Jianxin Zhang

The underlying dimensions of DSM-5 posttraumatic stress disorder symptoms in an epidemiological sample of Chinese earthquake survivors

The current study investigated the underlying dimensions of DSM-5 PTSD symptoms in an epidemiological sample of Chinese earthquake survivors. The sample consisted of 810 females and 386 males, with a mean age of 47.9 years (SD=10.0, range: 16-73). PTSD symptoms were assessed using the PTSD Checklist for DSM-5, and alternative models were evaluated with confirmatory factor analysis. Results indicated that a six-factor model comprised of intrusion, avoidance, negative affect, anhedonia, dysphoric arousal, and anxious arousal factors emerged as the best fitting model. The current findings add to limited literature on the latent structure of PTSD symptoms described in the recently released DSM-5, and carry implications for further trauma-related research and clinical practice.

Comparing alternative factor models of PTSD symptoms across earthquake victims and violent riot witnesses in China: Evidence for a five-factor model proposed by Elhai et al. (2011)

The present study investigated the factor structure of posttraumatic stress disorder (PTSD) symptoms measured by the PTSD Checklist (PCL) in two large samples exposed to different traumatic events (an earthquake and a violent riot) from China. Despite the samples difference in type of trauma, demographics, symptom severity, and elapsed time since trauma exposure, the results of a series of confirmatory factor analyses indicate that a five-factor intercorrelated model (intrusion, avoidance, numbing, dysphoric arousal, and anxious arousal) fit the data significantly better than the other alternative models including: the three-factor DSM-IV model, the four-factor numbing model (King et al., 1998), and the four-factor dysphoria model (Simms et al., 2002) in both samples. Implications and limitations regarding the results are discussed.

Mental Health Problems among the Survivors in the Hard-Hit Areas of the Yushu Earthquake

Background On April 14, 2010, an earthquake registering 7.1 on the Richter scale shook Qinghai Province in southwest China. The earthquake caused numerous casualties and much damage. The epicenter, Yushu County, suffered the most severe damage. As a part of the psychological relief work, the present study evaluated the mental health statuses of the people affected and identified the mental disorder risk factors related to earthquakes. Methods Five hundred and five earthquake survivors living in Yushu County were investigated 3–4 months after the earthquake. Participant demographic data including gender, age, marital status, ethnicity, educational level, and religious beliefs were collected. The Earthquake-Specific Trauma Exposure Indicators assessed the intensity of exposure to trauma during the earthquake. The PTSD Checklist-Civilian version (PCL-C) and the Hopkins Symptoms Checklist-25 (HSCL-25) assessed the symptoms and prevalence rates of probable Posttraumatic Stress Disorder (PTSD) as well as anxiety and depression, respectively. The Perceived Social Support Scale (PSSS) evaluated subjective social support. Results The prevalence rates of probable PTSD, anxiety, and depression were 33.7%, 43.8% and 38.6%, respectively. Approximately one fifth of participants suffered from all three conditions. Individuals who were female, felt initial fear during the earthquake, and had less social support were the most likely to have poor mental health. Conclusions The present study revealed that there are serious mental problems among the hard–hit survivors of the Yushu earthquake. Survivors at high risk for mental disorders should be specifically considered. The present study provides useful information for rebuilding and relief work.

Testing the dimensionality of posttraumatic stress responses in young Chinese adult earthquake survivors: further evidence for “dysphoric arousal” as a unique PTSD construct

Background: This study investigated an alternative five‐factor diagnostic model for posttraumatic stress disorder (PTSD) symptoms, and tested external convergent and discriminant validity of the model in a young Chinese sample of earthquake survivors. Methods: A total of 938 participants (456 women, 482 men) aged 15–20 years were recruited from a vocational school originally located in Beichuan County Town which was almost completely destroyed by the “Wenchuan Earthquake.” The participants were administrated with the PTSD Checklist and the Hopkins Symptoms Checklist‐25 12 months after the earthquake. Results: The results of confirmatory factor analysis showed that the five‐factor intercorrelated model (intrusion, avoidance, numbing, dysphoric arousal, and anxious arousal) fit the data significantly better than the four‐factor numbing model proposed by King et al. (1998: Psychol Assess 10:90–96) and the four‐factor dysphoria model proposed by Simms et al. (2002: J Abnorm Psychol 111:637–647). Further analyses indicated that four out of five PTSD factors yielded significantly different correlations with external measures of anxiety versus depression. Conclusions: The findings provide further empirical evidence in favor of the five‐factor diagnostic model of PTSD, and carry implications for the upcoming DSM‐5. Depression and Anxiety, 2011.

Assessing the underlying dimensionality of DSM-5 PTSD symptoms in Chinese adolescents surviving the 2008 Wenchuan earthquake

By analyzing data yielded from a sample of Chinese adolescents surviving a high-intensity earthquake, this study investigated the underlying dimensionality of DSM-5 PTSD symptoms. The sample included 743 traumatized middle school students (396 females and 332 males) aged 11-17 years (mean=13.6, SD=1.0). Results of confirmatory factor analysis showed that an intercorrelated seven-factor model comprised of intrusion, avoidance, negative affect, anhedonia, externalizing behaviors, anxious arousal, and dysphoric arousal factors provided a significant better representation of DSM-5 PTSD symptoms than other alternative models. Further analyses indicated that external measures of major depression disorder and panic disorder symptoms displayed unique associations with four PTSD factors. The findings provide further support for the newly proposed seven-factor model of DSM-5 PTSD symptoms, add to very limited empirical knowledge on the latent structure of DSM-5 PTSD symptoms among adolescents, and carry implications for further refinement of the current classifications of PTSD symptoms and further clinical practice and research on posttraumatic stress symptomatology.

PAC1 receptor (ADCYAP1R1) genotype is associated with PTSD's emotional numbing symptoms in Chinese earthquake survivors

BACKGROUNDnGenetic factors are important in the development of posttraumatic stress disorder (PTSD) following exposure to traumatic events. However, the molecular genetic underpinnings of this disorder remain largely unresolved. The present study investigated the association between ADCYAP1R1 rs2267735 genotype and PTSD symptoms in a highly traumatized sample of Chinese adults.nnnMETHODSnParticipants included 326 victims who experienced 2008 Wenchuan earthquake and lost their children during the disaster. PTSD symptoms were assessed with the PTSD Checklist (PCL). The ADCYAP1R1 rs2267735 SNP was genotyped with the Sequenom iPlex chemistries and the MassARRAY system.nnnRESULTSnThe results indicated that although the rs2267735 CC genotype was not associated with total PTSD symptoms, it could significantly predict severity of PTSDs emotional numbing symptoms in women.nnnLIMITATIONSnA relatively small sample exposed to specific traumatic events was used, and PTSD was assessed using a self-reported instrument.nnnCONCLUSIONSnThe findings suggest that the PACAP-PAC1 receptor pathway may play an important role in female human responses to traumatic stress, and carry implications for better understanding and treating of posttraumatic psychopathology.

The Beijing Twin Study (BeTwiSt): A Longitudinal Study of Child and Adolescent Development

Rates of emotional and behavioral problems among children and adolescents in China are increasing and represent a major public health concern. To investigate the etiology of such problems, including the effects and interplay of genes and environment, the Beijing Twin Study (BeTwiSt) was established. A representative sample of adolescent twins in Beijing (N = 1,387 pairs of adolescent twins, mostly between the ages of 10 and 18 years) was recruited and assessed longitudinally. Data collection included the following: emotional and behavioral problems (e.g., depressive symptoms, anxiety, delinquency, drinking, and smoking); family, peer, and school environments; stress; social and academic competence; cognitive traits (e.g., emotion suppression, rumination, and effortful control); and saliva samples for DNA genotyping and sequencing. The combination of quantitative and molecular genetic approaches and the timeliness of the project, with the sample residing in a region with a rapidly changing economic and cultural climate, are particular strengths of this study. Findings from this study are expected to help understanding of the etiological mechanisms underlying child and adolescent normal and abnormal development in regions undergoing substantial social, cultural, and economic changes.

Confirmatory factor analysis of posttraumatic stress symptoms assessed by the Impact of Event Scale-Revised in Chinese earthquake victims: Examining factor structure and its stability across sex

The current study investigated the factor structure of posttraumatic stress symptoms assessed by the Impact Event Scale-Revised (IES-R) in a large sample of individuals from China who recently experienced a destructive earthquake. The results of the confirmatory factor analysis indicated that a four-factor structure (intrusion, avoidance-numbing, hyperarousal, and sleep disturbance) emerged as the model best fit in total sample, female and male subsamples, respectively. Moreover, multiple-group confirmatory factor analysis further demonstrated that the four-factor model was quite stable across sex. Implication and limitations for the results are discussed.

Stathmin genotype is associated with reexperiencing symptoms of posttraumatic stress disorder in Chinese earthquake survivors

Stathmin (STMN1) has been demonstrated as a regulator of fear processing across species, which implicates that it may be important in the etiopathogenesis of fear-related psychiatric disorders such as posttraumatic stress disorder (PTSD). This study examined the association between STMN1 rs182455 genotype, a single nucleotide polymorphism (SNP) located within or close to the putative transcriptional control region of STMN1 gene, and PTSD symptoms. A total of 326 Chinese adults who suffered from a deadly 2008 Wenchuan earthquake and unexpectedly lost their children during the disaster participated in this study. PTSD symptoms were measured with the PTSD Checklist (PCL). The Sequenom iPlex chemistries and the MassARRAY system were used to genotype the STMN1 rs182455 SNP. Our results indicated that the STMN1rs182455 genotype was not associated with severity of total PTSD symptoms in either females or males; however, it could significantly predict severity of PTSDs reexperiencing symptoms in females. The findings provide preliminary evidence supporting the important role of STMN1 in the development of PTSD, and expand extant knowledge on the genetic underpinnings of PTSD and the sex-specific expression of PTSDs symptoms.

Latent structure of posttraumatic stress disorder symptoms in an adolescent sample one month after an earthquake

Increasing empirical studies suggest that the tripartite posttraumatic stress disorder (PTSD) model described in the DSM-IV does not accurately account for the underlying PTSD factor structure, and several alternative models have been proposed. The present study investigated a newly refined, five-factor model of PTSD symptoms in a sample of Chinese adolescent survivors of an earthquake. A total of 1198 middle school students (653 females, 526 males) with a mean age of 14.4 years (SDxa0=xa01.1, range: 11-18) participated in this study one month after an earthquake. The novel five-factor model comprised of intrusion, avoidance, numbing, dysphoric arousal, and anxious arousal demonstrated significantly better fit than two alternative four-factor models. Further analyses revealed differentiable relations between the PTSD factors and external measures of anxiety and depression. These findings provide empirical support for the robustness of five-factor model, and carry implications for further reorganization of PTSD criteria.