scholarly journals Changes Over Time in Post-traumatic Stress Disorder Among Children Who Survived the 2008 Wenchuan Earthquake and Predictive Variables

2021 ◽  
Vol 12 ◽  
Author(s):  
Ying Chen ◽  
Chow Lam ◽  
Hong Deng ◽  
Kam Ying Ko

Background: This study examines changes over time in post-traumatic stress disorder (PTSD) among children who survived the 2008 Wenchuan earthquake and the relevant predictive variables.Methods: A total of 203 children and adolescents were investigated 24 months after the earthquake, and 151 children and adolescents completed the 1-year follow-up study. Participants completed the Children's Revised Impact of Event Scale (CRIES-13), the Center for Epidemiologic Studies Depression Scale (CES-D) and the Connor-Davidson Resilience Scale (CD-RISC). Hierarchical linear regression analysis was used to evaluate the predictors of changes in PTSD severity.Results: Eighty percent of the children still had some PTSD symptoms 2 years after the Wenchuan earthquake, and 66.25% of the children had symptoms that lasted 3 years. In the model predicting PTSD symptom severity, the loss of family members and child burial explained a significant 21.9% of the variance, and depression explained a significant 16.7% of the variance. In the model predicting changes in PTSD severity, the change scores for resilience and depression explained a significant 18.7% of the variance, and cognitive behavioral therapy (CBT) explained a significant 33.6% of the variance.Conclusions: PTSD symptoms in children and adolescents can persist for many years after trauma. In addition to using psychological interventions to improve PTSD symptoms, improvements in depression and resilience should also be considered.

Author(s):  
Bingqing Lu ◽  
Wenqi Zeng ◽  
Zhuyue Li ◽  
Jin Wen

Abstract Aims To investigate the prevalence of post-traumatic stress disorder (PTSD) symptoms in the hard-hit areas 10 years after the Wenchuan earthquake, and explore the risk factors of long-term PTSD among Wenchuan earthquake survivors. Methods A matched case–control study was conducted. The involving participants were from the hard-hit areas 10 years after the Wenchuan earthquake. The collected information includes demographic characteristics, socioeconomic status, behaviour habits, earthquake exposure, perceived social support, physical health and mental health. Mental health status was measured using the PTSD Checklist-Civilian Version (PCL-C). Respondents with PCL-C score ⩾38 were classified as cases, and then the cases and controls were matched based on age (±3 years) and community location according to a ratio of 1:3. Results We obtained 86 cases and 258 controls. After controlling for confounding factors, it was found that lower income (OR 2.42; 95% CI 1.16–5.03), chronic diseases (OR 3.00; 95% CI 1.31–6.88) and death of immediate families in the earthquake (OR 7.30; 95% CI 2.36–22.57) were significantly associated with long-term PTSD symptoms. Conclusion Even 10 years after the Wenchuan earthquake, the survivors in the hard-hit areas still suffered from severe mental trauma. Low income, chronic diseases and death of immediate families in the earthquakes are significantly associated with long-term PTSD symptoms. Interventions by local governments and health institutions to address these risk factors should be undertaken to promote the health of survivors.


2011 ◽  
Vol 42 (8) ◽  
pp. 1687-1693 ◽  
Author(s):  
Z. Zhang ◽  
M.-S. Ran ◽  
Y.-H. Li ◽  
G.-J. Ou ◽  
R.-R. Gong ◽  
...  

BackgroundThe Wenchuan earthquake was a catastrophic earthquake in China. The aim of this study is to explore longitudinally the rates of post-traumatic stress disorder (PTSD) and depression in adolescents after the Wenchuan earthquake, and to identify independent predictors of PTSD.MethodPTSD and depression symptoms among adolescents at 6, 12 and 18 months after the Wenchuan earthquake were investigated using the PTSD Checklist Civilian Version and the Beck Depression Inventory (BDI). Subjects in this study included 548 high school student survivors in a local boarding high school.ResultsThe rates of PTSD symptoms were 9.7%, 1.3% and 1.6% at the 6-, 12- and 18-month follow-ups, respectively. BDI scores were found to be the best predictor of severity of PTSD at 6, 12 and 18 months. Gender was another variable contributing significantly to PTSD at 6 and 12 months after the earthquake. In the 12-month follow-up, home damage was found to be a predictor of severity of PTSD symptoms. Being a child with siblings was found to be a predictor of severity of PTSD symptoms at 12 and 18 months after the earthquake.ConclusionsPTSD symptoms changed gradually at various stages after the earthquake. Depression symptoms were predictive of PTSD symptoms in the 18-month follow-up study. Other predictors of PTSD symptoms included female gender and being a child with siblings. The results of this study may be helpful for further mental health interventions for adolescents after earthquakes.


Author(s):  
Susanne Fischer ◽  
Tabea Schumacher ◽  
Christine Knaevelsrud ◽  
Ulrike Ehlert ◽  
Sarah Schumacher

Abstract Background Less than half of all individuals with post-traumatic stress disorder (PTSD) remit spontaneously and a large proportion of those seeking treatment do not respond sufficiently. This suggests that there may be subgroups of individuals who are in need of augmentative or alternative treatments. One of the most frequent pathophysiological findings in PTSD is alterations in the hypothalamic–pituitary–adrenal (HPA) axis, including enhanced negative feedback sensitivity and attenuated peripheral cortisol. Given the role of the HPA axis in cognition, this pattern may contribute to PTSD symptoms and interfere with key processes of standard first-line treatments, such as trauma-focused cognitive behavioural therapy (TF-CBT). Methods This review provides a comprehensive summary of the current state of research regarding the role of HPA axis functioning in PTSD symptoms and treatment. Results Overall, there is preliminary evidence that hypocortisolaemia contributes to symptom manifestation in PTSD; that it predicts non-responses to TF-CBT; and that it is subject to change in parallel with positive treatment trajectories. Moreover, there is evidence that genetic and epigenetic alterations within the genes NR3C1 and FKBP5 are associated with this hypocortisolaemic pattern and that some of these alterations change as symptoms improve over the course of treatment. Conclusions Future research priorities include investigations into the role of the HPA axis in day-to-day symptom variation, the time scale in which biological changes in response to treatment occur, and the effects of sex. Furthermore, before conceiving augmentative or alternative treatments that target the described mechanisms, multilevel studies are warranted.


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