Post-traumatic Stress and Depressive Symptoms Among Adolescents After the 2015 Earthquake in Nepal: A Longitudinal Study

Gray matter atrophy in the middle frontal gyrus mediates post-traumatic stress symptoms in post-kidney transplant patients: The role of elevated urea levels

BACKGROUND

Kidney transplant recipients (KTRs) face numerous stressors including the risk of graft rejection, life-threatening infections, and long-term immunosuppressive therapy, which often contribute to post-traumatic stress symptoms (PTSS) that significantly impair psychological well-being and recovery. While there is evidence linking PTSS to brain gray matter volume (GMV), research on KTR populations remains limited. Additionally, most transplanted kidneys fail to recover completely and cannot function at the level of kidneys in healthy individuals, with evidence indicating consequent neurotoxic effects. However, the relationship between renal function, brain GMV, and PTSS remains poorly understood.

METHODS

A cohort of KTRs was assessed for PTSS using the Impact of Event Scale-Revised (IES-R), and 3D-T1 magnetic resonance imaging (MRI) scans were analyzed using voxel-based morphometry to measure GMV. Renal function was also quantified, and regression and mediation analyses were conducted to explore the relationship between renal function, GMV, and PTSS.

RESULTS

The analysis revealed significant reductions in GMV in the prefrontal cortex regions of KTRs with higher PTSS scores. Elevated urea levels were correlated with both reduced GMV and increased PTSS severity. Notably, mediation analysis indicated that decreased GMV mediated the relationship between high urea levels and increased PTSS.

CONCLUSION

This study provides novel evidence linking elevated urea levels with increased PTSS via decreased GMV in the frontal lobe of KTRs. These findings suggest that GMV changes may serve as biomarkers for PTSS in KTRs, and that urea levels may be a contributing factor to GMV alterations and PTSS.

Trauma Level of Midwifery Students After the Catastrophe of the Century Turkey Earthquake: A Cross-Sectional Descriptive Study

OBJECTIVE

Earthquakes deeply affect people's lives and cause significant psychological damage. This study was conducted to determine the trauma level of midwifery students after the devastating earthquake in Turkey.

METHODS

A descriptive cross-sectional study was conducted with 252 students enrolled in the midwifery department of the Faculty of Health Sciences of a state university in Turkey. Data were collected using the participant information form and the Scale for Determining the Level of Post-Earthquake Trauma. Kruskal-Wallis and Mann-Whitney U tests were used for data analysis.

RESULTS

This study found that post-earthquake, students had trauma levels and sub-dimension scores related to behavioral problems, excitement limitation, affective and cognitive structuring, and sleep problems that were above average. The research revealed that students who were present in one of the earthquake-affected provinces, experienced house destruction, suffered the loss of relatives, had previous traumatic events, or received disaster management training had significantly higher levels of trauma.

CONCLUSIONS

In this direction, it is of utmost importance for university students in midwifery departments to be prepared for natural disasters like earthquakes. This preparedness will enable them to effectively cope with the physical and psychological issues caused by such disasters, benefiting both their own health and public health.

Investigation of Posttraumatic Stress and Depression Symptoms in Children Who Experienced the Kahramanmaraş Earthquake

BACKGROUND

Trauma is important in the etiology of many problems including childhood anxiety, somatization, hostility and sleep disturbance.

AIMS

This study was conducted to examine the posttraumatic stress and depression symptoms of children who experienced the Kahramanmaraş earthquakes in Turkey.

METHODS

The research, designed as a descriptive and relational type, was conducted with 636 children in the 10 to 18 age group who experienced the earthquake. Data were obtained through the Child Information Form, the Child Posttraumatic Stress Disorder Reaction Index (CPTSD-RI), and the Depression Inventory for Children.

RESULTS

According to the scale scores, 100% of the children had depression symptoms, while 23% had severe trauma and 77% had very severe posttraumatic stress symptoms. It was revealed that children's posttraumatic stress reactions explained 71% of their depression (p < .001). It has been determined that the most important triggers affecting children's posttraumatic stress reactions were being trapped under debris and the problems they experienced in reaching shelter and assistance (B: -3.706; B: -1.547; B: 3.969).

CONCLUSIONS

It was determined that there was a strong relationship between posttraumatic stress reactions and depression symptoms of children who experienced the earthquake. It has been observed that the experiences of children during and after the earthquake can have an impact on their trauma situations.

El Niño-driven flooding and mental health symptomology among adolescents and young adults in Peru

Intensifying storms and inter-annual El Niño events may increase psychological stress and worsen mental health. This study examines the relationship between flood exposure and long-term mental health symptoms among adolescents and young people in Peru, the world's most affected country by El Niño. We analyzed community and self-reported survey data from the Young Lives Study to contrast mental health in 2016 among youth who lived in communities that experienced or did not experience flooding between 2013 and 2016. We pre-processed data on 1344 individuals in 93 communities, using optimal full matching on Mahalanobis distance with a propensity score caliper, and estimated relative risks to mental health scores in the general population of young people and among gender-stratified groups via quasi-Poisson regression. Exposure to floods did not yield conclusive differences in mental health scores in this sample. Further evidence is needed on mental health patterns over time, the influence of exposure severity, and the impact of disaster relief on symptomology in mounting an effective global health response.

Coping Mechanisms and Posttraumatic Stress Exhibited by Children in Areas of Yemen's Armed Conflict in Southern Saudi Arabia

This study is an attempt to explore war-related trauma, its stressful effects, and the coping strategies of Saudi schoolchildren. The authors hypothesized that children exposed to war-related trauma will show higher levels of PTSD, and that those with higher levels of PTSD symptoms use more maladaptive coping strategies. The study describes the correlation between traumatic events and posttraumatic stress disorder (PTSD) as well as coping strategies. Five hundred twenty-seven intermediate and high school students, 12 to 18 years old, living in the conflict zone in southern Saudi Arabia completed three standardized self-reported scales: the War Zone Traumatic Events Checklist, the Child PTSD Symptom Scale, and the Children's Coping Strategies Checklist. Each participating student was randomly chosen. Analysis was based on two groups: the high-PTSD symptoms group (182 children) and the low-PTSD symptoms group (345 children). The study was conducted between September 2020 and April 2022 while the war was ongoing as part of an ongoing larger study. Children exposed to war-related traumatic events exhibited greater prevalence rates for PTSD. The children reported high levels of PTSD symptoms and applied a variety of coping strategies to manage related stress. Participants rarely reported that psychological or educational interventions had been used to manage the war-related traumatic experiences and PTSD or to improve related coping styles. The results are discussed in the context of mental health services needed for children in the conflict zone. To bridge the gap between health care services and the needs of children with PTSD, and for better understanding and interventions, health professionals are invited to develop a biopsychosocial model that identifies the risks of PTSD related to exposure to war-related traumatic events in school-aged children and, hence, provide a multidisciplinary intervention program that educates, encourages, and supports teachers and parents in following medical recommendations and goals.

Experiences of adolescents affected by earthquakes: A qualitative study

PURPOSE

The aim of the study is to explore the experiences of adolescents affected by the earthquake.

DESIGN AND METHODS

This study was carried out in a descriptive phenomenological design, which is a qualitative research method. This research was conducted as a qualitative investigation utilizing a phenomenological approach to explore the experiences of 12 adolescents through the purposeful snowball sampling method. The interviews were conducted with adolescents who affected by the Kahramanmaraş earthquakes in a city located in the west of the country, between March 18, 2023 and June 30, 2023. Semistructured interviews were employed, and the data underwent inductive content analysis. COREQ reporting guidelines were used.

RESULTS

The participants in this study vividly recounted experiencing intense fear and panic during the earthquake. Subsequent challenges emerged from the lack of coordination in aid efforts, struggles to secure shelter and necessities, and the profound loss of relatives. These adversities posed considerable physical and psychological challenges. Notably, the adolescents' ability to reflect on their past lives and reshape their perspectives proved instrumental in facilitating their adaptation to a new life. However, witnessing the demise of loved ones, grappling with the fear of death and loss, and incessantly discussing the earthquake hindered their adjustment.

PRACTICE IMPLICATIONS

We found that adolescents experienced the quakes in three phases: in the moment, postquake, and adaptation to new life. The first theme underscores the limitations of current effectiveness of quake training. This finding has important implications for policy to better prepare the adolescent population for quake disasters. The second theme reveals that the communication and coordination problems experienced after the earthquake enable the weaknesses of the system to be noticed and political steps should be taken in this direction. The third theme focuses on the factors that increase or decrease the psychosocial adaptation of adolescents who have experienced this traumatic experience to the new life. This provides important clues to improve and support adolescent health.

Longitudinal patterns of natural hazard exposures and anxiety and depression symptoms among young adults in four low- and middle-income countries

We estimated the effect of community-level natural hazard exposure during prior developmental stages on later anxiety and depression symptoms among young adults and potential differences stratified by gender. We analyzed longitudinal data (2002-2020) on 5585 young adults between 19 and 26 years in Ethiopia, India, Peru, and Vietnam. A binary question identified community-level exposure, and psychometrically validated scales measured recent anxiety and depression symptoms. Young adults with three exposure histories ("time point 1," "time point 2," and "both time points") were contrasted with their unexposed peers. We applied a longitudinal targeted minimum loss-based estimator with an ensemble of machine learning algorithms for estimation. Young adults living in exposed communities did not exhibit substantially different anxiety or depression symptoms from their unexposed peers, except for young women in Ethiopia who exhibited less anxiety symptoms (average causal effect [ACE] estimate = - 8.86 [95% CI: - 17.04, - 0.68] anxiety score). In this study, singular and repeated natural hazard exposures generally were not associated with later anxiety and depression symptoms. Further examination is needed to understand how distal natural hazard exposures affect lifelong mental health, which aspects of natural hazards are most salient, how disaster relief may modify symptoms, and gendered, age-specific, and contextual differences.

Symptoms Description of Family Post Traumatic Stress Disorder of the Mount Merapi Eruption Disaster Victims during Covid19

BACKGROUND: Volcano disaster can cause psychological problems such as Post Traumatic Stress Disorder (PTSD). PTSD is an anxiety disorder caused by a scary or frightening, unpleasant and challenging event or experience with physical abuse or threatened feeling. AIM: The purpose of this study was to describe the symptoms of PTSD experienced by families after the volcanic eruption disaster in Magelang Regency. METHODOLOGY: This research was conducted with a descriptive-analytic strategy. The research population was community aged 15–64 years, with a total of 574 people, and 86 respondents were selected as samples using a quota sampling technique. RESULTS: The results show that the majority of respondents experience symptoms of PTSD in the mild category as many as 60 respondents with a percentage of 68.9%. However, there are two respondents included in the severe category. The results of this study are expected to be the basis for the community and other institutions to pay attention to the symptoms of PTSD. CONCLUSION: Respondents who are categorized as experiencing weight PTSD symptoms are expected to conduct further examinations at health services immediately; therefore, PTSD can be handled.

Psychological distress in children and adolescent disaster survivors

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Screening for post-traumatic stress disorder among adolescents following floods- a comparative study from private and public schools in Kerala, India

Introduction

Disasters can have deep physical and psychological impact among survivors. An extraordinary southwest monsoon has unleashed floods and landslides in Kerala state in 2018. Adolescents are more vulnerable to psychological impairment after a disaster and trauma during initial stages of life can etch an indelible signature in the individual’s development and may lead to future disorders.

Objectives

1. To screen for PTSD and associated factors among adolescents 8 months post floods in selected schools in flood-affected areas of Alleppey district of Kerala 2. To compare the proportion of adolescents screened positive for PTSD in public and private schools.

Methodology

A 3-month, Cross-sectional study was done among 670 adolescents in private and public schools using stratified sampling in Alleppey district. The study tool included a structured questionnaire that collected information on sociodemographics, flood-related variables, Trauma screening questionnaire and academic performance.

Results

The mean age of the participants was 16.03 ± 0.73 years with almost equal gender distribution. One-third of students reported flood-related damage to house/property, and a few lost their pets. Nearly 50% of the students reported that they still re-experience and get upsetting memories about flood events. The prevalence of probable PTSD noted to be 34.9%. We observed that 31% of students in public school screened positive for PTSD compared to 38.8% of private school students. (odds ratio = 1.409, CI 1.024–1.938). Male gender (Odds ratio = 1.503, CI 1.093–2.069), higher age (Odds ratio = 1.701, CI 1.120–2.585), damage during floods (Odds ratio = 2.566, CI 1.814–3.630), presence of morbidity (Odds ratio = 3.568, CI 1.888–6.743), camp stay (Odds ratio = 3.788, CI 2.364–6.067) and loss of pets (Odds ratio = 3.932, CI 2.019–7.657) were the factors significantly associated with PTSD. We noted a deterioration in academic performance in 45.9% of students who screened positive for PTSD.

Conclusion and recommendations

High prevalence of stress disorder highlights the need for early identification and intervention for PTSD and including trained counsellors as a part of the disaster management team in future.

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

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