Zhanbiao Shi

One year later: Mental health problems among survivors in hard-hit areas of the Wenchuan earthquake.

OBJECTIVES To investigate the prevalence of probable post-traumatic stress disorder (PTSD), anxiety and depression, and to identify risk factors related to these mental disorders among hard-hit survivors 1 year after the earthquake in Wenchuan, China. STUDY DESIGN : Cross-sectional survey. METHODS A door-to-door survey covering the entire temporary community was undertaken to investigate 1195 adult earthquake survivors. The survey instruments included a questionnaire determining exposure to the earthquake, the PTSD Checklist-Civilian Version (PCL-C), the Hopkins Symptoms Checklist-25 (HSCL-25), and the Perceived Social Support Scale (PSSS). Univariate and multivariate logistic regression analyses were undertaken to examine potential risk factors. RESULTS The prevalence rates of probable PTSD, anxiety and depression were 26.3%, 49.8% and 49.6%, respectively. Risk factors varied between the disorders. Among middle-aged and elderly people, bodily injury, loss of livelihood and initial fear during the earthquake were independently and significantly associated with all three mental disorders, while female gender was independently and significantly associated with PTSD and depression. CONCLUSIONS PTSD, anxiety and depression remained at an elevated level among survivors in hard-hit regions 1 year after the earthquake in Wenchuan. The groups at high risk of mental problems should be specifically attended.

Psychometric properties of the 10‐item Connor–Davidson Resilience Scale in Chinese earthquake victims

Aim:  Resilience refers to positive adaption in the face of stress or trauma. Assessing resilience is crucial in trauma‐related research and practice. The 10‐item Connor–Davidson Resilience Scale (CD‐RISC) has been demonstrated to be a valid and reliable tool to achieve this goal. This study was designed to examine the psychometric properties of the 10‐item CD‐RISC in a sample of Chinese earthquake victims.

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.

Diagnostic Utility of the PTSD Checklist in Detecting PTSD in Chinese Earthquake Victims

By using the posttraumatic stress disorder (PTSD) module of the Mini International Neuropsychiatric Interview (MINI) as the gold standard to identify PTSD, the current study investigated the diagnostic efficiency of the PTSD Checklist (PCL) as a screening questionnaire in a sample of 152 Chinese victims of the Wenchuan earthquake. The results showed that the area under the receiver operating characteristic (ROC) curve was .96 (SE = .02), and the optimally efficient cut-off score was 44. The findings provide preliminary support of the PCL as a screening questionnaire among Chinese earthquake victims. The present study may contribute to further PTSD-related research and practices in Chinese disaster settings.

Post-traumatic Stress Disorder, Anxiety and Depression among the Elderly: A Survey of the Hard-hit Areas a Year after the Wenchuan Earthquake

Few studies to date have examined psychological sequelae of natural disasters among the elderly in China. The aim of this study was to investigate the prevalence rates of probable post-traumatic stress disorder (PTSD), anxiety and depression in the elderly survivors a year after the Wenchuan earthquake as well as to analyse related risk factors. The community-based sample of the study consisted of 284 elderly survivors (≥60 years). PTSD was assessed by the PTSD Checklist--Civilian version, and anxiety and depression were assessed by the Hopkins Symptoms Checklist. In total, the estimated prevalence rates of probable PTSD, anxiety and depression were 26.3%, 42.9% and 35.2%, respectively. Nearly a fifth of the elderly participants reported symptoms that meet the criteria for all three of these mental disorders. Results indicated that some factors associated with earthquake-exposure intensity, which included loss of livelihood, bereavement, injury and initial fear during the earthquake, were among the significant risk factors for these mental disorders. Women had a higher risk of suffering from probable anxiety as compared to men. Finally, the significance and limitations of this study were also discussed.

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.

Response inhibition in adolescent earthquake survivors with and without posttraumatic stress disorder: A combined behavioral and ERP study

The aim of this study was to investigate whether adolescent patients with posttraumatic stress disorder (PTSD) show an impairment of executive control in a response inhibition task and to investigate its neurophysiological correlates using event-related potentials (ERPs). We analyzed data from 25 Wenchuan earthquake survivors between 15 and 19 years of age (16 diagnosed with PTSD) using a Go/NoGo task. The PTSD group made more commission errors than the non-PTSD group, indicating impairment in response inhibition. The PTSD group responded faster to Go trials and there was a significant negative correlation between their reaction time and commission/omission errors, reflecting a speed-accuracy tradeoff for the PTSD group. The PTSD group exhibited a shorter NoGo-N2 latency than the non-PTSD group, suggesting faster monitoring or detection of the response conflict. These results suggest that the impairment of response inhibition in adolescent participants with PTSD is related to their impulsive cognitive functioning.

Symptoms of Posttraumatic Stress Disorder Among Adult Survivors Two Months After the Wenchuan Earthquake

This study investigated the symptoms of Posttraumatic Stress Disorder (PTSD) and associated risk factors among adult survivors 2 mo. after the Wenchuan earthquake in China. 228 survivors completed the Chinese version of the Impact of Event Scale–Revised. The prevalence of probable PTSD was 43%. The significant predictive factors for the severity of PTSD symptoms included being female, having lower educational level, being bereaved, and witnessing death. Findings of this study suggest that PTSD is a common mental health problem among earthquake survivors in China. Given inadequate knowledge and practices concerning the mental health of disaster victims in China, the information provided by this study is useful for directing, strengthening, and evaluating disaster-related mental health needs and interventions after earthquakes.

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.

Symptoms of posttraumatic stress disorder among health care workers in earthquake-affected areas in southwest China.

The symptoms of posttraumatic stress disorder and associated risk factors were investigated among health care workers in earthquake-affected areas in southwest China. 343 health care workers completed the Chinese version of the Impact of Event Scale–Revised 3 mo. after the Wenchuan Earthquake. The prevalence of probable PTSD was 19%. The significant risk factors identified for PTSD severity included being female, being bereaved, being injured, and higher intensity of initial fear. These findings suggest that PTSD is a common mental health problem among health care workers in earthquake-affected areas. The present information can be useful in directing, strengthening, and evaluating disaster-related mental health needs and interventions after an earthquake.