Traumatic stress responses in earthquake survivors in Turkey

Rebuilding wellbeing: Understanding the role of self-criticism, anger rumination, and death distress after the February 6, 2023, Türkiye Earthquake

This study investigated self-criticism, anger rumination, and death distress in wellbeing after one of the most devastating natural disasters of this century. The study included 399 participants from 56 different cities across Türkiye. Participants were from 3 groups: those who themselves or one of their nuclear families are earthquake survivors (group 1), those who had a loved one other than a nuclear family member who was an earthquake survivor (group 2), and those who were deeply affected by the earthquake through media networks (group 3). Results showed that women experienced higher death distress and anger rumination and lower mental wellbeing compared to men post-earthquake. Individuals in group 1 had significantly lower mental wellbeing and higher death distress than groups 2 and 3. However, the effect size of this significant differentiation depending on earthquake experience was small. Moreover, anger rumination and death distress fully mediated the link between self-criticism and mental wellbeing.

School-based psychosocial and educational interventions for children and adolescents after the 1999 Marmara earthquakes in Turkey: A review on lessons learned

The massive earthquakes experienced in August and November 1999 affected thousands of people in the Marmara region, the most densely populated and industrialized part of Turkey. The humanitarian and economic cost was so enormous, and these earthquakes have changed the Turkish disaster management system and the Turkish people's approach to disasters. Marmara earthquakes are also considered as a milestone in the provision of psychosocial services for disaster victims. This paper aims to review the psychosocial interventions targeting children, adolescents, and their families after the 1999 earthquakes in Turkey. The progression from initial responses to more organized psychosocial interventions is outlined. Conducting the interventions at schools has ensured that thousands of children, teachers, and parents are reached in the most efficient and effective way possible. The significance of the school context in designing psychosocial interventions is highlighted and implications of the lessons learned for traumatic experiences of children and parents are also explored. It is evaluated that these inferences obtained from the Marmara earthquake in Turkey can be used in disasters around the world.

Paediatric oncology in the Eastern Mediterranean region (EMR): the current state and challenges

The WHO Eastern Mediterranean region (EMR) is characterised by highly economically diverse countries, with healthcare systems in various phases of development. Childhood cancer care provision also ranges from that provided in centres able to deliver sophisticated therapy resulting in outcomes comparable to those seen in highly developed nations, to countries with no provision for care of children with cancer. At 10·1 per 100,000 children at risk, the age standardised incidence-rate for cancer in children below 14 years of age is relatively low but may be consequent to poor registration. Shortages in trained care providers were identified in many regional countries, particularly in low and lower-middle income countries, however, implementation of training programs are beginning to counter this deficit. Significant diversity in patient care capacity exists in the region, leading to inequitable access to quality paediatric oncology care. There is strong potential for regional collaboration towards infrastructure and capacity improvement, with facilities available within the EMR for twinning and educational support to those centres and countries that need them. While cancer care coverage is available to citizens of high-income countries, in the lower-income countries out-of-pocket health expenditure can reach 75%. Some relief is achieved through the contribution of multiple charitable foundations working to support childhood cancer care in the region, as well as the provision of care in, often overburdened, public sector hospitals. War and other geo-political turmoil, as well as natural disasters, have negatively impacted healthcare capacity, including childhood cancer care, in several regional countries. Despite all this, the trajectory for change is upward and initiatives such as the WHO Global Initiative for Childhood Cancer are igniting positive change.

Depression and life satisfaction after Kahramanmaraş earthquakes: The serial mediation roles of life meaning and coping with earthquake stress

This study aims to examine the meaning of life, and the mediating effect of strategies for coping with earthquake stress in the relationship between depression, and life satisfaction in survivors of the 2023 Kahramanmaraş centered earthquakes. The participants of this study were 472 adults (31.1% male, 68.9% female; Mage = 24.52) who were affected by earthquakes. The data of the study were tested with the bootstrapping-based PROCESS macro program (Model-81). The results showed that depression negatively predicted life satisfaction. Meaning of life mediated the relationship between depression and life satisfaction. However, problem solving and cognitive avoidance coping strategies reduced the effects of depression and the meaning of life on life satisfaction. These results can be a resource for mental health services for earthquake victims. At the same time, the study provides evidence that protecting personal resources in disaster situations positively affects life satisfaction in terms of conservation of resources theory (COR).

The development of the fear of earthquake scale: validity and reliability study in Türkiye after the 2023 earthquake

BACKGROUND

In 2023, Türkiye experienced a significant earthquake disaster that profoundly impacted 11 provinces. The enduring consequences of these earthquakes on daily life triggered widespread fears and anxieties in society, leading to scholarly investigations in this field.

OBJECTIVE

The primary objective of this study was to create and evaluate the psychometric properties of the Fear of Earthquake Scale (FES), a modified adaptation of the Fear of COVID-19 Scale (FCV-19 S), tailored to measure earthquake-related experiences in Türkiye.

METHODS

A total of 315 Turkish adult participants (106 men, 209 women), with a mean age of 37.71 years, completed the FES, along with the Brief Psychological Resilience Scale (BPRS). Psychometric analyses included confirmatory factor analysis as well as the evaluation of alternative factor structures, internal consistency, convergent validity, and criterion validity with respect to resilience.

RESULTS

The findings indicate that the Turkish version of the Fear of Earthquake Scale has strong psychometric properties in terms of validity and reliability. After assessing various factor structures, it was observed that the two-factor model which represents the emotional and somatic response to fear, exhibited the best-fit values The Cronbach's alpha coefficients were calculated as 0.89 for the overall FES, 0.84 for the emotional subscale and 0.86 for the somatic subscale, indicating high internal consistency. Additionally, the negative correlation between resilience and the FES supports the criterion validity of the scale, and multi-group confirmatory factor analyses proved that measurement invariance held across genders and whether they experienced an earthquake or not for all groups. Furthermore, the results of the study revealed that women and individuals with prior earthquake experience reported higher levels of fear of earthquakes.

CONCLUSIONS

The FES emerged as a reliable and valid tool for assessing earthquake-related fears among the Turkish population.

Fear of COVID-19 and Fear of Earthquake: Multiple Distressing Events and Well-Being in Croatia

People in Croatia have recently experienced two major earthquakes in the midst of COVID-19 pandemic, which are possible sources of increased fear. In order to capture and understand the effects of the simultaneously occurring threatening events, the aims of this study were threefold. First, we aimed to examine the psychometric properties and factor structure of the Croatian version of the Fear of COVID-19 scale (FCV-19S). Second, bearing in mind that there is a lack of instruments for measuring fear of earthquakes, the study aimed to develop and examine the psychometric properties the Fear of Earthquake Scale (FES), as a version of FCV-19S, modified for the earthquake experience. Finally, the study aimed to examine differences in well-being indicators (life satisfaction, positive and negative affect) between four groups of participants who either had/did not have COVID-19 disease or had experienced/did not have experienced earthquake. The study was conducted among 1136 participants adults who took part in the fourth year of the Croatian longitudinal study on well-being. Among them, N = 665 participants experienced earthquake and responded to additional questions regarding that experience. The analyses demonstrated valid psychometric properties and one-factorial structure of FCV-19S and FES scales. The findings showed that people who went through earthquake experience (vs. those without earthquake experience and COVID-19 infection) reported higher negative affect and lower positive affect, indicating that people in Croatia seem to have been more fearful of earthquakes than COVID-19 pandemic. Findings suggest the long-term negative effects of earthquake on fear and well-being in comparison to COVID-19 pandemic.

The Impact of Earthquakes on Public Health: A Narrative Review of Infectious Diseases in the Post-Disaster Period Aiming to Disaster Risk Reduction

Earthquakes are among the most impressive natural phenomena with very high potential to set off a chain of effects that significantly affects public health through casualties and injuries. Related disasters are attributed not only to the strong ground motion and coseismic phenomena but also to secondary effects, comprising mainly landslides and tsunamis, among others. All these can create harsh conditions favorable for the emergence of infectious diseases that are capable of causing additional human and economic losses and disruption of the emergency and recovery process. The present study comprises an extensive narrative review of the existing literature on the earthquake-triggered infectious diseases recorded worldwide, along with their symptoms, causative pathogens, associated risk factors, most vulnerable population groups, and prevention strategies. Respiratory, gastrointestinal, and vector-borne diseases, as well as wound and skin infections, are mainly recorded among the earthquake-affected population. Measures for effectively preventing earthquake-triggered infectious diseases are also proposed. One of the widely proposed measures is the establishment of a proper disease surveillance system in order to immediately and effectively identify the pre- and post-disaster occurrence of infectious diseases. This approach significantly contributes to disease trends monitoring, validation of early warning, and support of the emergency response and recovery actions.

Post Traumatic Stress Disorder and Behavioral Therapy Intervention Techniques Used in Treatment

Post-traumatic stress disorder (PTSD) is a disorder that significantly reduces the functionality of people with symptoms of this disorder and negatively affects their psychological health. Behavioral therapy is an empirically based therapy approach used in the treatment of this psychological disorder and many other psychological disorders. In this study, the articles on behavioral therapy intervention techniques used in the treatment of PTSD and the empirical basis of these techniques were compiled. The literature review in Turkish and English revealed that psychoeducation, real-life exposure, imaginary exposure, prolonged exposure, breathing exercises, relaxation training and systematic desensitization behavioral therapy intervention techniques are commonly used in the treatment of PTSD and that these techniques are effective in the treatment of the disorder.

The role of balanced time perspective mediating the relationship between mindfulness as a trait and life satisfaction in Catalan University students

The objective of the present study was to replicate previous studies by examining the potential connections between mindfulness as a trait, life satisfaction and time perspectives (TP) and to analyze if balanced time perspective (BTP) could act as a possible mediator between mindfulness and life satisfaction in students from the University of Girona (Catalonia, Spain). Data was collected from 341 Catalan university students aged 18-52 (77.1% women; mean age = 23.62) who completed Zimbardo Time Perspective Inventory (ZTPI), the Mindfulness Awareness Scale (MAAS) and the Satisfaction with Life Scale (SWLS) to assess their Temporal Perspective, Mindfulness as a trait and Life Satisfaction respectively. Balanced time perspective (BTP) was calculated using the deviation index of BTP (DBTP). Results showed significant relationships between the various temporal dimensions, life satisfaction, and mindfulness as a trait, being the most significant associations with balanced temporal perspective. On the other hand, results also suggested that BTP may act as a mediator between mindfulness as a psychological trait and life satisfaction, confirming previous studies conducted in different countries. In conclusion, findings could highlight the importance of regulating one's attention in order to balance time perspectives, which in turn would translate into improved life satisfaction.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-022-03795-4.

Analysis of Gender Sensitivity of Turkey's Disaster Legislation to Create a Disaster-Resilient Society

Disasters frequently occur in Turkey. Although there is comprehensive disaster legislation in Turkey, it has not been well studied in terms of gender sensitivity. This study aimed to evaluate the disaster legislation of Turkey in the context of gender equality. We investigated 17 non-technical disaster legislations to determine in what context and to what level disaster management is gender-sensitive in Turkey. We also carried out a workshop with experts from governmental bodies and nongovernmental organizations (NGOs), and academics to discuss the gender sensitivity of the legislations. We found that only two of the 17 legislations included a gender perspective. One legislation addressed gender equality and equity very well, while one was partially gender-sensitive and the others 5 were gender blind. The workshop was conducted in collaboration with the Disaster and Emergency Management Presidency (AFAD) and 33 participants from 19 organizations. The participants agreed that the disaster legislation did not include a gender perspective and acknowledged the importance of integrating a gender perspective into the disaster policies of Turkey. They recommended that the AFAD and emergency response units should have at least one female president or vice president, gender equality training should be provided to officers and managers of government and non-governmental disaster institutions, and a working group should be established to develop strategies that integrate gender perspectives into disaster and emergency policies. The disaster legislation of Turkey is not gender sensitive. It is important to incorporate language terminologies, understanding, and approaches that are sensitive to gender into disaster-related legislation and regulations.

The Effect of Traumatic Loss on Posttraumatic Growth Among 2011 Van Earthquake Survivors: The Mediating Role of Posttraumatic Stress

OBJECTIVE

Posttraumatic growth (PTG), defined as a positive change after a traumatic event, has become the subject of various studies, and its relationship with posttraumatic stress symptoms (PTSS) has been extensively investigated. However, studies have indicated differences in the relationship between PTG and PTSS. Therefore, this study aimed to investigate the mediating role of PTSS in the relationship between the number of traumatic losses and PTG among the 2011 Van earthquake survivors.

METHODS

The sample of this study consisted of 917 participants who experienced the 2011 Van earthquake. A personal information form, impact of event scale-revised (IES-R), and posttraumatic growth inventory (PTGI) were used as data collection tools.

RESULTS

Survivors with traumatic loss were found to have higher PTSS and PTG than survivors without traumatic loss. The mean scores of the PTGI subscales were higher among survivors with traumatic loss except for changes in self-perception. A positive correlation was found between IES-R and PTGI total scores. In the regression analysis, it was found that PTSS played a mediating role in the relationship between the number of traumatic losses and PTG.

CONCLUSION

This study revealed that PTG is possible with the presence of PTSS. Mental health professionals assisting survivors with traumatic loss should take the enhancement of PTG into consideration in addition to their efforts to reduce PTSS.

Impact of peritraumatic distress on posttraumatic stress disorder symptoms at 6 months after acute coronary syndrome: a prospective cohort study

Background: Posttraumatic stress disorder (PTSD) symptoms are known to occur after acute coronary syndrome (ACS). Peritraumatic distress has been indicated as a risk factor for PTSD and can be measured by the Peritraumatic Distress Inventory (PDI). However, no studies have yet measured peritraumatic distress after ACS using the PDI to predict PTSD. Objectives: This prospective cohort study examined the impact of peritraumatic distress on PTSD symptoms at 6 months after ACS. Methods: We used the PDI to assess peritraumatic distress in patients treated for ACS at a teaching hospital in Tokyo within 7 days after percutaneous coronary intervention. They were followed up over the next 6 months and were assessed for PTSD symptoms at 6 months using the Impact of Event Scale-Revised. The association between peritraumatic distress and PTSD symptoms was examined by multiple linear regression analysis. Results: The study enrolled 101 ACS patients, and 97 completed the follow-up assessment. PDI total score was an independent predictor of PTSD symptoms after adjustment for potential covariates (beta = 0.38; p < 0.01). Limitations: The results were obtained from a single teaching hospital and assessment of PTSD symptoms was questionnaire based. Conclusion: We provide the first evidence that PDI score can predict the development of PTSD symptoms in ACS patients. Assessing peritraumatic distress after ACS with the PDI may be useful for initiating early intervention against PTSD symptoms.

A novel arousal-based individual screening reveals susceptibility and resilience to PTSD-like phenotypes in mice

Translational animal models for studying post-traumatic stress disorder (PTSD) are valuable for elucidating the poorly understood neurobiology of this neuropsychiatric disorder. These models should encompass crucial features, including persistence of PTSD-like phenotypes triggered after exposure to a single traumatic event, trauma susceptibility/resilience and predictive validity. Here we propose a novel arousal-based individual screening (AIS) model that recapitulates all these features. The AIS model was designed by coupling the traumatization (24 h restraint) of C57BL/6 J mice with a novel individual screening. This screening consists of z-normalization of post-trauma changes in startle reactivity, which is a measure of arousal depending on neural circuits conserved across mammals. Through the AIS model, we identified susceptible mice showing long-lasting hyperarousal (up to 56 days post-trauma), and resilient mice showing normal arousal. Susceptible mice further showed persistent PTSD-like phenotypes including exaggerated fear reactivity and avoidance of trauma-related cue (up to 75 days post-trauma), increased avoidance-like behavior and social/cognitive impairment. Conversely, resilient mice adopted active coping strategies, behaving like control mice. We further uncovered novel transcriptional signatures driven by PTSD-related genes as well as dysfunction of hypothalamic–pituitary–adrenal axis, which corroborated the segregation in susceptible/resilient subpopulations obtained through the AIS model and correlated with trauma susceptibility/resilience. Impaired hippocampal synaptic plasticity was also observed in susceptible mice. Finally, chronic treatment with paroxetine ameliorated the PTSD-like phenotypes of susceptible mice. These findings indicate that the AIS model might be a new translational animal model for the study of crucial features of PTSD. It might shed light on the unclear PTSD neurobiology and identify new pharmacological targets for this difficult-to-treat disorder.

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The AIS model includes highly requested features necessary to shape a translational PTSD animal model.

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Susceptible mice identified through the AIS model exhibited persistent PTSD-like phenotypes.

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Resilient mice identified through the AIS model adopted active coping strategies.

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The AIS model revealed molecular adaptations underlying trauma susceptibility/resilience.

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The AIS model meets the criterion of predictive validity by exclusively using susceptible mice.

Conceptualizing COVID-19 and Public Panic with the Moderating Role of Media Use and Uncertainty in China: An Empirical Framework

Uncertainty puts people in a binary state of mind, where every piece of external information can positively or negatively affect their state of health. Given the uncertain situation created by the new coronavirus pandemic, this study claims to be the first empirical analysis of the real-time status of public panic in China. It frames peoples’ intrinsic and extrinsic stimuli, creating a psychosocial analysis of public panic. We conducted an online survey of WeChat and QQ users in February 2020 and collected 1613 samples through a QR code questionnaire. We used the ordinary least squares (OLS) regression equation model to conceptualize public panic pathways in different gender and age groups. This underlines the psychological origins of fear and anxiety and points out how the media uses socially constructed public panic. The results show that the outbreak of COVID-19 created uncertainty among the public, and the official media intensified it because of the late dissemination of news about the outbreak’s real-time status. Hence, unofficial media remained faster in news reporting, but the news reporting remained contradictory with official reports. This created doubts about the authenticity of the given information and caused public mental health abnormalities. The study provides a conceptual framework based on lessons learned from physiology, psychology, and social psychology and real-time public analysis to inform policymakers and public administrators about the contextual dynamics of public panic in China. It provides useful insights into the wise handling of this uncertain time and controlling the fatal conditions of public panic created by COVID-19. It has implications for other countries as well.

Earthquake-related psychological distress and associated factors 4 years after the Parnitha earthquake in Greece

Exposure to earthquakes has been associated with psychological distress and in particular the development of post-traumatic stress disorder (PTSD). Earthquake-related psychological distress can be longstanding. The present study involved 157 Greek survivors of the 1999 Parnitha earthquake assessed approximately 4 years after the earthquake. Assessments were based on the Traumatic Stress Symptom Checklist (TSSC). Using stringent calibrations for the estimation of symptom presence 25% of the survivors endorsed at least 5 and 12% at least 10 TSSC symptoms. Approximately 22% of the survivors reported subjective distress and 15% impaired adjustment due to their symptoms. Intensity of fear during the earthquake and participation in rescue operations related to greater post-earthquake psychological distress. The results suggest that the psychological consequences of earthquakes can be serious and long-standing even when the magnitude of the earthquake is moderate. Psychological treatments that have been proven to reduce fear and PTSD symptoms need to be made available to the survivors. Such treatments may also increase the survivors' psychological preparedness and emotional resilience in view of future earthquakes.

Coping and Its Relation to PTSD in Greek Firefighters

Firefighters are exposed continuously to intense stress situations and traumatic incidents, and are at high risk of developing posttraumatic stress disorder (PTSD). Coping mechanisms and behaviors have been examined as factors contributing to PTSD. The strategies that may be used to cope with stress and/or trauma differ between individuals and also between different professions and traumatic events (). Although there is a vast literature on stress and coping processes that exists, very few studies investigated the way individual firefighters cope with trauma. Among several questionnaires that have been used to examine the effects of different types of coping mechanisms after traumatic incidents is the Albert Einstein College of Medicine-Coping Style Questionnaire (AECOM-CSQ; ). In August 2007, large areas in the Peloponnese, Greece, were devastated by wildfires. One month after the event, experienced researchers visited the affected area to provide psychological support and to investigate the psychosocial consequences among the local professional firefighters. One hundred two firefighters that were on duty for the entire period of firefighting (several days) were interviewed using several questionnaires, among them the AECOM-CSQ. Our hypothesis was that firefighters who presented with PTSD would be more inclined toward engaging in avoidance coping mechanisms. A total of 18.6% of the firefighters were found to have PTSD according to ICD-10 criteria. Logistic regression showed that firefighters using the coping mechanisms of minimization and blame were associated with the greater likelihood of PTSD. It seems that specific coping mechanisms used by firefighters immediately after the traumatic event might contribute to the development of PTSD.

Prevalence and risk factors of post-traumatic stress disorder among elderly survivors six months after the 2008 Wenchuan earthquake in China

BACKGROUND

Several studies indicate that older age is a risk factor for probable post-traumatic stress disorder (PTSD). However, evidence on the prevalence and risk factors for elderly disaster survivors is limited.

METHODS

Multi-stage stratified sampling was applied in this cross-sectional study. The Revised Version of the Impact of Event Scale (IES-R) was used to evaluate symptoms of PTSD. Chi-squared test was used for univariable analysis of prevalence of probable PTSD by possible determinants. Multivariable logistic regression analysis was utilized to further explore risk factors for PTSD.

RESULTS

427 elderly survivors age 60 or older participated. The prevalence of probable PTSD was 40.5, 36.3, and 21.5% according to a cut off score of the IES-R of 33, 35, and 2 points on average across items, respectively. In multivariable logistic regression, elderly survivors with a higher number of diagnosed chronic illnesses were more likely to be screened positive for PTSD and those with a greater number of family members living in the same home were less likely to be classified as having probable PTSD for all cut off scores. Elderly survivors with improved economic status and those with primary school or lower education were more often estimated to have probable PTSD with a cut off score of 35 and 2 points on average.

CONCLUSIONS

Elderly survivors in a high impact area following a major earthquake are at high risk for developing PTSD. Those who live alone and report pre-existing chronic illness are particularly vulnerable.

Prevalence of Post-traumatic Stress Disorder and Depression After the September 19th, 2017 Earthquake in Mexico

BACKGROUND AND AIM

Natural disasters cause mental disorders, the most frequent are Post-traumatic stress disorder (PTSD) and depression, which should be quickly identified for immediate psychological care. The aim of this study was to estimate the frequency of these disturbances in a population with social security, located in the states hit by the earthquake that took place on September 19^th, 2017 in Mexico.

METHODS

To identify persons with PTSD and depression, a random sample of the population was screened (1-2 months' post-earthquake) in primary health care clinics at the Mexican Institute of Social Security (IMSS). A questionnaire for the detection of mental conditions (The Screening Questionnaire for Disaster Mental Health, SQD) was used to select people for group therapy and/or psychotherapeutic support, when identified with severe PTSD and high risk of depression.

RESULTS

Over 44,855 persons (67.9% females, 32.1% males), residents of Mexico City, the State of Mexico, Puebla, Morelos were surveyed. The prevalence of severe PTSD was 11.9% and depression 9.2%. The highest prevalence of PTSD was observed in Mexico City (12.8%) the state with more material damage. Women were at higher risk for PTSD (OR, 2.08; 95% CI 1.97-2.19, p = 0.000) and depression (OR, 1.86; 95% CI 1.72-2.01, p = 0.000).

CONCLUSIONS

The prevalence of PTSD and depression was higher in those states with severe damage caused by the earthquake; women were more susceptible to mental disorders.

Posttraumatic stress disorder in Longmenshan adolescents at three years after the 2013 Lushan earthquake

OBJECTIVE

This study aimed to estimate the prevalence and risk factors of probable posttraumatic stress disorder (PTSD) among adolescent survivors of the 2013 Lushan earthquake.

METHODS

A cross-sectional survey was conducted in the Longmenshan thrust fault area at three years after the 2013 earthquake in Lushan, China. Most respondents (60.8%) had also been exposed to the 2008 Wenchuan earthquake. Probable PTSD was identified based on the Children's Revised Impact of Event Scale (CRIES-13), the Adolescent Self-Rating Life Events Checklist and Earthquake Experience Scale. Logistic regression was used to identify risk factors of probable PTSD.

RESULTS

Probable PTSD prevalence was 14.1% among all respondents (n = 3851), 15.9% among those who had been exposed to the 2008 and 2013 earthquakes (n = 2342) and 11.3% among those who had experienced only the 2013 earthquake (n = 1509). Earthquake-related factors most strongly associated with probable PTSD were feeling scared of dying and exposure to the Wenchuan earthquake. The negative life event most strongly associated with probable PTSD was academic stress.

CONCLUSION

Among survivors of the 2013 Lushan earthquake, risk of probable PTSD was significantly higher if the person had also been exposed to the Wenchuan earthquake. Researchers and health care workers should pay more attention to adolescent earthquake survivors, especially those who experienced both the Wenchuan and Lushan earthquakes. Providing psychological care and preventing negative events may be effective measures for reducing PTSD after an earthquake.

The prevalence of posttraumatic stress in adolescents eight years after the Wenchuan earthquake

In 2008, an 8.0 Richter scale earthquake devastated Wenchuan in China, which resulted in heavy casualties, and had wide-reaching psychological effects on survivors. To examine its impact on the survivors, this study aims to investigate the prevalence of posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG) in adolescents eight years after the earthquake. The cross-section survey was conducted in two different earthquake-affected areas, and data were collected from 4118 respondents. Instruments included the questionnaire on demographic information, the questionnaire on seismic exposure, PTSD Checklist-Civilian Version (PCL-C) questionnaire, Posttraumatic Growth Inventory (PTGI), Perceived Social Support Scale (PSSS) and Simple Coping Style Questionnaire (SCSQ). During the survey, there were 1998 valid questionnaires from the generally affected area and 2120 questionnaires from the severely affected area. The rate of PTSD is 1.9% in the generally affected area and 2.7% in the severely affected disaster area; there is no significant difference between the two differently affected areas. Occurrences of PTSD and PTG are significantly positively correlated in the generally affected area, nevertheless, there is a significant negative correlation between PTSD and PTG in most systems of the severely affected area. The results of this study help to expand our knowledge regarding posttraumatic stress in adolescents 8 years after the Wenchuan earthquake, and it provides suggestions for specific long-term health interventions in such populations. To prevent earthquake-related psychological issues among adolescent survivors, social support, psychological aid, and improvement of the living environment are necessary to buffer negative posttraumatic stress.

An investigation of physical and mental health consequences among Chinese parents who lost their only child

BACKGROUND

The term "loss-of-only-child family" means that the only child in a family passed away or is disabled due to an accident or other events. The parents who cannot conceive or do not adopt another child, are known as Shidu parents in China. This study compares the physical and mental health of Shidu parents with those parents who have not experienced such loss.

METHODS

The target group is comprised of parents being Shidu for more than 1 year (N = 95) and the control group is comprised of parents with a living child (N = 97) from the same area as the Shidu parents. Socio-demographic information and physical health outcomes were collected by the adapted questionnaires. PCL-C (PTSD Checklist-Civilian Version), CES-D (Center for Epidemiological Studies Depression Scale) and GHQ-12 (General Health Questionnaire) were applied to evaluate the parents' physical and mental status.

RESULTS

Shidu parents have a higher risk of developing PTSD and depression, and suffer more severe psychiatric disorders compared to parents with a living child. The rate of PTSD in the Shidu group was up to 32.6% and the scores of PCL-C are much higher than the control group. The physical status of Shidu parents were much worse than that of the control group, characterized by higher morbidity of chronic diseases and more hospital visits.

CONCLUSIONS

Shidu parents have more severe mental health problems and a higher rate of chronic diseases than parents who have a living child. Loss of the only child is the most traumatic event for the parents, which is a serious and unique problem in Chinese society that deserves attention. More studies and support are desired to improve the physical and mental health of Shidu parents.

The psychological and psychosocial impact of the Pakistan Kashmir earthquake after 8 months: a preliminary evaluation by PACTT

Natural disasters are complex events that challenge the coping abilities of individuals and communities (Alexander, 2005). They are characterised by substantial loss, physical injury and economic hardship, as well as by extensive internal displacement and damage to the infrastructure, as exemplified by the Pakistan Kashmir earthquake of 8 October 2005. Measuring 7.6 on the Richter scale, it affected an area of 30000 square miles and a population of 3.6 million. Approximately 90000 were killed, 200000 were injured and 3.5 million were left homeless (Khan, 2006). Based on a literature review and estimates from the World Health Organization (WHO), the National Plan of Action for Mental Health and Psychosocial Relief of Earthquake Survivors anticipated high levels of trauma-related psychopathology (Rana et al, 2006).

Personality characteristics and individual factors associated with PTSD in firefighters one month after extended wildfires

BACKGROUND

Firefighters participate in activities with intense physical and psychological stress and are constantly at risk to develop various psychopathological reactions.

AIMS

To investigate psychological reactions in firefighters one month after devastating wildfires in Greece, during August 2007, which lead to the devastation of large areas and the death of 43 people among whom three were firefighters.

METHODS

One month after the wildfires, a joint task force of mental health clinicians was organized in order to provide psychological support and to investigate the psychological consequences of wildfires to firefighters. One hundred and two firefighters, living within the fire-devastated area, who were on duty for the whole period of wildfires were interviewed and assessed with the use of several questionnaires and inventories.

RESULTS

Post-traumatic stress disorder (PTSD) was detected in 18.6% of firefighters. Multiple logistic regression found that existence of fear of dying during firefighting, insomnia and increased scores in neuroticism, as well as in depression subscale of the SCL-90, were significantly associated with greater likelihood for having PTSD. Additionally those firefighters who worked permanently had 70% lower probability of having PTSD vs. those seasonally employed.

CONCLUSIONS

Insomnia, depressive symptoms, as well as personality characteristics as neuroticism and the perception of fear of imminent death during firefighting operations may precipitate the development of PTSD in firefighters. Within this context, mental health clinicians should be aware that the early detection of these predisposing factors may facilitate the prevention and mitigation of PTSD in firefighters particularly those who are seasonally employed.

The Role of Relocation Patterns and Psychosocial Stressors in Posttraumatic Stress Disorder and Depression Among Earthquake Survivors

The psychological impact of relocation within and outside of a disaster region was examined in 541 survivors of the 2011 Van earthquake in Turkey at 16.5 months postdisaster. Relocation out of the region was determined by disaster-related property/financial losses and fear during the earthquake. Anticipatory fear of future earthquakes and less sense of control over life were the strongest predictors of posttraumatic stress disorder (PTSD) and depression symptoms. Relocation within the disaster region predicted PTSD but not depression. Dissatisfaction with emotional support received from close ones was significantly associated with depression, but it was associated with PTSD at a marginally significant level. Survivors who experienced more intense fear during the earthquake displayed higher levels of anticipatory fear in the long term, whereas avoidance of trauma reminders and fear-evoking situations sustained anticipatory fear of future earthquakes. These findings suggest that interventions that reduce fear and avoidance behaviors would help survivors overcome traumatic stress and depressive symptoms.

The Role of Personality and Subjective Exposure Experiences in Posttraumatic Stress Disorder and Depression Symptoms among Children Following Wenchuan Earthquake

This study aims to investigate the role of personality traits and subjective exposure experiences in posttraumatic stress disorder and depression symptoms. In Qingchuan, 21,652 children aged 7 to 15 years were assessed using face-to-face interviews one year after the Wenchuan earthquake in China. The Junior Eysenck Personality Questionnaire, a modified earthquake exposure scale, the UCLA Posttraumatic Stress Disorder Reaction Index (adolescent), and the Adolescent Depression Inventory were used to assess personality characteristics, trauma experiences, posttraumatic stress disorder and depression symptoms, respectively. The measurement was completed with 20,749 children. After adjusting for other factors by multinomial logistic regression analysis, neuroticism, having felt unable to escape from the disaster and having been trapped for a longer time were risk factors of posttraumatic stress disorder and depression symptoms. Socialization was a protective factor of them. Having felt extreme panic or fear was a risk factor of posttraumatic stress disorder symptoms. For depression symptoms, introversion and psychoticism were risk factors, and extraversion was a protective factor. This study was conducted with the largest representative sample of child survivors of a natural, devastating disaster in a developing country. These results could be useful for planning psychological intervention strategies for children and for influencing further research.

Risk factors for long-term post-traumatic stress disorder among medical rescue workers appointed to the 2008 Wenchuan earthquake response in China

This study aims to determine the risk factors for clinically-significant post-traumatic stress disorder (PTSD) among Chinese medical rescue workers one year after the response to the Wenchuan earthquake on 12 May 2008. A sample of 337 medical workers who performed response work within the first three months of the event completed an online questionnaire, which included information on demographics, social support, the management and organisation of the disaster response, and an assessment of PTSD. Symptoms consistent with PTSD were prevalent in 17 per cent of the rescue workers. Those who developed PTSD symptoms were more likely to have been injured, experienced a water shortage, been disconnected from family and friends during the response, and have passive coping styles and neurotic personalities. Factors that cannot be changed easily, such as personality traits, should be evaluated prior to deployment to ensure that rescue workers at higher risk of PTSD are provided with adequate support before and during deployment.

Forensic mental health evaluations of military personnel with traumatic life event, in a university hospital in Ankara, Turkey

INTRODUCTION

The definition of psychological trauma has been rephrased with the DSM-5. From now on, witnessing someone else's traumatic event is also accepted as a traumatic life event. Therefore, the psychiatric examination of forensic cases gains importance for not overlooking a psychiatric trauma. This research aims to discuss the psychiatric examinations of military personnel who had a traumatic life event and to reveal psychiatric states of soldiers after trauma.

MATERIALS AND METHODS

The forensic reports prepared at Gulhane Military Medical Academy (GMMA), Forensic Medicine polyclinic between January 1, 2011 and November 30, 2014 were examined, and among them the cases sent to GMMA Psychiatry polyclinic for psychiatric examination were analyzed retrospectively.

RESULTS

There were a total of 2408 cases who applied for the arrangement of a judicial report and 167 of them required a psychological examination. Among 167 cases, 165 were male and 2 were female, and the mean age was 25.6 years. Anxiety disorder (53.9%) was the most common diagnosis as a result of the psychiatric examination, following posttraumatic stress disorder (PTSD) (18.6%), and 3.6% had no psychopathology. It was determined that injuries caused by firearms (38.3%) and explosive materials (26.3%) had caused psychological trauma the most. On the other hand, 11 (6.6%) cases were determined to have undergone a psychological trauma on account of being a witness to their friends' injuries during the conflict without experiencing any physical injury. There were not any statistically significant relationships between the severity of physical injury and being PTSD or anxiety disorder.

DISCUSSION

Development of PTSD risk is directly correlated with the nature of trauma. The trauma types of the cases in our study were in the high-risk group because of the military population. Our study is of importance in terms of putting forward the psychiatric disorders seen in the military population with traumatic life history associated with war (combat-related). In this research, 26.1% of the cases followed up due to combat-related trauma were diagnosed with PTSD. Interestingly, this ratio was lower than the studies that have larger case numbers. There is still the need to conduct studies that will involve larger participants.

Post-Traumatic Stress Disorder and other mental disorders in the general population after Lorca's earthquakes, 2011 (Murcia, Spain): A cross-sectional study

AIMS

To describe the prevalence and severity of mental disorders and to examine differences in risk among those with and without a lifetime history prior to a moderate magnitude earthquake that took place in Lorca (Murcia, Spain) at roughly the mid-point (on May 11, 2011) of the time interval in which a regional epidemiological survey was already being carried out (June 2010 -May 2012).

METHODS

The PEGASUS-Murcia project is a cross-sectional face-to-face interview survey of a representative sample of non-institutionalized adults in Murcia. Main outcome measures are prevalence and severity of anxiety, mood, impulse and substance disorders in the 12 months previous to the survey, assessed using the Composite International Diagnostic Interview (CIDI 3.0). Sociodemographic variables, prior history of any mental disorder and earthquake-related stressors were entered as independent variables in a logistic regression analysis.

FINDINGS

A total number of 412 participants (response rate: 71%) were interviewed. Significant differences in 12-month prevalence of mental disorders were found in Lorca compared to the rest of Murcia for any (12.8% vs 16.8%), PTSD (3.6% vs 0.5%) and other anxiety disorders (5.3% vs 9.2%) (p≤ 0.05 for all). No differences were found for 12-month prevalence of any mood or any substance disorder. The two major predictors for developing a 12-month post-earthquake mental disorder were a prior mental disorder and the level of exposure. Other risk factors included female sex and low-average income.

CONCLUSIONS

PTSD and other mental disorders are commonly associated with earthquake disasters. Prior mental disorders and the level of exposure to the earthquakes are the most important for the development of a consequent mental disorder and this recognition may help to identify those individuals that may most benefit from specific therapeutic intervention.

The risk factors of possible PTSD in individuals exposed to a suicide attack in Turkey

The aims of this study were to determine both the rate of possible PTSD in individuals who were exposed to a suicide attack in Ankara, Turkey, and the factors that relate to the elevated risk for PTSD in individuals who survived that suicide attack. The researchers carried out the study with 93 participants who had attended a meeting held in Ankara on October 10, 2015. Participants completed a sociodemographic information form, the Traumatic Stress Symptom Checklist (TSSC), the Post-Traumatic Cognitions Inventory, the Beck Depression Inventory (BDI), and the Influence of Perceived Societal Attitudes Questionnaire (IPSAQ). Twenty-three of participants were determined to have possible PTSD (24.7%). Participants who were exposed previously to a suicide attack, who witnessed a life-threatening injury, who had the need for psychological help, and who had suicidal thoughts had significantly higher rates of possible PTSD. The IPSAQ, BDI, and TSSC scores were significantly higher in the participants with possible PTSD. The IPSAQ score was found to be related to the development of possible PTSD. This study demonstrated that in participants who had been exposed to a terrorist attack, the negative impact of perceived societal attitudes toward the victims was related to the possible development of PTSD.

Spatio-temporal variation of mood and anxiety symptom treatments in Christchurch in the context of the 2010/11 Canterbury earthquake sequence

This article explores the spatio-temporal variation of mood and anxiety treatments in the context of a severe earthquake sequence. The aim was to examine a possible earthquake exposure effect, identify populations at risk and areas with particularly large mood and anxiety treatment rate increases or decreases in the affected Christchurch urban area. A significantly stronger increase of mood and anxiety treatments among residents in Christchurch compared to others in New Zealand have been found, as well as children and elderly identified as especially vulnerable. Spatio-temporal cluster analysis and Bayesian spatio-temporal modelling revealed little changes in mood and anxiety treatment patterns for most parts of the city, whereas areas in the less affected north and northwest showed the strongest increases in risk. This effect may be linked to inner-city mobility activity as a consequence of the earthquakes, but also different levels of community cohesion after the disaster, which merit further research.

24-hour-restraint stress induces long-term depressive-like phenotypes in mice

There is an increasing risk of mental disorders, such as acute stress disorder (ASD), post-traumatic stress disorder (PTSD) and depression among survivors who were trapped in rubble during earthquake. Such long-term impaction of a single acute restraint stress has not been extensively explored. In this study, we subjected mice to 24-hour-restraint to simulate the trapping episode, and investigated the acute (2 days after the restraint) and long-term (35 days after the restraint) impacts. Surprisingly, we found that the mice displayed depression-like behaviors, decreased glucose uptake in brain and reduced adult hippocampal neurogenesis 35 days after the restraint. Differential expression profiling based on microarrays suggested that genes and pathways related to depression and other mental disorders were differentially expressed in both PFC and hippocampus. Furthermore, the depression-like phenotypes induced by 24-hour-restraint could be reversed by fluoxetine, a type of antidepressant drug. These findings demonstrated that a single severe stressful event could produce long-term depressive-like phenotypes. Moreover, the 24-hour-restraint stress mice could also be used for further studies on mood disorders.

The effects of spatially varying earthquake impacts on mood and anxiety symptom treatments among long-term Christchurch residents following the 2010/11 Canterbury earthquakes, New Zealand

This study investigates the effects of disruptions to different community environments, community resilience and cumulated felt earthquake intensities on yearly mood and anxiety symptom treatments from the New Zealand Ministry of Health's administrative databases between September 2009 and August 2012. The sample includes 172,284 long-term residents from different Christchurch communities. Living in a better physical environment was associated with lower mood and anxiety treatment rates after the beginning of the Canterbury earthquake sequence whereas an inverse effect could be found for social community environment and community resilience. These results may be confounded by pre-existing patterns, as well as intensified treatment-seeking behaviour and intervention programmes in severely affected areas. Nevertheless, the findings indicate that adverse mental health outcomes can be found in communities with worse physical but stronger social environments or community resilience post-disaster. Also, they do not necessarily follow felt intensities since cumulative earthquake intensity did not show a significant effect.

Caste, Education, Family and Stress Disorders in Orissa Supercyclone

Examines (a) the determinants of posttraumatic stress, and (b) the impacts of caste status, educational level, and family size on stress disorders. Structured interview sessions were used to obtain data 3 months after the Orissa supercyclone. The sample comprised 130 cyclone exposed praple. Disaster victims experienced more intrusion and arousal symptoms, and less avoidance and numbing symptoms of posttraumatic stress disorder. The avoidance and numbing symptoms were "decisive" symptoms to arrive at the diagnosis of such a stress disorder. Fifty % of the victims suffered from posttraumatic stress. Anxiety and externality of survivors intensified post-tranmatic stress but deprrssion failed to predict such stress. Survivors from low castes, being less educated, and from larger families were more vulnerable to stress and distress than those from high castes, being more educated, and from small families.

Decreased Prolidase Activity in Patients with Posttraumatic Stress Disorder

OBJECTIVE

Many neurochemical systems have been implicated in the development of Posttraumatic Stress Disorder (PTSD). The prolidase enzyme is a cytosolic exopeptidase that detaches proline or hydroxyproline from the carboxyl terminal position of dipeptides. Prolidase has important biological effects, and to date, its role in the etiology of PTSD has not been studied. In the present study, we aimed to evaluate prolidase activity in patients with PTSD.

METHODS

The study group consisted of patients who were diagnosed with PTSD after the earthquake that occurred in the province of Van in Turkey in 2011 (n=25); the first control group consisted of patients who experienced the earthquake but did not show PTSD symptoms (n=26) and the second control group consisted of patients who have never been exposed to a traumatic event (n=25). Prolidase activities in the patients and the control groups were determined by the ELISA method using commercial kits.

RESULTS

Prolidase activity in the patient group was significantly lower when compared to the control groups. Prolidase activity was also significantly lower in the traumatized healthy subjects compared to the other healthy group (p<0.01).

CONCLUSION

The findings of the present study suggest that the decrease in prolidase activity may have neuroprotective effects in patients with PTSD.

Altered lipid peroxidation markers are related to post-traumatic stress disorder (PTSD) and not trauma itself in earthquake survivors

The traumatic life events, including earthquakes, war, and interpersonal conflicts, cause a cascade of psychological and biological changes known as post-traumatic stress disorder (PTSD). Malondialdehyde (MDA) is a reliable marker of lipid peroxidation, and paraoxonase is a known antioxidant enzyme. The aims of this study were to investigate the relationship between earthquake trauma, PTSD effects on oxidative stress and the levels of serum paraoxonase 1 (PON1) enzyme activity, and levels of serum MDA. The study was carried out on three groups called: the PTSD group, the traumatized with earthquake exercise group, and healthy control group, which contained 32, 31, and 38 individuals, respectively. Serum MDA levels and PON1 enzyme activities from all participants were measured, and the results were compared across all groups. There were no significant differences between the PTSD patients and non-PTSD earthquake survivors in terms of the study variables. The mean PON1 enzyme activity from PTSD patients was significantly lower, while the mean MDA level was significantly higher than that of the healthy control group (p < 0.01 for both measurements). Similarly, earthquake survivors who did not develop PTSD showed higher MDA levels and lower PON1 activity when compared to healthy controls. However, the differences between these groups did not reach a statistically significant level. Increased MDA level and decreased PON1 activity measured in PTSD patients after earthquake and may suggest increased oxidative stress in these patients. The nonsignificant trends that are observed in lipid peroxidation markers of earthquake survivors may indicate higher impact of PTSD development on these markers than trauma itself. For example, PTSD diagnosis seems to add to the effect of trauma on serum MDA levels and PON1 enzyme activity. Thus, serum MDA levels and PON1 enzyme activity may serve as biochemical markers of PTSD diagnosis.

The association between exposure and psychological health in earthquake survivors from the Longmen Shan Fault area: the mediating effect of risk perception

Background

In this study, exposure refers to survivors who suffered from life-changing situations, such as personal injuries, the deaths or injury of family members, relatives or friends or the loss of or damage to personal or family property, as a result of the earthquake. The mediating effect of risk perception on the exposure and psychological health in survivors from the Longmen Shan Fault area and the moderating effect of social support on the relationship between risk perception and psychological health were both examined.

Method

A cross-sectional survey was conducted in a local Longmen Shan Fault area near the epicenter of the 2008 Wenchuan earthquake. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), the standard Chinese 12-item Short Form (SF-12v2), and the Social Support Rating Scale (SSRS) were used to interview 2,080 earthquake survivors in the period one-year after the earthquake. Based on the environment and the characteristics of the Longmen Shan Fault area, a risk perception questionnaire was developed to evaluate survivor risk perception. Factor and regression analyses were conducted to determine the hypothetical relations.

Results

The analyses provided effective support for the hypothesized model. Survivor risk perception was classified into direct risk perception and indirect risk perception. Survivor direct risk perception was found to play a partial mediating role in the relationship between exposure and the two domains (Physical component summary (PCS) and the Mental component summary (MCS)) of psychological health. Survivor indirect risk perception was found to have a only partial mediating effect on the association between exposure and MCS. Social support was found to moderate the influence of risk perception on psychological health.

Conclusion

Risk communication should be considered in future post-earthquake psychological assistance programs and social support strategies could also be useful in improving psychological health.

Associations between economic loss, financial strain and the psychological status of Wenchuan earthquake survivors

This study examines the effects of economic loss on the life satisfaction and mental health of Wenchuan earthquake survivors. Economic loss is measured by earthquake impacts on the income and houses of the survivors. The correlation analysis shows that earthquake impact on income is significantly correlated with life satisfaction and depression. The regression analyses indicate that earthquake impact on income is indirectly associated with life satisfaction and depression through its effect on financial strain. The research highlights the importance of coping strategies in maintaining a balance between economic status and living demands for disaster survivors.

Post traumatic stress disorder and coping in a sample of adult survivors of the Italian earthquake

The aim was to investigate the prevalence of post traumatic stress disorder (PTSD) in people who had left their damaged homes and were still living in temporary housing more than a year after the April 2009 L'Aquila (Italy) earthquake. In addition, we evaluated the differences in coping strategies implemented by persons who had and who did not have PTSD. A cross-sectional prevalence study was carried out on a sample of 281 people aged >18 years and living in temporary housing after the earthquake. The questionnaires used include the Davidson Trauma Scale and the Brief Cope. The prevalence of PTSD was 43%. Women and the non-employed were more vulnerable to PTSD, while, age and level of education were not associated with PTSD. Those with PTSD symptoms often employed maladaptive coping strategies for dealing with earthquake and had the highest scores in the domains of denial, venting, behavioral disengagement, self-blame. By contrast, those without PTSD generally had more adaptive coping mechanisms. Adults who were living in temporary housing after the earthquake experienced high rates of PTSD. The difference in coping mechanisms between those who have PTSD and those who do not also suggests that they influence the likeliness of developing PTSD.

Prospective Study of Posttraumatic Stress in Adolescents 6 and 24 Months After the 2010 Yushu Earthquake in China

Adolescents who have suffered through earthquakes often experience symptoms of posttraumatic stress disorder (PTSD). This particular population has received increasing attention from researchers. The goals of the present study are to describe longitudinally the prevalence and the severity of PTSD in adolescent survivors of the Yushu earthquake in China and to explore the risk factors which lead to psychiatric disorders. The PTSD Check List (Civilian Version) was used to assess the PTSD symptoms in participants. The rates of PTSD were found to be 10.9% after 6 months and 5.8% after 24 months. Bereavement, being buried in the ruins, and personal injury were found to be significant risk factors for the development of PTSD. We suggest that intervention strategies should be addressed and more attention should be paid to adolescents.

Return to work for severely injured survivors of the Christchurch earthquake: influences in the first 2 years

PURPOSE

This study looked at the influences on the return to work (RTW) in the first 2 years for people severely injured in the 22 February 2011 Christchurch earthquake.

METHOD

We used a constructivist grounded theory approach using semi-structured interviews to collect data from 14 people injured in the earthquake.

RESULTS

Analysis elicited three themes that appeared to influence the process of RTW following the Christchurch earthquake. Living the earthquake experience, the individual's experiences of the earthquake and how their injury framed their expectations; rebuilding normality, the desire of the participants to return to life as it was; while dealing with the secondary effects of the earthquake includes the earthquake specific effects which were both barriers and facilitators to returning to work.

CONCLUSION

The consequences of the earthquake impacted on experience, process and outcome of RTW for those injured in the Christchurch Earthquake. Work and RTW appeared key tools to enhance recovery after serious injury following the earthquake.

IMPLICATIONS FOR REHABILITATION

The altered physical, social and economic environment must be considered when working on the return to work (RTW) of individuals with earthquake injuries. Providing tangible emotional and social support so injured earthquake survivors feel safe in their workplace may facilitate RTW. Engaging early with employers may assist the RTW of injured earthquake survivors.

Serum total oxidant and antioxidant status in earthquake survivors with post-traumatic stress disorder

OBJECTIVE

Oxidative stress has been shown to play an important role in the pathogenesis of post-traumatic stress disorder (PTSD). Although there are some studies on oxidative stress and PTSD, there is no report available on the serum total oxidant and antioxidant status in earthquake survivors with PTSD. Therefore, this study aimed to investigate the serum total oxidant and antioxidant status in earthquake survivors with chronic PTSD.

MATERIAL AND METHODS

The study group included 45 earthquake survivors with PTSD and 40 earthquake survivors without PTSD. The oxidative status was determined using the total antioxidant status and total oxidant status (TOS) measurements and by calculating the oxidative stress index (OSI).

RESULTS

There were no statistically significant differences in the total antioxidant status, TOS, or OSI when comparing individuals with and without PTSD (all, p>0.05). There were no correlations between Clinician-Administered PTSD Scale scores and oxidant and antioxidant stress markers (all, p>0.05).

CONCLUSIONS

Our results suggest that the total oxidant and antioxidant status may not affect earthquake survivors with PTSD. This is the first study to evaluate the oxidative status in earthquake survivors with PTSD. Further studies are necessary to confirm these findings.

Prevalence and determinants of depression among survivors 8 months after the Wenchuan earthquake

The current study assessed the estimated rate of depression and associated risk factors among survivors 8 months after the 2008 Wenchuan earthquake in China. A stratified random sample of 1514 participants was recruited from all temporary camp communities in a county town 45 km away from the epicenter. The estimated rate of depression was 35.7%. The severity of depressive symptoms was significantly associated with female sex, perceived livelihood security, loss of a family member, residential house damage or collapse, and not living in an urban area, whereas married status is a protector against depressive symptoms. The results suggest that community-based effective, sustainable, and culturally sensitive interventions and services are warranted and should be directed to the groups at high risk for mental health problems.

An inconvenient dataset: bias and inappropriate inference with the multilevel model

The multilevel model has become a staple of social research. I textually and formally explicate sample design features that, I contend, are required for unbiased estimation of macro-level multilevel model parameters and the use of tools for statistical inference, such as standard errors. After detailing the limited and conflicting guidance on sample design in the multilevel model didactic literature, illustrative nationally-representative datasets and published examples that violate the posited requirements are identified. Because the didactic literature is either silent on sample design requirements or in disagreement with the constraints posited here, two Monte Carlo simulations are conducted to clarify the issues. The results indicate that bias follows use of samples that fail to satisfy the requirements outlined; notably, the bias is poorly-behaved, such that estimates provide neither upper nor lower bounds for the population parameter. Further, hypothesis tests are unjustified. Thus, published multilevel model analyses using many workhorse datasets, including NELS, AdHealth, NLSY, GSS, PSID, and SIPP, often unwittingly convey substantive results and theoretical conclusions that lack foundation. Future research using the multilevel model should be limited to cases that satisfy the sample requirements described.

Posttraumatic stress disorder and posttraumatic growth among adult survivors of Wenchuan earthquake after 1 year: prevalence and correlates

This study investigates the prevalence and predictors for posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG) in adult survivors 1year after the 2008 Wenchuan earthquake. Questionnaires were used to collect the data. PTSD was assessed using the PTSD Check List-Civilian (PCL-C), and PTG was assessed using the Post Traumatic Growth Inventory (PTGI). A total of 2,300 individuals were involved in the survey with 2,080 completing the questionnaire, a response rate of 90.4%. The PTSD prevalence estimate in this study was found to be 40.1%, and the prevalence for PTG among the participants was measured at 51.1%. A bivariate correlation analysis indicated that there was a positive association between PTG and PTSD. In the conclusions, possible explanations for the findings and implications for future research are discussed.

A data-based model to locate mass movements triggered by seismic events in Sichuan, China

Earthquakes affect the entire world and have catastrophic consequences. On May 12, 2008, an earthquake of magnitude 7.9 on the Richter scale occurred in the Wenchuan area of Sichuan province in China. This event, together with subsequent aftershocks, caused many avalanches, landslides, debris flows, collapses, and quake lakes and induced numerous unstable slopes. This work proposes a methodology that uses a data mining approach and geographic information systems to predict these mass movements based on their association with the main and aftershock epicenters, geologic faults, riverbeds, and topography. A dataset comprising 3,883 mass movements is analyzed, and some models to predict the location of these mass movements are developed. These predictive models could be used by the Chinese authorities as an important tool for identifying risk areas and rescuing survivors during similar events in the future.

Behavioural, emotional, and cognitive responses in European disasters: results of survivor interviews

In the European multi-centre study BeSeCu (Behaviour, Security, Culture), interviews were conducted in seven countries to explore survivors' emotional, behavioural, and cognitive responses during disasters. Interviews, either in groups or one-to-one, were convened according to type of event: collapse of a building; earthquake; fire; flood; and terror attack. The content analysis of interviews resulted in a theoretical framework, describing the course of the events, behavioural responses, and the emotional and cognitive processing of survivors. While the environmental cues and the ability to recognise what was happening varied in different disasters, survivors' responses tended to be more universal across events, and most often were adaptive and non-selfish. Several peri-traumatic factors related to current levels of post-traumatic stress were identified, while memory quantity did not differ as a function of event type or post-traumatic stress. Time since the event had a minor effect on recall. Based on the findings, several suggestions for emergency training are made.

Psychological recovery 5 years after the 2004 Niigata-Chuetsu earthquake in Yamakoshi, Japan

BACKGROUND

The 2004 Niigata-Chuetsu earthquake of Japan caused considerable damage. We assessed long-term changes in psychological distress among earthquake victims during the period 5 years after the earthquake.

METHODS

The participants were people aged 18 years or older living in Yamakoshi, a community in Niigata Prefecture near the epicenter. A self-administered questionnaire survey was conducted annually for 5 consecutive years after the earthquake. Response rates were 1316/1841 (71.5%) in 2005, 667/1381 (48.3%) in 2006, 753/1451 (51.9%) in 2007, 541/1243 (43.5%) in 2008, and 814/1158 (70.3%) in 2009. The questionnaire asked about demographic characteristics, including sex, age, employment status, social network, and psychological status. Psychological distress was assessed using the 12-item General Health Questionnaire and was defined as a total score of 4 or higher.

RESULTS

The overall prevalence of psychological distress decreased (P < 0.0001) gradually from 2005 (51.0%) to 2008 (30.1%) but tended to increase from 2008 to 2009 (P = 0.1590). Subgroup analyses showed that prevalence did not decrease over the 5-year study period among participants with poor social contact (P = 0.0659). From 2008 to 2009 prevalence increased in women (+7.5%, P = 0.0403) and participants aged 65 years or older (+7.2%, P = 0.0400).

CONCLUSIONS

The prevalence of psychological distress in Yamakoshi people decreased steadily during the 4 years immediately after the earthquake but appeared to increase thereafter. The earthquake victims are still reestablishing their lives. Thus, continued attention should be focused on maintaining and further assessing their mental health.

Persistent fear of aftershocks, impairment of working memory, and acute stress disorder predict post-traumatic stress disorder: 6-month follow-up of help seekers following the L'Aquila earthquake

The aim of our 6-month follow-up study was to assess predictors of post-traumatic stress disorder (PTSD) among individuals seeking treatment at the General Hospital Psychiatric Unit within the first month following the L'Aquila earthquake. Clinical, trauma-related and neurocognitive variables were considered. At the 6-month follow-up, 91 (74.5%) out of 122 subjects were re-assessed and administered the Impact of Events Scale-revised (IES-R) for the detection of PTSD according to DSM-IV criteria. Within 4 weeks following the earthquake, patients were assessed with a checklist of traumatic-event-related variables, along with the Stanford Acute Stress Disorder Questionnaire (SASDQ) for the detection of ASD, with a short battery on working (Wechler Memory Scale-R, Digit Forward and Backward) and verbal memory (subtest of Milan Overall Dementia Assessment, MODA). A statistically significant higher proportion of subjects affected by 'partial' ASD showed a PTSD diagnosis (80.6%, N = 29) compared to not diagnosed subjects (40%, N = 22) and a PTSD diagnosis was shown by all the 4 subjects (4.4%) affected by 'full' ASD at the entry in the study. At the 6-month follow-up 56% of the sample could be considered affected by PTSD on the IES-R scale. The results of the logistic regression analysis on our selected predictors indicated that the persistent fear of aftershocks seemed to increase by over 57 times the likelihood of positive estimate of PTSD, followed by impairment of working memory backward (OR 48.2), and having being diagnosed as ASD case in the first 4 week after the earthquake (OR 17.4). This study underlines the importance of identifying PTSD predictors, in order to planning early treatment interventions after natural disasters.