Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-25T08:20:36.414Z Has data issue: false hasContentIssue false
  • English
  • Français

Longitudinal trajectories of post-traumatic stress disorder symptoms among adolescents after the Wenchuan earthquake in China

Published online by Cambridge University Press:  20 May 2015

F. Fan ,
K. Long ,
Y. Zhou ,
Y. Zheng  and
X. Liu
F. Fan*
Affiliation:
School of Psychology, South China Normal University, Guangzhou, Guangdong, People's Republic of China Center for Studies of Psychological Application, South China Normal University, Guangzhou, Guangdong, People's Republic of China Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, Guangzhou, Guangdong, People's Republic of China
K. Long
Affiliation:
School of Psychology, South China Normal University, Guangzhou, Guangdong, People's Republic of China Center for Studies of Psychological Application, South China Normal University, Guangzhou, Guangdong, People's Republic of China Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, Guangzhou, Guangdong, People's Republic of China
Y. Zhou
Affiliation:
School of Psychology, South China Normal University, Guangzhou, Guangdong, People's Republic of China Center for Studies of Psychological Application, South China Normal University, Guangzhou, Guangdong, People's Republic of China Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, Guangzhou, Guangdong, People's Republic of China
Y. Zheng
Affiliation:
School of Psychology, South China Normal University, Guangzhou, Guangdong, People's Republic of China Center for Studies of Psychological Application, South China Normal University, Guangzhou, Guangdong, People's Republic of China Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, Guangzhou, Guangdong, People's Republic of China
X. Liu
Affiliation:
School of Psychology, South China Normal University, Guangzhou, Guangdong, People's Republic of China Center for Studies of Psychological Application, South China Normal University, Guangzhou, Guangdong, People's Republic of China Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, Guangzhou, Guangdong, People's Republic of China
*
* Address for correspondence: F. Fan, Ph.D., School of Psychology, South China Normal University, Shipai Road, Guangzhou 510631, People's Republic of China. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

This study examines the patterns and predictors of post-traumatic stress disorder (PTSD) symptom trajectories among adolescent survivors following the Wenchuan earthquake in China.

Method

A total of 1573 adolescent survivors were followed up at 6, 12, 18 and 24 months post-earthquake. Participants completed the Posttraumatic Stress Disorder Self-Rating Scale (PTSD-SS), Adolescent Self-Rating Life Events Checklist, Social Support Rate Scale, and the Simplified Coping Style Questionnaire. Distinct patterns of PTSD symptom trajectories were established through grouping participants based on time-varying changes of developing PTSD (i.e. reaching the clinical cut-off on the PTSD-SS). Multivariate logistic regressions were used to examine predictors for trajectory membership.

Results

PTSD prevalence rates at 6, 12, 18 and 24 months were 21.0, 23.3, 13.5 and 14.7%, respectively. Five PTSD symptom trajectories were observed: resistance (65.3% of the sample), recovery (20.0%), relapsing/remitting (3.3%), delayed dysfunction (4.2%) and chronic dysfunction (7.2%). Female gender and senior grade were related to higher risk of developing PTSD symptoms in at least one time point, whereas being an only child increased the possibility of recovery relative to chronic dysfunction. Family members’ injury/loss and witness of traumatic scenes could also cause PTSD chronicity. More negative life events, less social support, more negative coping and less positive coping were also common predictors for not developing resistance or recovery.

Conclusions

Adolescents’ PTSD symptoms showed an anniversary reaction. Although many adolescents remain euthymic or recover over time, some adolescents, especially those with the risk factors noted above, exhibit chronic, delayed or relapsing symptoms. Thus, the need for individualized intervention with these adolescents is indicated.

Keywords

Adolescent survivorslongitudinal studiespost-traumatic stress disorderpredictorstrajectories
Type
Original Articles
Information
Psychological Medicine , Volume 45 , Issue 13 , October 2015 , pp. 2885 - 2896
Copyright
Copyright © Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adams, RE, Boscarino, JA (2006). Predictors of PTSD and delayed PTSD after disaster: the impact of exposure and psychological resources. Journal of Nervous and Mental Disease 194, 485–493.CrossRefGoogle Scholar
Ahmad, S, Feder, A, Lee, EJ, Wang, Y, Southwick, SM, Schlackman, E, Buchholz, K, Alonso, A, Charney, DS (2010). Earthquake impact in a remote South Asian population: psychosocial factors and posttraumatic symptoms. Journal of Traumatic Stress 23, 408–412.Google Scholar
Armour, C, Shevlin, M, Elklit, A, Mroczek, D (2012). A latent growth mixture modeling approach to PTSD symptoms in rape victims. Traumatology 18, 20–28.CrossRefGoogle ScholarPubMed
Bal, A, Jensen, B (2007). Post-traumatic stress disorder symptom clusters in Turkish child and adolescent trauma survivors. European Child and Adolescent Psychiatry 16, 449–457.Google Scholar
Bonanno, GA, Brewin, CR, Kaniasty, K, La Greca, AM (2010). Weighing the costs of disaster: consequences, risks, and resilience in individuals, families, and communities. Psychological Science in the Public Interest 11, 1–49.CrossRefGoogle ScholarPubMed
Bonanno, GA, Mancini, AD (2012). Beyond resilience and PTSD: mapping the heterogeneity of responses to potential trauma. Psychological Trauma: Theory, Research, Practice, and Policy 4, 74–83.CrossRefGoogle Scholar
Brewin, CR, Andrews, B, Valentine, JD (2000). Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. Journal of Consulting and Clinical Psychology 68, 748–766.CrossRefGoogle ScholarPubMed
Cénat, JM, Derivois, D (2014). Assessment of prevalence and determinants of posttraumatic stress disorder and depression symptoms in adult survivors of earthquake in Haiti after 30 months. Journal of Affective Disorders 159, 111–117.Google Scholar
Chen, W, Wang, L, Zhang, XL, Shi, JN (2010). Posttraumatic stress disorder in adolescents of the 2008 Sichuan earthquake. Chinese Journal of Clinical Psychology 18, 83–85.Google Scholar
Cohen, S, Wills, T (1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin 101, 310–357.CrossRefGoogle Scholar
Cui, YW, Gao, WH, Wang, GY (1994). Study on mental characteristics in only child and exploration of mental education. Chinese Journal of School Health 15, 244–246.Google Scholar
Dedovic, K, Wadiwalla, M, Engert, V, Puessner, JC (2009). The role of sex and gender socialization in stress reactivity. Developmental Psychology 45, 45–55.CrossRefGoogle ScholarPubMed
Ehlers, A, Clark, DM (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy 38, 319–345.CrossRefGoogle ScholarPubMed
Fan, F, Liu, WM, Zheng, XY, Cui, MM (2010). Mental health problems and correlates among adolescents 6 months after exposed to the Wenchuan earthquake. Chinese Journal of Clinical Psychology 18, 56–59.Google Scholar
Fan, F, Zhang, Y, Yang, Y, Mo, L, Liu, X (2011). Symptoms of posttraumatic stress disorder, depression, and anxiety among adolescents following the 2008 Wenchuan earthquake in China. Journal of Traumatic Stress 24, 44–53.Google Scholar
Feder, A, Ahmad, S, Lee, EJ, Morgan, JE, Singh, R, Smith, BW, Southwick, SM, Charney, DS (2013). Coping and PTSD symptoms in Pakistani earthquake survivors: purpose in life, religious coping and social support. Journal of Affective Disorders 147, 156–163.CrossRefGoogle ScholarPubMed
Foa, EB, Stein, DJ, McFarlane, AC (2006). Symptomatology and psychopathology of mental health problems after disaster. Journal of Clinical Psychiatry 67, 15–25.Google Scholar
Freedy, JR, Saladin, ME, Kilpatrick, DG, Resnick, HS, Saunders, BE (1994). Understanding acute psychological distress following natural disaster. Journal of Traumatic Stress 7, 257–273.CrossRefGoogle ScholarPubMed
Furr, JM, Comer, JS, Edmunds, JM, Kendall, PC (2010). Disasters and youth: a meta-analytic examination of posttraumatic stress. Journal of Consulting and Clinical Psychology 78, 765–780.Google Scholar
Geng, FL, Fan, F, Zhang, L (2012). Poor sleep quality associated with PTSD, anxiety, and depression among adolescents exposed to 2008 Wenchuan earthquake, China. Chinese Journal of Clinical Psychology 20, 172–175.Google Scholar
He, J, Xu, SS, Zhu, ZH, Wang, L, Wang, WZ (2011). A study of symptoms of the post-traumatic stress disorder and its related factors in adolescents after the Wenchuan earthquake. Chinese Journal of Clinical Psychology 19, 103–105.Google Scholar
Hull, AM, Alexander, DA, Klein, S (2002). Survivors of the Piper Alpha oil platform disaster: long-term follow-up study. British Journal of Psychiatry 181, 433–438.CrossRefGoogle ScholarPubMed
Kessler, RC, Sonnega, A, Bromet, E, Hughes, M, Nelson, CB (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry 52, 1048–1060.Google Scholar
Kirsch, V, Wilhelm, F, Goldbeck, L (2011). Psychophysiological characteristics of PTSD in children and adolescents: a review of the literature. Journal of Traumatic Stress 24, 146–154.Google Scholar
Koenen, KC, Stellman, JM, Stellman, SD, Sommer, JF Jr (2003). Risk factors for course of posttraumatic stress disorder among Vietnam veterans: a 14-year follow-up of American legionnaires. Journal of Consulting and Clinical Psychology 71, 980–986.Google Scholar
Kronenberg, M, Hansel, T, Brennan, A, Osofsky, H, Osofsky, J, Lawrason, B (2010). Children of Katrina: lessons learned about postdisaster symptoms and recovery patterns. Child Development 81, 1241–1259.CrossRefGoogle ScholarPubMed
La Greca, AM, Silverman, WK, Lai, B, Jaccard, J (2010). Hurricane-related exposure experiences and stressors, other life events, and social support: concurrent and prospective impact on children's persistent posttraumatic stress symptoms. Journal of Consulting Clinical Psychology 78, 794–805.CrossRefGoogle ScholarPubMed
Liu, M, Wang, L, Shi, Z, Zhang, Z, Zhang, K, Shen, J (2011). Mental health problems among children one-year after Sichuan earthquake in China: a follow-up study. PLoS ONE 6, e14706.Google Scholar
Liu, X, Liu, QL, Yang, J, Zhao, GF (1997). Reliability and validity of the Adolescents Self-Rating Life Events Checklist. Chinese Journal of Clinical Psychology 5, 34–36.Google Scholar
Liu, X, Ma, DD, Liu, LQ (1998). Development of the Post-traumatic Stress Disorder Self-Rating Scale and its reliability and validity. Chinese Journal of Behavioral Medicine Science 7, 93–96.Google Scholar
Liu, ZY, Yang, YF, Ye, YL, Zeng, ZQ, Xiang, YJ, Yuan, P (2010). One-year follow-up study of post-traumatic stress disorder among adolescents following the Wen-Chuan earthquake in China. Bioscience Trends 4, 96–102.Google ScholarPubMed
Ma, X, Liu, X, Hu, X, Qiu, C, Wang, Y, Huang, Y, Wang, Q, Zhang, W, Li, T (2011). Risk indicators for post-traumatic stress disorder in adolescents exposed to the 5.12 Wenchuan earthquake in China. Psychiatry Research 189, 385–391.Google Scholar
McFarlane, AC (1987). Posttraumatic phenomena in a longitudinal study of children following a natural disaster. Journal of the American Academy of Child and Adolescent Psychiatry 26, 764–769.CrossRefGoogle Scholar
Norris, FH, Friedman, MJ, Watson, PJ, Byrne, CM, Diaz, E, Kaniasty, K (2002). 60,000 Disaster victims speak: part I. An empirical review of the empirical literature, 1981–2001. Psychiatry 65, 207–239.Google Scholar
Norris, FH, Tracy, M, Galea, S (2009). Looking for resilience: understanding the longitudinal trajectories of responses to stress. Social Science and Medicine 68, 2190–2198.Google Scholar
Pietrzak, RH, Feder, A, Singh, R, Schechter, CB, Bromet, EJ, Katz, CL, Reissman, DB, Ozbay, F, Sharma, V, Crane, M, Harrison, D, Herbert, R, Levin, SM, Luft, BJ, Moline, JM, Stellman, JM, Udasin, IG, Landrigan, PJ, Southwick, SM (2014). Trajectories of PTSD risk and resilience in World Trade Center responders: an 8-year prospective cohort study. Psychological Medicine 44, 205–219.Google Scholar
Pietrzak, RH, Van Ness, PH, Fried, TR, Galea, S, Norris, FH (2013). Trajectories of posttraumatic stress symptomatology in older persons affected by a large-magnitude disaster. Journal of Psychiatric Research 47, 520–526.CrossRefGoogle ScholarPubMed
Rubin, DB (1976). Inference and missing data. Biometrika 63, 581–592.CrossRefGoogle Scholar
Self-Brown, S, Lai, BS, Thompson, JE, McGill, T, Kelley, ML (2013). Posttraumatic stress disorder symptom trajectories in Hurricane Katrina affected youth. Journal of Affective Disorders 147, 198–204.Google Scholar
Terry, DJ (1994). Determinants of coping: the role of stable and situational factors. Journal of Personality and Social Psychology 66, 895–910.Google Scholar
Trickey, D, Siddaway, AP, Meiser-Stedman, R, Serpell, L, Field, AP (2012). A meta-analysis of risk factors for post-traumatic stress disorder in children and adolescents. Clinical Psychology Review 32, 122–138.CrossRefGoogle ScholarPubMed
Xiao, SY (1994). Theoretical basis and application of the Social Support Rating Scale. Journal of Clinical Psychological Medicine 4, 98–100.Google Scholar
Xie, YN (1998). Reliability and validity of the Simplified Coping Style Questionnaire. Chinese Journal of Clinical Psychology 6, 114–115.Google Scholar
Ye, Y, Fan, F, Li, LY, Han, QG (2014). Trajectory and predictors of depressive symptoms among adolescent survivors following the Wenchuan earthquake in China: a cohort study. Social Psychiatry and Psychiatric Epidemiology 49, 943–952.Google Scholar
Zhang, Z, Ran, MS, Li, YH, Ou, GJ, Gong, RR, Li, RH, Fan, M, Jiang, Z, Fang, DZ (2012). Prevalence of post-traumatic stress disorder among adolescents after the Wenchuan earthquake in China. Psychological Medicine 42, 1687–1693.CrossRefGoogle ScholarPubMed
Zheng, YH, Fan, F, Liu, X, Mo, L (2012). Life events, coping, and posttraumatic stress symptoms among Chinese adolescents exposed to 2008 Wenchuan Earthquake, China. PLOS ONE 7, e29404.Google Scholar