Long-Term Impact of Parental Post-Traumatic Stress Disorder Symptoms on Mental Health of Their Offspring After the Great East Japan Earthquake

Grief is a family affair: examining longitudinal associations between prolonged grief in parents and their adult children using four-wave cross-lagged panel models

BACKGROUND

Losing a parent or spouse in adulthood may result in prolonged grief disorder (PGD) symptoms. PGD levels in parents may affect PGD levels in their adult offspring and the other way around. However, research on transmission of PGD in parent-child dyads is lacking. Consequently, we aimed to examine temporal associations between PGD levels in parent and adult children.

METHODS

In doing so, we analyzed longitudinal self-report data on PGD levels (using the PG-13) assessed at 2, 11, 18, and 26 months after loss in 257 adult parent-child dyads from Denmark. Cross-lagged panel modeling was used for data-analyses.

RESULTS

Changes in PGD levels in parents significantly predicted PGD levels in adult children, but not vice versa. Small through moderate cross-lagged effects (β = 0.05 through 0.07) were found for PGD levels in parents predicting PGD levels in adult children at a subsequent time-point. These cross-lagged effects were found while taking into account the association between PGD levels in parents and adult children at the same time-point as well as the associations between the same construct over time and relevant covariates.

CONCLUSIONS

Pending replication of these findings in clinical samples and younger families, our findings offer tentative support for expanding our focus in research and treatment of PGD from the individual to the family level.

Mental Health Disorders Due to Disaster Exposure: A Systematic Review and Meta-Analysis

Natural disasters are complex, global issues that affect people individually, families, and communities, upsetting their emotional wellbeing. This research aims to comprehend the connections between disasters and their effects on mental health. We conducted a systemic review and meta-analysis on the effect of disasters on mental health disorders using defined search terms across three major databases. The search technique adhered to the PECO framework. The study locations were dispersed across Asia, Europe, and America. An electronic search was established in the Cochrane Central Register of Controlled Trials in the Cochrane Library, PubMed, and Medline databases. A random-effects meta-analysis was carried out. The I² statistic was used to explore heterogeneity. In the random-effects analysis, Tau-squared, τ², or Tau² evaluates the effects seen between the study variances. Publication bias was examined. The outcomes of the included studies on mental health issues (n = 48,170) brought on by catastrophic disasters were pooled using a random-effects meta-analysis. The three main mental health illnesses attributed to the disaster catastrophe in most studies were generalized anxiety disorder (GAD), depression, substance use, adjustment disorder, and post-traumatic stress disorder (PTSD). Storms, including cyclones and snowstorms, had an impact on 5,151 individuals. 38,456 people were harmed by flooding, and 4,563 people were affected by the earthquake. The included studies showed prevalence rates for mental health disorders ranging from 5.8% to 87.6%. The prevalence rates were between 2.2% and 84% for anxiety, 3.23% and 52.70% for depression, and 2.6% and 52% for PTSD, respectively. The point effect estimates of studies included the flood, storm/cyclone, and earthquake were 0.07 (95% confidence interval [CI]: 0.02-0.12), 0.18 (95% CI: 0.03-0.32), and 0.15 (95% CI: 0.03-0.27), respectively, which revealed a statistically significant positive effect (p-value: < 0.05) with a narrow 95% CI indicating more precise population estimates. However, the pooled effect estimates were not of a large effect size of 0.129 (95% CI: 0.05-0.20). This study found a link between disaster and poorer outcomes for mental health. The risk of psychological morbidity and fatalities increased with relocation and disruption of essential services. Flooding was the most frequent calamity. The "medium human development countries" were found to have the highest prevalence rate of mental health disorders in our meta-analysis. The "very high human development" and "high human development" nations, however, also had a higher prevalence rate of mental health disorders following catastrophic events. This study could aid in the creation of thorough strategies for the mitigation and avoidance of mental health problems during natural disasters. Increased community resilience, improved access to healthcare services, and a suitable mitigation strategy can all help to improve the situation of the disaster's vulnerable population.

Psychological distress in children and adolescent disaster survivors

BACKGROUND

This study aimed to clarify the association between mental and behavioral changes and subsequent psychological distress among children and adolescents living in areas affected by the 2011 Great East Japan Earthquake.

METHODS

We conducted a two-wave study, with waves 1 and 2 occurring in 2011 and 2014, respectively. Data of 462 respondents aged 9-14 years during wave 1 and who participated in both surveys were used in the present analysis. A factor analysis was performed using the mental and behavioral changes reported by respondents in wave 1. Psychological distress was defined as a score of ≥5 on the six-item Kessler Psychological Distress Scale, as measured in wave 2. With the factors generated in this analysis set as independent variables, the odds ratios (OR) (95% confidence intervals, 95% CIs) for psychological distress were calculated using logistic regression, adjusting for age, sex, house damage, living environment, and loss of family or friends.

RESULTS

Psychological distress was present in 108 (23.4%) of the respondents. The factor analysis yielded three factors describing mental and behavioral changes: interpersonal issues, brain fog, and anxiety and panic. Of these, interpersonal issues were significantly associated with subsequent psychological distress, with an OR of 2.59 (95% CI 1.58-4.25). This association did not change even when stratified by age and sex.

CONCLUSIONS

This study suggests that interpersonal issues are a significant predictor of psychological distress in children and adolescents living in areas affected by a large-scale disaster.

Evaluating the relationship between family resilience and grief-related symptoms: A preliminary analysis

Walsh's Family Resilience Framework offers clinicians a comprehensive theoretical approach for supporting bereaved families. In this study, a total of 139 bereaved adults who lost a family member in the last 5 years were surveyed about their family's resilience processes, their current outlook on life, and their current grief-related symptoms. The data from this sample were analyzed using confirmatory factor analysis and structural regression. Family resilience processes were negatively related to grief symptoms; however, this relationship was mediated by personal meaning. The results suggest that Walsh's Family Resilience Framework may be an appropriate conceptual tool to assess family resilience in bereavement practice.

Parental Internalizing Psychopathology and PTSD in Offspring after the 2012 Earthquake in Italy

Post-traumatic stress disorder (PTSD) is common in youths after earthquakes, with parental psychopathology among the most significant predictors. This study investigated the contribution and the interactional effects of parental internalizing psychopathology, the severity of exposure to the earthquake, and past traumatic events to predict PTSD in offspring, also testing the reverse pattern. Two years after the 2012 earthquake in Italy, 843 children and adolescents (9-15 years) living in two differently affected areas were administered a questionnaire on traumatic exposure and the UCLA PTSD Reaction Index. Anxiety, depression, and somatization were assessed in 1162 parents through the SCL-90-R. General linear model showed that, for offspring in the high-impact area, predictors of PTSD were earthquake exposure, past trauma, and parental internalizing symptoms, taken individually. An interaction between earthquake exposure and parental depression or anxiety (not somatization) was also found. In the low-impact area, youth PTSD was only predicted by earthquake exposure. The reverse pattern was significant, with parental psychopathology explained by offspring PTSD. Overall, findings support the association between parental and offspring psychopathology after natural disasters, emphasizing the importance of environmental factors in this relationship. Although further research is needed, these results should be carefully considered when developing mental health interventions.

Disruption of Child Environments and Its Psychological Consequences After the Fukushima Disaster: a Narrative Review Based on the Ecological Systems Model

PURPOSE OF REVIEW

A high prevalence of clinically significant mental health problems was found in children affected by the Fukushima disaster in Japan. We reviewed the literature on child mental health to examine how disasters impacted children in Fukushima.

RECENT FINDINGS

Children's environments, such as family and peer systems, were disrupted by radiation concerns and evacuation. As children struggled with less resources at home and school, they also had to deal with discrimination. Various interventions were implemented, ranging from government financial assistance to several mental health services provided by local care resources to families and children. In addition to organizing such interventions discretely in each microsystem, a collaborative approach involving various intervening entities across multiple levels was deemed necessary for providing comprehensive support to the affected children and their families. To promote the healthy psychological development of children, it is necessary to provide multidimensional support for their families, particularly parents, through multidisciplinary collaboration between professionals involved in child and family care.

The mental health status of children who have been evacuated or migrated from rural areas in Fukushima prefecture after the Fukushima daiichi nuclear power station accident:results from the Fukushima health management survey

INTRODUCTION

We evaluated the mental health status of children residing in Kawauchi village (Kawauchi), Fukushima Prefecture, after the 2011 accident at the Fukushima Daiichi Nuclear Power Station, based on the children's experience of the nuclear disaster.

METHODS

We conducted this cross-sectional study within the framework of the Fukushima Health Management Survey (FHMS);FHMS data on age, sex, exercise habits, sleeping times, experience of the nuclear disaster, and the "Strengths and Difficulties Questionnaire (SDQ)" scores for 156 children from Kawauchi in 2012 were collected. Groups with and without experience of the nuclear disaster - "nuclear disaster (+)" and "nuclear disaster (-)" - were also compared.

RESULTS

Our effective response was 93 (59.6%);the mean SDQ score was 11.4±6.8 among elementary school-aged participants and 12.4±6.8 among junior high school-aged ones. We statistically compared the Total Difficulties Scores (TDS) and sub-item scores of the SDQ between "elementary school" and "junior high school" or "nuclear disaster" (+) and (-). There was no significant difference between these items.

CONCLUSIONS

We found indications of poor mental health among elementary and junior high school-aged children in the disaster area immediately following the accident, but no differences based on their experience of the nuclear disaster. These results indicate the possibility of triggering stress, separate to that from experiences related to the nuclear disaster, in children who lived in affected rural areas and were evacuated just after the nuclear disaster.

The Association between Child and Parent Psychiatric Disorders in Families Exposed to Flood and/or Dioxin

Associations of disaster mental health sequelae between children and their parents have been demonstrated, but not using full diagnostic assessment. This study examined children and their parents after a series of disasters in 1982 to investigate associations of their psychiatric outcomes. Members of 169 families exposed to floods and/or dioxin or no disaster were assessed in 1986–1987 with structured diagnostic interviews. This vintage dataset collected several decades ago provides new information to this field because of the methodological rigor that is unparalleled in this literature. Disaster-related PTSD and incident postdisaster disorders in children were associated, respectively with disaster-related PTSD and incident postdisaster disorders in the chief caregiver and mother. More flood-only than dioxin-only exposed parents reported great harm by the disaster, but neither children nor parents in these two groups differed in incident psychiatric disorders. Although this study did not determine the direction of causal influences, its findings suggest that clinicians working with disaster-exposed families should work with children and adult members together, as their mental health outcomes may be intertwined.