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Symptoms of posttraumatic stress disorder, depression, and anxiety among adolescents following the 2008 Wenchuan earthquake in China

This study examined the symptoms of posttraumatic stress disorder (PTSD), anxiety, and depression among 2,250 adolescents 6 months after the 2008 Wenchuan earthquake in China. Results showed that 15.8%, 40.5%, and 24.5% of participants reported clinical symptoms of PTSD, anxiety, and depression, respectively. Posttraumatic stress disorder, anxiety, and depression were highly comorbid. Risk factors for symptoms of the 3 disorders were female gender, older age, and earthquake disaster exposure. In addition, the interaction effects of residence (urban/rural) and number of siblings of study subjects on symptoms of the 3 disorders were examined. Implications of findings on intervention and prevention of mental health problems among adolescents after experiencing earthquake disasters are discussed.

Sleep problems among adolescent survivors following the 2008 Wenchuan earthquake in China: a cohort study.

OBJECTIVE To examine sleep problems and associated risk factors among adolescent survivors following the 2008 Wenchuan earthquake, the deadliest earthquake to strike China in 30 years. METHOD A cohort of students (N = 1,573) in the 7th and 10th grades from Dujiangyan City, 21 kilometers from the epicenter, was followed up periodically for 2 years. Participants were assessed at 12 months (n = 1,398; May 18-22, 2009), 18 months (n = 1,288; November 23-27, 2009), 24 months (n = 1,313; May 17-21, 2010), and 30 months (n = 1,038; November 22-26, 2010) after the earthquake. Adolescents were asked to complete the Pittsburgh Sleep Quality Index (PSQI; cutoff for sleep problems: total score of ≥ 8), Post-Traumatic Stress Disorder Self-Rating Scale (cutoff for probable posttraumatic stress disorder: ≥ 50), Depression Self-Rating Scale for Children (cutoff for depressive disorder: ≥ 15), Screen for Child Anxiety Related Emotional Disorders (cutoff for clinical anxiety: ≥ 25), Social Support Rate Scale, and Adolescent Self-Rating Life Events Checklist and provide demographic information. Trajectory analysis was used to examine sleep disturbance changes and associated risk factors. RESULTS Twelve months after the earthquake, 48.90% of participants reported sleeping less than 7 hours per night, 27.68% disclosed difficulties initiating sleep, 8.82% experienced problems staying sleep, 22.60% felt their sleep quality was poor, and 40.01% had difficulties functioning during daytime hours. Overall sleep problems, as assessed by the PSQI global scale, were stable from 18 months to 30 months following the earthquake, and the prevalence rates were between 28.79% and 30.18%. The risk of sleep issues was significantly increased in senior high school students (OR = 2.29) and in those who witnessed the tragic events directly (OR = 1.21). Depression (OR = 1.69), anxiety (OR = 1.57), poor social support (OR = 1.83), and negative life events (OR = 2.62) were also associated with increased risk and persistence of sleep problems. CONCLUSIONS Sleep disturbances are common and persistent in adolescent earthquake survivors. Multiple demographic, psychosocial, and earthquake-related factors are associated with the increased risk of sleep difficulties.

Parent Ratings of ADHD Symptoms in Chinese Urban Schoolchildren Assessment With the Chinese ADHD Rating Scale–IV: Home Version

Objective: The objective of this study was to assess the psychometric properties of the Chinese ADHD Rating Scale–IV (ADHD RS-IV): Home Version and to explore parent ratings of ADHD symptoms in a large sample of urban schoolchildren in China. Method: Parents of a representative sample of 1,616 schoolchildren (aged 6-17) in 12 Chinese cities completed the ADHD RS-IV: Home Version. Results: The Chinese ADHD RS-IV: Home Version demonstrated satisfactory internal consistency, test–retest reliability, parent–teacher correlation, discriminant validity, and convergent validity. Factor analysis revealed the DSM-IV two-factor model with “inattention” and “hyperactivity-impulsivity” dimensions, accounting for equal variances. Parent ratings revealed lower/similar scores for Chinese schoolchildren compared with the U.S. study. Conclusion: The ADHD RS-IV: Home Version is a reliable and valid ADHD rating scale in China. The factor structure is similar but not identical to the U.S. study. Normative data reveal cultural differences in some aspects of the parent ratings of ADHD.

Cohort Profile: The Wenchuan Earthquake Adolescent Health Cohort Study

Cohort Profile: The Wenchuan Earthquake Adolescent Health Cohort Study Fang Fan,* Ya Zhou, Lei Mo, Wei Zhang, Jing Xie, Xianchen Liu and the WEAHC Study Group School of Psychology, Center for Studies of Psychological Application and Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, South China Normal University, Guangzhou, P.R. China, Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA and University of Tennessee Health Science Center, Memphis, TN, USA

Depressive Symptoms and Associated Psychosocial Factors among Adolescent Survivors 30 Months after 2008 Wenchuan Earthquake: A Follow-Up Study

Purpose: This study longitudinally investigated the changes of depressive symptoms among adolescent survivors over 2 years and a half after the 2008 Wenchuan earthquake in China, as well as the predictive effects of demographic characteristics, earthquake exposure, negative life events, social support, and dispositional resilience on the risk of depressive symptoms at two time points after the earthquake. Methods: Participants were 1573 adolescent survivors (720 males and 853 females, mean age at initial survey = 15.00 ± 1.26 years), whose depressive symptoms were assessed at 6 months (T6m) and 30 months (T30m) post-earthquake. Data on demographics, earthquake exposure, and dispositional resilience were collected at T6m. Negative life events and social support were measured at T6m and 24 months (T24m) post-earthquake. Results: The prevalence rates of probable depression, 27.5 at T6m and 27.2% at T30m, maintained relatively stable over time. Female gender was related with higher risk of depressive symptoms at both T6m and T30m, while being only child could only predict higher risk of depressive symptoms at T30m. Negative life events and social support at T6m, as well as earthquake exposure, were concurrently associated with increased risk of depressive symptoms at T6m, but not associated with the risk of depressive symptoms at T30m, while negative life events and social support at T24m could predict depressive symptoms at T30m, all of which suggested that these variables may have strong but short-term effect on adolescents’ depressive symptoms post-earthquake. Besides, dispositional resilience was evidenced as a relatively stable negative predictor for depressive symptoms. Conclusions: These findings could inform mental health professionals regarding how to screen adolescent survivors at high risk for depression, so as to provide them with timely and appropriate mental health services based on the identified risk and protective factors for depressive symptoms.

Developmental trajectories and predictors of prosocial behavior among adolescents exposed to the 2008 Wenchuan earthquake

This longitudinal study examined the developmental trajectories of prosocial behavior and related predictors among adolescents exposed to the 2008 Wenchuan earthquake. At 6-, 18-, and 30-months postearthquake, we followed a sample of 1,573 adolescents. Self-report measures were used to assess earthquake exposure, postearthquake negative life events, prosocial behavior, symptoms of posttraumatic stress disorder, depression, anxiety, social support, and coping style. Data were analyzed using growth mixture modeling and multinomial logistic regressions. Four trajectories of postearthquake prosocial behavior were identified in the sample: (a) high/enhancing (35.0%), (b) high/stable (29.4%), (c) low/declining (33.6%), and (d) low/steeply declining (2.0%). Female gender, more social support, and greater positive coping were significant factors related to a higher probability of developing the high/enhancing trajectory. These findings may be helpful for us to identify adolescents with poor prosocial behavior after exposure to earthquakes so as to provide them with appropriate intervention.

Longitudinal trajectories and predictors of anxiety symptoms among adolescent survivors exposed to Wenchuan earthquake

This study aimed to investigate the developmental trajectories and associated predictors of anxiety symptoms among Chinese adolescents exposed to Wenchuan earthquake. 1573 adolescent survivors were followed up at 6, 12, 18, and 24 months post-earthquake. Self-report measures were used to evaluate earthquake exposure, anxiety symptoms, negative life events, social support, and trait resilience. Growth mixture modeling (GMM) and multi-nominal logistic regression were used to analyze data. The results showed that 45.6%, 50.9%, 39.2%, and 39.9% of participants showed clinical levels of anxiety symptoms at 6, 12, 18, and 24 months post-earthquake, respectively. Four developmental trajectories were identified: resistance, recovery, delayed-onset anxiety, and chronic anxiety. Gender, injury of family members, negative life events, social support, and trait resilience were significant predictors for distinct anxiety trajectories. Individualized and appropriate psychosocial interventions should be provided for adolescents affected by natural disasters, especially those at higher risk for chronic or delayed mental problem symptoms.

A Prospective Study of Psychiatric Symptoms Among Adolescents After the Wenchuan Earthquake: Adolescent Mental Health After a Natural Disaster

Natural disaster exposure is associated with increased risk of mental health problems. This study aimed to investigate the prevalence, course, and risk factors of probable psychiatric disorders among 1,573 adolescents following the May 2008 Wenchuan earthquake in China. Symptoms of posttraumatic stress disorder (PTSD), depression, panic disorder (PD), generalized anxiety disorder (GAD), separation anxiety disorder (SAD), social phobia (SP), conduct disorder (CD), and attention deficit hyperactivity disorder (ADHD) were assessed at 6 and 18 months postearthquake using a battery of standardized measures. Approximately 62.9% and 56.1% of the sample, respectively, had at least one probable psychiatric disorder at 6 and 18 months postearthquake. The most common disorders were PTSD, depression, PD, GAD, and ADHD. With regard to the course of disorders, PTSD, GAD, PD, SAD. and ADHD decreased; SP and CD remained stable; and depression increased. Generalized estimating equations models showed that female sex, older age, having experienced the death or injury of family members, being a direct witness of tragic scenes, low social support, and a high level of negative life events were risk factors for most disorders, odds ratios (ORs) = 1.3-20.8. However, logistic regressions indicated that earthquake exposure variables were specifically related to persistent PTSD, ORs = 2.0-2.5, and negative life events were associated with persistent depression, ORs = 2.4-5.3. Various psychiatric symptoms are pervasive, intense, and persistent among adolescent survivors. Systematic and periodic screening are needed to closely monitor the onset, course, and risk factors of mental health problems after disasters.

A Longitudinal Study of Recurrent Experience of Earthquake and Mental Health Problems among Chinese Adolescents

Background: The effects of recurrent exposure to disasters on adolescents’ mental health have rarely been studied. We examined the effects of two earthquake experiences 5 years apart in a longitudinal cohort of Chinese adolescents. Methods: A total of 858 adolescents were assessed in September, 2011 (3.5 years after the Wenchuan earthquake, 1.5 years before Ya’an earthquake, T1) and April, 2013 (1 week after the Ya’an earthquake, T2). Participants’ Wenchuan earthquake experiences and symptoms of post-traumatic stress disorder (PTSD) and depression were assessed at T1, and their Ya’an earthquake experiences, Acute Stress Disorder (ASD), PTSD, and depression were assessed at T2. Results: Structural equation models showed a positive relationship between Ya’an earthquake experiences and symptoms of ASD, PTSD, and depression at T2. T1 PTSD symptoms significantly increased T2 ASD, PTSD, and depression symptoms, and also mediated the relationships between Wenchuan earthquake experiences and T2 ASD, PTSD, and depression symptoms. T1 Depression symptoms also significantly increased T2 ASD, PTSD, and depression symptoms, but only mediated the association between Wenchuan earthquake experiences and T2 depression symptoms. In addition, Wenchuan earthquake experiences moderated the effects of Ya’an earthquake experiences on ASD symptoms and PTSD symptoms but not depression. Conclusion: Repeated to exposure to disasters have adverse additive effects on adolescents’ mental health. Adolescents who experience one disaster may be sensitive to the negative impact of subsequent ones.