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Baziki Çetin S, Atilan Fedai Ü. Psychiatric Morbidity and Suicidal Ideation Among Early Survivors Following the 2023 Kahramanmaras Earthquake in Turkey. Psychiatry 2024; 87:165-178. [PMID: 38497597 DOI: 10.1080/00332747.2024.2321090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
OBJECTIVE The aim of this study was to investigate the effects of psychiatric morbidity along with sociodemographic and earthquake-related data on suicidal ideation among survivors of the 2023 Kahramanmaras earthquake in Turkey. METHOD The study included 270 volunteers who experienced the 2023 earthquake in Kahramanmaras, a province in middle east region of Turkey. These individuals were informed of the use of their personal data within the scope of the personal data protection law numbered 6698 and consent was obtained. The volunteers participated in the study online and were evaluated with a sociodemographic data form, Suicidal Ideation Scale and DSM-5 level one cross-sectional symptom scale. RESULTS Single individuals (p = .009) and those who stated that they had insufficient social support (p = .001), had been injured or had lost a relative during the earthquake (p = .02), felt discrimination-exclusion after the earthquake (p = .03), and those who could not attend the funeral or funeral ceremony of their deceased relative (p < .001) scored higher on the Suicidal Ideation Scale. The DSM-5 level one cross-sectional symptom scale scores indicated that the scores in the depression (p = .024), somatization (p = .001), personality (p < .001) and addiction (0.039) subscales were more related to suicidal ideation. CONCLUSION After a mass trauma, it is very important to investigate the risk factors that may be associated with suicidal ideation among survivors and to be aware of possible psychiatric symptoms. Preventive actions in the earthquake-affected regions can be made more effective by considering these factors.
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Carmassi C, Bertelloni CA, Dell'Oste V, Pedrinelli V, Fantasia S, Atti AR, Goracci A, Nanni MG, Massimetti E, Dell'Osso L, Bui E. The relationship between peritraumatic distress, mental health symptoms, and functioning impairment in healthcare workers during the COVID-19 emergency. CNS Spectr 2024:1-7. [PMID: 38327004 DOI: 10.1017/s1092852923006338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
OBJECTIVE Healthcare workers (HCWs) were considered a population at risk for developing psychiatric symptoms during the COVID-19 pandemic, such as anxiety, depression, and post-traumatic stress disorder (PTSD). Peritraumatic distress is associated with post-traumatic psychopathological symptoms; however, little is known about how it may affect functioning. The study aimed at evaluating the level of peritraumatic distress in a sample of HCWs during the first wave of the COVID-19 pandemic and at examining the relationship between peritraumatic distress, mental health symptoms, and functioning impairment. METHODS A sample of 554 frontline HCWs were consecutively enrolled in major university hospitals and community services in Italy. The PDI, IES-R, PHQ-9, and GAD-7 were used to assess peritraumatic distress, symptoms of PTSD, depression, and anxiety, respectively, and the WSAS to investigate functioning impairment. PDI scores were higher among females, community services, physicians, and nurses. Furthermore, the PDI correlated significantly with the GAD-7, PHQ-9, IES-R, and WSAS. RESULTS In a mediation analysis, the direct effect of PDI on WSAS and the indirect effects through the PHQ-9 and IES-R were statistically significant (P < .001). CONCLUSION Peritraumatic distress reported by HCWs was associated with symptoms of PTSD, depression, and anxiety, but the association with reduced functioning may be only partially mediated through symptoms of depression and PTSD.
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Affiliation(s)
- Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Valerio Dell'Oste
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Virginia Pedrinelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Sara Fantasia
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Anna-Rita Atti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Arianna Goracci
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Maria Giulia Nanni
- Department of Neurosciences and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Enrico Massimetti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Lilliana Dell'Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Eric Bui
- Department of Psychiatry Caen University of Caen, Normandy & Caen University Hospital, Caen, France
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Cénat JM, Moshirian Farahi SMM, Rousseau C, Bukaka J, Darius WP, Derivois D, Dalexis RD, Luyeye N. Prevalence and Factors Related to Post-traumatic Stress Disorder and Depression Symptoms Among Children and Adolescents Survivors and Orphans of Ebola Virus Disease in Democratic Republic of the Congo Eastern Regions During the COVID-19 Pandemic. J Adolesc Health 2023; 73:1019-1029. [PMID: 37737753 DOI: 10.1016/j.jadohealth.2023.07.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 07/16/2023] [Accepted: 07/17/2023] [Indexed: 09/23/2023]
Abstract
PURPOSE Although previous studies have shown a high prevalence of mental health problems among adult Ebola virus disease survivors, no studies have yet been conducted on mental health problems among children and adolescents in affected regions. Consequently, the current study aimed to examine the prevalence and factors associated with depression and post-traumatic stress disorder (PTSD) among children and adolescent survivors and orphans by utilizing a cross-sectional survey following the 2018-2020 epidemic in Eastern Democratic Republic of the Congo. METHODS A total of 146 survivors (mean age = 13.62, standard deviation [SD] = 2.50, 49.32% female), 233 orphans (mean age = 13.18, SD = 2.96, 53.32% female), and 34 orphan-survivor participants (mean age = 13.39, SD = 2.87, 44.12% female) were recruited. Participants completed measures assessing depression and PTSD symptoms, traumatic experiences, and stigma related to Ebola and COVID-19. RESULTS The prevalence of depression and PTSD symptoms was 87.32% and 44.42%, respectively. Results showed significant differences in depression and PTSD symptoms between orphan-survivors (100% and 97.06%), survivors (90.21% and 75.86%), and orphans (83.48% and 16.52%; χ2(2) = 9.02; p = .011 and χ2(2) = 168.85; p < .001). Experience of traumatic events, Ebola stigmatization, and COVID-19 stigmatization positively predicted depression and PTSD symptoms. The regression models explained 61%-72% of the variance of depression and PTSD. DISCUSSION The results reveal that the Ebola virus disease and its associated grief severely jeopardize the mental health of children and adolescents in affected regions. Despite the relative paucity of resources, intervention programs may be helpful to minimize associated stigma and promote psychological support.
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Affiliation(s)
- Jude Mary Cénat
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada; Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada; University of Ottawa Research Chair on Black Health, School of Psychology, University of Ottawa, Ottawa, Ontario, Canada.
| | | | - Cécile Rousseau
- Division of Social and Transcultural Psychiatry, McGill University, Montreal, Québec, Canada
| | - Jacqueline Bukaka
- Department of Psychology, University of Kinshasa, Kinshasa, DR of Congo
| | - Wina Paul Darius
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Daniel Derivois
- Department of Psychology, Université Bourgogne Franche Comté, Bourgogne, France
| | - Rose Darly Dalexis
- Interdisciplinary School of Health Sciences, University of Ottawa, Ontario, Canada
| | - Noble Luyeye
- Department of Psychology, University of Kinshasa, Kinshasa, DR of Congo
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Cénat JM, Derivois D. Addressing the Mental Health Needs and Building Resilience of Populations Affected by the Earthquakes in Turkey and Syria: Lessons From Haiti and Elsewhere. Int J Public Health 2023; 68:1605986. [PMID: 37056517 PMCID: PMC10086120 DOI: 10.3389/ijph.2023.1605986] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 03/17/2023] [Indexed: 03/30/2023] Open
Affiliation(s)
- Jude Mary Cénat
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
- *Correspondence: Jude Mary Cénat,
| | - Daniel Derivois
- Department of Psychology, Université Bourgogne Franche-Comté, Dijon, France
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Nearchou F. Self-harm in Young People: Investigating the Role of Resilience and Posttraumatic Stress Related to the COVID-19 Pandemic. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022:1-12. [PMID: 36590446 PMCID: PMC9795111 DOI: 10.1007/s40653-022-00511-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/09/2022] [Indexed: 06/17/2023]
Abstract
Evidence shows that young people may have experienced increased levels of posttraumatic stress and depression during the COVID-19 pandemic. However, the landscape on self-harm is still unclear. This study aimed to examine the role of COVID-19 related posttraumatic stress, depression and resilience as predictors of self-harm with and without suicidal intent. Participants were 625 young people aged 17-25 years old (M = 20.2 years, SD = 2.47). Resilience was measured using the self-reported Child & Youth Resilience Scale Measure - Revised (CYRM-R). Posttraumatic stress related to COVID-19 were measured using the Impact of Event Scale- Revised. Depression was measured using the depression subscale of the Depression, Anxiety and Stress Scale-21. Self-harm was evaluated with two dichotomous items. Participants reported high levels of depression and COVID-19 posttraumatic stress, and a significant percentage reported engaging in self-harm. Hierarchical logistic regressions showed that caregiver resilience decreased approximately 20% the odds of engaging in self harm with and without suicidal intent remaining a consistent predictor even after accounting posttraumatic stress and depression in the models. Posttraumatic stress and depression predicted a one-fold increase in the odds of engaging in self-harm with and without suicidal intent. However, posttraumatic stress was no longer a significant predictor when depression was entered in the model in self-harm without suicidal intent. The COVID-19 pandemic may have increased the likelihood of engaging in self-harm in young people. However, caregiver resilience seems to operate as a protective factor. This important finding carries implications beyond the context of the COVID-19 pandemic.
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Affiliation(s)
- Finiki Nearchou
- School of Psychology, University College Dublin, Newman Building, Belfield Campus, Dublin, Dublin 4 Ireland
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Thakur H, Stutts M, Choi JW, Temple JR, Cohen JR. Adolescent Loneliness during the COVID-19 Pandemic: The Role of Pre-Pandemic Risk Factors. CHILD INDICATORS RESEARCH 2022; 16:617-639. [PMID: 36310919 PMCID: PMC9589684 DOI: 10.1007/s12187-022-09984-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/10/2022] [Indexed: 05/27/2023]
Abstract
UNLABELLED The COVID-19 pandemic is a global mental health crisis that disproportionately impacts adolescents. Loneliness is a particularly salient pandemic psychosocial outcome to understand; however, research to date on this outcome is sparse and largely cross-sectional. In response, we examined pre-pandemic risk factors for pandemic loneliness. Further, we examined how risk may differ based on key demographics, and whether mediation or moderation models best explained potential disparities in experiencing loneliness. Self-reported, pre-pandemic mental health, trauma exposure, and family conflict survey data were collected at Wave 1 in a diverse sample of 369 adolescents (54.5% female, 45.5% male; 30.1% White; 30.9% Black; 18.4% Hispanic; Mage = 15.04; SD age = 1.10). Subsequently, self-reported experiences of loneliness during the pandemic were collected 6 months (April-June 2020) and 12 months (October-December 2020) later. Using a regression-based framework (i.e., PROCESS), we tested (a) which pre-pandemic risks uniquely predicted prospective loneliness and (b) whether loneliness risk was elevated for certain identities (i.e., mediation models) or whether certain identities were more sensitive to specific risks (i.e., moderation models). Overall, pre-pandemic depressive and aggression symptoms predicted early pandemic loneliness (6-month follow-up), whereas anxiety symptoms specifically predicted mid-pandemic loneliness (12-month follow-up). Environmental stressors were moderated by gender, such that females with pre-pandemic trauma exposure were more likely to report pandemic loneliness. Further, pre-pandemic internalizing distress for girls and externalizing symptoms for boys, reflected gender-specific pathways for loneliness. Implications for mental health prevention in the wake of national disasters are discussed. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s12187-022-09984-8.
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Affiliation(s)
- Hena Thakur
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL 61820 USA
| | - Morgan Stutts
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL 61820 USA
| | - Jae Wan Choi
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL 61820 USA
| | - Jeff R. Temple
- Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX USA
| | - Joseph R. Cohen
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL 61820 USA
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Wang D, You X. Post-disaster trauma and cultural healing in children and adolescents: Evidence from the Wenchuan earthquake. ARTS IN PSYCHOTHERAPY 2022. [DOI: 10.1016/j.aip.2021.101878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Cénat JM, Kokou-Kpolou CK, Mukunzi JN, Dalexis RD, Noorishad PG, Rousseau C, Derivois D, Bukaka J, Balayulu-Makila O, Guerrier M. Ebola virus disease, stigmatization, peritraumatic distress, and posttraumatic stress disorder in the Democratic Republic of the Congo: A moderated mediation model. J Affect Disord 2021; 293:214-221. [PMID: 34217958 DOI: 10.1016/j.jad.2021.06.047] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 05/31/2021] [Accepted: 06/19/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Mechanisms worsening the development of Posttraumatic stress disorder (PTSD) symptoms among individuals affected by high-mortality epidemics are unclear. This study examined the prevalence of PTSD and related risk factors among populations affected by the Ebola virus disease (EVD) outbreak, and investigated whether peritraumatic distress mediates the impact of exposure level to EVD on PTSD symptoms, and the moderation role of stigmatization. METHODS The sample included 1614 participants (50% women) affected by EVD in Democratic Republic of the Congo (DRC). Participants completed the PTSD Check-List for DSM-5, Peritraumatic Distress Inventory, and measures evaluating levels of exposure and stigmatization related to EVD. Descriptive analyses and a moderated mediation model were computed. RESULTS A total of 58.81% participants (95% CI: 56.41%; 61.21%) met PTSD diagnostic criteria. Participants living in rural areas presented greater risk, while there is no significant difference between men and women. Peritraumatic distress mediated partially the association between exposure to EVD and PTSD symptoms. Moreover, this relationship was moderated by stigmatization related to EVD. LIMITATIONS As the design was cross-sectional, this study could not examine the causality of PTSD symptoms among communities affected by EVD. CONCLUSIONS This study shows high prevalence rates and important risk factors associated with PTSD in populations affected by EVD. It indicates elements that could help to develop and implement prevention and intervention programs in affected communities.
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Affiliation(s)
| | | | | | - Rose Darly Dalexis
- Interdisciplinary School of Health Sciences, University of Ottawa, ON, Canada
| | | | - Cécile Rousseau
- Division of Social and Transcultural Psychiatry, McGill University, Montreal, Canada
| | - Daniel Derivois
- Laboratory of Psychology Psy-DREPI (EA 7458), Université Bourgogne Franche Comté, Dijon, France
| | - Jacqueline Bukaka
- Department of psychology, University of Kinshasa, Kinshasa, DR of Congo
| | - Oléa Balayulu-Makila
- Laboratory of Psychology Psy-DREPI (EA 7458), Université Bourgogne Franche Comté, Dijon, France; Department of psychology, University of Kinshasa, Kinshasa, DR of Congo
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Wang Y, Ge F, Wan M, Zhang J. Patterns of Depression and Resilience in Children and Adolescents Exposed to an Earthquake: A Latent Profile Analysis. Psychiatry Investig 2021; 18:580-588. [PMID: 34218644 PMCID: PMC8256135 DOI: 10.30773/pi.2020.0330] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 03/11/2021] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVE Depression and resilience are different psychological outcomes caused by experiencing traumatic events. We aimed to 1) explore heterogeneity patterns of co-occurrence between depression symptoms and resilience among children and adolescents exposed to an earthquake and 2) assess covariates (trauma exposure, sex, age, ethnicity, and sleep quality) in identifying the best fitting solution. METHODS Latent profile analysis (LPA) was used to examine patterns of self-reported depression and resilience in an epidemiological sample of 2,887 Chinese youth survivors 1 year after the Lushan earthquake. RESULTS A suitable 3-class model were identified, which are mild depression/high resilience (65.0%), severe depression/high resilience (22.1%), and severe depression/low resilience (12.9%). Trauma exposure, demographic characteristics and sleep state can be used to identify the different latent classes. CONCLUSION Our results contribute to understanding the heterogeneous coexisting patterns of depression and resilience and provide suggestions for identifying high-risk youth survivors and offering effective interventions.
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Affiliation(s)
- Yue Wang
- Mental Health Center of West China Hospital, Sichuan University, Chengdu Sichuan, P. R. China
| | - Fenfen Ge
- Mental Health Center of West China Hospital, Sichuan University, Chengdu Sichuan, P. R. China
| | - Mentong Wan
- Mentong Wan, Wuyuzhang Honors College, Sichuan University, Chengdu Sichuan, P. R. China
| | - Jun Zhang
- Mental Health Center of West China Hospital and Disaster Medicine Center, Sichuan University, Chengdu Sichuan, P. R. China
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Memarzia J, Walker J, Meiser-Stedman R. Psychological peritraumatic risk factors for post-traumatic stress disorder in children and adolescents: A meta-analytic review. J Affect Disord 2021; 282:1036-1047. [PMID: 33601676 DOI: 10.1016/j.jad.2021.01.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 01/03/2021] [Accepted: 01/07/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Meta-analytic reviews concerning predictors of PTSD in children and adolescents have predominantly identified evidence relating to pre- and post-trauma risk factors; however, there is little evidence regarding peritraumatic risk factors. This paper comprised a systematic review and meta-analysis of studies exploring psychological peritraumatic risk factors for PTSD in youth. METHODS Thirty-two studies were identified. Random effects meta-analyses were undertaken, with meta-regressions to explore the moderating role of study characteristics (gender, sex, timing of assessment after trauma, study quality, design and trauma type) on the size of effect of predictive factors. RESULTS Peritraumatic subjective threat (k = 28; r = 0.37, 95% CI=0.31-0.42) yielded a medium effect size estimate, while dissociation (k = 5; r = 0.17, 95% CI=0.03-0.29) and data-driven processing (feeling muddled or confused during the trauma) (k = 2; r = 0.29, 95% CI=0.14-0.43) yielded smaller population effect size estimates for the relationship with PTSD symptoms. Perceived life threat yielded a medium sized effect (k = 12; r = 0.37, 95% CI=0.32-0.41). The relationship between subjective threat and PTSD symptoms was moderated by the percentage of female participants. Estimates of heterogeneity were high in studies assessing perceived threat and fear (I2 = 95%), but moderate and low within studies assessing dissociation and data-driven processing (I2 = 57% and 0%, respectively). LIMITATIONS Peritraumatic psychological processes were commonly assessed using single-item measures. Studies primarily concerned single-incident traumas, limiting generalisability. CONCLUSIONS Peritraumatic experiences, particularly relating to subjective threat, are important correlates of subsequent PTSD, which implicates timely assessment of these experiences in youth to inform identification of at-risk groups and implementation and design of intervention.
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Affiliation(s)
- Jessica Memarzia
- Peterborough Integrated Neurodevelopmental Service, Child and Adolescent Mental Health Service, Cambridgeshire and Peterborough Foundation NHS Trust, Winchester Place, 80 Thorpe Road, Peterborough, PE3 6AP, Canada; Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, NR4 7TJ
| | - Jack Walker
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, NR4 7TJ
| | - Richard Meiser-Stedman
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, NR4 7TJ.
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Chen Y, Lam C, Deng H, Ko KY. Changes Over Time in Post-traumatic Stress Disorder Among Children Who Survived the 2008 Wenchuan Earthquake and Predictive Variables. Front Psychiatry 2021; 12:691765. [PMID: 34630174 PMCID: PMC8492922 DOI: 10.3389/fpsyt.2021.691765] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 08/18/2021] [Indexed: 02/05/2023] Open
Abstract
Background: This study examines changes over time in post-traumatic stress disorder (PTSD) among children who survived the 2008 Wenchuan earthquake and the relevant predictive variables. Methods: A total of 203 children and adolescents were investigated 24 months after the earthquake, and 151 children and adolescents completed the 1-year follow-up study. Participants completed the Children's Revised Impact of Event Scale (CRIES-13), the Center for Epidemiologic Studies Depression Scale (CES-D) and the Connor-Davidson Resilience Scale (CD-RISC). Hierarchical linear regression analysis was used to evaluate the predictors of changes in PTSD severity. Results: Eighty percent of the children still had some PTSD symptoms 2 years after the Wenchuan earthquake, and 66.25% of the children had symptoms that lasted 3 years. In the model predicting PTSD symptom severity, the loss of family members and child burial explained a significant 21.9% of the variance, and depression explained a significant 16.7% of the variance. In the model predicting changes in PTSD severity, the change scores for resilience and depression explained a significant 18.7% of the variance, and cognitive behavioral therapy (CBT) explained a significant 33.6% of the variance. Conclusions: PTSD symptoms in children and adolescents can persist for many years after trauma. In addition to using psychological interventions to improve PTSD symptoms, improvements in depression and resilience should also be considered.
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Affiliation(s)
- Ying Chen
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Chow Lam
- Department of Psychology, Illinois Institute of Technology, Chicago, IL, United States
| | - Hong Deng
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Kam Ying Ko
- Hong Kong Youth Foundation, Hong Kong, China
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Evaluating the Prevalence of PTSD among Children and Adolescents after Earthquakes and Floods: a Systematic Review and Meta-Analysis. Psychiatr Q 2020; 91:1265-1290. [PMID: 32901423 DOI: 10.1007/s11126-020-09840-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/30/2020] [Indexed: 01/06/2023]
Abstract
Our study systematically reviews articles about the prevalence of Post-traumatic Stress Disorder (PTSD) among children and adolescents, aiming to evaluate its prevalence after earthquakes and floods.Three databases (PubMed, Scopus, and Web of Science) were searched for articles published from 1981 to 2019 containing information on PTSD prevalence among survivors of earthquakes and floods. Articles with insufficient data on the prevalence of PTSD or without any available full-text were excluded. Major study variables consist of the prevalence of PTSD of the included studies, gender, and the elapsed time after the disaster. The overall PTSD prevalence was determined using a fixed-effect model for eligible studies. Of 4107 studies listed using our search strategy, 439 underwent full-text review, 59 records included in the systematic review, and 39 records met the criteria for meta-analysis. The pooled prevalence of PTSD among children and adolescent survivors after earthquakes and floods was 19.2% (95%CI = 18.6-19.7%), 30.0% (95%CI = 29.5-30.6%), 24.4% (95%CI = 23.4-25.4%) and 20.4% (95%CI = 19.1-21.7%), in the first, second, third and fourth six-month intervals after the disaster, respectively. Our analysis also revealed that PTSD was more prevalent among girls (p < 0.001). The absence of psychological support for affected areas considerably increases the risk of PTSD among survivors. Our results indicated that children and adolescents, especially girls, are more vulnerable and should be in top priority. The governments should refine their policies on post-disaster services and run early screening, immediate intervention, and ongoing monitoring for PTSD, as well as mental and emotional supports.
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Cénat JM, Smith K, Morse C, Derivois D. Sexual victimization, PTSD, depression, and social support among women survivors of the 2010 earthquake in Haiti: a moderated moderation model. Psychol Med 2020; 50:2587-2598. [PMID: 31583984 DOI: 10.1017/s0033291719002757] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
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.
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Affiliation(s)
| | - Kevin Smith
- Department of psychology, UQAM, Québec, Canada
| | | | - Daniel Derivois
- Laboratoire de Psychologie Psy-DREPI (EA 7458), Université Bourgogne Franche-Comté, Dijon, France
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Cénat JM, McIntee SE, Blais-Rochette C. Symptoms of posttraumatic stress disorder, depression, anxiety and other mental health problems following the 2010 earthquake in Haiti: A systematic review and meta-analysis. J Affect Disord 2020; 273:55-85. [PMID: 32421623 DOI: 10.1016/j.jad.2020.04.046] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 01/29/2020] [Accepted: 04/26/2020] [Indexed: 01/22/2023]
Abstract
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.
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Affiliation(s)
- Jude Mary Cénat
- School of psychology, University of Ottawa, Ontario, Canada.
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15
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Lai BS, Osborne MC, Veauuse-Brown ND, Swedo EA, Self-Brown S, Massetti GM. Violence victimization and negative health correlates of youth in post-earthquake Haiti: Findings from the cross-sectional violence against children survey. J Affect Disord 2020; 270:59-64. [PMID: 32275221 PMCID: PMC7359602 DOI: 10.1016/j.jad.2020.03.050] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 12/18/2019] [Accepted: 03/20/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND We examined the prevalence of and relationships between violence victimization and negative health correlates of Haitian youth exposed to the 2010 earthquake. METHODS Participants were randomly selected 13-24 year-old youth (1457 females; 1459 males) living in Haiti following the 2010 earthquake. Data collected via Haiti's 2012 Violence against Children Survey (VACS) were analyzed. RESULTS Participants reported violence victimization in the past 12 months (females: 49.93%; males: 41.68%), moderate-to-severe mental distress (females: 76.56%; males: 66.41%), and suicidal ideation (females: 26.79%; males: 8.05%). Compared to participants without experiences of violence, victims of violence had significantly higher mean number of sexual partners (females: 1.99, 95% CI: 1.81-2.16, p = .02; males: 4.33, 95% CI: 3.50-5.16, p = .03), mental distress (females: 80.39%, p = .01; males: 72.95%, p = .002), and suicidal ideation (females: 36.09%, p < .0001; males: 12.02%, p < .0001). Male victims of violence were more likely to have sex without a condom (26.02%, p = .01) and female victims of violence were more likely to report histories of STIs (28.04%, p = .01), when compared to participants without history of violence. LIMITATIONS Data were collected via self-report. Disaster exposure experiences were not assessed. Analysis was correlational and did not control for potential confounding variables. CONCLUSIONS Disaster-exposed youth endorsed high levels of violence victimization and negative health correlates. Earthquake survivors who experienced violence were more likely to report negative health correlates. Greater attention to downstream sequelae of natural disasters is needed.
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Affiliation(s)
- Betty S. Lai
- Lynch School of Education and Human Development, Boston College, 140 Commonwealth Ave, Chestnut Hill, MA, 02467, USA,Corresponding author. Tel.: 617.552.8026., (B.S. Lai)
| | | | | | - Elizabeth A. Swedo
- Division of Violence Prevention, Centers for Disease Control and Prevention, USA
| | | | - Greta M. Massetti
- Division of Violence Prevention, Centers for Disease Control and Prevention, USA
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Post-traumatic stress disorder, emotional and behavioral difficulties in children and adolescents 2 years after the 2012 earthquake in Italy: an epidemiological cross-sectional study. Eur Child Adolesc Psychiatry 2020; 29:227-238. [PMID: 31302773 DOI: 10.1007/s00787-019-01370-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 07/05/2019] [Indexed: 12/22/2022]
Abstract
Despite the occurrence of several earthquakes, only a few studies were conducted in Italy on the psychological impact in children and adolescents, with data mostly collected within one year after the disaster. This cross-sectional study aimed at exploring the prevalence of both post-traumatic stress disorder (PTSD) and emotional/behavioral difficulties, as well as at identifying their main predictors, among youths 2 years after the earthquake that hit Northern Italy in 2012. 682 children and adolescents (9-14 years) living in two districts (earthquake zone vs control zone) were administered an exposure questionnaire, the UCLA PTSD-Index for DSM-IV, and the Strengths and Difficulties Questionnaire (SDQ) and 1162 parents were assessed through the Symptom Checklist-90 (SCL-90). The prevalence of a likely PTSD in the earthquake zone was 1.9% (4.4% near the epicenter) and the total PTSD score in the affected area was significantly higher than in the control zone. 14.9% of youths living in the earthquake zone had a borderline/abnormal SDQ total difficulties score and 87.5% of youth with a likely PTSD also had a SDQ total score in the borderline/abnormal range. Regression analysis showed that the number of lifetime traumatic events (e.g., death of a relative) was the best predictor of children/adolescents psychological difficulties 2 years after the earthquake, followed by severity of exposure (personal injuries and losses) and parental psychopathology. Despite some limitations, this study highlights that youths may exhibit PTSD symptoms years after disasters, often in comorbidity with behavioral/emotional difficulties, stressing the need for long-term surveillance and interventions in exposed populations.
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Abstract
We aimed to assess psychiatric risk in children after admission to pediatric intensive care units (PICUs) and its association with greater psychiatric morbidity. We examined 130 children aged 6 to 13 years in a cross-sectional study divided into two groups: 65 children discharged from PICU and another 65 from general wards. The PICU group scored worse on all measured scales of psychiatric morbidities. The child-specific assessment methods included the posttraumatic stress disorder (PTSD) scale as per the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and Impact of Event Scale Revised for PTSD; Revised Children's Manifest Anxiety Scale for anxiety; and Birleson Depression Scale for depression. The PICU group had significantly higher frequencies of PTSD compared with the general ward group (84.6% vs. 6.2%, respectively; p < 0.001). Hence, PICU survivors have higher risk of psychiatric morbidities such as PTSD, anxiety, and depression compared with general ward patients.
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Joshi M, Rahill GJ, Rice C. Psychometric properties of a Haitian Kreyòl version of the trauma symptom checklist. J Affect Disord 2020; 260:238-244. [PMID: 31513967 DOI: 10.1016/j.jad.2019.09.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Revised: 07/08/2019] [Accepted: 09/01/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND In this study, the first to examine psychometrics of a Haitian Kreyòl version of the Trauma Symptom Checklist-40 (TSC-40), we investigated trauma symptoms in survivors of Haiti's 2010 earthquake who reside in Haiti's Cité Soleil slum, a violent neighborhood where non-partner sexual violence (NPSV) is rampant and whose residents are historically underrepresented in research. METHODS 233 women and 280 men 18 years or older completed the TSC-40. Differential Item Function (DIF) analysis was performed on the TSC-40 responses for women and men. We examined symptom counts by gender, between NPSV victims and non-victims, and by interaction between gender and NPSV experience. RESULTS We identified a reduced pool of 17-items that exhibited no gender bias. This 17-item index showed acceptable internal consistency reliability (α = 0.87). Employing this index, average symptom counts for women (x¯ = 11.3) did not differ from men (x¯= 11.1). Average symptom counts for NPSV victims was greater (x¯ = 12.5) than for non-victims (x¯= 10.7). The gender by experience of NPSV interaction indicated that women victims had the highest symptom counts (x¯=14.0). LIMITATIONS We used non-probability sampling, and data were from self-reports collected in a cross-sectional survey. CONCLUSIONS Observed differences in trauma burden are likely to be misleading if instruments are administered without regard to DIF. We contribute a Haitian Kreyòl Trauma Symptom 17-item index, which offers clinicians/practitioners in Haiti the opportunity to use a valid and reliable measure of enduring trauma symptoms validated in Haiti.
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Affiliation(s)
- Manisha Joshi
- University of South Florida, Tampa, FL, United States.
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19
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Cénat JM, Charles CH, Kebedom P. Multiple Traumas, Health Problems and Resilience among Haitian Asylum Seekers in Canada’s 2017 Migration Crisis: Psychopathology of Crossing. JOURNAL OF LOSS & TRAUMA 2019. [DOI: 10.1080/15325024.2019.1703610] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
| | - Carlo Handy Charles
- Department of Sociology, McMaster University, Hamilton for McMaster University, Canada
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Récits post-traumatiques dans le contexte post-séisme 2010 en Haïti. ANNALES MEDICO-PSYCHOLOGIQUES 2019. [DOI: 10.1016/j.amp.2018.07.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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21
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Derivois D, Cénat JM, Karray A, Charpillat-Richard E. Determinants of Resilience in Haitian Street Children Four Years After the January 2010 Earthquake. JOURNAL OF LOSS & TRAUMA 2019. [DOI: 10.1080/15325024.2019.1648017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Daniel Derivois
- Clinical Psychology and Psychopathology, Laboratory Psy-Drepi EA7458, Univ. Bourgogne Franche-Comté, Dijon, France
| | - Jude Mary Cénat
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Amira Karray
- Clinical Psychology and Psychopathology, Laboratory of Clinical Psychology, Psychopathology and Psychoanalysis LPCPP EA3278, Aix-Marseille Université, Marseille, France
| | - Emilie Charpillat-Richard
- Clinical Psychology and Psychopathology, Laboratory Psy-Drepi EA7458, Univ. Bourgogne Franche-Comté, Dijon, France
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22
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Vibhakar V, Allen LR, Gee B, Meiser-Stedman R. A systematic review and meta-analysis on the prevalence of depression in children and adolescents after exposure to trauma. J Affect Disord 2019; 255:77-89. [PMID: 31203106 DOI: 10.1016/j.jad.2019.05.005] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 01/31/2019] [Accepted: 05/04/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Depression is often reported as co-occurring with post-traumatic stress disorder in children and adolescents, but its prevalence within trauma-exposed child and adolescent samples is not well understood. METHODS Our meta-analyses addressed two questions: I. What is the prevalence of depression (either based on structured interview or cut-off on a self-report measure) in children and adolescents after exposure to trauma? II. Does trauma exposure increase the severity or rates of depression comparative to another comparison group of children and adolescents with milder exposure or no exposure to trauma? RESULTS Fifty-six studies reported depression prevalence. A random effects meta-analysis suggested that 24.2% [95% CI 20.6-28.0] of children and adolescents exposed to a traumatic event met criteria for depression. Our second meta-analysis across 30 studies found that the effect of trauma exposure (relative to unexposed or less exposed children and adolescents) on depression scores was medium in size (d = 0.51, 95% CI 0.41-0.61). The odds of a diagnosis of depression were 2.6 times greater [95% CI 2.0-3.3] for children and adolescents exposed to trauma as compared to those unexposed or less exposed. Participants exposed to interpersonal violence (IPV) had a higher prevalence and level of depression compared with those exposed to non-IPV trauma. LIMITATIONS Results should be interpreted with caution due to high levels of heterogeneity. CONCLUSION Depression in trauma-exposed children and adolescents is a common response to trauma that is not solely reflective of pre-traumatic difficulties. Post-traumatic depression merits serious consideration in trauma-exposed children and adolescents.
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Affiliation(s)
- Viktoria Vibhakar
- Faculty of Medicine, University of Queensland, Australia; Recover Injury Research Centre, University of Queensland, Australia; Department of Clinical Psychology, Norwich Medical School, University of East Anglia, UK.
| | - Leila R Allen
- Department of Clinical Psychology, Norwich Medical School, University of East Anglia, UK; University of Birmingham, UK.
| | | | - Richard Meiser-Stedman
- Department of Clinical Psychology, Norwich Medical School, University of East Anglia, UK.
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Abstract
PURPOSE OF REVIEW This paper reviews recent research on the depression in young people following exposure to catastrophic stresses such as disasters, terrorism and political violence. RECENT FINDINGS Depression is one of the commonest outcomes following mass trauma, for all ages including children and adolescents. Recent articles continue to report high prevalence of depression which often continues for years. It is often comorbid with other psychiatric disorders, especially PTSD. Post-traumatic depression in children and adolescence affects purpose of life, impairs scholastic achievements, increases suicidality and has extensive comorbidity. Besides the trauma, individual constructs, personality factors, social support, exposure to other traumatic events are some of the predicting factors. Biological and genetic basis of post-traumatic depression has been reported. Studies suggest some benefit to psychotherapeutic interventions such as trauma-focussed cognitive behavioural therapy and web-based therapy. A considerable proportion of youths develop depression following mass traumatic events. More research is required regarding the effectiveness of interventions in this population.
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Affiliation(s)
- Nilamadhab Kar
- Black Country Partnership NHS Foundation Trust, Steps to Health, Showell Circus, Low Hill, Wolverhampton, WV10 9TH, UK.
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Kesnold Mesidor J. Posttraumatic Growth in the 2010 Haitian Earthquake Survivors and Its Relationship With Posttraumatic Stress Symptoms Three Years After the Earthquake. JOURNAL OF LOSS & TRAUMA 2019. [DOI: 10.1080/15325024.2019.1615284] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Jean Kesnold Mesidor
- Department of Behavioral Sciences and Social Medicine, Isabel Collier Read Medical Campus, Immokalee Health Education Site, Florida State University College of Medicine, Immokalee, FL, USA
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Grelotti DJ, Gerbasi ME, Eustache E, Reginald Fils-Aimé J, Thérosmé T, Severe J, Raviola GJ, Darghouth S, Legha R, Pierre EL, Affricot E, Alcindor Y, Boyd K, Becker AE, Fawzi MCS. Prevalence of stressful life events and their association with post-traumatic stress disorder among youth attending secondary school in Haiti. Psychiatry Res 2018; 269:369-375. [PMID: 30173043 PMCID: PMC7050197 DOI: 10.1016/j.psychres.2018.08.074] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 05/28/2018] [Accepted: 08/17/2018] [Indexed: 01/03/2023]
Abstract
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.
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Affiliation(s)
- David J. Grelotti
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA,Correspondence to David J. Grelotti, MD, Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, MC 0603, La Jolla, CA 92093.
| | - Margaret E. Gerbasi
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Eddy Eustache
- Mental Health and Psychosocial Services, Zanmi Lasante, Mirebalais, Haiti
| | | | - Tatiana Thérosmé
- Mental Health and Psychosocial Services, Zanmi Lasante, Mirebalais, Haiti
| | - Jennifer Severe
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Giuseppe J. Raviola
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Sarah Darghouth
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Rupinder Legha
- Department of Psychiatry, University of California, Los Angeles, Los Angeles, CA, USA
| | - Ermaze L. Pierre
- Mental Health and Psychosocial Services, Zanmi Lasante, Mirebalais, Haiti
| | - Emmeline Affricot
- Mental Health and Psychosocial Services, Zanmi Lasante, Mirebalais, Haiti
| | - Yoldie Alcindor
- Mental Health and Psychosocial Services, Zanmi Lasante, Mirebalais, Haiti
| | | | - Anne E. Becker
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Mary C. Smith Fawzi
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
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Post-traumatic stress disorder, anxiety and depression symptoms among adolescent earthquake victims: comorbidity and associated sleep-disturbing factors. Soc Psychiatry Psychiatr Epidemiol 2018; 53:1241-1251. [PMID: 30109368 DOI: 10.1007/s00127-018-1576-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 07/30/2018] [Indexed: 12/18/2022]
Abstract
PURPOSE Our study aimed to examine the prevalence of psychiatric symptoms and their comorbidity and correlation with sleep problems among adolescent survivors 3 years after the 2013 Ya'an earthquake. METHODS A representative sample of 6132 adolescent students was analysed from 11 primary and high schools in the three counties most severely affected by the earthquake. Students were invited to complete the Pittsburgh Sleep Quality Index, Children's Revised Impact of Event Scale-13, Short Mood and Feelings Questionnaire, the Adolescent Self-Rating Life Events Checklist, and Screen for Child Anxiety-Related Emotional Disorders. RESULTS Three years after this major earthquake, 1-month prevalence of mental health problems was 13.1% for PTSD, 37.3% for anxiety, and 19.8% for depression. Among the participants who reported PTSD, 71.5% also reported anxiety, and 49.7% also reported depression. At least half of those with any type of mental health problem reported concurrent sleeping problems. Specific sleep risk factors were independently associated with increased risk of PTSD, depression or anxiety. Girls were more likely than boys to exhibit symptoms of PTSD, depression or anxiety. Older adolescents were more likely to have depression and anxiety. CONCLUSIONS Mental health problems are prevalent with high comorbidity and are associated with sleep-related problems among adolescent survivors, even years after the occurrence of a major earthquake. Nightmares and difficulty initiating sleep are independently associated with PTSD. Insufficient sleep is independently associated with anxiety and depression. Sleep-related problems may be effective targets of preventive interventions, which may need to be optimised for gender and age.
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Derivois D, Cénat JM, Karray A, Guillier-Pasut N, Cadichon JM, Lignier B, Joseph NE, Brolles L, Mouchenik Y. Resilience in Haiti: is it culturally pathological? BJPsych Int 2018; 15:79-80. [PMID: 30524126 PMCID: PMC6277951 DOI: 10.1192/bji.2017.25] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Not for the first time in recent history, the people of Haiti have been obliged to fall back on their resilience strategies in the aftermath of Hurricane Matthew. Following the powerful earthquake that struck the country on 12 January 2010, the entire population had to find the resources to survive in the face of extensive material damage and loss of life: over 222 000 dead, more than 300 000 injured and between 4000 and 7000 amputees (UNDP, 2010).
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Hiller RM, Creswell C, Meiser-Stedman R, Lobo S, Cowdrey F, Lyttle MD, Ehlers A, Halligan SL. A Longitudinal Examination of the Relationship between Trauma-Related Cognitive Factors and Internalising and Externalising Psychopathology in Physically Injured Children. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2018; 47:683-693. [PMID: 30264278 PMCID: PMC6439173 DOI: 10.1007/s10802-018-0477-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Cognitive models of posttraumatic stress disorder (PTSD) highlight maladaptive posttrauma appraisals, trauma memory qualities, and coping strategies, such as rumination or thought suppression, as key processes that maintain PTSD symptoms. Anxiety, depression and externalising symptoms can also present in children in the aftermath of trauma, yet there has been little empirical investigation of the potential relevance of posttrauma cognitive processes for such difficulties. Here, we examined whether: a) acute maladaptive cognitive processes (specifically, maladaptive appraisals, memory qualities, and cognitive coping) were associated with symptoms of PTSD, internalising, and externalising at 1-month posttrauma (T1); and b) changes in these cognitive processes predicted symptom change at a follow-up assessment 6 months later (T2). We recruited 132 6–13 year old children and their parents from emergency departments following the child’s experience of an acute trauma. Children self-reported on their maladaptive appraisals, trauma-memory and cognitive coping strategies, along with symptoms of PTSD, anxiety and depression. Parents also rated children’s internalising and externalising symptoms. We found each cognitive process to be robustly associated with PTSD and non-PTSD internalising symptoms at T1, and change in each predicted change in symptoms to T2. Maladaptive appraisals and cognitive coping were unique predictors of children’s posttrauma internalising. Effects were partially retained even controlling for co-occurring PTSD symptoms. There was less evidence that trauma-specific cognitive processes were associated with externalising symptoms. Findings suggest aspects of cognitive models of PTSD are applicable to broader posttrauma psychopathology, and have implications for how we understand and target children’s posttrauma psychological adjustment.
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Affiliation(s)
| | - Cathy Creswell
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | | | - Sarah Lobo
- Department of Psychology, University of Bath, Bath, UK
| | - Felicity Cowdrey
- Department of Psychology, University of Bath, Bath, UK.,Oxford Health NHS Foundation Trust, Cotswold House, Specialist Eating Disorder Service, Savernake Hospital, Marlborough, UK
| | - Mark D Lyttle
- Emergency Department, Bristol Royal Hospital for Children, Bristol, UK.,Faculty of Health and Applied Sciences, University of West England, Bristol, UK
| | - Anke Ehlers
- Department of Experimental Psychology, University of Oxford, Oxford, UK
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Posttraumatic Stress, Depression, and Coping Following the 2015 Nepal Earthquake: A Study on Adolescents. Disaster Med Public Health Prep 2018; 13:236-242. [PMID: 29792240 DOI: 10.1017/dmp.2018.37] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The study aimed to gather data on posttraumatic stress and depression in adolescents following the 2015 Nepal earthquake and explore the adolescents' coping strategies. METHODS In a questionnaire-based, cross-sectional study about 1 year after the earthquake, adolescents in two districts with different degrees of impact were evaluated for disaster experience, coping strategies, and symptoms of posttraumatic stress and depression measured with the Child Posttraumatic Stress Scale and the Depression Self Rating Scale. RESULTS In the studied sample (N=409), the estimated prevalence of posttraumatic stress disorder (PTSD) (43.3%) and depression (38.1%) was considerable. Prevalence of PTSD was significantly higher in the more affected area (49.0% v 37.9%); however, the prevalence figures were comparable in adolescents who reported a stress. The prevalence of depression was comparable. Female gender, joint family, financial problems, displacement, injury or being trapped in the earthquake, damage to livelihood, and fear of death were significantly associated with a probable PTSD diagnosis. Various coping strategies were used: talking to others, praying, helping others, hoping for the best, and some activities were common. Drug abuse was rare. Most of the coping strategies were comparable among the clinical groups. CONCLUSIONS A considerable proportion of adolescents had posttraumatic stress and depression 1 year after the earthquake. There is a need for clinical interventions and follow-up studies regarding the outcome. Disaster Med Public Health Preparedness. 2019;13:236-242).
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Suicidality, posttraumatic stress, and depressive reactions after earthquake and maltreatment: A cross-sectional survey of a random sample of 6132 chinese children and adolescents. J Affect Disord 2018; 232:363-369. [PMID: 29510354 DOI: 10.1016/j.jad.2018.02.081] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 02/07/2018] [Accepted: 02/25/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND Surviving an earthquake can greatly increase the risk of suicidality among children and adolescents, especially if they experience physical and emotional neglect or abuse within the family after the earthquake. How various types of childhood adversity affect the vulnerability of adolescents to suicidality after exposure to a natural disaster is not well understood. This study examined the relationships among different types of earthquake exposure, childhood trauma, psychopathology and suicidality. METHODS Suicidality, the level of earthquake exposure, post-traumatic stress disorder (PTSD), depression, and maltreatment, including physical and emotional abuse and neglect, were assessed in 6132 child and adolescent survivors randomly selected from three primary schools, five junior high schools, two senior high schools and one six-year high school in Baoxing, Lushan and Tianquan counties, which were the areas most severely affected by the 2013 Ya'an earthquake. RESULTS The Suicidal Behaviors Questionnaire-Revised (SBQ-R) scores were high, with 27.8% of the participants scoring at or above the cut-off score of 7. Multivariate regression showed that emotional abuse and depression experienced after the earthquake contributed to the suicide risk, whereas emotional neglect and PTSD made somewhat smaller contributions. The mediation analysis suggested that PTSD and depression symptoms partially mediated the association of suicidality with emotional neglect or abuse. The PTSD, depression and suicidality scores were generally higher for females than for males, whereas the depression and suicidality scores were higher for older than younger respondents. CONCLUSIONS Our results highlight the need for the implementation of school-based, adolescent-centered suicide prevention programs in the long-term aftermath of exposure to traumatic events. Interventions may also need to be tailored to gender and developmental stage. Suicidality is independently associated with emotional abuse, neglect, depression and PTSD symptoms in this disaster-exposed young population. Longitudinal studies should explore whether depression and PTSD symptoms mediate the relationship between past emotional abuse or neglect and the current suicide risk.
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Cénat JM, Derivois D, Hébert M, Amédée LM, Karray A. Multiple traumas and resilience among street children in Haiti: Psychopathology of survival. CHILD ABUSE & NEGLECT 2018; 79:85-97. [PMID: 29428880 DOI: 10.1016/j.chiabu.2018.01.024] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 01/19/2018] [Accepted: 01/28/2018] [Indexed: 06/08/2023]
Abstract
In Haiti, as in several developing countries, the phenomenon of street children has become a major public health issue. These children are often victims of traumas and adverse life events. This article aimed to investigate traumas experienced by street children and their coping and resilience strategies used to deal with adversities in a logic of survival, relying on a mixed method approach. A group of 176 street children, aged 7-18 (n = 21 girls), recruited in Port-au-Prince, completed measures assessing PTSD, social support and resilience. Semi-structured interviews were conducted to document traumatic experiences, factors related to resilience and coping strategies. After performing statistical analyses to evaluate prevalence and predictors associated with PTSD, and level of social support satisfaction and resilience, qualitative analysis using a grounded theory approach was conducted. Results showed that street children experienced multiple traumas such as neglect, maltreatment, psychological, physical and sexual abuse. However, they also showed self-efficacy to face their traumatic experiences and few of them (less than 15%) obtained scores reaching clinical rates of PTSD, while a large majority presented a level of resilience between moderate to very high. A socio-ecological model of multiple traumas and a model of coping, survival and resilience strategies are conceptualized. Data provide a better understanding of the traumas experienced by street children, their coping and resilience strategies. Results underscore ways to develop practices to offer psychological support, social and vocational integration based on the real needs of these children, in a perspective of social justice.
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Affiliation(s)
| | - Daniel Derivois
- Université de Bourgogne Franche-Comté, Laboratoire de Psychologie Psy-Drepi, EA 7458, France
| | - Martine Hébert
- Université du Québec à Montréal, Montréal, Québec, Canada
| | | | - Amira Karray
- Aix-Marseille Université, LPCPP, EA 3278, France
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Vance MC, Kovachy B, Dong M, Bui E. Peritraumatic distress: A review and synthesis of 15 years of research. J Clin Psychol 2018. [PMID: 29543336 DOI: 10.1002/jclp.22612] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
CONTEXT Although the subjective trauma exposure criterion was removed from the DSM-5 criteria set for posttraumatic stress disorder (PTSD), emerging literature suggests that peritraumatic distress may be useful in predicting outcomes after exposure to a stressful event. METHOD We conducted a comprehensive review of the literature examining the association between peritraumatic distress and PTSD and other psychiatric outcomes. The 57 studies herein varied in both experimental design and target populations. RESULTS Forty-eight studies found associations between peritraumatic distress and PTSD outcome measures, 23 found associations between peritraumatic distress and other psychiatric outcomes, and three found associations between peritraumatic distress and PTSD-related symptoms or other psychiatric outcomes after non-Criterion A stressful events by DSM-5 criteria. CONCLUSION Peritraumatic distress is associated with PTSD symptom severity, other psychiatric symptoms, and severity of PTSD-related symptoms after exposure to non-Criterion A events, suggesting that peritraumatic distress is a risk factor for various psychiatric outcomes and furthering our understanding of the impact of subjective experience on trauma psychopathology.
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Affiliation(s)
- Mary C Vance
- Institute for Healthcare Policy and Innovation, University of Michigan
| | | | | | - Eric Bui
- Harvard Medical School.,Massachusetts General Hospital
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Tang B, Deng Q, Glik D, Dong J, Zhang L. A Meta-Analysis of Risk Factors for Post-Traumatic Stress Disorder (PTSD) in Adults and Children after Earthquakes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14121537. [PMID: 29292778 PMCID: PMC5750955 DOI: 10.3390/ijerph14121537] [Citation(s) in RCA: 112] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Revised: 11/01/2017] [Accepted: 11/07/2017] [Indexed: 01/10/2023]
Abstract
PTSD is considered the most common negative psychological reactions among survivors following an earthquake. The present study sought to find out the determinants of PTSD in earthquake survivors using a systematic meta-analysis. Four electronic databases (PubMed, Embase, Web of Science, and PsycInfo) were used to search for observational studies about PTSD following earthquakes. The literature search, study selection, and data extraction were conducted independently by two authors. 52 articles were included in the study. Summary estimates, subgroup analysis, and publication bias tests were performed on the data. The prevalence of PTSD after earthquakes ranged from 4.10% to 67.07% in adults and from 2.50% to 60.00% in children. For adults, the significant predictors were being female, low education level or socio-economic status, prior trauma; being trapped, experiencing fear, injury, or bereavement during the disaster. For children, the significant predictors were being older age, high education level; being trapped, experiencing fear, injury, or bereavement, witnessing injury/death during the earthquakes. Our study provides implications for the understanding of risk factors for PTSD among earthquake survivors. Post-disaster mental health recovery programs that include early identification, on-going monitoring, and sustained psychosocial support are needed for earthquake survivors.
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Affiliation(s)
- Bihan Tang
- Department of Health Service, College of Health Service, Second Military Medical University, Shanghai 200433, China.
| | - Qiangyu Deng
- Department of Health Service, College of Health Service, Second Military Medical University, Shanghai 200433, China.
| | - Deborah Glik
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, CA 90095, USA.
| | - Junqiang Dong
- Department of Health Service, College of Health Service, Second Military Medical University, Shanghai 200433, China.
| | - Lulu Zhang
- Department of Health Service, College of Health Service, Second Military Medical University, Shanghai 200433, China.
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Cadichon JM, Lignier B, Cénat JM, Derivois D. Symptoms of PTSD Among Adolescents and Young Adult Survivors Six Years after the 2010 Haiti Earthquake. JOURNAL OF LOSS & TRAUMA 2017. [DOI: 10.1080/15325024.2017.1360585] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Baptiste Lignier
- Laboratoire Psy-DREPI, University of Bourgogne Franche-Comté, Dijon, France
| | - Jude-Mary Cénat
- Department of Sexology, University of Quebec, Montreal, Canada
| | - Daniel Derivois
- Laboratoire Psy-DREPI, University of Bourgogne Franche-Comté, Dijon, France
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Eustache E, Gerbasi ME, Smith Fawzi MC, Fils-Aimé JR, Severe J, Raviola GJ, Legha R, Darghouth S, Grelotti DJ, Thérosmé T, Pierre EL, Affricot E, Alcindor Y, Becker AE. High burden of mental illness and low utilization of care among school-going youth in Central Haiti: A window into the youth mental health treatment gap in a low-income country. Int J Soc Psychiatry 2017; 63:261-274. [PMID: 28367719 PMCID: PMC5967385 DOI: 10.1177/0020764017700174] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND The mental health treatment gap for youth in low- and middle-income countries (LMICs) is substantial; strategies for redress are urgently needed to mitigate the serious health and social consequences of untreated mental illness in youth. AIMS To estimate the burden of major depressive episode (MDE) and posttraumatic stress disorder (PTSD) as well as utilization of care among Haitian youth in order to describe the mental health treatment gap in a LMIC setting. METHODS We estimated the point prevalence of MDE, PTSD, and subthreshold variants in a school-based sample of youth ( n = 120, ages 18-22 years) using a modified Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID)-based interview and examined treatment utilization among those receiving one of these diagnoses. We assessed additional psychopathology with self-report measures to examine validity of study diagnostic assignments. RESULTS The combined prevalence of full-syndrome or subthreshold MDE or PTSD was high (36.7%). A large majority of affected individuals (88.6%) had accessed no mental health services in the health sector, and 36.4% had accessed no care of any kind in either the health or folk sectors in the past year. CONCLUSION Findings demonstrate a high mental health burden among Haiti's youth and that many youth with MDE and PTSD are not accessing mental health care.
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Affiliation(s)
- Eddy Eustache
- 1 Mental Health and Psychosocial Services, Zanmi Lasante, Mirebalais, Haiti
| | - Margaret E Gerbasi
- 2 Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Mary C Smith Fawzi
- 2 Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | | | - Jennifer Severe
- 2 Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- 3 Department of Psychiatry, Baystate Medical Center, Tufts University School of Medicine, Springfield, MA, USA
| | - Giuseppe J Raviola
- 2 Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- 4 Partners In Health, Boston, MA, USA
- 5 Department of Psychiatry, Boston Children's Hospital, Boston, MA, USA
| | - Rupinder Legha
- 6 Department of Psychiatry, University of California, Los Angeles, Los Angeles, CA, USA
| | - Sarah Darghouth
- 7 Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - David J Grelotti
- 8 Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Tatiana Thérosmé
- 1 Mental Health and Psychosocial Services, Zanmi Lasante, Mirebalais, Haiti
| | - Ermaze L Pierre
- 1 Mental Health and Psychosocial Services, Zanmi Lasante, Mirebalais, Haiti
| | - Emmeline Affricot
- 1 Mental Health and Psychosocial Services, Zanmi Lasante, Mirebalais, Haiti
| | - Yoldie Alcindor
- 1 Mental Health and Psychosocial Services, Zanmi Lasante, Mirebalais, Haiti
| | - Anne E Becker
- 2 Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- 7 Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
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Derivois D, Cénat JM, Joseph NE, Karray A, Chahraoui K. Prevalence and determinants of post-traumatic stress disorder, anxiety and depression symptoms in street children survivors of the 2010 earthquake in Haiti, four years after. CHILD ABUSE & NEGLECT 2017; 67:174-181. [PMID: 28279864 DOI: 10.1016/j.chiabu.2017.02.034] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 02/10/2017] [Accepted: 02/26/2017] [Indexed: 06/06/2023]
Abstract
Working with street children and adolescents who lived through the 2010 earthquake in Port-au-Prince, this paper aims to assess the prevalence of symptoms of PTSD, anxiety and depression in relation to peritraumatic distress, and age, and to explore other risk factors and socio-demographic characteristics, four years after the events. Between March and June 2014, with a sample of 128 children and adolescents (120 boys and 8 girls) aged between 7 and 18, of an average age of 13.88 (SD=2.15), all living on the streets of Port-au-Prince, we used the following scales: the Trauma Exposure (TE), the Life Events Subscale of the CAPS; the Peritraumatic Distress Inventory (PDI); the Children's Revised Impact of Event Scale (CRIES-13) and the Children Depression Inventory (CDI); (BAI). Our study reveals a high prevalence of PTSD, depression and anxiety among street children. It also demonstrates that this prevalence is lower than that of several other groups of children who were also victims of the 2010 earthquake in Port-au-Prince. Children living in the streets for economic reasons presented a lower prevalence of symptoms of PTSD, anxiety and depression than those who were on the streets as a result of psychological or physical abuse within their own families, in adoptive families or in children's homes. This study demonstrates the importance of care provision for these children in terms of helping them develop coping and resilience strategies. It also stresses the importance of providing them with nonviolent living environments and opportunities to facilitate their return to normality.
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Affiliation(s)
- Daniel Derivois
- Department of Psychology, Université de Bourgogne Franche-Comté, France.
| | - Jude Mary Cénat
- Department of Sexology, Université du Québec à Montréal, Québec, Canada
| | | | - Amira Karray
- Department of Clinical Psychology, Aix-Marseille Université, France
| | - Khadija Chahraoui
- Department of Psychology, Université de Bourgogne Franche-Comté, France
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Guo J, He H, Qu Z, Wang X, Liu C. Post-traumatic stress disorder and depression among adult survivors 8 years after the 2008 Wenchuan earthquake in China. J Affect Disord 2017; 210:27-34. [PMID: 28006696 DOI: 10.1016/j.jad.2016.12.009] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 10/22/2016] [Accepted: 12/12/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND The Wenchuan earthquake was China's worst natural disaster of the past three decades. Although the psychological sequelae of disasters can last for many years, the long-term sequelae and their risk factors tend to receive little research attention. OBJECTIVES The objectives of the present study were to estimate the prevalences of symptomalogical PTSD and depression among survivors 8 years after the Wenchuan earthquake, and to identify the shared and unshared risk factors associated with PTSD and depression, using data from a cross-sectional survey. METHODS 1369 participants were recruited from two different sites in the areas that were severely affected by the earthquake. Symptomalogical PTSD was assessed by the Impact of Event Scale-Revised (IES-R). The Chinese edition of the Center for Epidemiologic Studies Depression Scale (CES-D) was used to assess depression. Traumatic exposure to the Wenchuan earthquake was assessed using an exposure checklist designed by this study. RESULTS Eight years after the Wenchuan earthquake, 11.8% of the respondents had symptomalogical PTSD, and 24.8% of respondents had probable depression. The results also indicated that female gender, low education, poor perceived health, and traumatic experiences after the earthquake were associated with higher odds of both PTSD and depression among survivors. Direct exposure to the earthquake was associated with comorbid symptomalogical PTSD and depression (OR=1.86; 95% CI=1.42, 2.44). Those having only depression were more likely to be unmarried/divorced/widowed, and to have experienced fear at the time of the earthquake (OR=1.34; 95% CI=1.04, 1.72), while those with only symptomalogical PTSD were likely to be from the township of Yongan as opposed to Guangji (OR=1.86; 95% CI=1.06, 3.31). LIMITATIONS This is a cross-sectional study, and thus is insufficient for determining causal relationships with regard to chronic PTSD or depression. CONCLUSIONS The results of this study indicate that symptomalogical PTSD and depression persist among many survivors of the Wenchuan earthquake, 8 eight years later. Objective earthquake exposure is associated with symptomalogical PTSD, while subjective exposure is associated with long-term depression.
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Affiliation(s)
- Jing Guo
- School of Sociology, Huazhong University of Science and Technology, Wuhan 430074, PR China.
| | - Huan He
- Department of Public Administration, Southwestern University of Finance and Economics, Chengdou 610074, PR China
| | - Zhiyong Qu
- School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, Beijing 100875, PR China
| | - Xiaohua Wang
- School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, Beijing 100875, PR China
| | - Chengbin Liu
- School of Sociology, Huazhong University of Science and Technology, Wuhan 430074, PR China
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Cénat JM, Derivois D, Karray A. Psychopathologie de la mort et de la survivance en Haïti. ACTA ACUST UNITED AC 2017. [DOI: 10.3917/psys.171.0007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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39
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La reconstruction des enveloppes psychiques et environnementales dans les dessins d’enfants des rues en Haïti : une étude post-séisme. EVOLUTION PSYCHIATRIQUE 2017. [DOI: 10.1016/j.evopsy.2015.12.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Hong C, Efferth T. Systematic Review on Post-Traumatic Stress Disorder Among Survivors of the Wenchuan Earthquake. TRAUMA, VIOLENCE & ABUSE 2016; 17:542-561. [PMID: 26028651 DOI: 10.1177/1524838015585313] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Post-traumatic stress disorder (PTSD) widely occurs among victims or witness of disasters. With flashbacks, hyperarousal, and avoidance being the typical symptoms, PTSD became a focus of psychological research. The earthquake in Wenchuan, China, on May 12, 2008, was without precedent in magnitude and aftermath and caused huge damage, which drew scientists' attention to mental health of the survivors. We conducted a systematic overview by collecting published articles from the PubMed database and classifying them into five points: epidemiology, neuropathology, biochemistry, genetics and epigenetics, and treatment. The large body of research during the past 6 years showed that adolescents and adults were among the most studied populations with high prevalence rates for PTSD. Genomic and transcriptomic studies focusing on gene × environment studies as well as epigenetics are still rare, although a few available data showed great potential to better understand the pathophysiology of PTSD as multifactorial disease. Phytotherapy with Chinese herbs and acupuncture are rarely reported as of yet, although the first published data indicated promising therapy effects. Future studies should focus on the following points: (1) The affected populations under observation should be better defined concerning individual risk factor, time of observation, spatial movement, and individual disease courses of patients. (2) The role of social support for prevalence rates of PTSD should be observed in more detail. (3) Efficacy and safety of Chinese medicine should be studied to find potential interventions and effective treatments of PTSD.
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Affiliation(s)
- Chunlan Hong
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Mainz, Germany
| | - Thomas Efferth
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Mainz, Germany
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Brolles L, Derivois D, Joseph NE, Karray A, Guillier Pasut N, Cénat JM, Pamphile J, Lafontant EM, Alexandre MR, Felix G, Chouvier B. Art workshop with Haitian street children in a post-earthquake context: Resilience, relationship and socialisation. INTERNATIONAL JOURNAL OF ART THERAPY 2016. [DOI: 10.1080/17454832.2016.1245768] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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42
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Dai W, Chen L, Lai Z, Li Y, Wang J, Liu A. The incidence of post-traumatic stress disorder among survivors after earthquakes:a systematic review and meta-analysis. BMC Psychiatry 2016; 16:188. [PMID: 27267874 PMCID: PMC4895994 DOI: 10.1186/s12888-016-0891-9] [Citation(s) in RCA: 100] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Accepted: 05/27/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) is a common psychological disorder caused by unusual threats or catastrophic events. Little is known about the combined incidence of PTSD after earthquakes. This study aimed at evaluating the combined incidence of PTSD among survivors after earthquakes using systematic review and meta-analysis. METHODS The electronic databases of PubMed, Embase, Web of Science and PsycARTICLES were searched for relevant articles in this study. Loney criteria were used to assess the quality of eligible articles. The combined incidence of PTSD was estimated by using the Freeman-Tukey double arcsine transformation method. Subgroup analyses were conducted using the following variables: the time of PTSD assessment, gender, educational level, marital status, damage to one's house, bereavement, injury of body and witnessing death. RESULTS Forty-six eligible articles containing 76,101 earthquake survivors met the inclusion criteria, of which 17,706 were diagnosed as having PTSD. Using a random effects model, the combined incidence of PTSD after earthquakes was 23.66 %. Moreover, the combined incidence of PTSD among survivors who were diagnosed at not more than 9 months after earthquake was 28.76 %, while for survivors who were diagnosed at over nine months after earthquake the combined incidence was 19.48 %. A high degree of heterogeneity (I(2) = 99.5 %, p<0.001) was observed in the results, with incidence ranging from 1.20 to 82.64 %. The subgroup analyses showed that the incidence of PTSD after earthquake varied significantly across studies in relation to the time of PTSD assessment, gender, educational level, damage to one's house, bereavement, injury of body and witnessing death. However, stratified analyses could not entirely explain the heterogeneity in the results. CONCLUSIONS Given the high heterogeneity observed in this study, future studies should aim at exploring more possible risk factors for PTSD after earthquakes, especially genetic factors. In spite of that, the results of this study suggest that nearly 1 in 4 earthquake survivors are diagnosed as having PTSD. Therefore, the local government should plan effective psychological interventions for earthquake survivors.
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Affiliation(s)
- Wenjie Dai
- Department of Epidemiology and Health Statistics, School of Xiangya Public Health, Central South University, Changsha, China
| | - Long Chen
- Department of Epidemiology and Health Statistics, School of Xiangya Public Health, Central South University, Changsha, China ,Zhuhai Center for Disease Control and Prevention, Zhuhai, China
| | - Zhiwei Lai
- Department of Epidemiology and Health Statistics, School of Xiangya Public Health, Central South University, Changsha, China
| | - Yan Li
- Department of Epidemiology and Health Statistics, School of Xiangya Public Health, Central South University, Changsha, China
| | - Jieru Wang
- Department of Epidemiology and Health Statistics, School of Xiangya Public Health, Central South University, Changsha, China ,Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, USA
| | - Aizhong Liu
- Department of Epidemiology and Health Statistics, School of Xiangya Public Health, Central South University, Changsha, China.
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Cénat JM, Derivois D, Hébert M, Eid P, Mouchenik Y. Psychometric properties of the Haitian Creole version of the Resilience Scale with a sample of adult survivors of the 2010 earthquake. Compr Psychiatry 2015; 63:96-104. [PMID: 26555497 DOI: 10.1016/j.comppsych.2015.09.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 09/02/2015] [Accepted: 09/05/2015] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Resilience is defined as the ability of people to cope with disasters and significant life adversities. The present paper aims to investigate the underlying structure of the Creole version of the Resilience Scale and its psychometric properties using a sample of adult survivors of the 2010 earthquake. METHODS A parallel analysis was conducted to determine the number of factors to extract and confirmatory factor analysis was performed using a sample of 1355 adult survivors of the 2010 earthquake from people of specific places where earthquake occurred with an average age of 31.57 (SD=14.42). All participants completed the Creole version of Resilience Scale (RS), the Impact of Event Scale Revised (IES-R), the Beck Depression Inventory (BDI) and the Social Support Questionnaire (SQQ-6). To facilitate exploratory (EFA) and confirmatory factor analysis (CFA), the sample was divided into two subsamples (subsample 1 for EFA and subsample 2 for CFA). RESULTS Parallel analysis and confirmatory factor analysis results showed a good-fit 3-factor structure. The Cronbach α coefficient was .79, .74 and .72 respectively for the factor 1, 2 and 3 and correlated to each other. Construct validity of the Resilience scale was provided by significant correlation with measures of depression and social support satisfaction, but no correlation was found with posttraumatic stress disorder measure, except for factor 2. CONCLUSIONS The results reveal a different factorial structure including 25 items of the RS. However, the Haitian Creole version of RS is a valid and reliable measure for assessing resilience for adults in Haiti.
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Affiliation(s)
- Jude Mary Cénat
- Department of Sexology, Université du Québec à Montréal, Montréal, Québec.
| | - Daniel Derivois
- Department of Psychology, Université de Bourgogne Franche-Comté
| | - Martine Hébert
- Department of Sexology, Université du Québec à Montréal, Montréal, Québec
| | - Patricia Eid
- Department of Psychology, Education and Physical Education, Notre Dame University - Louaize, Lebanon
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Kaiser BN, Kohrt BA, Wagenaar BH, Kramer MR, McLean KE, Hagaman AK, Khoury NM, Keys HM. Scale properties of the Kreyòl Distress Idioms (KDI) screener: association of an ethnographically-developed instrument with depression, anxiety, and sociocultural risk factors in rural Haiti. ACTA ACUST UNITED AC 2015. [DOI: 10.1080/17542863.2015.1015580] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Zhang J, Zhu S, Du C, Zhang Y. Posttraumatic stress disorder and somatic symptoms among child and adolescent survivors following the Lushan earthquake in China: A six-month longitudinal study. J Psychosom Res 2015; 79:100-6. [PMID: 26080620 DOI: 10.1016/j.jpsychores.2015.06.001] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2014] [Revised: 06/01/2015] [Accepted: 06/03/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To explore somatic conditions in a sample of 2299 child and adolescent survivors of an earthquake and their relationship to posttraumatic stress disorder (PTSD) symptoms. METHODS The Children's Revised Impact of Event Scale, the Patient Health Questionnaire (PHQ)-13 scale, a short version of PHQ-15 scale that omits two items involving sexual pain/problems and menstrual problems, and a project-developed questionnaire were administered to participants three and six months after the earthquake. RESULTS Among child and adolescent survivors, the prevalence rates of probable PTSD were 37.4 and 24.2% three and six months, respectively, after the earthquake. The most common somatic symptoms were trouble sleeping (58.4 and 48.4%), feeling tired or having low energy (52.0 and 46.1%), and stomach pain (45.8 and 45.4%) after three and six months, respectively. Several specific somatic symptoms evaluated three months after the earthquake including trouble sleeping, headache, and shortness of breath were predictors of the overall PTSD symptoms evaluated six months after the earthquake. Additionally, the symptom of hyperarousal evaluated after three months could predict the overall somatic symptoms evaluated after six months. CONCLUSIONS PTSD and somatic symptoms were common after the earthquake, and a longitudinal association between PTSD and somatic symptoms was detected among child and adolescent survivors. These findings have implications in China and possibly elsewhere.
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Affiliation(s)
- Jun Zhang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu 610041, China.
| | - Shenyue Zhu
- Baoxing County Education Bureau, Yaan 625700, China.
| | - Changhui Du
- Chengdu Center of Disease Control, Chengdu 610041, China.
| | - Ye Zhang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu 610041, China.
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