A Meta-Analysis of Risk Factors for Post-Traumatic Stress Disorder (PTSD) in Adults and Children after Earthquakes

A meta-analysis on gender differences in prevalence estimates of mental disorders following exposure to natural hazards

Background: Women report higher rates of trauma-related disorders compared to men. With women being disproportionately impacted by the consequences of natural hazards, this gender disparity may increase in their aftermath.Objective: This meta-analysis aimed at quantifying gender gaps in mental disorder prevalence following natural hazards, considering both the recent and long-term aftermath of natural hazards, the developmental status of affected countries, and type of hazard.Method: A systematic search was conducted in MEDLINE, PsycINFO, and Web of Science in February 2024. Random effects models were used to calculate odds ratios (OR) based on point prevalences. OR adjusted for covariates were also descriptively reported.Results: In total, 141 reports (N = 3,726,153 independent participants) were included. The prevalence for posttraumatic stress disorder (PTSD), major depression (MD), and generalized anxiety disorder (GAD) within the first year after the hazard were 24.95%, 8.11%, and 14.24%, respectively. More than one-year post-natural hazard the prevalence for PTSD and MD were 22.89% and 13.51%, respectively. Women had significantly higher odds for PTSD (OR = 1.85) and MD (OR = 1.52) within the first year after the hazard, as well as in later assessments (OR = 1.83 for PTSD, OR = 1.41 for MD). Only four studies reported on GAD gender differences in the recent aftermath of natural hazards, resulting in a non-significant OR of 1.85. Subgroup analyses indicated no differences between developmental status of affected countries and adjusted OR showed no systematic variations upon the inclusion of covariates. Gender differences were larger in the aftermath of earthquakes.Conclusions: Significant gender differences for mental disorders following natural hazards exist, although these differences appear similar to other contexts. Gender-sensitive disaster response plans for mental health are essential.

Mediator role of cognitive distortions in the relationship between posttraumatic stress disorder symptoms and peritraumatic stress levels

BACKGROUND

There are many studies showing the relationships between posttraumatic stress disorder (PTSD), peritraumatic stress, and cognitive distortions. However, there is a very limited number of studies focusing on the relationship between PTSD and cognitive distortions in children and adolescents. This study aimed to investigate the relationship between PTSD symptoms and peritraumatic stress levels in adolescents who experienced the 6 February Turkey earthquakes and the mediator role of cognitive distortions in this relationship.

METHODS

The study sample consisted of 261 adolescents with a mean age of 15.51 ± 1.07. The Child Posttraumatic Stress Disorder Reaction Index (CPTSD-RI), the Peritraumatic Distress Inventory (PDI), and the Cognitive Distortion Scale (CDS) were administered to the participants.

RESULTS

It was determined that there was a positive relationship between the peritraumatic stress levels and PTSD symptoms of the participants, and their peritraumatic stress levels significantly and positively predicted their PTSD symptoms and cognitive distortions. According to the results of the regression analyses, the self-perception, self-blame, helplessness, hopelessness, and perceiving life as dangerous dimensions of cognitive distortions and total CDS scores of the participants had partial mediator roles in the relationship between their peritraumatic stress levels and PTSD symptoms.

LIMITATIONS

Participants' PTSD symptoms were assessed using self-report scales. Pre-traumatic factors were not questioned.

CONCLUSION

Our results showed that the peritraumatic stress levels of adolescents who survived the 6 February Turkey earthquakes predicted their PTSD symptom levels, and their cognitive distortions played a mediator role in the relationship between their peritraumatic stress levels and PTSD symptoms.

IMPLICATIONS AND CONTRIBUTION

In psychological and psychiatric assessments of adolescents living in earthquake zones, peritraumatic stress levels should be kept in mind as a significant factor that can pose a risk in terms of PTSD. Furthermore, it is believed that cognitive distortions that can be causally related to PTSD should be taken into account in the treatment of PTSD.

Shadows of trauma: an umbrella review of the prevalence and risk factors of post-traumatic stress disorder in children and adolescents

INTRODUCTION

Post-Traumatic Stress Disorder (PTSD) is a significant mental health concern affecting children and adolescents, often resulting from exposure to traumatic events such as violence, natural disasters, or abuse. A substantial number of children and adolescents experience these traumatic events; however, the reported prevalence of PTSD in this population varies widely across systematic reviews and meta-analyses. This umbrella review aims to synthesize findings from multiple systematic reviews and meta-analyses to provide a comprehensive estimate of PTSD prevalence and identify key risk factors associated with the disorder.

METHODS

A comprehensive literature search was conducted across several databases, including PubMed, Scopus, EMBASE, and others, using the COCOPOP framework. Systematic reviews and meta-analyses published between January 1, 2014, and December 1, 2024, were included. Data were extracted by two reviewers independently and analyzed using Stata 17 with a random-effects meta-analysis model.

RESULTS

A total of twelve studies were included, with a combined sample size of 121,333 participants. The pooled prevalence estimate for PTSD among children and adolescents was found to be 25% (95% CI: 20-30%), with substantial heterogeneity (I² = 99.9%). Subgroup analyses indicated variations in prevalence based on publication year and the number of primary studies included in the systematic reviews. Key risk factors identified included older age, female gender, low social support, feelings of entrapment, and experiencing bereavement.

CONCLUSIONS

The prevalence of PTSD among children and adolescents exposed to trauma is notably high. Key contributing factors include older age, female gender, low social support, feelings of entrapment, and experiencing bereavement. Targeted interventions focusing on these risk factors, such as enhancing social support systems and providing early mental health interventions, are essential to improve outcomes for this vulnerable population. Further research is needed to refine these strategies and ensure they effectively meet the needs of children and adolescents affected by trauma.

Investigating links between posttraumatic stress symptoms, posttrauma appraisals, and social support in older adults

Research has established the importance of posttrauma appraisals to the development of posttraumatic stress symptoms (PTSS) across a variety of trauma types, populations, and developmental periods. Considering this large body of evidence, there is a notable lack of research on posttrauma appraisals in older adulthood. As rates of elder abuse and maltreatment grow, rates of PTSS are also expected to rise, signaling an urgent need to pinpoint the factors associated with the development and maintenance of PTSS during this unique developmental period. This study extends previous research by exploring whether alienation appraisals were positively associated with PTSS when controlling for other factors known to predict PTSS, including fear appraisals, social support, and cumulative maltreatment. In a convenience sample of community-dwelling older adults (N = 99), multiple linear regression revealed that alienation appraisals were significantly associated with PTSS, β = .34, p = .002, after controlling for cumulative maltreatment (before and after 60 years of age), financial exploitation, fear appraisals, and social support, R2 = .51. Our findings suggest that consistent with research from earlier developmental periods, alienation appraisals are significantly associated with PTSS in older adults even when accounting for other factors, such as social support, that are known to be particularly important in old age. Implications, limitations, and future directions are discussed.

The moderating effect of resilience in the association between insomnia severity and PTSD symptoms in Lebanese adolescents in the aftermath of the 2023 earthquake

The interplay between insomnia and PTSD symptoms remains misunderstood, and seems to be influenced by other factors like individual resilience. Our study examined the moderating role of resilience in the relationship between insomnia and PTSD symptoms among a sample of Lebanese adolescents, in the aftermath of the 2023 earthquake. This cross sectional study, conducted in April, 2 months after the earthquake, enrolled 546 Lebanese adolescents. We used the Sleep Self Report, the Resilience Scale for Adolescents and the 13-item Children's Impact of Event Scale. The interaction insomnia severity by resilience was significantly associated with PTSD scores. At low, moderate and high resilience levels, higher insomnia severity was significantly associated with lower PTSD. Resilience moderated the relationship between insomnia and PTSD, mitigating the detrimental impact of disrupted sleep on PTSD symptoms. This data can guide healthcare administrators and psychiatric caregivers in classifying risk factors and implementing interventions to predict PTSD development.

Shared suffering predicts prosocial commitment among Turkish earthquake survivors

Previous research suggests that the perception of shared emotion associated with personally transformative events can foster a strong form of social bonding known as 'identity fusion', which motivates pro-group action. Here we test predictions from this model among Turkish citizens and Syrian refugees following the catastrophic earthquakes in Turkey on February 6th, 2023. The lead researcher administered surveys in person to 120 Turkish earthquake survivors in the most heavily affected areas. In line with our predictions, mean levels of identity fusion significantly increased with perceived shared suffering for both Turkish and Syrian groups. Further, identity fusion predicted prosocial commitment, measured by the expressed willingness of earthquake survivors to volunteer assistance to disaster victims. Remarkably, participants were as likely to pledge help to other Turkish earthquake survivors as they were to their own families. This study contributes to a growing understanding of how shared suffering facilitates group bonding and cooperation, both within and across social groups.

Post-traumatic stress disorder and its associated factors among internally displaced people due to conflict in Northwest Ethiopia

Background

Post-traumatic stress disorder (PTSD) is a mental health condition that develops after being exposed to trauma, such as experiencing or witnessing life-threatening events, including war and other natural disasters. Despite the high levels of conflict, little attention has been given to post-traumatic stress disorder, particularly in low- and middle-income countries. Therefore, this study aimed to determine the prevalence of post-traumatic stress disorder and its associated factors among internally displaced people in Northwest Ethiopia.

Methods

A cross-sectional study design was employed from June to July 2022 in Northwest Ethiopia among internally displaced people. Simple random sampling was used to recruit 410 study participants. The standard tools used in this study included the Post-Traumatic Stress Disorder Checklist for DSM-5 (PLC-5), Kessler-10, and Oslo Social Support Scale to assess various variables. Binary logistic regression analysis was used to identify factors associated with post-traumatic stress disorder. Statistically significant factors were selected at a 95% confidence interval (CI) with adjusted odds ratio (AOR).

Results

The prevalence of post-traumatic stress disorder among internally displaced people was 54.3%, with a 95% CI (49.5, 59.3). Current substance use [AOR 95% CI: 2.01(1.16, 3.48)]; living arrangements, such as living alone or with non-relatives [AOR = 2.13; 95% CI (1.17, 3.86) and AOR = 2.39; 95% CI: (1.21, 4. 70), respectively]; being violated [AOR = 2.49; 95% CI: (1.26, 4.94)]; and psychological distress [AOR = 3.21; 95% CI: (4.35, 9.34)] were significantly associated with post-traumatic stress disorder.

Conclusion

The prevalence of post-traumatic stress disorder among internally displaced people was high. Therefore, stakeholders should provide immediate interventions that include further assessments using diagnostic criteria. In addition, Eye Movement Desensitization and Reprocessing psychotherapy along with selective serotonin reuptake inhibitors as psycho-pharmacological treatment are recommended. Furthermore, efforts should be made to reduce the identified risk factors to improve outcomes for individuals with post-traumatic stress disorder.

Assessment of post-traumatic stress disorder and well-being among Sudanese during the ongoing war: a cross-sectional study

BACKGROUND

Wars profoundly impact mental health with growing long lasting consequences. This study assessed the prevalence of post-traumatic stress disorder (PTSD) and well-being among Sudanese affected by the ongoing conflict, with a specific focus on healthcare workers (HCWs).

METHODS

A cross-sectional study was conducted between April 1 and June 30, 2024, using the validated Arabic versions of PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (PCL-5) and the World Health Organization (WHO)-5 Well-Being Index.

RESULTS

A total of 1022 participants were included, and 44% were recruitted through online questionnaire and face-to-face interviews. Their mean age was 31.4 ± 12.5 years, 63.4% were females, 16.3% were HCWs and 83.3% were displaced due to conflict. The mean score of PTSD was 35 ± 21.3 with 56.9% having PTSD. The mean well-being score was 55.0 ± 23.9 with 40% reporting poor well-being. Among HCWs, 60.5% suffered from PTSD and 27.5% experienced poor well-being. A significant negative correlation was observed between PTSD and well-being scores (r=-0.273, p < 0.001). Predictors of PTSD were being male [β = -10.91, 95% confidence interval (CI) (-13.44, -8.38); p < 0.001], urban area resident [β = -10.38, 95%CI (-18.78, -1.98); p = 0.016], non-medical profession [β = 5.07, 95%CI (1.46, 8.67); p = 0.006], living with 2 to 10 households [β = 6.69, 95%CI (0.46, 12.91); p = 0.035], living with more than 20 households [β = 13.20, 95%CI (4.17, 22.23); p = 0.004], insufficient income [β = 4.32, 95% CI (1.84,6.81); p = 0.001], living in conflict zones [β = 13.38 95%CI (8.83,17.92); p < 0.001], refugee resettlement [β = 13.18, 95%CI (9.98,16.38); p < 0.001], and well-being score [β = -0.20, 95%CI (-0.25, -0.15); p < 0.001]. Predictors of well-being scores were living with more than 20 households [β = -17.44, 95%CI (-28.83, -6.04); p = 0.003], being a HCW [β =-6.22, 95%CI (-11.87, -0.57); p = 0.031], being a student [β = -7.55, 95%CI (-12.94, -2.16), p = 0.006, insufficient income [β = -5.04, 95%CI (-8.17, -1.90); p = 0.002], and living in conflict zones [β = -8.22, 95%CI (-13.96, -2.48); p = 0.005].

CONCLUSIONS

The study highlights an alarmingly high prevalence of PTSD among Sudanese including HCWs, with significant mental health consequences. These findings emphasize the urgent need for mental health interventions and humanitarian support to mitigate the psychological challenges faced by the conflict affected population.

Pathway from Earthquake Fear to Post-Traumatic Growth: The Roles of Resilience, Self-Efficacy, and Positive Childhood Memories Among Survivors of the 2023 Türkiye Earthquakes

Posttraumatic growth is essential for understanding how individuals process trauma and adapt psychologically in the aftermath of seismic events. This study aims to explore the mediating effects of resilience, self-efficacy, and positive childhood memories on the relationship between fear of earthquakes and post-traumatic growth among survivors of the 2023 Türkiye earthquake (N = 423). The results of a multi-mediation analysis indicated that earthquake fear indirectly influenced post-traumatic growth through resilience, self-efficacy, and positive childhood memories. Consequently, these factors may serve as protective mechanisms promoting post-traumatic growth in earthquake survivors. Implementing strategies to enhance resilience and self-efficacy, as well as fostering positive childhood memories, may be essential for mitigating the adverse effects associated with earthquakes.

Posttraumatic stress disorder in the aftermath of the Turkey earthquake: exploring the role of demographics, level of exposure, and personality traits

BACKGROUND AND OBJECTIVES

Post-Traumatic Stress Disorder (PTSD) is an important mental disorder that can develop after mass traumas such as earthquakes. In our study, we aimed to investigate the development of PTSD after the Turkey earthquake (6 February 2023) and its association with some demographic variables, personality traits, and psychological vulnerability.

METHOD

547 participants completed assessments of personality, disaster exposure, and PTSD symptoms. Multiple regression analyses were used to identify predictors of PTSD symptoms.

RESULTS

PTSD scores were higher in women, single people, those with low educational level, those who witnessed someone else's injury or death, those who were injured, and those whose homes were destroyed. Physical injury, conscientiousness, marital status, income, and agreeableness predicted PTSD. Among these variables, physical injury was the strongest predictor of PTSD.

CONCLUSIONS

Psychological vulnerability, conscientiousness, physical injury, employment, witnessing someone else's injury, gender, and emotional stability predicted PTSD score in a significant way. Physical injury, conscientiousness, marital status, income, agreeableness predicted PTSD in a significant way.

The Mediating Role of Difficulties in Emotion Regulation and Earthquake Stress Coping in the Relationship Between Posttraumatic Cognitive Attribution and Posttraumatic Stress Disorder in Türkiye 2023 Earthquake Survivors

Natural disasters such as earthquakes leave deep psychological effects on individuals that can lead to posttraumatic stress disorder, and understanding these effects is vital to support psychological recovery processes after trauma. In this context, the aim of this study was to examine the mediating role of emotion regulation difficulties, religious coping, positive reappraisal and seeking social support in the relationship between posttraumatic cognitive attributions and posttraumatic stress disorder in 2023 Kahramanmaraş Pazarcık, Elbistan and Hatay Yayladağı earthquake survivors (N = 408). The findings from the multiple mediation analysis showed the indirect effect of posttraumatic cognitive attribution on PTSD through difficulties in emotion regulation, religious coping, positive reappraisal, and seeking social support. Therefore, difficulties in emotion regulation may be a risk factor for PTSD, while religious coping, positive reappraisal and seeking social support may be protective factors. Strategies to reduce difficulties in emotion regulation and to improve religious coping, positive reappraisal and social support seeking in earthquake survivors may be necessary to reduce PTSD that may be caused by the earthquake.

Psychological impact of disaster and migration on preschool children following the 2023 Turkey earthquakes

This study aimed to investigate the psychological impact of the Turkey 2023 earthquakes on preschool-aged children and to compare them with those with other life-threatening traumas. Thirty-four preschool children who experienced earthquakes on February 6, 2023, and applied to our outpatient clinic in the following 3 months, and 37 other trauma-experienced preschool children were included in this cross-sectional study. Preschool Age Psychiatric Assessment/Post-Traumatic Stress sections were conducted. Parents were asked to complete the Pediatric Emotional Distress Scale and the Child Behavior Checklist for Ages 1.5-5 to evaluate stress-related reactions alongside psychiatric problems of children. The results showed that acute stress disorder and post-traumatic stress disorder (PTSD) were more common in the earthquake-experienced group than in the other trauma-experienced group (Fisher's exact test, 52.9% vs. 8.1%, p < 0.001 and 38.2% vs. 8.1%, p = 0.004, respectively). Migration after the earthquake had no additional impact on trauma-related psychiatric outcomes, either ASD or PTSD (p = .153, and p = 0.106, respectively); whereas sleep problems predicted PTSD (OR = 1.26, β = 0.42, p = 0.036) in the earthquake-experienced group. Our study provides implications for understanding the psychological impact of earthquakes and risk factors for PTSD among preschool children.

Posttraumatic stress disorder and associated factors in the aftermath of the 2015 earthquake in Nepal: A systematic review and meta-analysis

We aimed to estimate the pooled incidence of posttraumatic stress disorder among survivors after the 2015 earthquake in Nepal based on available literature and highlight the psychological effects of natural disasters that can hamper the recovery process in the aftermath of disaster. The study protocol was registered on PROSPERO with reference number CRD42024576444. Electronic databases such as PubMed and Google Scholar were searched for observational studies in English that assessed posttraumatic stress disorder at least 1 month after the earthquake via a validated tool from April 2015 to August 2024. In addition, references to the included studies were thoroughly searched. High-quality articles were included after the risk of bias assessment. The random-effects model was used to calculate the pooled incidence with a 95% confidence interval along with subgroup analysis. An analysis of 25 studies revealed a pooled incidence of 22.6%, ranging from 17.6 to 27.5%. A high degree of heterogeneity (I2 = 97.56%, p<0.001) was observed in the results, with the incidence ranging from 3% to 51%. The subgroup analyses revealed that the incidence of posttraumatic stress disorder after an earthquake varied significantly across studies in terms of the time of assessment, sex, age, marital status, ethnicity, educational level, disease history, bereavement, injury to the body, witnessing death, social support, loss of property and damage to one's house. However, stratified analyses could not fully explain the heterogeneity in the results. Our analysis revealed a high incidence of posttraumatic stress disorder among survivors of the 2015 earthquake in Nepal. Addressing the psychological well-being of these survivors is essential. Psychosocial counseling becomes pivotal in assisting them in coping with the trauma they have experienced since the earthquake.

Impact of the Kahramanmaraş Earthquake on the Profiles of Patients Admitted to the Child and Adolescent Psychiatry Outpatient Clinic: A University Hospital Experience from the Earthquake Epicenter

BACKGROUND

This study aims to investigate the effect of the Kahramanmaraş earthquake on admissions to the child and adolescent psychiatry outpatient clinic admissions in a university hospital in the epicenter of the earthquake in Turkey and the relationship between psychiatric diagnoses and earthquake-related symptoms.

METHOD

The data set includes children and adolescents aged 0 to 18 who were admitted to the child and adolescent psychiatry outpatient clinic within one month before one year of the earthquake (February 6 to March 5, 2022; Before Earthquake (BE)), the first month after the earthquake (February 6 to March 5, 2023; After Earthquake 1 (AE1)), and one month after one of the earthquake (February 6 to March 5, 2024; After Earthquake 2 (AE2)). The sociodemographic characteristics, the psychiatric diagnoses, and the relationship of the diagnoses to the earthquake of the child and adolescent were recorded and analyzed from the file.

RESULTS

The data demonstrate a statistically significant increase over time in the proportion of children and adolescents with at least one psychiatric diagnosis, from 349 (87.5%) in BE to 48 (92.3%) in AE1 and 489 (93.6%) in AE2 (p = 0.026). The proportion of children and adolescents with two or more psychiatric diagnoses also increased significantly, from 116 (29.1%) in BE to 208 (40.5%) in AE2 (p < 0.001). In AE2, the prevalence of trauma- and stressor-related disorders (p < 0.001), anxiety disorders (p < 0.001), sleep-wake disorders (p < 0.001), and dissociative disorders (p = 0.009) significantly increased compared to BE. Furthermore, a comprehensive analysis revealed statistically significant associations between earthquake-related symptoms and specific disorders, including trauma- and stressor-related disorders, anxiety disorders, depressive disorders, sleep-wake disorders, dissociative disorders, and feeding and eating disorders (all p < 0.05). Notably, earthquake-related diagnoses were more prevalent among females (78, 61.4%) compared to males (49, 38.6%), a statistically significant difference (p = 0.001).

CONCLUSION

The findings of this study provide significant insights into the psychological consequences of earthquakes on children and adolescents, revealing both immediate and long-term changes in psychiatric presentations. It is crucial to recognize that, in the aftermath of an earthquake, the relationship may persist beyond the trauma- and stressor-related disorders, thereby extending to encompass other psychiatric presentations.

Smoking as a Marker of Comorbid Vulnerability Among Persons with Probable Posttraumatic Stress Disorder Who Engage in Hazardous Drinking

Background: Persons with posttraumatic stress disorder (PTSD) compared to those without evince high rates of hazardous drinking, or patterns of alcohol consumption that increase the risk for harmful consequences. One potential marker of vulnerability for PTSD-hazardous drinking comorbidity may be smoking behavior. Individuals with PTSD have a higher prevalence of smoking and smoke at higher rates. Smokers, compared to nonsmokers, are more apt to engage in hazardous alcohol use. Notably, there is a need to expand research on smoking in the context of PTSD and hazardous drinking to inform treatment of these morbidities. Objective: The present cross-sectional investigation sought to examine smoking status as a marker of risk among persons with probable PTSD who engage in hazardous drinking (N = 647; Mage = 38.90 years, SD = 10.71; 51.2% female). Results: Results indicated that trauma-exposed smokers, compared to non-smokers, evinced greater severity of PTSD symptoms, depression, emotion regulation difficulties, hazardous drinking, and substance use problems, with small effect sizes. No statistically significant group differences were found for anxiety symptom severity. Secondary analyses among only smokers supported an interrelation between cigarette dependence and each of the criterion variables that demonstrated statistically significant group differences. Specifically, cigarette dependence was statistically significantly and incrementally related to PTSD symptom severity, depression, emotion regulation difficulties, more severe hazardous drinking, and a greater degree of substance use problems. Conclusions: Overall, the current investigation found that smoking status among persons with probable PTSD who engaged in hazardous drinking was associated with numerous indicators of mental health and substance use vulnerability.

The Investigation of Quality of Life and Post-traumatic Stress Disorder Levels of Midwifery Students Experiencing an Earthquake

OBJECTIVES

The knowledge of students' quality of life and post-traumatic stress disorder levels, investigation of the relationship between them, and taking measures are essential in terms of guiding the necessary interventions. This study was conducted to determine the quality of life and post-traumatic stress disorder levels of midwifery students experiencing an earthquake.

METHODS

This descriptive and correlational study was conducted with 363 midwifery students who had experienced the Kahramanmaras, Türkiye earthquake. Data were obtained using a Descriptive Information Form, the PTSD-Brief Scale, and the World Health Organization Quality of Life Scale (WHOQOL-BREF).

RESULTS

The rate of post-traumatic stress disorder in the sample studied (n = 363), which consisted of midwifery students who would work in the field of health, was 21.5% 2 months after the earthquake. The multiple linear regression analysis indicated that factors predicting post-traumatic stress disorder following the earthquake were quality of life score related to physical and environmental domains, damage status of the house, presence of family history of depression, and smoking status.

CONCLUSIONS

This study, which was conducted 2 months following the earthquakes, showed that living spaces had an impact on the occurrence of post-traumatic stress disorder symptoms.

Differences associated with different prior mental disorders among earthquake-exposed treatment-seeking individuals

BACKGROUND

History of prior mental disorder, particularly post-traumatic stress disorder (PTSD), increases risk for PTSD following subsequent trauma exposure. However, limited research has examined differences associated with specific prior mental disorders among people with PTSD.

AIMS

The current study examined whether different prior mental disorders were associated with meaningful differences among individuals presenting to a specialist service for severe earthquake-related distress following the Canterbury earthquakes (N = 177).

METHOD

Two sets of comparisons were made: between participants with no history of prior disorder and participants with history of any prior disorder; and between participants with history of prior PTSD and those with history of other prior disorders. Comparisons were made in relation to sociodemographic factors, earthquake exposure, peri-traumatic distress, life events and current psychological functioning.

RESULTS

Participants with any prior mental disorder had more current disorders than those with no prior disorder. Among participants with history of any prior disorder, those with prior PTSD reported more life events in the past 5 years than those with other prior disorders.

CONCLUSIONS

Findings suggest a history of any prior mental disorder contributes to increased clinical complexity, but not increased PTSD severity, among people with PTSD seeking treatment. Although post-disaster screening efforts should include those with prior mental disorders, it should also be recognised that those with no prior disorders are also at risk of developing equally severe PTSD.

A longitudinal investigation of mental health outcomes after the Henan floods in China: Examining predictors of resilience trajectories

A heavy rainstorm struck Henan, China, in July 2021. Previous studies have indicated that natural disasters have a wide range of psychological sequelae, but little research has been done on the psychological effects of floods specifically. This study aimed to track the mental health trajectories of flood victims over time and identify associated protective and risk factors. People living in the areas most impacted by the flood (N = 376) were surveyed at four different time points: 3 weeks, 1 month, 2 months, and 3 months post-flood. Latent growth mixture modeling was utilized to delineate longitudinal patterns of depression, anxiety, and posttraumatic stress disorder (PTSD). Least absolute shrinkage and selection operator logistic regression, a supervised machine-learning approach, was employed to discern predictors among 49 assessed variables at both contextual and personal levels. Results revealed three classes of PTSD (resilience, recovery, moderate symptoms) and anxiety (resilience, chronicity, recovery) trajectories, along with two classes of depression trajectories (resilience, chronicity). Key factors predicting resilience in mental health included personality traits, media consumption habits, pre-existing health conditions at the individual level, and asset loss and ongoing adversities at the contextual level. In spite of the widespread impact of the flood, most victims displayed resilience in the face of adversity. Identifying critical factors across various psychological symptoms offers valuable insights for both pre-disaster preparation and post-disaster trans-diagnostic psychological interventions.

Mediator role of psychological resilience between post-traumatic stress symptoms and burnout in academicians affected by the earthquakes in Türkiye

Purpose

This study aims to investigate the mediator role of psychological resilience in the relationship between post-traumatic stress and burnout symptoms in academicians affected by two earthquakes that occurred on February 6, 2023, affecting 11 provinces of Türkiye.

Methods

The research sample consisted of 175 academicians affected by these earthquakes. Each academician completed an online survey consisting of a sociodemographic form, the PTSD Checklist for DSM-5 (PCL-5), the Brief Psychological Resilience Scale, and the Burnout Syndrome Inventory-Short Version.

Results

Negative relationships were found between the post-traumatic stress symptom and burnout levels of academicians and their psychological resilience levels. Psychological resilience had a partial mediating role in the relationships of post-traumatic stress symptoms (reexperiencing, avoidance, and hyperarousal) and burnout.

Conclusion

It can be said that higher post-traumatic stress symptoms' severity is associated with higher levels of burnout, and psychological resilience has a mediator role in the relationship between post-traumatic stress and burnout in earthquake-affected academicians.

Examining Predictors of Post-Traumatic Changes Among Mothers in Turkey Following Earthquakes

OBJECTIVES

This study aims to assess the prevalence of Post-Traumatic Stress Disorder (PTSD) in mothers affected by the February 2023 earthquakes in Turkey and to explore the influence of spiritual well-being and other factors on their Post-Traumatic Growth (PTG) levels.

METHODS

The study's sample consisted of mothers invited to participate voluntarily through online social media platforms between October-December 2023. The Mother Information Form, Post-Traumatic Stress Disorder Control List, Post-Traumatic Growth Scale, and Spiritual Well-Being Scale (SWBS) were used as data collection instruments.

RESULTS

A total of 303 mothers participated in this study. The mean total PTSD score was 49.35 (SD: 19.76), and 83.5% of mothers were categorized under severe anxiety levels. There was a statistically significant weak and positive relationship between PTSD and PTG levels (r: 0.282, P:0.000). When the predictors of PTG are considered, the spiritual well-being of mothers significantly predicts PTG (F: 43.944, P: 0.000). It accounts for 12.7% (R Square = 0.127) of the variance in mothers' PTG.

CONCLUSIONS

Mothers showed high PTSD levels 9 months after the earthquakes, but alongside these high levels, it has a positive relation with their PTG, which may show mothers becoming stronger after their traumatic experience. Study results showed the mothers' spiritual levels were a significant predictor for PTG.

Population-level effects of Hurricane Sandy on adolescent health

BACKGROUND

Disasters are increasing in frequency and intensity due to climate change. Youth are the largest and most vulnerable group exposed to disasters. More evidence is needed regarding how youth mental health and health behaviors vary based on disaster exposure, how mental health influences health behaviors, and how diverse groups of youth may be differentially affected.

METHODS

Using data from the Youth Risk Behavior Survey and Federal Emergency Management Agency, we examined the impact of Hurricane Sandy (2012) on mental health (sadness, suicidality) and health behaviors (substance use, physical activity, screen time, sexual behaviors) of 240,365 youth. Difference-in-differences regression analyses evaluated pre-disaster (2005-2011) and post-disaster (2013-2019) changes.

RESULTS

There were 83,442 (34.7 %) adolescents (51.2 % female, 18.1 % non-Hispanic White) located in 6 districts exposed to Hurricane Sandy and 156,923 (65.3 %) adolescents located in 13 non-exposed districts. Exposure was associated with differences in substance use, physical (in)activity, and risky sexual behaviors, but not mental health outcomes. Mental health did not moderate the association between disaster exposure and health behaviors. Hispanic adolescents and those identifying as Other races/ethnicities were most vulnerable to post-disaster negative health outcomes.

LIMITATIONS

Study limitations include questionnaire design, cross-sectional data, sampling, and possible response biases.

CONCLUSIONS

Findings provide critical information about youth mental health and health behaviors following disasters, as well as how youth may differ in their responses. Findings provide guidance for early identification and resource allocation for youth at higher risk for post-disaster health issues.

Resilience and Religious Coping in Libyan Survivors of Hurricane Daniele

The aim of the study was to investigate the mediating roles of resilience, posttraumatic growth (PTG) and religiosity between the impact of hurricane trauma and psychological distress. Using a cross-sectional design, the study involved 101 Libyan participants with an average age of 30.43 years (SD = 9.59), of whom 72% were women. Participants completed validated tests, including the Impact of Event Scale (IES), Brief Resilience Scale, Muslim Religiosity Scale and Patient Health Questionnaire (PHQ). The results indicated that posttraumatic stress symptoms (PTSS) were not associated with PTG (r = 0.04, p > 0.05) or religiosity (r = 0.02, p > 0.05) but were negatively associated with resilience (r = -0.39, p < 0.001) and positively associated with psychological distress including anxiety (r = 0.72, p < 0.001) and depression (r = 0.69, p < 0.001). Structural equation modelling (SEM) revealed that only resilience positively mediated the association between PTSS and anxiety (indirect effect = 0.04, p = 0.031), while PTSS positively predicted psychological distress (β = 0.037, p < 0.001). Network analysis identified parent loss is strongly connected with intrusion (r = 0.121), as most central node, while partner loss was associated with hyperarousal (r = 0.063), irritability (r = 0.036) and both share the same connection with numbing, while interestingly partner and friends loss share connection with resilience (r = 0.177). The study concludes that urgent clinical interventions, such as trauma-focused cognitive behavioural therapy, are required for the affected individuals, with a focus on enhancing resilience as a protective factor against PTSS.

Posttraumatic stress symptoms in parents of children with newly diagnosed cancer: 1-year trajectories and relationship variables as predictors

OBJECTIVE

The way in which parental posttraumatic stress symptoms (PTSS) unfold in the first year after a cancer diagnosis in their child is poorly understood. The aims of this study were to identify parental PTSS trajectories and to examine couple-related predictors (dyadic coping and we-disease appraisals), sociodemographic predictors (education and sex), and medical predictors (child's physical impairment) of trajectory membership.

METHOD

A 1-year prospective study was conducted, and 157 parents of children newly diagnosed with cancer were assessed. PTSS was measured with the Posttraumatic Diagnostic Scale for DSM-5 (PDS-5) at 3-6 weeks (T1), 6 months (T2), and 12 months (T3) after the diagnosis. The trajectories were identified with Latent Class Growth Analysis, the predictors were explored with binomial logistic regression.

RESULTS

Two distinct trajectories were found. The majority of parents (86.0%) followed a low PTSS trajectory, characterized by initially low scores that slightly decreased over 12 months. In contrast, 14.0% of parents displayed a stable, high PTSS trajectory. A high trajectory of child's physical impairment and low scores in parental dyadic coping were significantly associated with the likelihood of a high parental PTSS trajectory.

CONCLUSIONS

The findings provide new insights into the critical period of the first year after a child's cancer diagnosis. While most parents display a resilient, low PTSS trajectory, a minority consistently experience high PTSS levels. Child's physical impairment and dyadic coping should be considered as predictors for early identification of vulnerable parents. Incorporating dyadic coping in parental support following a childhood cancer diagnosis could be beneficial for parental mental health.

Determinants of Posttraumatic Stress Disorder (PTSD) among children and adolescents in the subacute stage of Kahramanmaras earthquake, Turkey

BACKGROUND

Earthquakes are potentially traumatic natural disasters due to their destructive nature, and huge impacts, producing scenes of horror, undesirable and uncontrollable results. Children are affected mainly by earthquakes not only physically but also psychologically. We aimed to evaluate the rates of probable PTSD and related factors in children and adolescents after the February 6 Kahramanmaras earthquake.

METHODS

In this cross-sectional study, 246 children and adolescents were included. The research was conducted in Hatay, one of the most affected provinces, between 06/07/2023-06/08/2023. Sociodemographic form, Children's Depression Inventory, Children's Posttraumatic Response Reaction Index, Screen for Child Anxiety Related Emotional Disorders, Child and Youth Resilience Measure and Social Support Appraisals Scale for Children were applied by face-to-face survey method.

RESULTS

The median age of the participants was 12 (8-18). 133 (54%) of the participants were girls. Probable depression rate was 98%, and probable anxiety disorder rate was 63%. Probable mild, moderate, severe and very severe PTSD rates were 18%, 29%, 43% and 8%, respectively. The probable severe PTSD rate was higher in children who were injured in the earthquake (p = 0.032), who received outpatient treatment (p = 0.016), and who saw people trapped under the collapse (p = 0.012). Also, the children whose sleep routines have changed post-earthquake were found to have more probable severe PTSD (p < 0.001). Access time to the potable water supply (p = 0.045), toilet facilities (p = 0.045), shelter facilities (p = 0.004), heating facilities (p = 0.001), clothing supply (p < 0.001) and healthcare services (p = 0.009) were found to be associated with probable severe PTSD right after the earthquake. In the fifth month of the earthquake, inadequate meeting of clothing needs (p = 0.018), educational services (p = 0.028) and social activity opportunities (p < 0.001) were significantly associated with probable severe PTSD. In the multivariate analysis, the risk of probable severe PTSD was increased 2.9 times in those with post-earthquake sleep changes (p = 0.001) and 11.1 times in those with probable anxiety disorders (p < 0.001). Also, it has been shown that each unit increase in the APP-family score reduces probable severe PTSD risk by 2% (p = 0.002).

CONCLUSION

In the current study, the rates of probable PTSD, depression and anxiety disorders were considerably high. Probable anxiety disorder and sleep disturbance were significant predictors of probable severe PTSD. On the other hand, social support from family was found to be a significant protective factor for severe PTSD risk. We conclude that the lack of meeting needs that increase the risk of probable severe PTSD differs in the acute and subacute phases.

A prediction model of PTSD in the Israeli population in the aftermath of october 7th, 2023, terrorist attack and the Israel-Hamas war

BACKGROUND

On October 7th, 2023, a mass terror attack was launched by Hamas militants, which was followed by the Israel-Hamas war. These events constitute a nationwide trauma with major ramifications for public mental health. This article presents an evidence-based model for the prediction of the prevalence of posttraumatic stress disorder (PTSD) related to the terrorist attack and the war.

MAIN BODY

The creation of the model consisted of several steps. Firstly, the Israeli population was divided into six groups based on the intensity, context, and type of traumatic exposure (direct exposure to terror, close proximity to terror, soldiers in combat and support units, intense exposure to rocket attacks, moderate exposure to rocket attacks, and indirectly affected communities), and the population size of each group was assessed using official national databases. Secondly, an estimation of the expected prevalence of PTSD in each of the exposure groups was based on a review of the relevant literature. A random-effects meta-analysis of the prevalence rates was conducted separately per each exposure group. Finally, the predicted number of PTSD causalities in the population was calculated by multiplying the group size and the PTSD prevalence estimation. Based on population size and estimated PTSD prevalence within each exposure category, the model predicts that approximately 5.3% (N = 519,923) of the Israeli population (95% confidence interval, 1.64-9%), may develop PTSD as a result of the terrorist attack and the war.

CONCLUSIONS

The predicted number of individuals with PTSD following mass trauma is expected to be considerable. The presented model can assist policymakers, clinicians, and researchers in preparing and devising adequate interventions for the mental health needs of large populations. Moreover, this model can be applied in other instances of mass-trauma exposure.

The Effects of Post-Earthquake Trauma Levels of Nursing Students on their Academic Motivation and Career Decisions

OBJECTIVES

This study was carried out to determine the effects of post-earthquake trauma levels of nursing students on their academic motivation and career decisions.

METHODS

The sample of this descriptive study consisted of 228 students studying at Gaziantep Islamic Science and Technology University, Department of Nursing. The data were collected using an online questionnaire created by the researchers. This online questionnaire form consists of seven questions about socio-demographic characteristics, and it also includes the Determination of Post-Earthquake Trauma Levels Scale, Academic Motivation Scale, and Career Decision Scale. SPSS 23.0 package program was used for the analysis of the data, and P < 0.05 was accepted for the level of significance.

RESULTS

It was determined that the post-earthquake trauma level of the students was above the moderate level (63.49 ± 17.29) and that the extrinsic motivation-identified regulation, extrinsic motivation-external motivation, and intrinsic-knowledge levels were more affected by the earthquake (P < 0.05). In addition, it was determined that the mean Career Decision Scale score of the students (74.20 ± 17.35) was below the average.

CONCLUSIONS

It was determined that post-earthquake trauma level had positive effects on intrinsic motivation-stimulation, extrinsic motivation, and amotivation, but had no effect on career decision.

A cross-sectional study on the relationship between trauma levels and fear of happiness with sexual quality of life in women earthquake survivors

To evaluate the relationship between post-earthquake trauma levels and fear of happiness with sexual quality of life in women who had survived the earthquake. The study revealed that as the level of post-earthquake trauma and fear of happiness increased, so too did the quality of sexual life. These findings indicate that traumatic events strengthen the bonds between couples and positively affect the quality of sexual life. Nevertheless, providing support to individuals following the earthquake and informing them about sexual life and sexual health issues can contribute to individual health and harmony within the family, thereby positively impacting public health.

The effect of earthquake exposure on PTSD symptoms is mediated by intrusive rumination and moderated by gender: a cross-sectional study on the 2023 Kahramanmaraş earthquake survivors

BACKGROUND

Evidence suggests that natural disasters, such as earthquakes, can lead to post-traumatic stress disorder (PTSD), with women being particularly vulnerable. However, there is a dearth of knowledge about the underlying mechanisms linking traumatic experiences to PTSD as well as gender differences in the operation of these mechanisms. This study examined the mediating effect of intrusive rumination and the moderating effect of gender on the relationship between earthquake exposure level and PTSD symptoms.

METHODS

This cross-sectional study was conducted 12 months after the devastating earthquake in Kahramanmaraş, Turkey. The sample included 632 adult survivors of the earthquake, including 374 females (59.2%) and 258 males (40.8%). Participants completed a set of questionnaires assessing their demographic information, level of earthquake exposure, intrusive rumination, and PTSD symptoms. Correlation analysis, mediation analysis, and conditional process analysis were employed to evaluate the research hypotheses.

RESULTS

Findings revealed significant associations between the level of earthquake exposure, intrusive rumination and PTSD symptoms. The level of earthquake exposure significantly predicted PTSD symptoms. Moreover, intrusive rumination partially mediated the relationship between earthquake exposure level and PTSD symptoms. Additionally, the mediating effect of intrusive rumination was more pronounced among females than males.

CONCLUSION

This study revealed the significant mediating role of intrusive rumination in the development of post-earthquake PTSD symptoms. By uncovering gender differences in this mechanism, it also emphasized the importance of designing interventions that are sensitive to the varying needs of different demographic groups affected by the disaster in post-disaster mental health interventions.

PTSD risk factors in earthquake survivors and their families: a systematic review

Background: Exposure to earthquakes can cause adverse effects on the mental health of survivors, including an increased risk of PTSD.Objective: This systematic review aims to analyse the previous secondary studies to identify the risk factors for PTSD from children to elderly earthquake survivors. In addition, it aims to consider the complexity of the joint effects of the individual, relational, and contextual risk factors, to also detect the most at-risk families.Method: After reviewing and screening studies from the literature search through PubMed, Web of Science, Scopus, and EBSCO under the guidance of PRISMA guidelines, ten eligible secondary studies were identified that examine the risk factors for PTSD in individuals (from children to elderly) affected by worldwide earthquakes.Results: The analysis of the included studies allowed the identification of a series of socio-demographic, pre-traumatic, peri-traumatic, and post-traumatic PTSD risk factors in children, adolescents, youth, adults, and elderly survivors. The results represent the complexity of the joint effects of these risk factors at individual, relational, and contextual levels.Conclusions: The consideration of the PTSD risk factors highlights the importance of individual characteristics and the type of experiences and exposure in the period before, during, and after the earthquake. This knowledge could allow the early identification of at-risk individuals of different ages and families and the implementation of intervention programmes.

Correlates of post-traumatic stress disorder among adult residents of conflict-affected communities in Cross River State, Nigeria: a cross-sectional study

BACKGROUND

Conflict-affected communities in Nigeria experience a range of problems. These experiences have been associated with different types of mental disorders, most notably, post-traumatic stress disorder (PTSD).

AIM

This study sought to assess PTSD and its associated factors among adults in conflict-affected communities in Odukpani Local Government Area (LGA), Cross River State, Nigeria.

METHODS

A cross-sectional study was conducted using non-probability and probability sampling techniques. The sample size for this study was 486 conflict-affected adults. The symptoms of PTSD were assessed using the Harvard Trauma Questionnaire and a semistructured questionnaire was employed to collect data on sociodemographic and trauma-related characteristics. Data were analysed using descriptive statistics, χ2 and multivariable logistic regression.

RESULTS

The prevalence of PTSD in conflict-affected communities in Odukpani LGA, Cross River State, Nigeria was 73.9%. The multivariate analysis revealed that higher educational attainment (AOR 5.66; p<0.001; 95% CI 2.37 to 13.54), family size >4 (AOR 1.72; p=0.03; 95% CI 1.06 to 2.77), discrimination because of present status (AOR 1.96; p=0.03; 95% CI 1.26 to 3.06) and family history of mental illnesses (AOR 2.08; p=0.002; 95% CI 1.31 to 3.31) showed statistically significant relationships with PTSD in the study population.

CONCLUSION

A multisectoral approach for creating and routinely arranging mental health interventions and aid programmes aimed at improving social outcomes such as employment, living conditions and social networks for conflict-affected communities is recommended.

Prevalence of posttraumatic stress disorder and associated factors among displaced people in Africa: a systematic review and meta-analysis

Background

The number of people who have been displaced from their homes due to violence, conflict, and natural disasters. The displaced persons are vulnerable to PTSD; however, being women, individuals with lower socio-economic status and intense exposure to physical assault are more vulnerable. The reviews stated that the pooled prevalence of PTSD among refugees in high-income countries was higher than the general population. However, there has been no review done on PTSD among displaced persons in Africa. Therefore, the aim of this review was to summarise the most recent data evidence on the pooled prevalence of posttraumatic stress disorder and the pooled effect of associated factors on adult displaced people in Africa.

Methods

We used an appropriate guideline for systematic reviews and meta-analyses reports, which is the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). This review protocol was registered in PROSPERO (CRD42023411371). The publications were identified from PubMed/Medline, EMBASE, the Cochrane Library, Scopus databases, and other grey searches of Google Scholar and World Health Organisation (WHO) reports. The data was extracted in Microsoft Excel, and then it will be imported into STATA 11.0 for analysis.

Results

We have included 10 studies conducted in African countries with 5287 study participants. In this meta-analysis, the pooled prevalence of PTSD among displaced people in Africa was 55.64 (95% CI: 42.76-68.41%). Further, in subgroup analysis regarding the study participants, the pooled prevalence of PTSD among internally displaced people and refugees was 56.35% and 54.04%, respectively. Among the associated factors, being female, unemployed, and depression were significantly related to PTSD among displaced people.

Conclusions

In this review, the pooled prevalence of PTSD among displaced people in Africa was high. Demographic characteristics (female, single, and unemployed), substance use disorder, and depression were risk factors for PTSD among displaced people. This finding might help the stakeholders (mental health policy makers, administrators, and mental health professionals) to address the prevention, early screening, and management of PTSD among displaced people and to give attention to more vulnerable bodies.

Systematic review registration

PROSPERO, identifier CRD42023411371.

Prevalence and determinants of post-traumatic stress disorder five months after the 2019 huge flooding in Iran

BACKGROUND

Despite the high occurrence of floods in Iran, its psychological consequences have been less discussed. The present paper addresses the prevalence of Post-traumatic Stress Disorder (PTSD) and its determinants among the affected adults by the huge flood of 2019.

METHODS

An analytical cross-sectional study was conducted through household face-to-face surveys in August and September 2019. Individuals who were affected by floods and were at least 16 years old were randomly selected from three provinces in Iran: Lorestan and Khuzestan in the west and southwest, and Golestan in the northeast. The questionnaire of demographic and flood related variables in addition to the Impact of Event Scale-Revised (IES-R) were utilized to collect the data. We applied a complex sample analysis to describe the prevalence of PTSD and logistic regression analyses to find its determinants.

RESULTS

Out of the 2,305 individuals approached for surveys, 1,671 (72.5%) adults affected by the floods participated in the study. The majority of participants were housewives, married, had either no formal education or primary education, and resided in rural areas. The prevalence of PTSD in the participants was 24.8% (CI 95%: 20.7-28.8%) and was significantly higher in Lorestan province (39.7%, P < 0.001). Determinants of PTSD, were unemployment (adjusted odds ratio [AOR] = 3.53, CI 95%: 1.38-9.00), primary (AOR = 2.44, CI 95%: 1.10-5.41) or high school (AOR = 2.35, CI 95%: 1.25-4.40) education (vs. university), a history of mental disorders (AOR = 2.36, CI 95%: 1.22-4.58), high damage to assets (AOR = 2.29, CI 95%: 1.40-3.75), limited access to health care services after the flood (AOR = 1.95, CI 95%: 1.20-3.19), not receiving compensation for flood damage (AOR = 1.94, CI 95%: 1.01-3.83), high wealth index (AOR = 1.90, CI 95%: 1.23-2.93), and flooded house with a height of more than one meter (AOR = 1.66, CI 95%: 1.02-2.76).

CONCLUSION

Results show a notable prevalence of PTSD, especially in Lorestan province, among adults affected by floods. Determinants of PTSD include unemployment, lower education, psychiatric history, extensive property damage, limited post-flood healthcare access, lack of compensation, and increased flood exposure. We recommend adopting an inclusive screening approach for high-risk groups and developing appropriate therapeutic and supportive interventions.

Socio-economic factors associated with post-traumatic stress symptoms among adolescents and young people during the first wave of the COVID-19 pandemic

This study assessed the association between sociodemographic factors and post-traumatic stress symptoms (PTSS) among 18-24-year-olds during the first wave of the COVID-19 pandemic. This was a secondary analysis of data from 4508 individuals collected through an online survey conducted between June and January 2021. PTSS was measured as a dependent variable using the checklist for post-traumatic stress disorder in civilians. Age, birth sex, sexual, level of education, access to emotional and social support, and emotional distress were the independent variables. A multivariate logistic regression analysis was conducted to determine the associations between the dependent and independent variables while controlling for the country related confounding variables. Females (AOR:2.023), sexual minority individuals (AOR:1.868), those who did not disclose their sexual identify (AOR:1.476), those with poor access to emotional and social support (AOR:4.699) and individuals with no formal education (AOR:13.908), and only primary level education (AOR:4.521) had higher odds of PTSS. The study highlights the multifaceted nature of PTSS during the pandemic and suggests the importance of promoting access of young people, especially females, sexual minority individuals and those with low educational status, to emotional/social support to mitigate the probability of PTSS, especially among sexual minority individuals.

Multilayer analysis of dynamic network reconfiguration in pediatric posttraumatic stress disorder

Neuroimage studies have reported functional connectome abnormalities in posttraumatic stress disorder (PTSD), especially in adults. However, these studies often treated the brain as a static network, and time-variance of connectome topology in pediatric posttraumatic stress disorder remain unclear. To explore case-control differences in dynamic connectome topology, resting-state functional magnetic resonance imaging data were acquired from 24 treatment-naïve non-comorbid pediatric posttraumatic stress disorder patients and 24 demographically matched trauma-exposed non-posttraumatic stress disorder controls. A graph-theoretic analysis was applied to construct time-varying modular structure of whole-brain networks by maximizing the multilayer modularity. Network switching rate at the global, subnetwork, and nodal levels were calculated and compared between posttraumatic stress disorder and trauma-exposed non-posttraumatic stress disorder groups, and their associations with posttraumatic stress disorder symptom severity and sex interactions were explored. At the global level, individuals with posttraumatic stress disorder exhibited significantly lower network switching rates compared to trauma-exposed non-posttraumatic stress disorder controls. This difference was mainly involved in default-mode and dorsal attention subnetworks, as well as in inferior temporal and parietal brain nodes. Posttraumatic stress disorder symptom severity was negatively correlated with switching rate in the global network and default mode network. No significant differences were observed in the interaction between diagnosis and sex/age. Pediatric posttraumatic stress disorder is associated with dynamic reconfiguration of brain networks, which may provide insights into the biological basis of this disorder.

The effect of fear of contagion/being contagious on depression, anxiety and stress levels of university students during the COVID-19 pandemic

BACKGROUND

University students are generally quite active in social life. It is thought that their fear of contagion/being contagious will affect their depression, anxiety and stress levels due to the removal of restrictions and the increase in individual responsibilities. This study aims to determine the effect of fear of contagion/being contagious on depression, anxiety and stress levels of university students during the COVID-19 pandemic.

METHODS

This study, descriptive and cross-sectional. Quantitative data were collected using the Demographic Information Form, the Fear of Contagion/Transmission Scale and the Depression-Anxiety-Stress Scale. The sample included 3500 participants. Descriptive statistics were used for the presentation of the results. The STROBE checklist for cross-sectional studies was used in this study.

RESULTS

This study revealed that the depression, anxiety and stress levels of university students were above normal, and these results were mostly associated with females, those with a chronic disease and high fear of contagion/being contagious.

CONCLUSION

The findings of this study may be useful for precautionary plans to support the psychological health of university students after the COVID-19 pandemic and in the fight against possible new pandemics. Considering the findings of our study, educational programs should be planned for youth in general and university students in particular to deal with depression, anxiety, stress and fears.

RELEVANCE TO CLINICAL PRACTICE

The depression, anxiety and stress levels of university students were above normal. As the fear of contamination and contagion increases, the level of depression, anxiety and stress increases. Those with chronic diseases have high levels of depression, anxiety and stress.

PATIENT OR PUBLIC CONTRIBUTION

Research data were collected through an online questionnaire. Data collection tools were prepared on Google Forms, and then, links were shared with student groups over social media. Students shared the link on their social platforms, allowing it to reach wider audiences.

The Impact of Moderate Earthquakes on Antidepressant Prescriptions in Ulsan, South Korea: A Controlled Interrupted Time Series Analysis

BACKGROUND

In 2016, two consecutive moderate magnitude earthquakes occurred in Ulsan, South Korea. Therefore, we aimed to investigate the impact of earthquakes on the mental health of residents in Ulsan.

METHODS

We used data from the 2015-2017 Korean Health Insurance Review & Assessment Service National Patient Sample. We conducted an interrupted time series analysis using location-based controls. Changes in the number of antidepressants, benzodiazepines, and zolpidem prescriptions in Ulsan were compared to controls. Overall changes in weekly prescriptions 1 year after the first earthquake, compared to a non-earthquake scenario, were estimated.

RESULTS

In antidepressant prescriptions, the increase in trend after an earthquake was significantly higher than controls. However, the changes in benzodiazepines and zolpidem prescribing were not significant. Overall, the impact of the earthquake on weekly antidepressant prescriptions at 1 year was estimated as a 1.32 (95% CI, 1.18-1.56) rate ratio compared to the non-earthquake scenario. This corresponded to an increase of 1,989.7 (95% CI, 1,202.1-3,063.0) in the number of prescriptions. Among subgroups, the increase was highest among males aged 20-39 years.

CONCLUSION

The moderate earthquake in Ulsan was associated with an increase in antidepressant prescriptions. The increase in the male group aged 20-39 was the highest. The impact may vary according to the context of the population.

Societal influence and psychological distress among Indonesian adults in Java on the early Omicron wave of COVID-19

Aim

Changes during the COVID-19 pandemic might create pressure on different people, thus this study aimed to measure respondents' psychological distress during the early phase of the Omicron wave in Java Island.

Methods

A web-based survey on societal influence and COVID-19-related psychological distress was distributed through social media in November-December 2021, and received 396 responses.

Results

This study showed that almost 50% of respondents faced psychological distress during the early phase of the Omicron variant, especially concerning hypervigilance and avoidance. Several sociodemographic factors might contribute to the incidence of psychological distress including comorbidity, age and education.

Conclusion

Taken together, the incidence of COVID-19-related psychological distress was still found in the early phase of the Omicron variant, especially among young adults.

Assessment of post-traumatic stress disorder (PTSD) in elderly survivors of the Wenchuan earthquake: A cross-sectional study

OBJECTIVE

Post-traumatic stress disorder (PTSD) is a prevalent condition characterized by prolonged psychological distress following traumatic events encompassing serious health threats, domestic abuse, and natural disasters. The onset and persistence of PTSD can be attributed to advanced age. This study aimed to explore the occurrence and influencing factors of enduring post-traumatic stress disorder (PTSD) in survivors aged 60 years and over in the main area of the 2008 Wenchuan earthquake 10 years after the disaster.

METHODS

Data were collected using a multistage sampling method from individuals aged 60 years and older living in the main impacted areas of Wenchuan 10 years after the Wenchuan earthquake. The PTSD Checklist-Civilian Version (PCL-C) was used to evaluate PTSD symptoms. We evaluated participants based on their PTSD symptoms: those exhibiting and those without. The latter group was four times the size of the former and was matched based on gender and age (within ± 2 years). Conditional logistic regression was used to discern the risk factors.

RESULTS

Out of the total, 56 participants were recognized as having probable PTSD as per the PCL-C checklist, leading to a rate of 9.4% (56/588). The univariate conditional logistic regression values showed that playing Mahjong/poker (odds ratio (OR) = 0.394, 95% confidence interval (CI) = 0.171-0.911) and displacement (OR = 0.446, 95% CI = 0.220-0.907) were protective factors for the long-term mental health of survivors in the hard-hit areas, while the presence of a 2-week illness (OR = 3.605, 95% CI = 1.751-7.424), possessing insurance (OR = 0.250, 95% CI = 0.072-0.864), suffering from a chronic ailment (OR = 3.132, 95% CI = 1.2-8.174), and having an injured family member (OR = 2.26, 95% CI = 1.136-4.496) emerged as risk factors for PTSD symptoms. Multivariate analysis indicated that the absence of insurance and prevalence of 2-week illness correlated with increased PTSD symptoms.

CONCLUSIONS

Ten years after the Wenchuan earthquake, the prevalence of probable PTSD remained significantly high in the elderly population. The major risk factors were the absence of insurance and the occurrence of a 2-week illness. Policymakers should incorporate these findings when devising strategies for aging societies.

Quality of Life During the First Three Waves of the COVID-19 Pandemic and Two Earthquakes in Croatia

ABSTRACT

In a cross-sectional study, we measured the impact of the first three COVID-19 pandemic waves and two earthquakes, occurring during the same period in Croatia, on the quality of life (QoL) of the general adult population. An online survey consisting of sociodemographic questions, questions related to COVID-19 and earthquake stressors, the World Health Organization Quality of Life (WHOQoL)-BREF scale, Impact of Event Scale, and Patient Health Questionnaire 4 was completed by 220 men and 898 women (mean age, 35.1 ± 12.3 years). In a series of regressions, we examined the association among five blocks of predictors and six dependent QoL variables, four domain scores, and two global scores. Both WHOQoL-BREF global and domain scores after the prolonged stress were significantly predicted by anxiety, depression, stress symptoms, and sociodemographic characteristics. COVID-19-related stressors predicted significantly physical and psychological health, social relationships, and environmental QoL, whereas earthquake-related stressors predicted health satisfaction, physical and psychological health, and environmental QoL.

Correlates of posttraumatic stress in cancer patients and their family caregivers across two years following diagnosis

OBJECTIVE

To examine risk-factors of cancer-related PTSS in the 2-years post-diagnosis in adult colorectal cancer patients and caregivers.

METHODS

Patients with colorectal cancer and their caregivers (N = 130 dyads) self-reported sociodemographic, psychosocial, and medical factors at diagnosis/treatment initiation (T1), at 1- (T2), and 2-year (T3) post-diagnosis. Cancer-related PTSS were assessed, and path analysis examined associations between proposed correlates and PTSS.

RESULTS

Among patients, higher neuroticism and greater physical symptom distress were concurrently associated with higher PTSS (Bs ≥ 0.10, ps ≤ 0.02); greater physical symptom distress at T1 and greater social support at T2 were associated with higher PTSS at T3 (Bs ≥ 0.37, ps ≤ 0.04). Among caregivers, female gender, higher neuroticism (Bs ≥ 0.12, ps < 0.01), and lower social support (Bs  ≤ -0.24, ps ≤ 0.02) were associated with higher concurrent PTSS; lower patient physical symptom distress and social support at T1 (Bs  ≤ -0.27, ps ≤ 0.03) and longer hours spent caregiving at T2 (B = 0.03, p = 0.05) were associated with higher PTSS at T3.

CONCLUSIONS

Findings identify cancer-specific risk factors (physical symptoms, hours caregiving), in addition to established risk factors (female, neuroticism, social support) in non-medical populations. The identified subgroups should receive ongoing screening and psychosocial referral for cancer-related PTSS.

Associations of TNF-RII rs1061622 With Post-Traumatic Stress Disorder and Their Interplays on Serum Lipids Levels in Adolescents

OBJECTIVE

To verify effects of rs1061622 at tumor necrosis factor-α receptor II (TNF-RII) gene (TNF-RII) on post-traumatic stress disorder (PTSD) and its interactive effects with PTSD on serum lipids levels in adolescents.

METHODS

PTSD was measured by PTSD Checklist-Civilian Version (PCL-C) in 699 adolescent survivors at 6 months after Wenchuan earthquake in China. A polymerase chain reaction and restriction fragment length polymorphism assay were utilized for TNF-RII rs1061622 genotyping followed by verification using DNA sequencing. Serum triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol were tested using routine methods.

RESULTS

G (deoxyguanine) allele carriers had higher PCL-C scores than TT (deoxythymidine) homozygotes in female subjects. Female adolescents had higher PCL-C scores than male subjects in TT homozygotes. Predictors of PTSD prevalence and severity were different between G allele carriers and TT homozygotes. Subjects with PTSD had lower TG, TG/HDL-C, TC/HDL-C, and higher HDL-C than adolescents without PTSD in male G allele carriers. G allele carriers had higher TG/HDL-C and TC/HDL-C than TT homozygotes in male adolescents without PTSD, and lower TG and TG/HDL-C in male PTSD patients. G allele carriers had higher TG than TT homozygotes only in female adolescents without PTSD.

CONCLUSION

These results suggest reciprocal actions of TNF-RII rs1061622 with other factors on PTSD severity, interplays of TNF-RII rs1061622 with PTSD on serum lipid levels, and novel treatment strategies for PTSD and comorbidities of PTSD with hyperlipidemia among adolescents with different genetic backgrounds of TNF-RII rs1061622 after experiencing traumatic events.

Depression and stress levels in patients with different psychiatric disorders during concurrent early-phase COVID-19 pandemic and earthquake in Croatia

BACKGROUND

While Croatia shared COVID-19 pandemic with other countries, its capital area was also hit by a 5.6 magnitude earthquake. The simultaneous impact of these two disasters on psychiatric patients is largely unknown, and we addressed those knowledge gaps.

METHODS

The cross-sectional study was conducted during the pandemic's first peak, in the aftermath of earthquake, by telephonic survey. Measurements included the Patient Health Questionnaire-9, the Perceived Stress Scale and the semi-structured interview to evaluate the impact of pandemic stress and earthquake. Overall 396 patients with depression and/or anxiety disorders (DAD), 229 participants with schizophrenia spectrum disorders (SSD) and 205 healthy controls were enrolled.

RESULTS

Both patient groups had higher depression and stress levels than controls, independent of sex, age and the presence of somatic comorbidity. After controlling for the same covariates, patient groups had higher COVID-19- and earthquake-related fears than controls. In patients with DAD, both fears were greater than among SSD patients. When comparing the two fears, the fear from earthquake was higher in DAD and control groups, whereas in SSD patients there was no such difference.

CONCLUSIONS

Patients with DAD were the most vulnerable group during disasters, while earthquake seems to be associated with more fear than the pandemics, at least in DAD patients and healthy individuals. Future longitudinal studies should determine if early psychological support might alleviate stress levels after disasters and prevent further worsening of mental health, particularly among DAD patients.

Prevalence and associated risk factors of post-traumatic stress disorder among survivors of the 2023 Turkey earthquake

BACKGROUND

Earthquakes can cause psychological trauma among survivors as well as physical trauma. This study aims to determine the prevalence of post-traumatic stress disorder (PTSD) and identify associated risk factors among earthquake survivors after the 2023 Turkey earthquake.

METHODS

This prospective cross-sectional study was conducted in the emergency department of a tertiary university hospital between May 6, 2023, and May 16, 2023. An online questionnaire was sent to the participants. The questionnaire form consisted of three parts. In the first part, the sociodemographic characteristics of the participants were included. In the second part, the participants were asked about their experiences with the earthquake. In the third part, the post-traumatic stress disorder checklist for the Diagnostic and Statistical Manual of Mental Disorders, which screens PTSD among the participants, was included. Participants who did not complete all the questions and had severe communication disorders were excluded.

RESULTS

The prevalence of probable PTSD among the participants was 51.4% (n = 197). Age (OR: 0.96 95% CI: 0.93-99), female gender (OR: 4.54 95% CI: 2.39-8.61), being the head of the family (OR: 2.00 95% CI: 1.04-3.82), bereavement (OR: 1.71 95% CI: 1.03-2.82), lost loved ones (OR: 3.15 95% CI: 1.67-5.92), low social support (OR: 1.80 95% CI: 1.12-2.90) and receiving emergency care at the field (OR: 6.67 95% CI: 1.03-43.2) were the associated risk factors of PTSD among earthquake survivors.

CONCLUSIONS

The prevalence of PTSD among survivors three months after the 2023 Turkey earthquake is over half of the survivors. Younger age, female gender, being the head of the family, bereavement, lost loved ones, low social support, and receiving emergency care in the field were the associated risk factors of PTSD among earthquake survivors. Considering survivors may visit EDs until other outpatient clinics are re-established and the high rate of PTSD, rapid psychological evaluations can be performed in emergency departments. Emergency physicians should be aware of possible risk factors and high rate of PTSD.

Prospective network of post-traumatic stress disorder (PTSD) symptoms across adolescent survivors with distinct trajectories of PTSD: A cohort study of the Wenchuan earthquake

There are multiple trajectories of post-traumatic stress disorder (PTSD) symptoms following disasters. Unraveling the patterns of interactions between PTSD symptoms across distinct PTSD trajectories is crucial. This study was aimed at investigating the temporal sequences, changes, and predictive symptoms in PTSD networks over time across distinct PTSD trajectory groups. Data were exacted from the Wenchuan Earthquake Adolescent Health Cohort (WEAHC) study. The current study included 1022 adolescents (424 males) who participated in follow-up surveys at 12 months and 24 months post-earthquake. Self-reported PTSD symptoms were assessed with the Post-traumatic Stress Disorder Self-Rating Scale. The between-person network revealed significant differences across distinct trajectories. In the chronic dysfunction group, "Intrusive thoughts" had the strongest value in predicting on other PTSD symptoms. In contrast, "Difficulty in study or work" in the recovery group and "Physiological cue reactivity" in the resistance group were highly associated with the remission of other PTSD symptoms. These findings underscore the importance of "Difficulty in study or work" and "Physiological cue reactivity" for promoting the spontaneous remission of PTSD and further suggest that "Intrusive thoughts" maybe helpful to minimize the subsequent presence of other PTSD symptoms. Future research should investigate the causality and associations between within-person networks.

Post-traumatic Stress Disorder and Moral Injury Among Ukrainian Civilians During the Ongoing War

While severity of post-traumatic stress disorder (PTSD) symptoms and moral injury among civilians affected by armed conflicts is generally understudied, even less research exists on civilian populations during an active war. This paper reports a large-scale study that administered standard assessments of PTSD and moral injury severity, as well as rich demographic questionnaires, to nearly 1300 Ukrainian civilians during the ongoing Russian invasion. Analyses revealed an extremely high prevalence of severe PTSD symptoms and moral injury, relative to both proposed clinical cut-offs and to earlier measurements from a similar population. Further regression analyses identified risk factors and protective factors. Greater severity of PTSD symptoms was observed among women, older and forcibly displaced individuals, and individuals from geographic regions under Russian occupation. Higher education correlated with milder PTSD symptoms. Moral injury was particularly strong in younger individuals. The present study is one of the first to report a large scale set of psychological data collected from the civilian population of Ukraine during the ongoing Russian invasion. It is obvious from the scope and long-term nature of the atrocities that psychological treatment of the civilian population will be required both presently, while the hostilities are ongoing, and in the future. This data contributes to a detailed understanding of the psychological response to traumatic stress, including its overall prevalence and presence in specific demographically and geographically defined civilian groups.

Pretrauma risk factors and posttraumatic stress disorder symptoms following subsequent exposure: Multilevel and univariate meta-analytical approaches

The endeavour to comprehend why certain individuals develop posttraumatic stress disorder (PTSD) symptoms subsequent to experiencing traumatic events, while others do not, underscores the paramount importance of pretraumatic risk factors. This meta-analysis summarises the extant results of studies assessing risk factors prior exposure and PTSD symptoms following an index event on the same participants. It includes 43 studies (N = 19,239) yielding 174 effect sizes of pretraumatic risk factors categories such as demographic factors, cognitive factors, personality traits, coping styles, psychopathology, psychophysiological and environmental factors, which were examined using a three-level meta-analysis. Additionally, univariate random-effects meta-analyses were performed to separately investigate individual risk factors reported in more than one study. The findings revealed significant, small and medium associations for all categories, except for demographic factors and coping styles, also highlighting that certain individual risk factor domains (i.e. previous mental disorders, negative emotionality, sleep complaints and PTSD symptoms) represent the strongest predictors for PTSD symptoms after subsequent exposure. Several moderators were also investigated for individual risk factors. Future research could benefit from considering the interplay of pretraumatic risk factors to draw a more complex picture of the aetiology and underlying mechanisms of PTSD symptoms.

The Incidence of Posttraumatic Stress Symptoms in Children

OBJECTIVE

To determine the incidence of posttraumatic stress disorder (PTSD) symptoms and risk factors for their development in children and adolescents undergoing orthopaedic surgery for trauma.

DESIGN

Prospective cohort study.

SETTING

Level-1 trauma center.

PATIENTS

Children (8 to 18), undergoing surgery for orthopaedic trauma.

INTERVENTION

Upper and lower extremity surgery for orthopaedic trauma.

MAIN OUTCOME MEASUREMENTS

PTSD symptoms at postoperative follow-up as determined by the Child PTSD Symptom Scale (CPSS).

RESULTS

A total of 176 children with an average age at surgery of 13 years (8 to 18.8 years) participated in the study. Twenty-six subjects had high levels of PTSD symptoms (15%; 95% CI = 10.0 to 21.1%). Univariable and multivariable analyses determined that female sex (OR 2.63, 95% CI = 1.06 to 6.67, P = 0.04), older age at surgery (OR 1.25, 95% CI = 1.04 to 1.51, P = 0.02), and undergoing a previous surgery (OR 2.86, 95% CI = 1.06 to 7.73, P = 0.04) were all associated with increased PTSD risk.

CONCLUSIONS

Children and adolescents experience a high level of PTSD symptoms (15%) after surgery for orthopaedic trauma. Clinicians should be aware of PTSD symptoms in children and adolescents after surgery for orthopaedic injuries and use comprehensive screening to facilitate timely intervention and treatment.

LEVEL OF EVIDENCE

II.

A multi-country study of the associations between HIV vulnerability status, perception of COVID-19 related stigma and post-traumatic stress symptoms during the first wave of the pandemic

BACKGROUND

This study investigated the associations between COVID-19 related stigma and post-traumatic stress symptoms (PTSS); and the associations between PTSS and COVID-19 related stigma, HIV status, COVID-19 status and key HIV population status.

METHODS

This was a secondary analysis of data of 12,355 study participants generated through an online survey that recruited adults from 152 countries between July and December 2020. The dependent variables were COVID-19-related stigma and PTSS. The independent variables were HIV status (positive/negative), transaction sex (yes/no), use of psychoactive drugs (yes/no), and vulnerability status (transaction sex workers, people who use psychoactive drugs, living with HIV, and COVID-19 status). The confounding variables were age, sex at birth (male/female), level of education, sexual minority individuals (yes/no) and country income level. Multivariable logistic regression analyses were conducted to determine associations between the dependent and independent variables after adjusting for confounders.

RESULTS

There were 835 (6.8%) participants who experienced COVID-19 related stigma during the pandemic and 3,824 (31.0%) participants reported PTSS. Respondents who were living with HIV (AOR: 1.979; 95%CI: 1.522-2.573), tested positive for COVID-19 (AOR: 3.369; 95%CI: 2.692-4.217), engaged in transactional sex (AOR: 1.428; 95%CI: 1.060-1.922) and used psychoactive drugs (AOR: 1.364; 95%CI: 1.053-1.767) had significantly higher odds of experiencing COVID-19 related stigma. Individuals with vulnerability status (AOR:4.610; 95%CI: 1.590-13.368) and who experienced COVID-19 related stigma (AOR: 2.218; 95%CI: 1.920-2.561) had significantly higher odds of PTSS.

CONCLUSION

Individuals with vulnerability status may be at increased risk for COVID-19 related stigma. Key and vulnerable populations who were living with HIV and who experienced stigma may be at a higher risk of experiencing PTSS. Populations at risk for PTSS should be routinely screened and provided adequate support when they contract COVID-19 to reduce the risk for poor mental health during COVID-19 outbreaks and during future health crisis with similar magnitude as the COVID-19 pandemic.

Post-traumatic stress disorder among individuals with traumatic spinal cord injury in Nepal: a cross-sectional study

STUDY DESIGN

Cross-sectional study OBJECTIVES: To identify the prevalence of posttraumatic stress disorder (PTSD) among the individuals with traumatic spinal cord injury (TSCI) and to examine the relationships between demographic and clinical characteristics, and PTSD.

SETTING

Spinal Injury Rehabilitation Center (SIRC) and Dhulikhel Hospital, Kathmandu University Hospital (DH, KUH), Kavrepalanchowk, Nepal.

METHODS

Individuals above 18 years of age with TSCI of at least one month from trauma and admitted to SIRC and DH, KUH from June 2019 to May 2021 were included. The specific stress version of the PostTraumatic Stress Disorder Checklist (PCL), was utilized. To classify the neurological status of TSCI individuals, International Standard for Neurological Classification of Spinal Cord Injury (ISNCSCI) was used. Hierarchical multiple regression analysis between independent variables and normalized PCL score was done to evaluate the predictors of PTSD.

RESULTS

Among 163 patients, the overall prevalence of PTSD was 27%, and the mean PCL score was 36 ± 13.9. Factors predictive of PTSD included gender, family type, ethnicity, and literacy rate. No significant association was found between the clinical characteristics and PTSD.

CONCLUSIONS

PTSD appears to be considerably prevalent among individuals with TSCI in Nepal. Females, individuals from nuclear families, individuals with lower literacy, and individuals from lower caste are significantly vulnerable to developing PTSD. However, clinical characteristics do not appear to be influential in the development of PTSD.

Post-traumatic stress disorders, anxiety, and depression in college students during the COVID-19 pandemic: a cross-sectional study

OBJECTIVES

The COVID-19 pandemic has caused an increase in psychiatric disorders in college students, particularly posttraumatic stress disorders (PTSD), depression, and anxiety. While existing studies assess the prevalence of these disorders and their predictors, they overlook potential complications caused by comorbidity between these disorders. To fill this gap, this study examined the prevalence of PTSD, depression, anxiety, and their comorbidity to inform targeted intervention for college students during the COVID-19 pandemic.

DESIGN

Self-report questionnaires were used to assess 6,898 college students about six months after the COVID-19 outbreak.

RESULTS

The results found that the prevalence of PTSD, depression, and anxiety were 15.5%, 32.2%, and 32.1% respectively, and the prevalence of comorbid PTSD and depression, comorbid PTSD and anxiety, comorbid depression and anxiety, and comorbid PTSD, depression, and anxiety symptoms were 11.5%, 11.6%, 20.4%, and 9.4% respectively. Moreover, left-behind status, lower economic status, previous trauma experiences, exposure to the pandemic, and rumination were risk factors of psychological distress, but self-disclosure was a protective factor for these disorders.

CONCLUSION

These results indicate that distinct psychiatric disorders may be comorbid in individuals, and are further influenced by pre-, within-, and post-disaster factors. Furthermore, psychological service targeted at college students should pay attention to comorbid symptoms rather than only symptoms of single disorders.