| | - Hiroyuki Toda
- 0000 0004 0374 0880grid.416614.0Department of Psychiatry, School of Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama Japan
| | - Aihide Yoshino
- 0000 0004 0374 0880grid.416614.0Department of Psychiatry, School of Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama Japan
| | - Kunio Shimizu
- 0000 0004 0374 0880grid.416614.0Division of Behavioral Science, National Defense Medical College Research Institute, 3-2 Namiki, Tokorozawa, Saitama 359-8513 Japan
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11
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Takada S, Kameoka S, Okuyama M, Fujiwara T, Yagi J, Iwadare Y, Honma H, Mashiko H, Nagao K, Fujibayashi T, Asano Y, Yamamoto S, Osawa T, Kato H. Feasibility and psychometric properties of the UCLA PTSD reaction index for DSM-5 in japanese youth: A multi-site study. Asian J Psychiatr 2018; 33:93-98. [PMID: 29549818 DOI: 10.1016/j.ajp.2018.03.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2017] [Revised: 02/06/2018] [Accepted: 03/01/2018] [Indexed: 10/17/2022]
Abstract
The purpose of this study was to determine the reliability and validity of the UCLA PTSD Reaction Index for DSM-5 (PTSD-RI-5) among Japanese youth. This is the first study to explore psychometrics of the DSM-5 version of the PTSD-RI-5, as well as the first multisite study of an Asian population. This article presents psychometric characteristics of the PTSD-RI-5 derived from a sample of Japanese children and adolescents (N = 318). The PTSD-RI-5 total scale displayed good internal consistency reliability (α = 0.85). Correlations of PTSD-RI scores with the posttraumatic stress scores on the TSCC-A for the entire sample provided evidence of convergent validity. The four-factor structure of the PTSD-RI-5 was supported through confirmatory factor analysis in this sample. In conclusion, a DSM-5 version of the PTSD-RI-5 can be regarded as an adequate instrument for clinical and research purposes in Japan.
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Affiliation(s)
- Saeko Takada
- Research Department, Hyogo Institute for Traumatic Stress, 1-3-2 Wakinohama, Kaigandoru, Chuo-ku, Kobe, 651-0073, Japan.
| | - Satomi Kameoka
- Research Department, Hyogo Institute for Traumatic Stress, 1-3-2 Wakinohama, Kaigandoru, Chuo-ku, Kobe, 651-0073, Japan.
| | - Makiko Okuyama
- Department of Psychosocial Medicine, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan.
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
| | - Junko Yagi
- Department of Neuropsychiatry, Iwate Medical University, 19-1, Uchimaru, Morioka, Iwate, 020-0023, Japan.
| | - Yoshitaka Iwadare
- Department of Child and Adolescent Psychiatry, Kohnodai Hospital, National Center for Global Health and Medicine, 1-7-1, Kohnodai, Ichikawa, Chiba, 272-8516, Japan.
| | - Hiroaki Honma
- Miyagi Child Center, 1-4-39, Honmachi, Aoba-ku, Sendai, 980-0014, Japan.
| | - Hirohumi Mashiko
- Department of Neuropsychiatry, Fukushima Medical University, 1, Hikarigaoka, Fukushima, 960-1247, Japan.
| | - Keizo Nagao
- Nagao Mental Clinic 379, Hadokoro-coh, Tsu, Mie, 514-0009, Japan.
| | - Takeshi Fujibayashi
- Consultation Division, Fukuoka Children's Advisory Center, 1-28, Jigyohama, Chuo-ku, Fukushima, 810-0065, Japan.
| | - Yasuko Asano
- Consultation Division, Osaka Prefectural Government Child Guidance Center, 28-5, Yasakacho, Neyagawa, Osaka, 572-0838, Japan.
| | - Sayaka Yamamoto
- Research Department, Hyogo Institute for Traumatic Stress, 1-3-2 Wakinohama, Kaigandoru, Chuo-ku, Kobe, 651-0073, Japan.
| | - Tomoko Osawa
- Research Department, Hyogo Institute for Traumatic Stress, 1-3-2 Wakinohama, Kaigandoru, Chuo-ku, Kobe, 651-0073, Japan.
| | - Hiroshi Kato
- Research Department, Hyogo Institute for Traumatic Stress, 1-3-2 Wakinohama, Kaigandoru, Chuo-ku, Kobe, 651-0073, Japan.
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Nagamine M, Yamamoto T, Shigemura J, Tanichi M, Yoshino A, Suzuki G, Takahashi Y, Miyazaki M, Uwabe Y, Harada N, Shimizu K. The Psychological Impact of the Great East Japan Earthquake on Japan Ground Self-Defense Force Personnel: A Three-Wave, One-Year Longitudinal Study. Psychiatry 2018; 81:288-296. [PMID: 29485350 DOI: 10.1080/00332747.2017.1333340] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE Approximately 70,000 Japan Ground Self-Defense Force (JGSDF) personnel were dispatched in the wake of the 2011 Great East Japan Earthquake and the tsunami and nuclear disaster that followed. This study was conducted to evaluate the mental health of the JGSDF personnel and the correlates. METHODS Data collected from 56,753 participants at three time points (one, six, and 12 months after mission completion) were analyzed. Those who scored 25 or more points on the Impact of Events Scale-Revised (IES-R) and the Kessler Psychological Distress Scale (K10) were allocated into the high posttraumatic stress response (high-PTSR) group, and the high general psychological distress (high-GPD) group, respectively. RESULTS The multiple logistic regression analysis identified the following factors as the significant risk factor related to high-PTSR or high-GPD status, with odds ratios of 2.0 or higher: deployment length of three or more months, being personally affected by the disaster, and being overworked continuously for three or more months after mission completion. No significant association was observed for duties with radiation exposure risk. CONCLUSIONS Our findings suggest that disaster workers may be able to conduct disaster relief activities more safely with mission-related considerations of shorter deployment length and recognizing the effects on personnel personally affected by the disaster, in addition to avoiding overworking personnel after mission completion.
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Investigating Lushan Earthquake Victims' Individual Behavior Response and Rescue Organization. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14121556. [PMID: 29232912 PMCID: PMC5750974 DOI: 10.3390/ijerph14121556] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 11/14/2017] [Accepted: 11/22/2017] [Indexed: 11/29/2022]
Abstract
Research concerning the impact of earthquake victims’ individual behavior and its association with earthquake-related injuries is lacking. This study examined this relationship along with effectiveness of earthquake rescue measures. The six most severely destroyed townships during the Lushan earthquake were examined; 28 villages and three earthquake victims’ settlement camp areas were selected as research areas. Inclusion criteria comprised living in Lushan county for a longtime, living in Lushan county during the 2013 Lushan earthquake, and having one’s home destroyed. Earthquake victims with an intellectual disability or communication problems were excluded. The earthquake victims (N (number) = 5165, male = 2396) completed a questionnaire (response rate: 94.7%). Among them, 209 were injured (5.61%). Teachers (p < 0.0001, OR (odds ratios) = 3.33) and medical staff (p = 0.001, OR = 4.35) were more vulnerable to the earthquake than were farmers. Individual behavior was directly related to injuries, such as the first reaction after earthquake and fear. There is an obvious connection between earthquake-related injury and individual behavior characteristics. It is strongly suggested that victims receive mental health support from medical practitioners and the government to minimize negative effects. The initial reaction after an earthquake also played a vital role in victims’ trauma; therefore, earthquake-related experience and education may prevent injuries. Self-aid and mutual help played key roles in emergency, medical rescue efforts.
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Nagamine M, Harada N, Shigemura J, Dobashi K, Yoshiga M, Esaki N, Tanaka M, Tanichi M, Yoshino A, Shimizu K. The effects of living environment on disaster workers: a one-year longitudinal study. BMC Psychiatry 2016; 16:358. [PMID: 27769203 PMCID: PMC5073968 DOI: 10.1186/s12888-016-1058-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 10/04/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Defense Force workers engaged in disaster relief activities might suffer from strong psychological stress due to the tasks that they had been involved. We evaluated how living environments, work environments, and individual factors psychologically affect those who engaged in disaster relief activities. METHOD Data generated with 1506 personnel engaged in the Great East Japan Earthquake relief activity were analyzed. Those who scored ≥25 points on the Impact of Events Scale-Revised and the Kessler Psychological Distress Scale (K10) were allocated into the high post-traumatic stress response (high-PTSR) group, and the high general psychological distress (high-GPD) group, respectively. RESULTS The multiple logistic regression analysis extracted living environment (camping within the shelter sites) as the significant risk factor for both high-PTSR (OR = 3.39, 95 % CI 2.04-5.64, p < 0.001) and high-GPD (OR = 3.35, 95 % CI 1.77-6.34, p < 0.001) groups. CONCLUSION It is desirable for disaster workers to have a living environment in which they can keep an appropriate distance from the victims.
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Affiliation(s)
- Masanori Nagamine
- Division of Behavioral Science, National Defense Medical College Research Institute, Saitama, Japan.
| | - Nahoko Harada
- Department of Nursing Science of Community Health Care System, Tohoku University School of Health Sciences, Miyagi, Japan
| | - Jun Shigemura
- Department of Psychiatry, National Defense Medical College, Saitama, Japan
| | - Kosuke Dobashi
- Camp Kokura, Japan Ground Self-Defense Force, Fukuoka, Japan
| | - Makiko Yoshiga
- Camp Beppu, Japan Ground Self-Defense Force, Oita, Japan
| | - Naoki Esaki
- Camp Kurume, Japan Ground Self-Defense Force, Fukuoka, Japan
| | - Miyuki Tanaka
- Camp Omura, Japan Ground Self-Defense Force, Nagasaki, Japan
| | - Masaaki Tanichi
- Department of Psychiatry, National Defense Medical College, Saitama, Japan
| | - Aihide Yoshino
- Department of Psychiatry, National Defense Medical College, Saitama, Japan
| | - Kunio Shimizu
- Division of Behavioral Science, National Defense Medical College Research Institute, Saitama, Japan
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Jiang S, Yan Z, Jing P, Li C, Zheng T, He J. Relationships between Sleep Problems and Psychiatric Comorbidities among China's Wenchuan Earthquake Survivors Remaining in Temporary Housing Camps. Front Psychol 2016; 7:1552. [PMID: 27803679 PMCID: PMC5068134 DOI: 10.3389/fpsyg.2016.01552] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 09/22/2016] [Indexed: 12/17/2022] Open
Abstract
Earthquake survivors are a diverse population. This study focused on a special group of earthquake survivors, who had still stayed in temporary housing camps for about 2 years after China's Wenchuan Earthquake rather than those who moved back to rebuild their lives or immigrated to large cities to seek new lives. The research goals were to (1) assess their sleep problems as well as their PTSD, depression and anxiety and (2) examine the relationship between different dimensions of sleep quality and PTSD, depression, and anxiety among these survivors. Three-hundred and eighty seven earthquake survivors who remained in temporary housing camps and had sleep problems were recruited 17-27 months after Wenchuan Earthquake. Four standardized instruments-The Pittsburgh Sleep Quality Index, PTSD Checklist-Civilian Version, Self-rating Depression Scale, Self-rating Anxiety Scale, and face-to-face one-on-one structured interviews were used to assess these survivors' sleep quality, PTSD, depression, and anxiety. It was found that (1) 83.20% of these survivors reported having sleep problems, and 79.33% of them considered insomnia as the most common sleep problem; (2) 12.14% suffered PTSD, 36.43% experienced depression, and 38.24% had anxiety; (3) sleep disturbance, sleep medication use, and subjective sleep quality were significantly related to PTSD; (4) habitual sleep efficiency, sleep disturbance, sleep medication use, and daytime dysfunction were significantly related to depression; and (5) sleep disturbance, sleep medication use, and daytime dysfunction were significantly related to anxiety. Clinic implications of the study are discussed.
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Affiliation(s)
- Suo Jiang
- Institute of Developmental Psychology, School of Psychology, Beijing Normal UniversityBeijing, China
- Department of Applied Psychology, Wenzhou Medical UniversityWenzhou, China
| | - Zheng Yan
- Department of Educational and Counseling Psychology, University at Albany/State University of New YorkAlbany, NY, USA
| | - Pan Jing
- Department of Psychiatry, Ningbo Kangning HospitalNingbo, China
| | - Changjin Li
- Department of Applied Psychology, Wenzhou Medical UniversityWenzhou, China
| | - Tiansheng Zheng
- Department of Applied Psychology, Wenzhou Medical UniversityWenzhou, China
| | - Jincai He
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical UniversityWenzhou, China
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Warsini S, Mills J, West C, Usher K. Living through a volcanic eruption: Understanding the experience of survivors as a phenomenological existential phenomenon. Int J Ment Health Nurs 2016; 25:206-13. [PMID: 26892390 DOI: 10.1111/inm.12212] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 10/28/2015] [Accepted: 12/17/2015] [Indexed: 01/14/2023]
Abstract
Mount Merapi in Indonesia is the most active volcano in the world with its 4-6-year eruption cycle. The mountain and surrounding areas are populated by hundreds of thousands of people who live near the volcano despite the danger posed to their wellbeing. The aim of this study was to explore the lived experience of people who survived the most recent eruption of Mount Merapi, which took place in 2010. Investigators conducted interviews with 20 participants to generate textual data that were coded and themed. Three themes linked to the phenomenological existential experience (temporality and relationality) of living through a volcanic eruption emerged from the data. These themes were: connectivity, disconnection and reconnection. Results indicate that the close relationship individuals have with Mount Merapi and others in their neighbourhood outweighs the risk of living in the shadow of an active volcano. This is the first study to analyze the phenomenological existential elements of living through a volcanic eruption.
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Affiliation(s)
- Sri Warsini
- School of Nursing, Midwifery and Nutrition, James Cook University, Cairns, Queensland, Australia.,School of Nursing, Faculty of Medicine, Universitas Gadjah Mada, Sleman, Yogyakarta, Indonesia
| | - Jane Mills
- School of Nursing, Midwifery and Nutrition, James Cook University, Cairns, Queensland, Australia
| | - Caryn West
- School of Nursing, Midwifery and Nutrition, James Cook University, Cairns, Queensland, Australia
| | - Kim Usher
- School of Health, Armidale, University of New England, New South Wales, Australia
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17
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Goodwin R, Takahashi M, Sun S, Ben-Ezra M. Psychological distress among tsunami refugees from the Great East Japan earthquake. BJPsych Open 2015; 1:92-97. [PMID: 27703729 PMCID: PMC4995552 DOI: 10.1192/bjpo.bp.115.000422] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 06/30/2015] [Accepted: 08/06/2015] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The 2011 Great Japan tsunami and nuclear leaks displaced 300 000 people, but there are no large studies of psychological distress suffered by these refugees. AIMS To provide a first assessment of major factors associated with distress and dysfunctional behaviour following the disasters. METHOD All refugee families living in Miyagi were sent a questionnaire 10-12 months after the disasters. 21 981 participants (73%) returned questionnaires. Questions assessed psychological distress (Kessler Psychological Distress Scale, K6), dysfunctional behaviours, demographics, event exposure, change in physical activity, household visitors and emotional support. RESULTS Nine percent scored 13+ on the K6 indicating risk of severe mental illness. Psychological distress was greater among Fukushima refugees. Demographic variables, family loss, illness history and change in physical activity were associated with psychological distress and dysfunctional behaviours. Associations between psychological distress and dysfunction and visitors/supporters depended on relation to supporter. CONCLUSIONS Practitioners need to recognise existing disease burden, community histories and family roles when intervening following disasters. DECLARATION OF INTEREST None. COPYRIGHT AND USAGE © The Royal College of Psychiatrists 2015. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence.
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Affiliation(s)
- Robin Goodwin
- , PhD, Department of Psychology, University of Warwick, Coventry, UK
| | | | - Shaojing Sun
- , PhD, School of Journalism, Fudan University, Shanghai, China
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18
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Post-traumatic psychological changes among survivors of the Lushan earthquake living in the most affected areas. Psychiatry Res 2014; 220:384-90. [PMID: 25128250 DOI: 10.1016/j.psychres.2014.07.050] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 07/21/2014] [Accepted: 07/24/2014] [Indexed: 01/10/2023]
Abstract
The primary objective of our study was to investigate both the negative and positive psychological changes following the Lushan earthquake, and to explore the factors associated with psychological changes. Multi-stage random sampling was used to select respondents from Lushan County, Sichuan Province, China. A simplified Chinese version of the short form of Changes in Outlook Questionnaire (CiOQ-S) was used to assess psychological changes in earthquake survivors. Descriptive statistics, t-tests, ANOVA and stepwise linear regression analysis were used for data analysis. A total of 4972 respondents were investigated in the cross-sectional study. The mean scores of the positive and negative psychological changes were 26.61 and 8.12, respectively. The factors associated with positive psychological changes included ethnic minority, high level of education, high household income, not injured in the earthquake, not trapped during the earthquake, and having experienced the Wenchuan earthquake. The factors associated with negative psychological changes included female gender, ethnic minority, low household income, history of diseases, injured during the earthquake, and trapped during the earthquake. The current analysis helps expand our knowledge of the negative and positive psychological changes that may occur following an earthquake experience.
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Miyaji N. A new metaphor for speaking of trauma: the toroidal island model. VIOLENCE AND VICTIMS 2014; 29:137-151. [PMID: 24672999 DOI: 10.1891/0886-6708.vv-d-12-00108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This article provides a model for speaking of trauma based on the author's ethnographic and clinical experiences mainly in Japan. It is often assumed that a person with more serious trauma has the right and ability to speak out. But those who are at the center of trauma and unable to survive cannot testify. Based on this notion, a toroidal island (TI) model, shaped like a doughnut with a landlocked inner sea, is developed. The voices come from the survivors on the inner slope and from the supporters on the outer slope on the island. The model integrates various aspects of trauma by employing metaphors of "gravity" for symptoms of trauma, "wind" for interpersonal conflicts, and "water level" for intelligibility of the speech and its social recognition. It addresses the social construction of trauma and shows the relativistic nature of when and how some traumatic experiences are recognized. Clinical and social activity to raise awareness of unrecognized trauma can be analogized to a process of creating a TI. By defying gravity and wind and lowering the water level, they keep the voices of the traumatized from being silenced and allow their suffering to be alleviated.
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20
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Tuerk PW, Hall B, Nagae N, McCauley JL, Yoder M, Rauch SA, Acierno R, Dussich J. Forty days after the Great East Japan Earthquake: field research investigating community engagement and traumatic stress screening in a post-disaster community mental health training. Int J Psychiatry Med 2013; 45:159-74. [PMID: 23977819 PMCID: PMC4887095 DOI: 10.2190/pm.45.2.e] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The current article describes the results of posttraumatic stress educational outreach and screening offered to 141 citizens of Japan who attended a public-service mental health training regarding post-disaster coping 40 days after a 6.8 Richter Scale earthquake, local and regional deaths, and an ongoing nuclear radiation threat. Attendees were given access to anonymous questionnaires that were integrated into the training as a tool to help enhance mental health literacy and bridge communication gaps. Questionnaires were turned in by a third of those in attendance. Among respondents, multiple exposures to potentially-traumatic events were common. More than a quarter of respondents met criteria for probable PTSD. Physical health and loss of sense of community were related to PTSD symptoms. Associations and diagnosis rates represented in these data are not generalizable to the population as a whole or intended for epidemiological purposes; rather, they are evidence of a potentially useful approach to post-disaster clinical screening, education, and engagement. Results are presented in the context of previous findings in Japan and ecologically-supportive post-disaster field research is discussed.
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Affiliation(s)
- Peter W. Tuerk
- Mental Health Service Line, Ralph H. Johnson Department of Veterans Affairs Medical Center, Charleston, SC,Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Brian Hall
- Department of Mental Health; Johns Hopkins Bloomberg School of Public Health
| | - Nobukazu Nagae
- Faculty of Humanities, Fukuoka University, Fukuoka, Japan
| | - Jenna L. McCauley
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Matthew Yoder
- Mental Health Service Line, Ralph H. Johnson Department of Veterans Affairs Medical Center, Charleston, SC,Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Sheila A.M. Rauch
- VA Ann Arbor Healthcare System, Ann Arbor MI,University of Michigan Medical School, Department of Psychiatry, Ann Arbor, MI
| | - Ron Acierno
- Mental Health Service Line, Ralph H. Johnson Department of Veterans Affairs Medical Center, Charleston, SC,Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - John Dussich
- Tokiwa International Victimology Institute, Tokiwa University, Mito, Japan
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Goodwin R, Takahashi M, Sun S, Gaines SO. Modelling psychological responses to the Great East Japan earthquake and nuclear incident. PLoS One 2012; 7:e37690. [PMID: 22666380 PMCID: PMC3364293 DOI: 10.1371/journal.pone.0037690] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2011] [Accepted: 04/23/2012] [Indexed: 11/30/2022] Open
Abstract
The Great East Japan (Tōhoku/Kanto) earthquake of March 2011was followed by a major tsunami and nuclear incident. Several previous studies have suggested a number of psychological responses to such disasters. However, few previous studies have modelled individual differences in the risk perceptions of major events, or the implications of these perceptions for relevant behaviours. We conducted a survey specifically examining responses to the Great Japan earthquake and nuclear incident, with data collected 11–13 weeks following these events. 844 young respondents completed a questionnaire in three regions of Japan; Miyagi (close to the earthquake and leaking nuclear plants), Tokyo/Chiba (approximately 220 km from the nuclear plants), and Western Japan (Yamaguchi and Nagasaki, some 1000 km from the plants). Results indicated significant regional differences in risk perception, with greater concern over earthquake risks in Tokyo than in Miyagi or Western Japan. Structural equation analyses showed that shared normative concerns about earthquake and nuclear risks, conservation values, lack of trust in governmental advice about the nuclear hazard, and poor personal control over the nuclear incident were positively correlated with perceived earthquake and nuclear risks. These risk perceptions further predicted specific outcomes (e.g. modifying homes, avoiding going outside, contemplating leaving Japan). The strength and significance of these pathways varied by region. Mental health and practical implications of these findings are discussed in the light of the continuing uncertainties in Japan following the March 2011 events.
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Affiliation(s)
- Robin Goodwin
- Department of Psychology, School of Social Sciences, Brunel University, Uxbridge, Middlesex, United Kingdom.
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22
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Kyutoku Y, Tada R, Umeyama T, Harada K, Kikuchi S, Watanabe E, Liegey-Dougall A, Dan I. Cognitive and psychological reactions of the general population three months after the 2011 Tohoku earthquake and tsunami. PLoS One 2012; 7:e31014. [PMID: 22347421 PMCID: PMC3275613 DOI: 10.1371/journal.pone.0031014] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Accepted: 12/29/2011] [Indexed: 11/26/2022] Open
Abstract
Background The largest earthquake on record in Japan (magnitude 9.0) occurred on March 11, 2011, and the subsequent tsunami devastated the Pacific coast of Northern Japan. These further triggered the Fukushima I nuclear power plant accidents. Such a hugely complex disaster inevitably has negative psychological effects on general populations as well as on the direct victims. While previous disaster studies enrolled descriptive approaches focusing on direct victims, the structure of the psychological adjustment process of people from the general population has remained uncertain. The current study attempted to establish a path model that sufficiently reflects the early psychological adaptation process of the general population to large-scale natural disasters. Methods and Findings Participants from the primary disaster area (n = 1083) and other areas (n = 2372) voluntarily participated in an online questionnaire study. By constructing path models using a structural equation model procedure (SEM), we examined the structural relationship among psychological constructs known related to disasters. As post-traumatic stress symptoms (PTS) were significantly more present in people in the primarily affected area than in those in secondary- or non-affected areas, the path models were constructed for the primary victims. The parsimoniously depicted model with the best fit was achieved for the psychological-adjustment centered model with quality of life (QoL) as a final outcome. Conclusion The paths to QoL via negative routes (from negative cognitive appraisal, PTS, and general stress) were dominant, suggesting the importance of clinical intervention for reducing negative cognitive appraisal, and for caring for general stress and PTS to maintain QoL at an early stage of psychological adaptation to a disaster. The model also depicted the presence of a positive route where positive cognitive appraisal facilitates post-traumatic growth (PTG) to achieve a higher QoL, suggesting the potential importance of positive psychological preventive care for unexpected natural disasters.
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Affiliation(s)
- Yasushi Kyutoku
- Functional Brain Science Laboratory, Center for Development of Advanced Medical Technology, Jichi Medical University, Tochigi, Japan.
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Posttraumatic stress disorder of Red Cross nurses in the aftermath of the 2008 Wenchuan China Earthquake. Arch Psychiatr Nurs 2012; 26:63-70. [PMID: 22284081 DOI: 10.1016/j.apnu.2011.02.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2010] [Revised: 01/27/2011] [Accepted: 02/19/2011] [Indexed: 11/21/2022]
Abstract
This study investigated the symptoms, psychological distress characteristics, and related factors in China Red Cross disaster relief nurses following the 2008 Wenchuan Earthquake in China that began on May 12 and lasted to June 23, 2008. A sample of 210 exposed nurses and a reference group of 236 nonexposed Red Cross nurses were surveyed within 1 year after the catastrophic earthquake. They were given a self-report questionnaire to assess demographics, posttraumatic stress disorder, and depression symptoms. Exposed nurses reported higher psychological distress on all aspects than nonexposed nurses. Scores on the Traumatic Stress Symptom Checklist were predicted by the avoidance of traumatic thoughts during the earthquake, personality traits, prior disaster experience, and preexisting stress, and other background factors were associated with scores on measures of psychological distress in exposed nurses. The conclusion indicated that disaster relief nurses experienced psychological distress and that immediate psychological intervention should be initiated.
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Day KW. Violence Survivors With Posttraumatic Stress Disorder: Treatment by Integrating Existential and Narrative Therapies. ADULTSPAN JOURNAL 2011. [DOI: 10.1002/j.2161-0029.2009.tb00061.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Xu J, Liao Q. Prevalence and predictors of posttraumatic growth among adult survivors one year following 2008 Sichuan earthquake. J Affect Disord 2011; 133:274-80. [PMID: 21684612 DOI: 10.1016/j.jad.2011.03.034] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2010] [Revised: 03/16/2011] [Accepted: 03/16/2011] [Indexed: 02/06/2023]
Abstract
BACKGROUND The aim of this study was to explore prevalence and predictors of posttraumatic growth, including its relationship with PTSD symptoms among adult survivors of a severe earthquake. METHODS A stratification random sampling strategy was adopted and 2080 adult survivors of the 2008 Sichuan earthquake were surveyed. Posttraumatic Growth Inventory and Impact of Event Scale - Revised were used in the assessment of posttraumatic growth (PTG) and posttraumatic stress disorder (PTSD) symptoms, respectively. Hierarchical multiple regression analyses were used to explore the best predictors. RESULTS At one year following the earthquake, prevalence rates for posttraumatic growth and PTSD symptoms were 51.1% and 56.8%, respectively. Best predictors of posttraumatic growth were being female, younger age, higher level of education, higher degree of earthquake-related exposure and PTSD symptoms, including intrusion and hyperarousal symptoms. LIMITATIONS The limitations of this study lie in that no comparison was made due to the lack of pre-disaster data, so it is very hard to conclude to what extent did this earthquake affect the people there. Our participants were mainly workers from different fields. Survey of affected population in rural and remote areas was unavailable. More representative samples are needed to examine the generalizability of these findings. CONCLUSIONS Psychological interventions and care for survivors of Sichuan earthquake disaster should focus on females and older people who can be more affected by disasters. Besides, in order to produce positive outcomes after disasters, programs on adjustment and management of posttraumatic stress disorder symptoms should be implemented.
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Affiliation(s)
- Jiuping Xu
- Uncertainty Decision-Making Laboratory, Sichuan University, Chengdu, 610064, PR, China.
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Taku K, Calhoun LG, Tedeschi RG, Gil-Rivas V, Kilmer RP, Cann A. Examining posttraumatic growth among Japanese university students. ANXIETY STRESS AND COPING 2007; 20:353-67. [DOI: 10.1080/10615800701295007] [Citation(s) in RCA: 99] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Lu MK, Lin YS, Chou P, Tung TH. Post-traumatic stress disorder after severe burn in southern Taiwan. Burns 2007; 33:649-52. [PMID: 17482369 DOI: 10.1016/j.burns.2006.09.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2006] [Accepted: 09/26/2006] [Indexed: 11/21/2022]
Abstract
This cross-sectional study was conducted to examine the prevalence and risk factors of post-traumatic stress disorder (PTSD) after severe burn, and the need for psychological intervention for burn patients in southern Taiwan. Participants (N=82) were assessed by means of the Mini-International Neuropsychiatry Interview (MINI) scale with a structured questionnaire. Results showed that the prevalence of post-traumatic stress disorder in burn patients who met the DSM-IV criteria for PTSD was 26.8%. The risk factors related to PTSD in burn patients were: female, unmarried, and a lack of leisure arrangements after adjusting for confounding factors. PTSD patients needed more psychological intervention than the non-PTSD patients. These results suggest that PTSD after severe burn was not uncommon in southern Taiwan. The identified risk factors could provide clues to help burn care professionals provide multidisciplinary intervention.
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Affiliation(s)
- Ming-Kun Lu
- Community Medicine Research Center & Institute of Public Health, National Yang-Ming University, Taiwan
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Tang CSK. Trajectory of traumatic stress symptoms in the aftermath of extreme natural disaster: a study of adult thai survivors of the 2004 Southeast Asian earthquake and tsunami. J Nerv Ment Dis 2007; 195:54-9. [PMID: 17220740 DOI: 10.1097/01.nmd.0000242971.84798.bc] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study investigated the trajectory of traumatic stress symptoms in the aftermath of the 2004 Southeast Asian earthquake-tsunami. A total of 265 adult Thai survivors were assessed at 2 weeks and 6 months following the earthquake-tsunami. The percentages of survivors reporting traumatic stress symptoms were 22% at 2 weeks and 30% at 6 months postdisaster. Four trajectories of traumatic stress symptoms were identified: 12% of survivors presented with chronic stress symptoms, 18% had a delayed onset, 10% showed improvement, and the remaining 60% maintained a stable emotional equilibrium. Among survivors, the chronic group was the oldest, the delayed group reported the lowest level of perceived government support, and the resilient group experienced the fewest postdisaster psychiatric symptoms. Results pointed to the need to broaden the conceptualization of postdisaster stress responding as well as to establish disaster psychiatry and related mental health activities in the region.
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Tang CSK. Positive and negative postdisaster psychological adjustment among adult survivors of the Southeast Asian earthquake-tsunami. J Psychosom Res 2006; 61:699-705. [PMID: 17084149 DOI: 10.1016/j.jpsychores.2006.07.014] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2006] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study explored psychosocial factors associated with psychological adjustment among survivors of a severe natural disaster. METHODS Two hundred sixty-seven adult Thai survivors of the 2004 Southeast Asian earthquake-tsunami were surveyed. RESULTS At 6 months following the disaster, percentages of survivors who reported positive and negative adjustment were 34% and 40%, respectively. For positive adjustment, best predictors were predisaster employment, increased arousal, and frequent support seeking. Support seeking also partially mediated the association between arousal and positive adjustment. For negative adjustment, infrequent support seeking and increased intrusion and arousal were the best predictors. Arousal was a partial mediator between intrusion and negative adjustment, and support seeking also partially mediated the influence of intrusion and arousal on negative adjustment. CONCLUSION Mental health programs for survivors of natural disasters should focus on promoting active coping strategies such as support seeking, strengthening of support networks, and management of posttraumatic stress symptoms to facilitate adjustment.
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Affiliation(s)
- Catherine So-kum Tang
- Department of Psychology, The Chinese University of Hong Kong, Shatin NT, Hong Kong, People's Republic of China.
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Goto T, Wilson JP, Kahana B, Slane S. The Miyake Island Volcano Disaster in Japan: Loss, Uncertainty, and Relocation as Predictors of PTSD and Depression. JOURNAL OF APPLIED SOCIAL PSYCHOLOGY 2006. [DOI: 10.1111/j.0021-9029.2006.00091.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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