Earthquake Survivors Research Articles

Protective Effects of Social Support Content and Support Source on Depression and Its Prevalence 6 Months after Wenchuan Earthquake

A magnitude 8.0 earthquake struck China's southwestern Sichuan province on 12 May 2008. The reported rates of depression symptoms across studies were not consistent, and its protective factors were unknown. This study collected data from Wenchuan earthquake survivors to estimate the prevalence of depression and explore the protective effects of social support and support source on depression. A randomized sampling cross-sectional survey based on community was conducted in January 2009, in Mianzhu and Anxian counties, and 633 survivors were entered into the study. The Chinese edition of the Center for Epidemiologic Studies Depression Scale and the Social Support Rating Scale were used to investigate depression and social support. The prevalence of probable depression in adults 6 months after the Wenchuan earthquake was 22.9% (145/633). Total social support, subjective support, support use and support from family members, neighbours and organizations negatively predicted depression. According to the results, depression was common 6 months after this major disaster. Total social support, subjective support, support use and support from family members, neighbours and organizations were all protective factors for depression after a major disaster.

Trauma, depression, and resilience of earthquake/tsunami/nuclear disaster survivors of Hirono, Fukushima, Japan

A mega-earthquake and tsunami struck the northeastern coast of Japan, and many survivors were forced to evacuate to temporary housing due to rising radiation levels. The aims of this study were to investigate the prevalence of symptoms of post-traumatic stress disorder (PTSD), depression, and poor general health among survivors, to test the predictive roles of resilience on mental and physical health, and to examine the predictive sociodemographic factors on resilience. Two hundred and forty-one evacuees (men/women: 116/125) from Hirono, Fukushima participated in the study. They were asked to complete the Connor-Davidson Resilience Scale, the Zung Self-Rating Depression Scale, the Impact of Events Scale-Revised, and a demographic questionnaire. Among all participants, 53.5% exhibited the clinically concerning symptoms of PTSD, and among them 33.2% indicated clinical PTSD symptoms. Additionally, 66.8% reported symptoms of depression, and among them 33.2% showed mildly depressive symptoms, while 19.1% and 14.5% demonstrated moderate and severe depressive symptoms, respectively. Resilience was a significant buffer for depression, PTSD, and general health. Additionally, employment status, eating/exercise habits, and drinking habits predicted resilience. The results indicated that depression and PTSD are prevalent among the survivors of massive earthquakes, tsunamis, and accidents from nuclear power plants. However, the results also showed that some survivors managed to endure the traumatic events relatively well, and resilience was a significant protective factor in dealing with such events. Therefore, it is crucial to assist survivors in improving their resilience by providing job opportunities and encouraging a healthy lifestyle.

The presence of post‐traumatic stress disorder symptoms in earthquake survivors one month after a mudslide in southwest China

The psychological impact of a mudslide on survivors of the Wenchuan earthquake in China and the risk factors for development of disaster-related post-traumatic stress disorder (PTSD) were investigated. The study design was cross-sectional and included 1321 survivors who had endured both an earthquake and a mudslide. Participants filled out a self-report questionnaire. One month after the mudslide, the rate of PTSD symptoms was 18.7%. Females, the elderly, those with lower educational levels, those that lacked social support, those who did not take precautionary measures, those living with children below 6 years of age, and those who had higher exposure to traumatic events experienced a higher level of PTSD symptoms. Results indicated that timely rescue, abundant material help, and mental rehabilitation after a disaster play important roles in recovery, and that there are still some high-risk groups that need attention, care, and effective intervention from healthcare professionals and society.

Remote Detection of Human Vital Sign With Stepped-Frequency Continuous Wave Radar

The stepped-frequency continuous wave (SFCW) radar technique was used to detect cardio-respiratory signals as the vital sign from a human subject positioned behind obstacles under laboratory conditions. The experiments were organized with a number of detection scenarios by collecting data from a group of human subjects. The experiments also investigated the effect of varying thickness of the obstacles, human subject postures, status of breathing, position of radar antenna relative to human subject's chest, as well as the length of survey times. The experimental results have shown that respiration as the primary vital sign can be detected with very high confidence and should be highlighted in developing radar systems for search and rescue for earthquake disaster survivors. Among the four human subject postures of face up, face down, face left, and face right, detection of the cardiologic signals can solely be achieved possibly when the subject was facing up. When the radar antennas to be placed at certain offset, not directly above the human subject's chest, it is still possible for good detection of the breathing signal. The minimum recording time for extracting respiration signal can be as short as 5 s. Even be conservative, a period of 30 s should be long enough for catching the respiratory signal with high signal to noise ratio.

Temporal features of elevated hair cortisol among earthquake survivors

This study aimed to determine the effect on hair cortisol level of a chronic stress response from the Wenchuan earthquake, and to explore the temporal features of elevated hair cortisol. We recruited two cohorts of earthquake survivors: cohort A consisted of 12 male adults and 8 females and cohort B of 20 male adolescents, with 23 and 29 participants as controls, respectively. Their hair samples closest to the scalp were assayed with mass spectrometry to determine cortisol content. Results revealed that hair cortisol content in survivors of cohort A was significantly higher than in the control. For survivors of cohort B, hair cortisol levels increased 6 and 22 weeks after the earthquake and decreased 43 weeks after the outburst. In conclusion, the chronic stress response elicited by the earthquake resulted in elevated hair cortisol. Timing since the earthquake outburst played an important role in the long-term response of the HPA axis to a major acute stressor.

Assessment of prevalence and determinants of posttraumatic stress disorder and depression symptoms in adults survivors of earthquake in Haiti after 30 months

BackgroundOn January 12, 2010, a powerful 7.0 magnitude earthquake struck the Republic of Haiti and destroyed Port-au-Prince, the capital and others cities across the country. While some studies have examined the long-term traumatic effects of the seismic event on children and adolescents victims, so far no study has examined the consequences on adults generally. As such, this study aims to investigate the traumatic consequences of the earthquake among adults related to degree of exposure, peritraumatic distress, depressive symptoms and sociodemographic factors two and a half years after. In addition, predictive factors of PTSD and depressive symptoms were also identified. MethodsFrom June to July 2012, a total of 1355 adults (660 women) was assessed by means the traumatic exposure questionnaire, the Life Events Checklist subscale, the Peritraumatic Distress Inventory (PDI), the Impact of Event Scale – Revised (IES-R) and the Beck Depression Inventory (BDI), in addition to social demographic characteristics. ResultsThe prevalence rates of PTSD and depressive symptoms were 36.75% (498 cases) and 25.98% (352 cases) respectively. The risk factors for PTSD and depressive symptoms were young and old age, female gender, unemployed status and low level of education. The bests predictives variables were peritraumatic distress for PTSD (β=.57, p<.0001) and for depressive symptoms (β=.21, p<.0001). The commorbidity between PTSD and depression was 13.36%. ConclusionsThis study found that psychological symptoms are frequent event 30 months after the earthquake. The different mental health care providers, the public health ministry, NGOs working on the ground in Haiti should design programmes in order to aid the psychological wellbeing of the population focussing on youth, older and retired adults, females, people with low levels of education and those who do not work.

A Longitudinal Study of Posttraumatic Stress Disorder Symptoms and Its Relationship with Coping Skill and Locus of Control in Adolescents after an Earthquake in China

Background/ObjectivesPost-traumatic stress disorder is a common psychological maladaptation among adolescents after undergoing an earthquake. Knowledge about the prevalence and maintenance of post-traumatic stress disorder symptoms and the changes of its predictors over time can help medical providers assist adolescent survivors with mitigating long-term impacts. This study examined the changes in posttraumatic stress disorder symptoms and its relationship with coping skill and locus of control among adolescent earthquake survivors in China.Methodology/FindingsThe study used an observational longitudinal design. A total of 1420 adolescents were evaluated twice after the earthquake by using the Post-traumatic stress disorder Checklist-Civilian Version, The Internality, Powerful others and Chance scale and the Coping Styles Scale. The results indicated that the mean scores of posttraumatic stress disorder symptoms were decreased significantly and the positive rates of posttraumatic stress disorder symptoms also declined remarkably at 17 months compared to the 3 months post-earthquake. Internality locus of control and problem solving coping skill were effective resilient factors for the development and maintenance of posttraumatic stress disorder symptoms, while chance locus of control was a powerful risk factor of posttraumatic stress disorder symptoms as well as being female, being injured and property loss.Conclusions/SignificanceContinuous screening is recommended to identify adolescent earthquake survivors with posttraumatic stress disorder symptoms. More attention should be paid to adolescent survivors who are prone to adopt passive coping strategies responding to trauma events and who own external causal attribution.

Rate and predictors of postpartum depression in a 22-year follow-up of a cohort of earthquake survivors in Armenia

Disasters have serious long-term impact on mental health for those exposed. The aim of this study was to identify predictors of postpartum depression among survivors of the 1988 devastating earthquake in Armenia. A nested case-control design was applied to investigate postpartum depression in a large-scale cohort of survivors followed between 1990 and 2012. From an original group of 725 adults who were assessed for psychopathology in 1990, 146 women reported having a delivery after the earthquake and were included in this study. Women with postpartum depression were identified using Edinburgh Postnatal Depression Scale. A logistic regression model was fitted to identify the predictors of postpartum depression. Of the 146 women, 19 (13.0%) had postpartum depression. Five independent predictors of postpartum depression were identified: number of woman's stressful life events (odds ratio (OR)=2.06), her prior history of postpartum depression (OR=16.98), delivering sick/dead neonate (OR=13.65), poor living standards during the post-earthquake decade (OR=5.77), and perceiving oneself reliable in 1990 (OR=0.24). Anxiety in 1990 was marginally significantly related to the outcome (OR=3.75). The rate of postpartum depression in this 22-year cohort was similar to that among the Armenian general population. Earthquake exposure was not related to postpartum depression, indicating that the impact of disaster-related trauma diminishes over time. The identified predictors provided evidence to develop interventions targeting groups of women most prone to postpartum depression under such circumstances.

Use of Traditional East Asian Medicine to Diagnose and Kampo Medicine Kamishoyosan to Treat Survivors of the Great East Japan Earthquake 2011: A Retrospective Study

Objective: In the aftermath of the Great East Japan Earthquake of March 11, 2011 and the associated tsunami, the Japanese medical system was not adequately prepared to deal with the many cases of post-traumatic stress disorder (PTSD), and commonly used pharmaceuticals were not always effective in dealing with the symptoms of PTSD. The aim of this paper is to evaluate the physical and mental condition of tsunami survivors by using traditional East Asian medicine (TEAM) principles and examine the effects of Kampo medicine (Japanese herbal medicine) Kamishoyosan (Jia-wei-xiao-yao-san) on stress-related disorders such as PTSD. Method: The study participants consisted of 32 tsunami survivors of the Great East Japan Earthquake. Clinical records were used to analyze (1) patient complaints, (2) diagnosis, and (3) treatment with traditional Chinese medicine. The clinical records were also used for Japanese-language version of the Impact of Event Scale – Revised (IES-R-J) assessments. Results: Thirty-two employees at the Urayasu nursing facility (7 men, 25 women; age, 40 ± 13 years) were enrolled as patients. The physical symptoms reported by the patients were insomnia, fatigue, palpitations, and shoulder discomfort; the mental symptoms included anxiety, sense of guilt, dreams, fear, anger, and irritation. Among TEAM syndromes, “liver qi stagnation” and “depressed liver qi transforming into fire” were most common. The herbal medicine Kamishoyosan was prescribed for 23 participants. The IES-R-J scores after the prescribed use of Kamishoyosan showed significant improvement compared to the pre-treatment IES-R-J scores. Conclusions: Kamishoyosan for applicable cases can be helpful as an adjunctive therapy for treatment of stress-related disorders such as PTSD following major disasters. Further investigation of the role of Kamishoyosan in reducing the symptoms of PTSD is warranted. Follow-up for survivors and rescue workers affected by the Great East Japan Earthquake is indispensable

A mixed-methods assessment of the experiences of lay mental health workers in postearthquake Haiti.

A mixed-methodological study conducted in the aftermath of the 2010 Haiti earthquake assessed experiences of 8 lay mental health workers (earthquake survivors themselves) implementing a psychosocial intervention for residents of camps for displaced people in Port-au-Prince. Quantitative results revealed decreased posttraumatic stress disorder symptoms, consistently high compassion satisfaction, low burnout, moderate secondary trauma, and high levels of posttraumatic growth measured over 18 months. Qualitative accounts from lay mental health workers revealed enhanced sense of self-worth, purpose, social connection, and satisfaction associated with helping others. Results support the viability of utilizing local lay disaster survivors as implementers of psychosocial intervention.

Adapting narrative exposure therapy for Chinese earthquake survivors: a pilot randomised controlled feasibility study

Narrative exposure therapy (NET) is a brief, manualised treatment for Posttraumatic Stress Disorder (PTSD). It has been shown to have therapeutic benefits for a wide range of individuals and settings. This study, following our previous work applying the original NET in earthquake survivors, aimed to revise NET to be adaptable for treating PTSD after a natural disaster. A randomised waiting-list controlled study was conducted with 30 adult participants with PTSD who were randomly allocated to NET (n?=?10), revised NET (NET-R; n?=?10) or a waiting list condition (WL; n?=?10). Participants in NET and NET-R received treatment immediately; those in the WL condition received NET-R treatment after a waiting period. All groups were assessed on PTSD, general distress, anxiety, depression, social support, coping and posttraumatic change before and after treatment and three-month follow-up. Compared with WL, both NET and NET-R groups showed significant reductions in PTSD and related symptoms. Significant increases were found in posttraumatic growth, active coping and perceived social support. The WL group showed similar improvements after treatment. Further reductions on PTSD symptoms were found at three months, showing that NET-R is as effective as the original NET in treating post-earthquake traumatic symptoms in adult Chinese earthquake survivors. NET-R is a feasible and cost-effective intervention for Chinese earthquake survivors. Further studies are needed to replicate these findings in other survivor populations, and with larger samples and over longer periods. This study highlighted the value of oral narrative approach, which is well-accepted and useful in the context of single natural disaster and lower- income area. Chinese Clinical Trial Registry: ChiCTR-TRC-12002931

Medium- to Long-term Psychological Support for Women Living in Areas Affected by the Great East Japan Earthquake: Empirical Studies on the Impact of Horticultural Therapy

Copyright: © 2014 Kotozaki Y. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. In the near future, three years will have passed since the Great East Japan Earthquake. Despite the passage of time, several residents living off the Pacific coast of Tohoku continue to suffer from mental and physical repercussions of the event. In other words, numerous survivors of the Great East Japan Earthquake continue to live with emotional trauma and stress. Previous studies suggest that mental health problems among natural disaster survivors are most pronounced within a specified period after the event [1]. Although recovery among survivors is progressing incrementally in the disaster area of Tohoku, one may argue that availability of mediumto long-term psychological care for these people is important. Immediately following the earthquake, our research team provided horticultural therapy as a mediumto longterm psychological support to the survivors. The motivation behind this study is based on previous research suggesting that women are more susceptible to experiencing anxiety in post-disaster environments than men [2], that women are more likely to be diagnosed with PostTraumatic Stress Disorder (PTSD) than men after experiencing natural disasters [3], and that weak social support is associated with a higher susceptibility to PTSD.

Efficacy of Herbal Drugs in Human Diseases and Disorders

According to a ballpark figure by World Health Organization, more than three-quarters of population of the developing nations exploit herbal medicine for their primary health care. Herbal drugs and their constituents have advantageous effects on long-term fitness and can be used to efficiently treat human diseases or disorders. In veracity, herbs frequently include various active ingredients that imaginably have drug allying commotion in the body. Bringing into play, herbs are often more affordable than procuring expensive contemporary pharmaceuticals to take care of ailments. A large number of herbs have proved their usefulness in managing various illnesses. Latest advances in biology and medicine have introduced new technologies to study the biological significance of herbal drugs in various human diseases and disorders. Hence it is important to understand the mechanism(s) of herbal drug action for the knowledge and development of successful therapies. The current special issue brings together several exciting papers defining the efficacy of herbal drugs in an assortment of human diseases and disorders. J. Li et al. have tested the effects and mechanism of Bufei Yishen formula (BYF) in a rat chronic obstructive pulmonary disease (COPD) model and provided the basis for mechanisms of BYF on COPD and new therapeutic drug targets. X. Yu et al. have reported the treatment of Si-Jun-Zi decoction, a famous Chinese medicine that promotes the restoration of intestinal function after obstruction by regulating intestinal homeostasis. Tong xinluo (TXL), a Chinese herbal compound, has been used in China with traditional therapeutic efficacy in patients with diabetic nephropathy (DN). N. Zhang et al. demonstrated that TXL successfully inhibits TGF-β1-induced epithelial-to-mesenchymal transition in DN, which may account for the therapeutic efficacy in TXL-mediated renal protection. W. Zhang et al. explored the effects of Jian-Pi-Zhi-Dong decoction (JPZDD) on Tourette syndrome (TS) by investigating the expression of gamma-aminobutyric acid (GABA) and its type A receptor (GABAAR) in the striatum of a TS mice model induced by 3,3′-iminodipropionitrile (IDPN) treatment. It was revealed that JPZDD alleviates TS symptoms which may be associated with GABAAR expression downregulation in striatum thereby controlling GABA metabolism. TZQ-F has been traditionally used as a traditional Chinese medicine formula for the treatment of diabetes. H. Yuhong et al. compared the pharmacologic effects and gastrointestinal adverse events between TZQ-F and acarbose in Chinese healthy volunteers. T. Numata et al. reported the treatment of posttraumatic stress disorder (PTSD) using the traditional Japanese herbal medicine Saikokeishikankyoto in survivors of the great east Japan earthquake and tsunami. The traditional medicine may be a valid choice for the treatment of psychological and physical symptoms in PTSD patients. Y. Ewnetu et al. evaluated the synergetic antimicrobial effect of Ethiopian honey and ginger powder extract mixtures on standard and resistant clinical isolates of Staphylococcus aureus, Escherichia coli, and Klebsiella pneumoniae. The combination has the potential to serve as cheap source of antibacterial agents especially for the drug resistant strains. Herbs are now gaining much attention as the main source of effective drugs for lowering serum lipids and lipid peroxidation. M. Rafieian-kopaei et al. assessed the impact of Ferulago angulata on serum lipid profiles and on levels of lipid peroxidation in male Wistar rats. Administration of a hydroalcoholic extract reduces the serum levels of total cholesterol, triglycerides, and LDL comparable to atorvastatin (a standard lipid lowering drug). A-J. Lee et al. investigated the absolute counts and percentages of peripheral blood (PB) lymphocyte subtypes in end-stage cancer patients before and after localized radiotherapy (RT) and after oral administration of Bojungikki-tang water extract (BJITE) and to evaluate the changes mediated by RT and BJITE. It was observed that immune deterioration occurs after RT and administration of BJITE was found effective in its restoration. T. Shimizu provides a good overview of efficacy of Kampo medicine (KM) in treating atopic dermatitis (AD). KM is a traditional herbal medicine in Japan and has a long history and plays an important role in the prevention and treatment of various diseases including AD. Y. Ma et al. explored the efficacy of herb-partitioned moxibustion in patients with diarrhoea-predominant irritable bowel syndrome (DPIBS) and suggest it as a promising, efficacious, and well-tolerated treatment for patients. Melinjo (Gnetum gnemon L.) seed extract containing transresveratrol (3,5,4′-trihydroxy-trans-stilbene) and other derivatives exerts diverse beneficial effects. H. Konno et al. reported melinjo seed extract decreases serum uric acid levels in nonobese Japanese males regardless of insulin resistance and may improve lipid metabolism by increasing HDL cholesterol. We anticipate that readers and scientific fraternity working in the area of herbal drugs will find not only the updated review on the subject but also a compilation of precise data on the efficacy of herbal drugs in some lifestyle diseases and disorders with their suggested mechanism of action. Suaib Luqman Syed Ibrahim Rizvi Andre-Michael Beer Sunil Kumar Khare Pinar Atukeren

Treatment of posttraumatic stress disorder using the traditional Japanese herbal medicine saikokeishikankyoto: a randomized, observer-blinded, controlled trial in survivors of the great East Japan earthquake and tsunami.

The Great East Japan earthquake and tsunami caused immense damage over a wide area of eastern Japan. Hence, many survivors are at high risk for posttraumatic stress disorder (PTSD). This randomized, observer-blinded, controlled trial examined the efficacy and safety of the traditional Japanese herbal formula saikokeishikankyoto (SKK) in the treatment of PTSD among survivors of this disaster. Forty-three participants with an Impact of Event Scale-Revised (IES-R) score ≥ 25 were randomized into SKK (n = 21) and control (n = 22) groups. The primary endpoint was the change in IES-R scores from baseline till after 2 weeks of treatment. Intergroup statistical comparisons were performed. The magnitude of changes in total IES-R scores differed significantly between the two groups (P < 0.001). Post hoc analysis showed that the total IES-R score improved significantly in the SKK group from 49.6 ± 11.9 to 25.5 ± 17.0 (P < 0.001). Subscale scores improved significantly in the SKK group (avoidance, P = 0.003; hyperarousal, P < 0.001; intrusion, P < 0.001). Two-week treatment with SKK significantly improved IES-R scores among PTSD patients. This traditional medicine may be a valid choice for the treatment of psychological and physical symptoms in PTSD patients.

Health-Related Quality of Life of Chinese Earthquake Survivors: A Case Study of Five Hard-Hit Disaster Counties in Sichuan

As one of the most destructive natural disasters, earthquakes affect the health of survivors. The devastating earthquakes that hit Sichuan, China have aroused the concern of domestic and international scholars. The health-related quality of life (HRQOL) of survivors also requires substantial research. Studies on impact factors, such as gender, age, monthly income, and education, have become controversial. The subjects in this study are the people of five hard-hit disaster counties in Sichuan Province, namely, Wenchuan, Qingchuan, Mianzhu, Lushan, and Dujiangyan. A preliminary survey was conducted in May and June 2013 in areas badly hit by the earthquake in Sichuan, China. A total of 2000 questionnaires were distributed, and 1672 of which were received, yielding a recovery rate of 83.6 %. To further complement and corroborate the conclusions, a follow-up survey was conducted in October and November 2013, where 1526 effective questionnaires were received. The analysis in this paper is mainly based on the first survey, and the collected data from the follow-up survey were used to perform a supplementary analysis. By analyzing data from five hard-hit areas in Sichuan and by establishing models, we drew the following conclusions: The results of analysis of variance and Tukey’s honestly significant difference tests revealed the following results. First, the results of two investigations indicate the HRQOL of earthquake survivors is relatively poor, especially in terms of general health (GH), mental health (MH), social functioning (SF), etc. However, results of the second survey indicate that the scores of all domains (except GH) have increased significantly, with the SF having the most significant increase. Second, the HRQOL scores of men are higher than those of women. Individuals with higher education or monthly income have higher HRQOL scores than those with lower education or income. Moreover, younger survivors have higher HRQOL scores than older survivors. Third, a positive correlation exists among the HRQOL domains of all survivors. Among all domains, the PF, RP, GH, MH, and VT of survivors have a very strong correlation. In addition, SF, BP, MH, and VT have a strong correlation. Other variables have a relatively weak correlation.

A longitudinal study of quality of life of earthquake survivors in L'Aquila, Italy.

BackgroundPeople’s well-being after loss resulting from an earthquake is a concern in countries prone to natural disasters. Most studies on post-earthquake subjective quality of life (QOL) have focused on the effects of psychological impairment and post-traumatic stress disorder (PTSD) on the psychological dimension of QOL. However, there is a need for studies focusing on QOL in populations not affected by PTSD or psychological impairment. The aim of this study was to estimate QOL changes over an 18-month period in an adult population sample after the L’Aquila 2009 earthquake.MethodsThe study was designed as a longitudinal survey with four repeated measurements performed at six monthly intervals. The setting was the general population of an urban environment after a disruptive earthquake. Participants included 397 healthy adult subjects. Exclusion criteria were comorbidities such as physical, psychological, psychiatric or neurodegenerative diseases at the beginning of the study. The primary outcome measure was QOL, as assessed by the WHOQOL-BREF instrument. A generalised estimating equation model was run for each WHOQOL-BREF domain.ResultsOverall, QOL scores were observed to be significantly higher 18 months after the earthquake in all WHOQOL-BREF domains. The model detected an average increase in the physical QOL scores (from 66.6 ± 5.2 to 69.3 ± 4.7), indicating a better overall physical QOL for men. Psychological domain scores (from 64.9 ± 5.1 to 71.5 ± 6.5) were observed to be worse in men than in women. Levels at the WHOQOL domain for psychological health increased from the second assessment onwards in women, indicating higher resiliency. Men averaged higher scores than women in terms of social relationships and the environmental domain. Regarding the physical, psychological and social domains of QOL, scores in the elderly group (age > 60) were observed to be similar to each other regardless of the significant covariates used.ConclusionsWHOQOL-BREF scores of the psychological domain displayed trends conditioned by age and education: older subjects experienced less satisfaction with psychological health on average. Less-educated subjects always demonstrated the worst QOL scores. Gender, age and education impacted the variability of QOL in the environmental dimension in the elderly.

Brain structural plasticity in survivors of a major earthquake

Stress responses have been studied extensively in animal models, but effects of major life stress on the human brain remain poorly understood. The aim of this study was to determine whether survivors of a major earthquake, who were presumed to have experienced extreme emotional stress during the disaster, demonstrate differences in brain anatomy relative to individuals who have not experienced such stressors. Healthy survivors living in an area devastated by a major earthquake and matched healthy controls underwent 3-dimentional high-resolution magnetic resonance imaging (MRI). Survivors were scanned 13-25 days after the earthquake; controls had undergone MRI for other studies not long before the earthquake. We used optimized voxel-based morphometry analysis to identify regional differences of grey matter volume between the survivors and controls. We included 44 survivors (17 female, mean age 37 [standard deviation (SD) 10.6] yr) and 38 controls (14 female, mean age 35.3 [SD 11.2] yr) in our analysis. Compared with controls, the survivors showed significantly lower grey matter volume in the bilateral insula, hippocampus, left caudate and putamen, and greater grey matter volume in the bilateral orbitofrontal cortex and the parietal lobe (all p < 0.05, corrected for multiple comparison). Differences in the variance of survivor and control data could impact study findings. Acute anatomic alterations could be observed in earthquake survivors in brain regions where functional alterations after stress have been described. Anatomic changes in the present study were observed earlier than previously reported and were seen in prefrontal-limbic, parietal and striatal brain systems. Together with the results of previous functional imaging studies, our observations suggest a complex pattern of human brain response to major life stress affecting brain systems that modulate and respond to heightened affective arousal.

Developing a new perspective to study the health of survivors of Sichuan earthquakes in China: a study on the effect of post-earthquake rescue policies on survivors’ health-related quality of life

BackgroundSichuan is a province in China with an extensive history of earthquakes. Recent earthquakes, including the Lushan earthquake in 2013, have resulted in thousands of people losing their homes and their families. However, there is a research gap on the efficiency of government support policies. Therefore, this study develops a new perspective to study the health of earthquake survivors, based on the effect of post-earthquake rescue policies on health-related quality of life (HRQOL) of survivors of the Sichuan earthquake.MethodsThis study uses data from a survey conducted in five hard-hit counties (Wenchuan, Qingchuan, Mianzhu, Lushan, and Dujiangyan) in Sichuan in 2013. A total of 2,000 questionnaires were distributed, and 1,672 were returned; the response rate was 83.6%.ResultsResults of the rescue policies scale and Medical Outcomes Study Short Form 36 (SF-36) scale passed the reliability test. The confirmatory factor analysis model showed that the physical component summary (PCS) directly affected the mental component summary (MCS). The results of structural equation model regarding the effects of rescue policies on HRQOL showed that the path coefficients of six policies (education, orphans, employment, poverty, legal, and social rescue policies) to the PCS of survivors were all positive and passed the test of significance. Finally, although only the path coefficient of the educational rescue policy to the MCS of survivors was positive and passed the test of significance, the other five policies affected the MCS indirectly through the PCS.ConclusionsThe general HRQOL of survivors is not ideal; the survivors showed a low satisfaction with the post-earthquake rescue policies. Further, the six post-earthquake rescue policies significantly improved the HRQOL of survivors and directly affected the promotion of the PCS of survivors. Aside from the educational rescue policy, all other policies affected the MCS indirectly through the PCS. This finding indicates relatively large differences in the effects of different post-earthquake rescue policies on the HRQOL of survivors.

An examination of resilience cross-culturally in child and adolescent survivors of the 2008 China earthquake using the Connor–Davidson Resilience Scale (CD-RISC)

BackgroundThe 2008 Sichuan earthquake in China destroyed towns and village, displaced over a million people and caused thousands of deaths. There is a need to understand how children and adolescents are able to bounce back after this distressing event. This study conducts a psychometric assessment of the Connor–Davidson Resilience Scale (CD-RISC) and the measure's validity among children and adolescent survivors in order to identify the factors associated with resilience in this socio-cultural setting. MethodsTranslated and culturally verified versions of the CD-RISC, UCLA-PTSD Index and Birleson Self-rating Depression Scale were used to collect data from 2132 children and adolescents located in post-disaster areas 1 year after the event. ResultsThrough exploratory factor analysis, a 2-factor model was found and defined by Chinese scholars as Rational Thinking and Self-Awareness. Internal consistency of total CD-RISC was 0.86, 0.91 for Rational Thinking and 0.74 for Self-Awareness. Convergent validity between items ranged from 0.17–0.69 and 0.12–0.20 to the total score. Items related to post-traumatic stress disorder loaded separately than CD-RISC items, demonstrating discriminant validity. ConclusionsOur findings demonstrate that resilience may be understood and manifested dissimilarly in different socio-cultural settings. This study confirms the applicability of the CD-RISC scale to Chinese children and adolescent earthquake survivors, and adds to the richness of resilience research cross-culturally.

Social Support as a Moderator of the Relationship between Anxiety and Depression: An Empirical Study with Adult Survivors of Wenchuan Earthquake

BackgroundOn May 12th 2008, an earthquake with a magnitude of 8.0 on the Richter scale struck China, causing a large number of casualties and significant economic losses. By interviewing 2080 survivors of Wenchuan earthquake, the objective of this study is to estimate the role of different types of social support as possible moderating factors between anxiety and depression.MethodsA stratified random sampling strategy about the cross-sectional study was adopted. The self-rating anxiety scale (SAS), Self-Rating Depression Scale (SDS) and Social Support Rating Scale (SSRS) were used. A total of 2080 adult survivors of the Wenchuan earthquake from 19 damaged countries participated in the survey. Correlation analysis and regression analysis were performed to evaluate the moderating role of social support on the relationship between anxiety and depression.ResultsOne year after the Wenchuan earthquake, anxiety and depression were found to be 37.6% and 40.7%, respectively. Demographic characteristics were seen as significant in the cases of depression, except for age (p=0.599), while age and education level were not found to be significant for anxiety. The results showed that social support, especially subjective support could moderate the association between anxiety and depression.ConclusionsSocial support should be particularly focused on female survivors, those of the Han ethnic group, and those with a lower level of education and a lower income. Psychological intervention and care for survivors should focus on those most disoriented by the disaster.