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Risk and Resilience in Trajectories of Post-Traumatic Stress Symptoms among First Responders after the 2011 Great East Japan Earthquake: a 7-year prospective cohort study

Published online by Cambridge University Press:  01 September 2022

F. Van Der Does ,
T. Saito ,
M. Nagamine ,
N. Van Der Wee ,
J. Shigemura ,
T. Yamamoto ,
Y. Takahashi ,
M. Koga ,
H. Toda  and
A. Yoshino
...Show all authors
F. Van Der Does*
Affiliation:
Leiden University Medical Center, Psychiatry, Leiden, Netherlands
T. Saito
Affiliation:
School of Medicine, National Defense Medical College, Psychiatry, Tokorozawa, Japan
M. Nagamine
Affiliation:
National Defense Medical College Research Institute, Behavioral Science, Tokorozawa, Japan
N. Van Der Wee
Affiliation:
Leiden University Medical Center, Psychiatry, Leiden, Netherlands
J. Shigemura
Affiliation:
School of Medicine, National Defense Medical College, Psychiatry, Tokorozawa, Japan
T. Yamamoto
Affiliation:
School of Medicine, National Defense Medical College, Psychiatry, Tokorozawa, Japan
Y. Takahashi
Affiliation:
School of Medicine, National Defense Medical College, Psychiatry, Tokorozawa, Japan
M. Koga
Affiliation:
School of Medicine, National Defense Medical College, Psychiatry, Tokorozawa, Japan
H. Toda
Affiliation:
School of Medicine, National Defense Medical College, Psychiatry, Tokorozawa, Japan
A. Yoshino
Affiliation:
School of Medicine, National Defense Medical College, Psychiatry, Tokorozawa, Japan
E. Vermetten
Affiliation:
Leiden University Medical Center, Psychiatry, Leiden, Netherlands
E. Giltay
Affiliation:
Leiden University Medical Center, Psychiatry, Leiden, Netherlands
*
*Corresponding author.

Abstract

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Introduction

First responders to disasters are at risk of developing post-traumatic stress disorder (PTSD). The trajectories of post-traumatic stress symptom severity differ among individuals, even if they are exposed to similar events. These trajectories have not yet been reported in non-Western first responders.

Objectives

We aimed to explore post-traumatic stress symptom severity trajectories and their risk factors in first responders to the 2011 Great East Japan Earthquake (GEJE)— a historically large earthquake that resulted in a tsunami and a nuclear disaster.

Methods

56 388 Japan Ground Self-Defense Force (JGSDF) personnel dispatched to the GEJE were enrolled in this seven-year longitudinal cohort study. PTSD symptom severity was measured using the Impact of Event Scale-Revised (IES-R). Trajectories were identified using latent growth mixture models (LGMM). Nine potential risk factors for the symptom severity trajectories were analyzed using multinomial logistic regression.

Results

Five symptom severity trajectories were identified: “resilient” (54.7%), “recovery” (24.5%), “incomplete recovery” (10.7%), “late-onset” (5.7%), and “chronic” (4.3%). The main risk factors for the four non-resilient trajectories were older age, personal disaster experiences, and working conditions. These working conditions included duties involving body recovery or radiation exposure risk, longer deployment length, later or no post-deployment leave, and longer post-deployment overtime.

Conclusions

The majority of first responders to GEJE were resilient and developed few or no PTSD symptoms. A substantial minority experienced late-onset and chronic symptom severity trajectories. The identified risk factors can inform policies for prevention, early detection, and intervention in individuals at risk of developing symptomatic trajectories.

Disclosure

No significant relationships.

Keywords

Trajectory AnalysisPost-traumatic stress disorderFirst respondersNatural disaster
Type
Abstract
Information
European Psychiatry , Volume 65 , Special Issue S1: Abstracts of the 30th European Congress of Psychiatry , June 2022 , pp. S244
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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