Hirokage Ushijima

Relationships between Traumatic Symptoms and Environmental Damage Conditions among Children 8 Months after the 2011 Japan Earthquake and Tsunami

Background To evaluate relationships between traumatic symptoms and environmental damage conditions among children who survived the 2011 Great East Japan Earthquake and Tsunami. Methods The subjects were 12,524 children in kindergartens, elementary schools, and junior high schools in Ishinomaki City, Miyagi Prefecture, Japan. The Post Traumatic Stress Symptoms for Children 15 items (PTSSC-15), a self-completion questionnaire on traumatic symptoms, was distributed to the children and a questionnaire regarding environmental damage conditions affecting the children was distributed to their teachers. Of 12,524 questionnaires distributed, an effective response was obtained from 11,692 (93.3%). Results The PTSSC-15 score was significantly higher in females than in males among 4th to 6th grade students in elementary schools and among junior high school students. In terms of traumatic symptoms and environmental damage conditions, with the exception of kindergartners, children who had their houses damaged or experienced separation from family members had a significantly higher PTSSC-15 score than children who did not experience environmental damage. Except for kindergartners and 4th- to 6th-grade elementary school students, children who experienced evacuation had a significantly higher PTSSC-15 score. Conclusions This study demonstrated relationships between traumatic symptoms and environmental damage conditions in children who had suffered from the disaster. Factors examined in studying the relationship between environmental damage conditions and traumatic symptoms were gender, age, house damage, evacuation experience, and bereavement experience. It was critical not only to examine the traumatic symptoms of the children but also to collect accurate information about environmental damage conditions.

Sleep Duration among Children 8 Months after the 2011 Japan Earthquake and Tsunami

Background To elucidate relationships between disaster damage conditions and sleep duration among children who survived the 2011 Japan earthquake and tsunami. Methods The subjects comprised 12,524 children in kindergartens, elementary schools, and junior high schools in Ishinomaki City, Miyagi Prefecture, Japan. The Post Traumatic Stress Symptoms for Children 15 items (PTSSC-15), a self-completion questionnaire on traumatic symptoms, and a sleep questionnaire were distributed to them. A questionnaire regarding disaster damage conditions of the children’s homes was distributed to their teachers. Of 12,524, an effective response was obtained from 11,692 (93.3%). Results Relationships between sleep duration and traumatic symptoms were displayed low correlations. Children with house damage and/or evacuation experiences slept for a significantly shorter time than children without these experiences. Conclusion It is critical not only to examine traumatic symptoms in children but also to collect sleep duration and disaster damage conditions following natural disasters.

Posttraumatic Symptoms in Elementary and Junior High School Children after the 2011 Japan Earthquake and Tsunami: Symptom Severity and Recovery Vary by Age and Sex

OBJECTIVES To measure psychiatric symptoms exhibited by children in Ishinomaki City, Japan, an area severely damaged by the 2011 earthquake and tsunami, at 8 and 20 months post-tsunami to investigate differences in symptom severity and recovery rate by age, sex, and degree of trauma experienced. STUDY DESIGN Prospective data were collected from children in elementary school (5th and 6th grades) and junior high school (8th and 9th grades). Students completed the Post-Traumatic Stress Symptoms for Children-15 (PTSSC-15) survey. Trauma severity was scored according to experiences of bereavement, home damage, and evacuation. In total, 3795 PTSSC-15 surveys were analyzed, yielding total scores, post-traumatic stress disorder (PTSD) factor subscores, and depression factor subscores, which were analyzed according to grade group, sex, and degree of trauma (trauma dose). RESULTS In the elementary school children, mean total PTSSC-15 score, PTSD factor score, and depression factor score were significantly improved at 20 months post-tsunami compared with 8 months (P < .0001 for all), whereas there were no significant improvements in the junior high school children. In females of the older group, the depression factor score at 20 months post-tsunami was significantly higher than at 8 months (P < .01). CONCLUSIONS Elementary school and junior high school children living near the epicenter of the 2011 Japan earthquake and tsunami exhibited marked differences in PTSD and depressive symptoms. The mental health status of elementary school children improved, whereas that of junior high school children did not.

Poor performance on the Iowa gambling task in children with obsessive-compulsive disorder

BackgroundSeveral lines of evidence implicate orbitofrontal cortex dysfunction in the pathophysiology of obsessive-compulsive disorder (OCD). The purpose of this study was to investigate neuropsychological dysfunction of the orbitofrontal cortex in children with OCD.MethodsThe Iowa Gambling Task (IGT), which reflects orbitofrontal cortex function, and the Wisconsin Card Sorting Test (WCST), which is associated with functioning of the dorsolateral prefrontal cortex, were administered to 22 children with OCD and 22 healthy controls matched for gender, age, and intelligence.ResultsOCD patients displayed poor performance on the IGT. In contrast, performance on the WCST was not impaired in OCD patients compared to controls.ConclusionsThese findings are in line with previous studies demonstrating that OCD in childhood is associated with a dysfunction of orbitofrontal-striatal-thalamic circuitry.

Analysis of changes in traumatic symptoms and daily life activity of children affected by the 2011 Japan earthquake and tsunami over time.

Background On March 11, 2011, Japan was struck by a massive earthquake and tsunami. The tsunami caused tremendous damage and traumatized a number of people, including children. This study aimed to compare traumatic symptoms and daily life activity among children 20 months after the 2011 Great East Japan Earthquake and Tsunami with those observed after 8 months. Methods The study comprised two groups. The first comprised 12,524 kindergarten, elementary school, and junior high school children in Ishinomaki City, Miyagi Prefecture, Japan, who were evaluated 8 months after the disaster. The second comprised 10,597 children from the same place who were evaluated 20 months after the disaster. The Post Traumatic Stress Symptoms for Children 15 items (PTSSC-15), a self-completion questionnaire on traumatic symptoms, and a questionnaire on childrens daily life were distributed to the children. An effective response was obtained from 11,639 (92.9%, 8 months after) and 10,597 (86.9%, 20 months after) children. Results The PTSSC-15 score was significantly higher in junior high school girls than in boys. The PTSSC-15 score was significantly higher in 4th–6th grade girls than in boys after 8 months. Elementary and junior high school children evaluated after 20 months had a significantly lower PTSSC-15 score than those evaluated after 8 months. The number of children having breakfast was significantly higher after 8 months than that after 20 months. In both the groups, children of all grades who had breakfast had a significantly lower PTSSC-15 score than those who did not have breakfast. Conclusions We conclude that traumatic symptoms and daily life activity of children who survived the earthquake and tsunami improved over time.

Did parents and teachers struggle with child survivors 20 months after the 2011 earthquake and tsunami in Japan? A retrospective observational study.

Background On March 11, 2011, Japan was struck by the earthquake and tsunami. Twenty months after the disaster, we collected information on the difficulties faced by parents and teachers in dealing with the post-traumatic symptoms of child survivors. The aim of this study was to evaluate the relationship between post-traumatic symptoms in children and parents’ and teachers’ difficulties in dealing with children who survived the huge disaster. Methods The subjects included 12,524 children from elementary, middle, and junior high schools in Ishinomaki City. The Post Traumatic Stress Symptoms for Children 15 items (PTSSC-15), a self-rating questionnaire on post-traumatic symptoms, was distributed among the children, and Strength and Difficulties Questionnaire (SDQ), a self-rating questionnaire on difficulties in dealing with children, was given to their parents and teachers. With PTSSC-15, a valid response was obtained from 10,909 (89.5%) participants. With SDQ for teachers and parents, valid responses were obtained from 10,577 (86.7%) and 7052 (83.9%) participants, respectively. Results PTSSC-15 scores were significantly higher (P<0.001) in girls than in boys from the junior high school. These effect sizes were less than 0.30. Correlations of teachers’ SDQ scores and PTSSC-15 scores were significantly low (r<0.21, P<0.001) for both genders and all children. Likewise, correlations between SDQ scores assigned by parents (excluding “prosocial behavior”) and PTSSC-15 scores were significantly low (r<0.21, P<0.001) for both genders and at all school levels. Conclusion This study elucidated that the difficulties faced by parents and teachers while dealing with child survivors significantly low correlate with the child’s post-traumatic symptoms caused by the 2011 earthquake and tsunami. Thus, it is important that clinicians should not only evaluate post-traumatic symptoms with a self-rating questionnaire but also try to objectively evaluate whether there were day-to-day difficulties caused by the post-traumatic symptoms.

Prosocial Behaviors during School Activities among Child Survivors after the 2011 Earthquake and Tsunami in Japan: A Retrospective Observational Study

Background The 2011 Japan massive tsunami traumatized many children. The aim of this study was to assess changes in strengths and difficulties experienced in home and school by among surviving children after the 2011 tsunami, in comparison with published normal Japanese data. Methods In November 2012 (20 months after the disaster) and September 2013 (30 months after the disaster), the Strengths and Difficulties Questionnaire (SDQ), a questionnaire on childrens strengths and difficulties in home and school activities, were distributed to 12,193 and 11,819 children, respectively. An effective response of children 20 months and 30 month after the disaster was obtained in 10,597 children (86.9%), and 10,812 children (91.4%), respectively. The SDQ scores evaluated by parents and teachers were compared with published normal Japanese SDQ scores. Results The SDQ scores (emotional problems, conduct problems, hyperactivity/inattention, peer relationship problems, and total difficulty score) evaluated by parents of children in the 4th to 9th grade who were evaluated after 30 and 20 months were significantly high compared with the published normal data of children without traumatic experiences (all P<0.001). The SDQ scores (prosocial behavior) evaluated by teachers of children in the 4th to 9th grade who were evaluated after 30 and 20 months were significantly low compared with the published normal data of children without traumatic experiences (all P<0.001). Conclusions This study showed that the experience of the disaster affected those children with prosocial behaviors towards teachers and friends at school. However, no significant changes (in their prosocial attitude) had been seen at home, where they continued to keep their respect and caring feelings for parents. These results indicate that for accurate diagnosis, clinicians should not only evaluate these childrens daily activities at home but also try to objectively assess their daily activities at school.

What time periods of the day are concerning for parents of children with attention deficit hyperactivity disorder

Background/Aim The questionnaire-children with difficulties (QCD) is a parent-assessed questionnaire designed to evaluate a child’s difficulties in functioning during specific time periods of the day. In this study, the QCD was applied to determine the time periods of the day that are concerning for the parents of children with attention deficit hyperactivity disorder (ADHD). The results were compared with those for a community sample. Methods Elementary and junior high school students with ADHD (243 boys, 55 girls) and a community sample of children (518 boys, 618 girls) were enrolled in this study. Their behaviors were assessed by the QCD, the ADHD-rating scale (ADHD-RS), and the Oppositional Defiant Behavior Inventory (ODBI). The effects of gender (boy/girl) and diagnosis (ADHD/community sample) on the total QCD score were analyzed across each school grade (elementary/junior high school). Correlation coefficients between QCD and ADHD-RS/ODBI scores were analyzed. Results The QCD score for the ADHD group was significantly lower than that for the community sample (P < 0.001). There were significantly strong correlations between “evening” and ADHD-RS and ODBI scores for all children with ADHD (r > 0.41, P < 0.001) and between “night” and inattention and oppositional symptoms for the girls with ADHD (r > 0.40, P < 0.001). Conclusions Parents reported that children with ADHD faced greater difficulties in completing basic daily activities compared with the community controls, particularly in the evening. Furthermore, these difficulties were related to the severity of ADHD symptoms. The parents’ perceptions depended on the gender, ADHD and oppositional symptoms, and the time period of the day. This study determined that children with ADHD face greater difficulties in daily functioning compared with community sample children, that these difficulties are time-dependent, and that these difficulties were particularly experienced in the evening.

Sense of coherence, health problems, and presenteeism in Japanese university students

AIM Sense of coherence (SOC) is thought to be a major determinant in maintaining health. SOC gained attention recently in the fields of psychiatry after it was reported to be associated with a lowered risk of various health problems. However, the effect of SOC as a buffer against performance impairment caused by health problems is not well known. Thus, we aimed to examine the relationships among health problem, the degree of presenteeism (performance loss due to health problems), and SOC in adolescents. METHODS Participants were 2824 university students (1855 males, mean age; 18.35±0.84 years). SOC and self-reported health problems were assessed using an SOC scale (29 items) and the presenteeism scale for students, respectively. RESULTS SOC scores differed between students with and without health problems (t(2822)=5.75, P<0.001). The effect size (Cohens d) was 0.22 for this difference. In a multiple logistic regression analysis, male gender (odds ratio [OR]=0.62; 95% confidence interval [CI]=0.53-0.73), moderate SOC (within ±1 SD; OR=0.59; 95% CI=0.47-0.72), and high SOC (>1 SD; OR=0.43; 95% CI=0.33-0.58) were independently associated with a lower frequently of health problems. In addition, SOC showed a significant inverse correlation with presenteeism (r=-0.27, P<0.001). CONCLUSION These results suggest that application of the concept of SOC might aid in the prevention of health problems among university students. Students with a strong SOC might be less prone to a decline in performance when health problems arise.

Dysfunction of orbitofrontal and dorsolateral prefrontal cortices in children and adolescents with high-functioning pervasive developmental disorders

BackgroundSeveral lines of evidence suggest that dysfunction of the dorsolateral prefrontal cortex (DLPFC) and orbitofrontal cortex (OFC) contributes to the pathophysiology of pervasive developmental disorders (PDD). The purpose of this study was to investigate neuropsychological dysfunctions in both the DLPFC and OFC of children and adolescents with high-functioning PDD.MethodsThe Iowa gambling task (IGT), which reflects OFC function, and the Wisconsin Card Sorting Test (WCST), which reflects DLPFC function, were assigned to 19 children and early adolescents with high-functioning PDD and 19 healthy controls matched for gender, age, and intelligence.ResultsCompared to healthy controls, patients with high-functioning PDD displayed poorer performance on the IGT and the WCST.ConclusionsThese results indicate that both the DLPFC and OFC could be impaired in children and early adolescents with high-functioning PDD.