Earthquake Exposure Research Articles

Consistencies and differences in posttraumatic stress disorder and depression trajectories from the Wenchuan earthquake among children over a 4-year period

BackgroundPosttraumatic stress disorder (PTSD) and depression are the most prevalent mental disorders following disasters, and they often co-occur. The current study investigated trajectories of PTSD and depression among children after exposure to the Wenchuan earthquake and identified factors associated with PTSD or depression trajectories. MethodsThree hundred children who were exposed to the Wenchuan earthquake reported PTSD and depression symptoms 4, 16, 29, 40 and 52 months after the disaster, and potential predictors (age, earthquake exposure, prequake trauma and parental relationship) were identified. The PTSD and depression trajectories were identified with latent growth mixture modeling (LGMM), and the predictors were explored with multinomial logistic regression. ResultsTwo depression trajectories emerged: resilient (66.2%) and chronic (33.8%). Three PTSD trajectories emerged: resilient (74.9%), recovery (7.5%) and relapsing (17.7%). Overall, 57.3% of the children had low depression and PTSD symptoms over four years. Depression trajectories were significantly predicted by age and parental relationship, while PTSD trajectories were significantly predicted by trauma exposure and prequake trauma experience. LimitationsThe children's prequake mental health statuses were unknown, and all assessments relied on self-report questionnaires. ConclusionThe postdisaster developmental course of depression was more stable than that of PTSD, and PTSD and depression had different risk factors. Previous studies that focus only on PTSD or depression trajectories may overestimate children's resilient responses. Longer-term postdisaster intervention should pay more attention to depression than to PTSD.

Maternal exposure to Wenchuan earthquake and prolonged risk of offspring birth outcomes: a natural experiment study

BackgroundThe prolonged effects of disasters on reproductive outcomes among the survivors are less studied, and the findings are inconsistent. We examined the associations of maternal exposure to the 2008 Wenchuan earthquake years before conception with adverse birth outcomes.MethodsWe included 73,493 women who delivered in 96 hospitals in 24 provinces and autonomous regions from the 2015/16 China Labor and Delivery Survey. We weighted the multivariable logistic models based on the combination of coarsened exact matching (CEM) weight and survey weight, and performed sex-stratified analysis to test whether associations of maternal earthquake exposure with adverse birth outcomes (Stillbirth, preterm birth [PTB], low birthweight [LBW], and small for gestational age [SGA]) varied by sex.ResultsThe bivariate models showed that the weighted incidence of each adverse birth outcome was higher in exposed group than unexposed group: stillbirth (2.00% vs. 1.33%), PTB (14.14% vs. 7.32%), LBW (10.82% vs. 5.76%), and SGA (11.32% vs. 9.52%). The multivariable models showed maternal earthquake exposure was only associated significantly with a higher risk of PTB in offspring among all births (adjusted risk ratio [aRR](95%CI):1.25(1.06–1.48), P = 0.010). The sex-stratified analysis showed the association was significant among male births (aRR (95%CI): 1.40(1.12–1.75),P = 0.002),but unsignificant among female births. The sensitivity analysis reported similar findings.ConclusionsThe 2008 Wenchuan earthquake exposure has a long-term effect on PTB. Maternal acute exposure to disasters could be a major monitor for long-term reproductive outcomes. More attention should be paid to the underlining reasons for disaster-related adverse birth outcomes.

The role of trauma experiences, personality traits, and genotype in maintaining posttraumatic stress disorder symptoms among child survivors of the Wenchuan earthquake

BackgroundPosttraumatic stress disorder (PTSD) is the most prevalent type of psychiatric disorder among children after an earthquake. This study investigated the role of trauma experiences, personality traits, and genotype in the maintenance of PTSD symptoms.MethodsIn a previous large-scale epidemiological investigation 1 year after the Wenchuan earthquake, 215 children with PTSD symptoms were selected at random with their blood samples collected. All of them were followed up, and their PTSD symptoms were assessed 3 years later. The adolescent version of the UCLA PTSD Reaction Index, the earthquake exposure scale, and the Junior Eysenck Personality Questionnaire were used to determine PTSD symptoms, trauma experiences, and personality traits, respectively. We sequenced candidate genes involved in the regulation of long-term potentiation via NMDA-type receptors to identify the related SNP variations.ResultsBeing trapped for a longer period of time, feeling one’s own or a family member’s life to be in danger, losing a close family member or friend, extraversion, neuroticism, TrkB, G72 and CNTF were found to be associated with the maintenance of PTSD symptoms.ConclusionsExperiences, personality traits, and genotype influenced the maintenance of PTSD in child survivors who were considered to be followed up without medicine. This result could help to identify potential targets for treatment and promote the rational allocation of medical resources.

The effects of earthquake exposure on preparedness in the short and long term: a difference-in-differences estimation

Emergency support is often delayed after a disaster. Despite the importance of being prepared to deal with the immediate aftermath of disasters, not everyone prepares effectively. While exposure to disasters improves people’s preparedness in the short term, it is yet to be determined whether this improvement is long lasting. In this paper, we use a difference-in-differences method to estimate the causal effects of the 2010 and 2011 Canterbury earthquakes on people’s preparedness in the short-term (1 month after the second earthquake) and long-term (up to 25 months after the second earthquake). Our results show that people who experienced the earthquakes increase their preparedness by 0.67 standard deviations in the short term. This impact stays positive, but declines to 0.42 standard deviations in the long term.

Psychotic-like experiences in Chinese children and adolescents: The effect of earthquake exposure, maltreatment and negative life events.

Psychotic-like experiences (PLEs) are common in adolescents who have experienced or are experiencing trauma. However, the potential relationships between exposure to a major earthquake, negative life events or maltreatment and PLEs in Chinese adolescents are poorly understood. Therefore, this study explored the prevalence of PLEs and the psychosocial correlates in adolescent earthquake survivors. A total of 6132 adolescents from 11 primary and high schools in the areas most severely affected by the Ya'an earthquake completed questionnaires on earthquake exposure, maltreatment, negative life events and PLEs, which included paranoid ideation and psychoticism. It was found that earthquake exposure significantly contributed to the PLEs, child maltreatment explained a significant amount of the PLE variances, emotional abuse had the most important PLE role and negative life events also explained a large amount of the PLE variances, of which interpersonal difficulties and academic pressure had the greatest effects. Interventions should seek to reduce parental emotional abuse, reduce academic performance pressure, improve interpersonal skills and resolve interpersonal difficulties, and specific interventions should target children and adolescents exposed to the earthquake to prevent PLEs, schizophrenia or other mental illnesses arising from multiple traumas.

Household adjustment to seismicity in Oklahoma

Earthquakes have manifested as a slow-onset hazard for the state of Oklahoma. While this shaking is resulting in considerable damage, we know little about how residents understand or are adjusting to this new hazard. To explore this issue, we deployed a survey in two Oklahoma communities with varying levels of earthquake exposure and experience to better understand the adjustments, such as purchasing earthquake insurance or installing earthquake latches, residents are intending to undertake within these communities. In line with the protection motivation theory, we found that hazard adjustment intentions were related to both threat appraisals (TAs), or an individual’s perceived probability of a hazard occurring and severity of a given threat, and coping appraisals (CAs), which captures the perceived efficacy and cost of an adjustment, with variations between the two sites. We also found that CAs had more explanatory power for adjustments than TAs.

Impact of earthquake exposure, family adversity and peer problems on anxiety-related emotional disorders in adolescent survivors three years after the Ya'an earthquake

BackgroundTraumatic experiences often give rise to an increased risk of anxiety problems in adolescents. This study investigated the anxiety prevalence in adolescent earthquake survivors and the effect of secondary stressors such as bullying, poverty, or being “left behind” by parents working in the cities. MethodsThis cross-sectional study was conducted three years after the 2013 Ya'an (China) earthquake on 6,132 adolescents aged 9 to 18 years from 11 public schools in three severely earthquake affected counties. The participants completed self-report questionnaires that assessed anxiety, earthquake exposure, poverty level, left-behind duration and bullying. ResultsSeparation anxiety (38.7%) and panic symptoms (32.2%) were found to be the primary contributors to anxiety in this adolescent sample. The regression and structural equation modeling indicated that adolescents who had suffered from high earthquake exposure, peer bullying, being left-behind, or poverty were more likely to report problems in all anxiety subcategories, with females reporting more anxiety symptoms than males. The likelihood of all anxiety disorders except separation anxiety was found to increase with age. ConclusionsThis study highlighted the need for post-disaster interventions aimed at minimizing post-earthquake adversity such as peer bullying and specialized psychological services that target subgroups that might be more susceptible to anxiety-related emotional problems. The results could be used to identify possible markers for anxiety problems in children who had not experienced any major traumas.

Post-traumatic growth among 5195 adolescents at 8.5 years after exposure to the Wenchuan earthquake: Roles of post-traumatic stress disorder and self-esteem.

We evaluated the level of post-traumatic growth in a large sample of Chinese adolescent earthquake survivors (n = 5195) and relationships among self-esteem, post-traumatic stress disorder, and post-traumatic growth. This cross-sectional study indicated that the prevalence of post-traumatic growth among adolescent survivors was 14.8 percent. Post-traumatic growth was independently associated with self-esteem, severity of exposures, and avoidance facets of post-traumatic stress disorder. Post-traumatic stress disorder was found to be partially mediated by self-esteem on post-traumatic growth; and post-traumatic stress disorder was also a mediator between earthquake exposure and post-traumatic growth. This study suggests that future longitudinal research and clinical practice should test whether promoting self-esteem can enhance post-traumatic stress disorder treatment.

Do somatic symptoms relate to PTSD and gender after earthquake exposure? A cross-sectional study on young adult survivors in Italy.

Increasing evidence confirms a strict relationship between mental disorders and physical health. Particularly, stressful life events and post-traumatic stress disorder (PTSD) have been closely correlated with various physical disorders and somatic symptoms, such as chronic pain, gastrointestinal disorders, and headaches. The aim of this study was to investigate the emergence of somatic symptoms in a sample of young adult survivors 21months after exposure to the L'Aquila 2009 earthquake, with particular attention to PTSD and gender impact. Four hundred and fifty high-school senior students (253 male and 197 female) exposed to the 2009 L'Aquila earthquake, 21months earlier, were enrolled and evaluated by the Trauma and Loss Spectrum Self-Report (TALS-SR), for symptomatological PTSD, and the Mood Spectrum Self-Report-Lifetime Version (MOODS-SR) "rhythmicity and vegetative functions" domain, for somatic symptoms. Significantly higher rates of endorsement of the MOODS-SR somatic symptoms emerged in survivors with PTSD compared to those without. Females reported higher rates of endorsement of at least one MOODS-SR somatic symptom compared to males; however, a Decision Tree model and a two-way analysis of variance model confirmed a significant effect of PTSD only. A multivariate logistical regression showed a significant association between the presence of at least one MOOD-SR somatic symptom and re-experiencing and maladaptive coping TALS-SR domains. This study corroborates a relevant impact of symptomatological PTSD, across both the genders, on somatic symptoms occurring in young adults after months from exposure to a massive earthquake.

Numerical analysis, design and behavior of rockfill dams with reinforced concrete faces during seismic actions

Introduction. Over the last 10–20 years many rockfill dams with reinforced concrete faces that are 140–200 m high (Mohale in Lesotho, Tian Sheng Yao, Zipingpu in China, etc.) have experienced serious problems, including face slab cracking and perimeter joint opening. Most of these dams were built in high seismic hazard areas, and their seismic resistance to the maximal earthquake exposure, having the magnitude equal to 8–9, raises doubts. The goal of this research is to employ numerical methods to verify the seismic resistance of dams, to project their behavior in case of the seismic exposure that may damage the dam face, cause the face joints to open and the dam face to detach from its toe, etc. Materials and methods. The author offers his analysis of reliability and applicability of numerical methods to the seismic resistance of dams. Incidents have demonstrated the need for a thorough assessment and analysis of each aspect of a new project whenever it is extrapolated from the precedent. Results. The analysis of the dam behavior in the course of the first reservoir filling has demonstrated face top cracking that causes its damage. Deeper in the water, face joints may be exposed to localized damages due to compression and shear; one should expect vertical face joints to open; excessive compressibility of the downstream rockfill zone may cause the water to leak through the dam face. The author offers recommendations for the performance of the dynamic analysis of dams in respect of the boundaries of the computational domain, given that seismic waves are transmitted or absorbed at the interface between the dam face and the transition zone, on the one hand, and between dam slabs, on the other hand. In furtherance of his recommendations, real and synthetic accelerograms are applied to the bottom boundary of the computational domain; the choice of an explicit or implicit computational method should be made; the author’s method pre-sets the intermediate solution which is to comply with the accelerogram digitization pattern. Conclusions. In addition to internationally established measures for improving the static and seismic safety of dams, the author proposes a new effective dam safety improvement method to be used in the course of designing high dams to be con-structed in high seismic hazard areas. This method improves dam safety by drastically reducing face deflections with the help of a support zone made of roller compacted concrete instead of the gravel transition zone, as exemplified by the 275 m high Kambaratinskaya-1 dam in Kyrgyzstan and the 192 m high Sogamoso dam in Colombia (both dams are located in highly seismic regions). The information on China's successful track record in designing and building similar dams, which are 220–250 m high, is also provided.

Prevalence and Influencing Factors of Post-Traumatic Stress Disorder Among Survivors in the Hard-Hit Areas Ten Years After the Wenchuan Earthquake: A Cross-Sectional Study.

BackgroundPost-traumatic stress disorder (PTSD) is common psychological distress after natural disasters, which is persistent. Chronic PTSD leads to a heavy disease burden. The purpose of this study is to explore the prevalence and influencing factors of chronic PTSD among survivors in the hard-hit areas ten years after the Wenchuan earthquake.Materials and MethodsA cross-sectional survey was conducted on residents aged 16 or above in hard-hit areas through a multi-stage sampling approach ten years after the Wenchuan earthquake. The items of the questionnaire included demographic characteristics and earthquake exposure factors, and the PTSD Checklist-Civilian Version (PCL-C) was used to evaluate the PTSD of the respondents.ResultsA total of 1039 complete questionnaires were obtained. The median age of 1039 respondents was 60 years, 63.2% of whom were female, 70.2% were illiterate or had received primary education, and 58% had an annual household income of less than 20,000 yuan (US$ 2871.3). The rate of PTSD was 9.1% (95/1039). After controlling for confounding factors, it was found that higher income level and education level, and moving to concentrated rural settlement (CRS) after the earthquake might be protective factors for the long-term mental health of survivors in the hard-hit areas, and the loss of immediate families in the earthquake was an important risk factor.ConclusionEven though ten years have passed since the Wenchuan earthquake, the survivors in the hard-hit areas still have a serious mental disorder. The local government and health-care institutions should take appropriate measures to improve the mental health of residents.

The mediating role of alexithymia between earthquake exposure and psychopathology among adolescents 8.5 years after the wenchuan earthquake

Alexithymia refers to difficulties in recognizing and describing one's emotions. We studied potential connections of alexithymia with severity of earthquake exposure, panic/somatic symptoms, posttraumatic stress disorder (PTSD) and depression in 5,195 adolescents affected by the Wenchuan earthquake. Participants completed the Toronto Alexithymia Scale (TAS-20), the Children's Revised Impact of Event Scale (CRIES)-13, the abbreviated Kutcher Adolescent Depression Scale (KADS), and the panic/somatic subscale of the Screen for Child Anxiety-Related Emotional Disorders. The rate of alexithymia was 6.7%, and a greater proportion females were alexithymic than males (7.6% vs 5.7%). Alexithymia was more frequent among older subjects and those who were only-children. Alexithymia, severity of earthquake exposure and negative life events were independently associated with post-disaster psychological or somatic symptoms, and alexithymia was a mediator between traumatic experiences and psychopathology. Our data highlight the importance of alexithymia in the development of psychological distress, implying that alexithymia-targeted interventions may help treat or even prevent psychological distress after a disaster.

Trajectories of maternal symptoms of posttraumatic stress disorder predict long-term mental health of children following the Wenchuan earthquake in China: A 10-year follow-up study

Background: Maternal psychopathology can be an important factor associated with psychological adjustment of children. However, there is limited research on long-term impacts of maternal posttraumatic stress disorder (PTSD) on children's mental health. This study examined how PTSD trajectories of women exposed to the 2008 Wenchuan earthquake in China predicted their children's mental health symptoms 10 years after the earthquake. Methods: 410 dyads of mothers and their adolescent children who exposed to the Wenchuan earthquake were investigated at 12 and 18 months post-earthquake. While the mothers completed measures of earthquake exposure and PTSD symptoms, the children completed measures of earthquake exposure, PTSD, depression and anxiety symptoms. In the 10-year follow up, 257 out of the 410 children completed measures of PTSD, depression and anxiety symptoms. Data were analyzed using linear regression. Results: Four trajectories of maternal PTSD symptoms were identified: (a) chronic (9.5%); (b) resilient (66.3%); (c) delayed (7.6%); and (d) recovery (16.6%); More importantly, the findings demonstrated that children whose mothers experienced chronic PTSD reported higher level of PTSD and anxiety symptoms 10 years after the earthquake. Limitations: Only two waves of maternal PTSD were collected, self-reported tools other than clinical reviews were used to collect data, and a significant proportion of participants did not respond at the 10-year follow-up. Conclusions: This study identified maternal PTSD trajectories following the Wenchuan earthquake. Chronic PTSD symptoms in mothers were associated with increased risk of children's PTSD and anxiety 10 years after the earthquake.

Depressive symptoms between parent and adolescent survivors: A longitudinal actor-partner interdependence model

Background: The association between parent-child depression following disasters has been well documented. However, longitudinal studies of posttraumatic depression using parent-child dyadic are scarce. This study aimed to investigate inter-related effects between parent and child depression, as well as predictors of depressive symptoms, in a large sample of Wenchuan earthquake survivors. Methods: Data are from the Wenchuan Earthquake Adolescent Health Cohort (WEAHC) Study that included 685 parent-child dyads exposed to the earthquake. Depression was assessed with the Self-Rating Depression Scale (for parents) and Depression Self-Rating Scale for Children, at 12 (T12m) and 18 months (T18m) post-earthquake. Longitudinal actor-partner interdependence models (APIMs) were employed to examine depression within dyads. Predictors of depressive symptoms were assessed by the cart algorithm throughout the 6-month follow-up. Results: Adjusting for earthquake exposure and previous depressive symptoms, parents’ depression at 12 months predicted children's depressive symptoms at 18 months, and vice versa (β = 0.14 for parents and β = 0.12 for children). Psychomotor retardation in parents, and dysphoria/social isolation and positive affect in children were identified as crucial screening indicators identifying parents and children at increased risk for depression. Conclusion: A bidirectional association was found between parent and child depression following a mass disaster. Both parent and child depression status should be examined when implementing interventions to identify and treat depression in earthquake survivors.

Long-Term Mental Health Effects of Exposure to Earthquake-Related Prenatal Maternal Stress

ABSTRACT Background: Many studies involving human subjects have shown that exposure to negative factors during pregnancy can have both short- and long-term effects. This study aims to examine the effects on the mental health of the adolescent children of mothers exposed to prenatal maternal stress during earthquakes. Method: The sample consisted of 407 adolescents aged 17 years at the time the study was conducted, as well as their mothers, who were pregnant during the earthquake of August 17, 1999 in Turkey. The mothers’ mental state were evaluated using the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI) and the Traumatic Stress Symptom Checklist (TSSC). The evaluations of the mental status of the mother following earthquake exposure in pregnancy were conducted retrospectively using self-reported depression, anxiety and trauma scales. The mothers were asked to fill out the BDI and BAI questionnaires based on their mental state in the week following the earthquake, while for the TSSC they were asked to select the statements that best described their status in the 6 months following the earthquake. The adolescents’ current depression, anxiety and Attention Deficit Hyperactivity Disorder (ADHD) symptoms were evaluated with the BDI, BAI and the Wender Utah Rating Scale. Given the contribution of stressful events to their current mental status and to the long-term effects of perinatal stress, the Traumatic Experiences List (TEL) was also administered. The presence of depression, anxiety and ADHD among adolescents and the link to the mother’s mental status, and the factors predicting depression, anxiety and ADHD were analyzed. Results: The adolescents whose mothers had mental complaints during pregnancy were found to have significantly higher levels of depression and mental complaints than those whose mothers had no mental complaints in their case histories (p

The impact of exposure to memorial reports on the 5.12 Wenchuan earthquake on sleep quality among adult survivors ten years after the disaster: Evidence for nonlinear associations

IntroductionVery few studies have explored the effect of exposure to disaster memorial reports in the media on long-term sleep quality during the recovery period and post-disaster era. This study investigated the relationship between exposure to memorial reports and adult survivors' long-term sleep quality 10 years after the 5.12 Wenchuan earthquake in 2008, and determined whether exposure to memorial reports are associated with poor sleep quality. MethodUsing a cross-sectional methodology, we surveyed participants (N = 1000) recruited from six disaster-affected counties. We measured sleep quality using the Pittsburgh Sleep Quality Index questionnaire (PSQI). ResultsAfter controlling for the effects of demographic factors, socioeconomic status, and earthquake exposure factors, exposure to memorial reports and the PSQI global score had a strong inverted U-shaped relationship. Relationships among three sub-scores of PSQI (subjective sleep quality, sleep latency, daytime dysfunction) were also found to have similar relationships with memorial report exposure. That is, survivors who were exposed to low or high degrees of memorial reports had better sleep quality than those who were exposed to intermediate memorial reports. DiscussionThe curvilinear relationship between media exposure and sleep quality in the post-disaster era reveals that media exposure could be used to identify victims at risk of poor sleep quality. Clinicians and practitioners may consider adopting psychological intervention programs to enhance victims' psychological controllability to overcome mental disorders caused by media exposure.

Mediating role of post-traumatic stress disorder in post-traumatic growth in adults who experienced the 2017 Pohang earthquake

Background: The largest earthquake recorded in Korea occurred in Pohang in 2017. This study aimed to investigate the mediating role of post-traumatic stress disorder (PTSD) on the relationship between earthquake exposure level and post-traumatic growth (PTG) in adults who experienced the earthquake. Methods: We used a cross-sectional survey via convenience sampling to collect data from 200 respondents 18 months after the earthquake. Results: PTSD was severe in individuals who were married, had no religious affiliation, lower income, and higher earthquake exposure. PTG was higher in older, married, and more religious respondents. PTSD and PTG had a positive relationship, with PTSD fully mediating the relationship between earthquake exposure level and PTG. Limitations: The Pohang earthquake, with limited damage to life and property, may have had different effects on exposed individuals than more destructive earthquakes. Additionally, this study used the Korean version of the Posttraumatic Growth Inventory; most of the participants reporting a religious affiliation were Christians, which may have affected the results. Conclusions: Exposure to the Pohang earthquake was strongly associated with PTSD, which indirectly affected PTG. Future research should focus on developing an adequate PTG tool for natural disaster victims, more extensively investigating PTSD and PTG, and analyzing PTSD and PTG in terms of the disaster type.

Post Traumatic Stress Disorder (PTSD) and It’s Associated Factors among Secondary Level Students in Chautara Municipality, Nepal

Children and adolescents are more prone to developing Post Traumatic Stress Disorders. Objective of this study was to assess the magnitude of Post Traumatic Stress Disorder and associated factors among secondary level students in Chautara Municipality, Nepal. A cross sectional study was conducted among 249 secondary level students. Data were collected using population proportionate sampling method along with UCLA PTSD RI with 31 questionnaires DSM V tool was used to assess the PTSD symptom. Questionnaire was design to obtain socio demographic factor and earthquake exposure. Factor associated with PTSD development was assessed through chi square and binary logistic regression. Mean age of respondents was 15.42±1.079 years. Majority of them were middle adolescents (74.3%) and 25.7 percent were early adolescents. More than half of respondents were female 54.6 percent. This study revealed that PTSD was found to be among 27(10.8%) respondents and dissociative subtype PTSD was among 14(5.6%) respondents. Age was significantly associated with development of PTSD. Earthquake exposures like financial constraints after earthquake food deficiency displacement due to earthquake was the major factors associated with PTSD development. Psychological tutorship for PTSD is found to be protective factors for PTSD development in adolescents. PTSD was quite high among the secondary level students after six month of earthquake in Chautara municipality, Sindupalchwok district and psychological tutorship and humanitarian program for traumatized students could prevent development of PTSD.
 Key words: Post traumatic stress disorder; Associated factors; Earthquake; Secondary levels students

Identifying predictors of probable posttraumatic stress disorder in children and adolescents with earthquake exposure: A longitudinal study using a machine learning approach

BackgroundEvidence has identified risk factors associated with individuals with trauma exposure who develop posttraumatic stress disorder (PTSD). How to combine risk factors to predict probable PTSD in young survivors using machine learning is limited. The study aimed to integrated multiple measures at 2 weeks after the earthquake using machine learning for the prediction of probable PTSD at 3 months after earthquake. MethodsA total of 2099 young survivors with earthquake exposure were included. We integrated multiple domains of variables to ‘train’ a machine learning algorithm (XGBoost). Thirty-one combination types were implemented and evaluated. The resulting XGBoost was utilized in identifying individual participants as either probable PTSD or no PTSD. ResultsAny combination type predicted young survivor probable PTSD, with prediction accuracies ranging between 66%-80% (p < 0.05). In particular, the combination of earthquake experience, everyday functioning, somatic symptoms and sleeping correctly predicted 683 out of 802 cases of probable PTSD, translating to a classical accuracy of 74.476% (85.156% sensitivity and 60.366% specificity) and an area under the curve of 0.80. The most relevant variables (e.g. age, sex, property loss and a sedentary lifestyle) revealed in the present study. LimitationsParticipants from a specific district might limit the generalizability of our results. Self-report questionnaires and non-standardized measures were used to assess symptoms. ConclusionDetection of probable PTSD according to self-reported measurement data is feasible, may improve operational efficiencies via enabling targeted intervention, before manifestation of symptoms.

Associations among trauma exposure, post-traumatic stress disorder, and depression symptoms in adolescent survivors of the 2013 Lushan earthquake

BackgroundPost-traumatic stress disorder (PTSD) frequently occurs in survivors of natural disasters, while symptom of depression is related mostly to interpersonal trauma. These conditions are highly correlated and strongly impact adolescent quality of life. This study aimed to explore the relationship among trauma exposure, PTSD symptoms, and/or depression symptoms in adolescent survivors of the 2013 Lushan (China) earthquake. MethodsA cross-sectional survey of 2921 adolescents in the Longmenshan seismic fault zone was conducted three years after the Lushan earthquake. Participants were evaluated using the Earthquake Experience Scale, the Adolescent Self-rating Life Events Checklist (ASLEC), the Children's Revised Impact of Event Scale (CRIES-13), and the Depression Self-Rating Scale (KADS-6). Stepwise regression was used to explore relationships between trauma exposure and PTSD or depression symptoms. ResultsThere was a strong correlation between PTSD and depression symptoms, with a 10.7% comorbidity. Earthquake-related exposure, negative life events, prior exposure to the 2008 Wenchuan (China) earthquake, and being left behind by parents all contributed to PTSD and depressive symptoms. Earthquake exposures contributed mainly to PTSD symptoms, while interpersonal traumas contributed mainly to depression symptoms. ConclusionPTSD and depression symptoms strongly correlate in adolescent survivors of the 2013 Lushan earthquake. The high comorbidity between PTSD and depression symptoms may reflect shared risk factors. Natural disasters are more likely to cause PTSD symptoms, while interpersonal traumas are more likely to cause depression symptoms.