Wenchuan Earthquake Survivors Research Articles

Long term impact of Wenchuan earthquake on population mental and behavioral disorders in heavily-stricken areas: An ecological study based on big data

BackgroundThis study aimed to explore and evaluate the development trends and differential changes in the prevalence of mental and behavioral disorders among the earthquake survivors in exposure groups (highly hard-hit areas) and control groups (general disaster areas) from 2015 to 2019, as well as to investigate the potential influencing factors. MethodsData was obtained from the Sichuan Health Information System and the Sichuan Health Yearbook, the prevalence of the exposure group and the control group were calculated, the difference between the two groups was evaluated using the prevalence rate ratio, and a fixed effect model was developed to investigate the potential influencing factors of the prevalence. ResultsThe prevalence by gender and age in the exposure group was always greater than those in the control group (RR>1), although the disparity between the two proceeded to diminish with time. The urbanization rate (β = 0.0448, P < 0.05) and disaster area levels (β = 0.0104, P < 0.05) were risk factors for the prevalence of mental and behavioral disorders. LimitationsThe study only collected data at the group level following the Wenchuan earthquake. Consequently, the findings are only applicable at the group level. Furthermore, diagnostic criteria for various types of mental and behavioral disorders diseases were not provided. ConclusionsThe earthquake has a significant long-term impact on mental health. It is necessary to continuously monitor the mental health of Wenchuan earthquake survivors and take appropriate post-disaster intervention measures.

Trajectory of adolescents' nightmares in relation to depression and post-traumatic stress disorder in young adulthood: a 10-year cohort of Chinese Wenchuan earthquake survivors.

This study examined the longitudinal trajectories of adolescent survivors' nightmares after the Wenchuan earthquake and tested whether specific trajectory memberships of nightmares could predict depression and post-traumatic stress disorder (PTSD) in the 10years after earthquake. 610 adolescents exposed to the Wenchuan earthquake were surveyed on nightmares at 18months (T18m), 24months (T24m), and 30months (T30m) after the earthquake. Depression and PTSD were assessed at baseline (T18m) and 10years (T10y) after the catastrophe. Data were analyzed using linear regression analysis. The prevalence rates of frequent nightmares at three time points were 9.8%, 11.5%, and 9.3%, respectively. Five different trajectories of nightmares were identified: resistance (77.0%), recover (8.4%), delayed-dysfunction (7.9%), chronic-dysfunction (1.1%), and relapsing/remitting (5.6%). Additionally, we found that participants in relapsing/remitting, chronic or delayed dysfunction trajectories compared with those in the resistant group were more likely to experience depression and PTSD in young adulthood after adjusting for a wide range of covariates. Nightmares had heterogeneity after a catastrophic earthquake. Timely assessment and targeted interventions on specific nightmares are necessary for reducing the incidence of psychiatric disorders.

Comorbid trajectories of posttraumatic stress disorder symptoms and depressive symptoms in a 10-year cohort of Chinese Wenchuan earthquake survivors: Course, predictors, and consequences.

Survivors may suffer mental health problems following disasters, particularly posttraumatic stress disorder (PTSD) and depressive symptoms. However, few studies have explored longitudinal processes of co-occurring PTSD and depressive symptoms among adolescent survivors and their associated predictors and consequences. The present study examines the codevelopment of both symptoms postearthquake using a 10-year cohort. A total of 1,357 senior high school students reported PTSD and depressive symptoms at 6, 12, 18, and 24 months after the 2008 Wenchuan earthquake. Self-report measures were also used to evaluate earthquake exposure, negative life events, social support, and trait resilience. At the 10-year follow-up (T10y), 799 participants reported their quality of life (QoL) online and 744 of them provided available data. A parallel-process latent class growth analysis was used to identify trajectories. Multinominal logistic and linear regressions were used, respectively, to analyze the predictors and consequences of these trajectories. Three comorbid trajectories were found: a resilient group (56.7%), a vulnerable group (33.3%), and a chronic high-risk group (9.9%). Gender, injury/missing/killed of family members, witnessing of traumatic sciences, negative life events, social support, and trait resilience were significant predictors of vulnerable and chronic high-risk groups. Finally, adolescents in these two groups were more likely to experience poorer QoL in adulthood. The results highlight the heterogeneity of depression-PTSD comorbidities among adolescent survivors. They also emphasize PTSD-depression symptoms predictors and their adverse impacts on life outcomes in adulthood. Individualized interventions should be provided for adolescents affected by natural disasters, especially those in the vulnerable and higher risk groups. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Supplemental Material for Comorbid Trajectories of Posttraumatic Stress Disorder Symptoms and Depressive Symptoms in a 10-Year Cohort of Chinese Wenchuan Earthquake Survivors: Course, Predictors, and Consequences

Supplemental Material for Comorbid Trajectories of Posttraumatic Stress Disorder Symptoms and Depressive Symptoms in a 10-Year Cohort of Chinese Wenchuan Earthquake Survivors: Course, Predictors, and Consequences

PTSD, FOMO and fake news beliefs: a cross-sectional study of Wenchuan earthquake survivors

BackgroundPost-traumatic stress disorder (PTSD) sufferers show problematic patterns of Internet use such as fear of missing out (FOMO) and sharing misinformation and fake news. This study aimed to investigate these associations in survivors of the 2008 earthquake in Wenchuan, China.MethodsA self-reported survey was completed by 356 survivors of the Wenchuan earthquake. A mediated structural equation model was constructed to test a proposed pattern of associations with FOMO as a mediator of the relationship between PTSD symptoms and belief in fake news, as well as moderators of this pathway.ResultsPTSD was directly associated with believing fake news (β = 0.444, p < .001) and with FOMO (β = 0.347, p < .001). FOMO mediated the association between PTSD and fake news belief (β = 0.373, p < .001). Age moderated the direct (β = 0.148, t = 3.097, p = .002) and indirect (β = 0.145, t = 3.122, p = .002) pathways, with effects more pronounced with increasing age. Gender was also a moderator, with the indirect effect present in females but not in males (β = 0.281, t = 6.737, p < .001).ConclusionThose with higher PTSD symptoms are more likely to believe fake news and this is partly explained by FOMO. This effect is present in females and not males and is stronger in older people. Findings extend knowledge of the role of psychological variables in problematic Internet use among those with PTSD.

Long-term effectiveness of rehabilitation services delivery for Wenchuan earthquake survivors with impairments over a 4-year period: a prospective cohort study

ObjectiveTo examine long-term effectiveness of rehabilitation services on physical function, pain severity and post-traumatic stress disorder (PTSD) in earthquake survivors over a 4-year period.DesignProspective cohort study with early and late...

A Positive Legacy of Trauma? The Role of Perceived Social Support on Mental Health Among Earthquake Survivors During the COVID-19 Outbreak.

BackgroundPeople with prior experience of severe trauma may be particularly vulnerable in the face of the COVID-19 pandemic. However, little is known about mental health problems among prior trauma survivors during the pandemic outbreak.MethodsA total of 362 Wenchuan earthquake survivors were assessed using Patient Health Questionnaire, Generalized Anxiety Disorder Scale, as well as Multidimensional Scale of Perceived Social Support, as part of an online survey between February 3 and 10, 2020.ResultsOur results showed that 6.6 and 4.7% of the participants experienced depression and anxiety during the COVID-19 outbreak, respectively. Perceived social support was negatively associated with depressive and anxiety symptoms. Earthquake exposure has no direct effect on current depressive and anxiety symptoms, but it would moderate the direct relationship between perceived social support and psychological symptoms.ConclusionsOur findings suggested that trauma exposure may lead to salutogenic outcomes. The protective effect of perceived social support on psychological symptoms was greater in people with a higher level of trauma exposure than in a lower one.

When Housing and Communities Were Delivered: A Case Study of Post-Wenchuan Earthquake Rural Reconstruction and Recovery

This study contributes to an in-depth examination of how Wenchuan earthquake disaster survivors utilize intensive built environment reconstruction outcomes (housing and infrastructural systems) to facilitate their long-term social and economic recovery and sustainable rural development. Post-disaster recovery administered via top-down disaster management systems usually consists of two phases: a short-term, government-led reconstruction (STGLR) of the built environment and a long-term, survivor-led recovery (LTSLR) of human and social settings. However, current studies have been inadequate in examining how rural disaster survivors have adapted to their new government-provided housing or how communities conducted their long-term recovery efforts. This qualitative case study invited sixty rural disaster survivors to examine their place-making activities utilizing government-delivered, urban-style residential communities to support their long-term recovery. This study discovered that rural residents’ recovery activities successfully perpetuated their original rural lives and rebuilt social connections and networks both individually and collectively. However, they were only able to manage their agriculture-based livelihood recovery temporarily. This research suggests that engaging rural inhabitants’ place-making expertise and providing opportunities to improve their housing and communities would advance the long-term grassroots recovery of lives and livelihoods, achieving sustainable development.

Risk factors of post-traumatic stress disorder 10 years after Wenchuan earthquake: a population-based case-control study.

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. 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. 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. 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.

Social capital, policy fairness, and subjective life satisfaction of earthquake survivors in Wenchuan, China: a longitudinal study based on post-earthquake survey data

BackgroundExisting research has rarely examined an earthquake’s sustained impact and the trajectory of the earthquake survivors’ life satisfaction over time. This study aims to analyze longitudinal changes in life satisfaction of Wenchuan earthquake survivors and the impact of social capital and government relief policy.MethodsThis research applied a hierarchical linear model to longitudinal survey data collected after the earthquake. The survey was divided into three waves and was collected from Deyang City and Mianyang City of Sichuan Province. A random sampling method was used; a sample of 225 participants had valid responses over three waves of the survey.ResultsThis study found that a survivor’s social capital and the perception of the fairness of government relief policy have a significant effect on the trajectory of life satisfaction post-disaster. First, the initial life satisfaction of those with high social capital was significantly higher than of those with low social capital, whilst survivors with high social capital had a lower rate of change in life satisfaction. Second, one year after the earthquake, those who felt government policy was unfair had a lower life satisfaction than those who felt it was fair. However, from the first year to the fourth year after the disaster, survivors who believed that the government policy was unfair experienced a higher rate of change in life satisfaction than those who did not. Third, the fairness of government relief policy moderates the relationship between survivors’ social capital and changes in life satisfaction. A fair policy of relief can reduce the negative impact of the lack of individual social capital on life satisfaction.ConclusionsSurvivors reconstruct life satisfaction through their social network and the perception of the fairness of the government’s post-disaster relief policy. Therefore, to promote the improvement of life satisfaction of survivors, it is necessary to cultivate social capital and ensure fairness of the relief policy.

Psychological predictors of posttraumatic growth among adult survivors of Wenchuan earthquake in China.

The current research investigates the applicability of the posttraumatic growth inventory and psychological predictors of posttraumatic growth among adult survivors of the Wenchuan earthquake in China. The results indicated that although the survivors reported a high degree of posttraumatic stress symptoms, they also experienced a moderate to high level of posttraumatic growth two years after the earthquake. The simplified Chinese version of the Posttraumatic Growth Inventory had good reliability in the current study. Confirmatory factor analysis of the simplified Chinese version of the Posttraumatic Growth Inventory verified that the original five-factor model fit the data better than the four-factor model documented by Ho et al. (2004, 2011) among Chinese cancer patients. The current study also demonstrates that positive changes in outlook, positive affect, and perceived social support are significant predictors of posttraumatic growth among adult survivors of the Wenchuan earthquake. Directions for future research on posttraumatic growth among survivors of natural disasters and implications for developing psychological interventions to help people recover from traumatic events are discussed.

Trust in stakeholders and social support: risk perception and preparedness by the Wenchuan earthquake survivors

ABSTRACT Trust in stakeholders and social support are essential but neglected factors that shape people's disaster protective behaviours such as mitigation and preparedness. This paper examines the effects of various forms of trust and social support on seismic risk perception and self-reported preparedness in rural China. A household survey (N = 415) of survivors of the 2008 Wenchuan earthquake was conducted in 2012. The perceived seismic risk and self-reported preparedness were analysed as dependent variables. Trust in the general public, close relationships, government, and outside helpers were used as various forms of trust. Social support from formal organisations and informal personal networks were included as social support measures, and ordinal logistics and logistic regression models were used for the analysis. The results demonstrate that trust in government and outside helpers are positively associated with perceived risk and adaptation of preparedness actions. Informal social support is negatively correlated with the self-reported preparedness, as well as the perceived likelihood and consequence of the potential earthquakes. The effect of formal support is not significant in predicting disaster risk perception or preparedness. Different forms of trust in stakeholders and social support have different impacts on individuals’ risk perception and preparedness.

Post-traumatic stress disorder in a population of 2008 Wenchuan earthquake survivors with disabilities: the role of environmental barriers

Purpose Earthquake survivors whose physical injuries result in disability may be at increased risk for prolonged and severe post-traumatic stress disorder. We estimated the prevalence of post-traumatic stress disorder, functional limitations, and environmental barriers in 289 survivors with disabilities induced by the 2008 Wenchuan earthquake eight years after the disaster. We also investigated the relationship of post-traumatic stress disorder symptom severity with function, considering a mediating role of environmental barriers. Methods Post-traumatic stress disorder was measured with post-traumatic stress disorder checklist-civilian version. Physical and mental functioning was assessed with Medical Outcomes Short Form-36 and perceived environmental barriers were evaluated with Nottwil Environmental Factors Inventory-Short Form. Path analysis was employed to examine the relationship of exposures, post-traumatic stress disorder symptom severity, environmental barriers, and physical and mental function. Results Prevalence of probable post-traumatic stress disorder was 18.68% (95% CI: 14.19–23.18%). Earthquake survivors with lower physical and mental functioning perceived more environmental barriers, and those who perceived more barriers demonstrated more severe post-traumatic stress disorder symptoms, confirming a mediating role of environmental barriers. Conclusions Long-term community-based health services for earthquake survivors with disabilities should combine both mental and physical rehabilitation and focus on creating disability-inclusive environments. Implications for rehabilitation Earthquake survivors whose physical injuries result in permanent disability may experience two different types of psychological trauma. The first originates from the initial psychological impact of the disaster and their injuries and the second arises from the added difficulty of coping with environmental barriers given the limitations imposed by their impairments. Even years after the disaster, prevalence of post-traumatic stress disorder is likely high in earthquake survivors with acquired musculoskeletal or neurological impairments and needs to be considered in the rehabilitation process. Physical and mental functioning, as well as environmental barriers, are important intervention targets to reduce post-traumatic stress disorder symptoms. Long-term community-based health services for earthquake survivors with disabilities are needed that combine both mental health and physical rehabilitation components with advocating for disability-inclusive environments.

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.

Longitudinal associations between adolescents' trajectory membership of depressive symptoms and suicidality in young adulthood: a 10-year cohort of Chinese Wenchuan earthquake survivors.

Previous studies regarding associations between depressive symptoms and suicidality (suicidal ideation, plans and attempts) have usually employed a variable-centred approach, without considering the individual variance in time-varying changes of depressive symptoms. Through 10-year follow-up of a large cohort of Chinese adolescents exposed to the 2008 Wenchuan earthquake, this study examined whether individual variance in depressive symptoms during the early phases post-earthquake could generate different suicidality outcomes in young adulthood. A total of 1357 Chinese adolescents exposed to the Wenchuan earthquake were surveyed on depressive symptoms and other variables at 6, 18 and 30 months post-earthquake. In total, 799 participants responded to the 10-year follow-up and completed an online survey covering suicidality and other variables. The analytic sample was 744 participants who had valid data on depressive symptoms and suicidality. Data were analysed using logistic regressions. Prevalence estimates of past-year suicidal ideation, suicide plans and suicide attempts measured at 10 years post-earthquake were found to be 10.8%, 7.3% and 3.0%, respectively. Five trajectories of depressive symptoms were classified: resistance (54.4%), chronicity (13.3%), recovery (10.4%), delayed dysfunction (12.0%) and relapsing/remitting (10.0%). After controlling for covariates, whole-sample regressions revealed only the relapsing/remitting depressive trajectory remained significantly predictive of suicidality. Moreover, males not females in the chronic group were more likely to have suicide plans. The findings highlight the importance of detecting disaster survivors with different trajectories of mental status and providing with them individualised and effective mental health services, to decrease their risk of suicidality in the future.

The relationship between PTSD and suicidality among Wenchuan earthquake survivors: The role of PTG and social support

BackgroundPrevious studies have found that suicide rates are likely to increase after the occurrence of earthquakes. Most existing studies that examined the relationship between PTSD and suicidality focus on risk factors. It remains unclear whether protective factors, such as post-traumatic growth (PTG) and social support, play a role in this relationship. ObjectivesThe aim of this study was to investigate the role of PTG and social support in the association between PTSD and suicidality, using data from a cross-sectional study conducted in China. Methods1,369 participants were recruited from two study sites that were severely affected by the Wenchuan earthquake. Univariate and multivariate regression analyses were conducted to examine the relationship between PTSD, PTG, social support, and suicidality. ResultsThe results indicate that the prevalence of suicidal ideation, suicide plans, and suicide attempts among adult survivors were 9.06%, 2.97% and 3.31%, respectively, even after 8 years following the Wenchuan earthquake. Furthermore, the findings show that PTSD was significantly associated with suicidality (OR = 1.96; 95% CI = 1.53, 2.52). Additionally, individuals reporting lower levels of social support and the acquisition of PTSD (OR = 5.99; 95% CI = 1.66, 21.56) were significantly related to suicidality. Moreover, compared to individuals who reported no presence of PTSD and high PTG, those who lived with PTSD and lower levels of PTG (OR = 2.33; 95%CI = 1.00, 5.42) were more likely to report suicidality. LimitationsThe cross-sectional design of this study limits our ability to determine causal relationships. Effects of other related factors, such as cultural and life events, were not examined in this study. ConclusionsSuicidality is a long-term health issue among survivors of the Wenchuan earthquake. PTG and social support play important roles on the association between PTSD and suicidality and are important contributing factors to understanding this relationship. These results contribute new knowledge of suicidal risk for a number of years after an earthquake and have implications for further mental health promotion following earthquakes.

Environmental barriers, functioning and quality of life in 2008 Wenchuan earthquake victims with spinal cord injury eight years after the disaster: A cross-sectional study.

To examine environmental barriers, func-tioning, and quality of life in Wenchuan earthquake survivors with spinal cord injury. Cross-sectional study. Thirty-two adult Wenchuan earthquake survivors with spinal cord injury. Data were collected on environmental factors with the Nottwil Environmental Factors Inventory Short Form (NEFI-SF), physical and mental functioning with the 36-item Short-Form Health Survey (SF-36), and quality of life with the World Health Organization Quality of Life-BREF (WHOQOL-BREF). Descriptive analysis of environmental barriers and comparisons of SF-36 and WHOQOL-BREF domain scores with normative data were performed. Variations in outcomes across demographic and lesion characteristics were examined using Mann-Whitney U test. Associations of NEFI-SF with SF-36 and WHOQOL-BREF domain scores were explored using Spearman's correlation. Wenchuan earthquake survivors with spinal cord injury were affected by a large number of environmental barriers. Their functioning and quality of life were considerably reduced in comparison with respective reference populations. Neither environmental barriers nor functioning or quality of life varied systematically by demographic and lesion characteristics. Increased numbers of perceived environmental barriers were strongly associated with decreased scores across SF-36 and WHOQOL-BREF sub-domains. Wenchuan earthquake survivors with SCI faced a considerable number of environmental barriers and showed decreased functioning and quality of life. Environmental barriers were strongly related to functioning and quality of life.

Relationships between Sleep Problems and Psychiatric Comorbidities among China's Wenchuan Earthquake Survivors Remaining in Temporary Housing Camps.

Earthquake survivors are a diverse population. This study focused on a special group of earthquake survivors, who had still stayed in temporary housing camps for about 2 years after China's Wenchuan Earthquake rather than those who moved back to rebuild their lives or immigrated to large cities to seek new lives. The research goals were to (1) assess their sleep problems as well as their PTSD, depression and anxiety and (2) examine the relationship between different dimensions of sleep quality and PTSD, depression, and anxiety among these survivors. Three-hundred and eighty seven earthquake survivors who remained in temporary housing camps and had sleep problems were recruited 17–27 months after Wenchuan Earthquake. Four standardized instruments-The Pittsburgh Sleep Quality Index, PTSD Checklist-Civilian Version, Self-rating Depression Scale, Self-rating Anxiety Scale, and face-to-face one-on-one structured interviews were used to assess these survivors' sleep quality, PTSD, depression, and anxiety. It was found that (1) 83.20% of these survivors reported having sleep problems, and 79.33% of them considered insomnia as the most common sleep problem; (2) 12.14% suffered PTSD, 36.43% experienced depression, and 38.24% had anxiety; (3) sleep disturbance, sleep medication use, and subjective sleep quality were significantly related to PTSD; (4) habitual sleep efficiency, sleep disturbance, sleep medication use, and daytime dysfunction were significantly related to depression; and (5) sleep disturbance, sleep medication use, and daytime dysfunction were significantly related to anxiety. Clinic implications of the study are discussed.

Posttraumatic stress disorder and posttraumatic growth coexistence and the risk factors in Wenchuan earthquake survivors

Various studies have assessed the negative and/or positive changes in the aftermath of traumatic events. Yet few of these have addressed the factors associated with the coexistence of both negative and positive changes after a devastating earthquake. The aim of this study is to assess the relationship between the negative and positive changes and elucidate the risk factors of such changes one year after Wenchuan earthquake. A total of 2080 survivors from 19 counties participated in a self-report questionnaire survey which included the posttraumatic stress disorder (PTSD) Check list-Civilian, the posttraumatic growth PTG Inventory (PTGI). The prevalence of PTSD and moderate PTG was found to be 40.1% (95% CI [37.9% 42.3%]) and 51.1% (95% CI [48.9% 53.3%]). The PTSD and moderate PTG coexistence was 19.6% (95% CI [17.8% 21.4%]). PTSD symptom severity was significantly positively associated with the PTG score. Middle aged groups (31–40 and 41–50 years old, OR=2.323, 95% CI [1.059, 5.095] and OR=2.410, 95% CI [1.090, 5.329] respectively), those with lower income levels (OR=8.019, 95% CI [2.421, 26.558]), those living in temporary house (OR=1.946, 95% CI [1.280, 2.956]), and those who had had less social support (OR=1.109, 95% CI [1.076, 1.143]) had a significantly higher possibility for the presence of PTSD and moderate PTG coexistence. The results indicated the widespread positive changes in earthquake survivors. Better income levels and living conditions and higher social support were suggested to promote PTG in those with PTSD.

Altered functional connectivity in the brain default-mode network of earthquake survivors persists after 2 years despite recovery from anxiety symptoms.

Although acute impact of traumatic experiences on brain function in disaster survivors is similar to that observed in post-traumatic stress disorders (PTSD), little is known about the long-term impact of this experience. We have used structural and functional magnetic resonance imaging to investigate resting-state functional connectivity and gray and white matter (WM) changes occurring in the brains of healthy Wenchuan earthquake survivors both 3 weeks and 2 years after the disaster. Results show that while functional connectivity changes 3 weeks after the disaster involved both frontal-limbic-striatal and default-mode networks (DMN), at the 2-year follow-up only changes in the latter persisted, despite complete recovery from high initial levels of anxiety. No gray or WM volume changes were found at either time point. Taken together, our findings provide important new evidence that while altered functional connectivity in the frontal-limbic-striatal network may underlie the post-trauma anxiety experienced by survivors, parallel changes in the DMN persist despite the apparent absence of anxiety symptoms. This suggests that long-term changes occur in neural networks involved in core aspects of self-processing, cognitive and emotional functioning in disaster survivors which are independent of anxiety symptoms and which may also confer increased risk of subsequent development of PTSD.