Corona virus disease 2019 (COVID-19) outbreak has attracted worldwide attention.The COVID-19 outbreak is unique in its rapid transmission and results in heavy stress for the front-line health care workers (HCWs). The current study aimed to exam posttraumatic stress symptoms (PTSSs) of HCWs fighting for the COVID-19 and to evaluate their sleep quality after 1-month stressful suffering. Three hundred seventyseven HCWs working in different provinces of China participated in the survey between February 1 and 5. The demographic information was collected first. Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5) and the Pittsburgh Sleep Quality Index (PSQI) were selected to measure PTSSs and sleep quality. Results showed that 1 month after the outbreak, the prevalence of PTSSs was 3.8% in HCWs. Female HCWs were more vulnerable to PTSSs with hazard ratio of 2.136 (95% CI = 1.388-3.286). HCWs with higher exposure level also significantly rated more hyperarousal symptoms (hazard ratio = 4.026, 95% CI = 1.233-13.140). There was a significant difference of sleep quality between participants with and without PTSSs (z value = 6.014, p < .001) and among different groups with various contact frequencies (chi-square = 7.307, p = .026). Path analysis showed that there was a significant indirect effect from exposure level to PTSSs through sleep quality (coefficient = 1.750, 95% CI of Boostroop test = 0.543-2.998). In summary, targeted interventions on sleep contribute to the mental recovery during the outbreak of COVID-19. Understanding the mental health response after a public health emergency might help HCWs and communities prepare for a population's response to disaster. K E Y W O R D S

BackgroundThe term “loss-of-only-child family” means that the only child in a family passed away or is disabled due to an accident or other events. The parents who cannot conceive or do not adopt another child, are known as Shidu parents in China. This study compares the physical and mental health of Shidu parents with those parents who have not experienced such loss.MethodsThe target group is comprised of parents being Shidu for more than 1 year (N = 95) and the control group is comprised of parents with a living child (N = 97) from the same area as the Shidu parents. Socio-demographic information and physical health outcomes were collected by the adapted questionnaires. PCL-C (PTSD Checklist-Civilian Version), CES-D (Center for Epidemiological Studies Depression Scale) and GHQ-12 (General Health Questionnaire) were applied to evaluate the parents’ physical and mental status.ResultsShidu parents have a higher risk of developing PTSD and depression, and suffer more severe psychiatric disorders compared to parents with a living child. The rate of PTSD in the Shidu group was up to 32.6% and the scores of PCL-C are much higher than the control group. The physical status of Shidu parents were much worse than that of the control group, characterized by higher morbidity of chronic diseases and more hospital visits.ConclusionsShidu parents have more severe mental health problems and a higher rate of chronic diseases than parents who have a living child. Loss of the only child is the most traumatic event for the parents, which is a serious and unique problem in Chinese society that deserves attention. More studies and support are desired to improve the physical and mental health of Shidu parents.

Medical staff were battling against coronavirus disease 2019 (COVID-19) at the expense of their physical and mental health, particularly at risk for posttraumatic stress disorder (PTSD). In this case, intervening PTSD of medical staff and preparing them for future outbreaks are important. Previous studies showed that perceived stress was related to the development of PTSD. Hence, in this study, the association between risk perception of medical staff and PTSD symptoms in COVID-19 and the potential links were explored. Three hundred four medical staff's exposure to COVID-19 patients, risk perception for working during COVID-19, PTSD symptoms, anxiety, and sleep quality were measured. Mediation analysis tested the indirect effects of anxiety and sleep quality on the relationship between risk perceptions and PTSD symptoms; 27.6% of participants were deemed as having probable PTSD diagnosis. Mediation analysis showed a significant chain-mediating effect of anxiety and sleep quality on the relationships between risk perceptions and PTSD symptoms; higher risk perceptions were related to increased anxiety, worsened sleep quality, and severe PTSD symptoms. Conclusively, medical staff have a high prevalence of PTSD symptoms after 3 months of COVID-19. Their PTSD symptoms were associated with the perceived risk level through the potential links with anxiety and sleep quality. Therefore, risk perception could be critical for our medical staff's responses to public health emergencies. It could be plausible to intervene in the perceived stress to alleviate aroused anxiety and improve sleep quality and thereby deter the development of PTSD.

Background: The heartache from the devastating 8.0 magnitude Wenchuan earthquake, which killed nearly 90,000 people in western China, is still felt despite the large-scale recovery and reconstruction of the affected areas. This study investigated the relationships of earthquake-trauma exposures and personality with posttraumatic stress disorder (PTSD), to identify the long-term consequences of the Wenchuan earthquake on the survivors and the risk factors related to chronic PTSD. We hope the findings can contribute to developing new health care prevention and interventions for the survivors. Methods: We collected a sample of 490 people over 3 years after the Wenchuan earthquake, using questionnaires about demographic information and the traumatic experience in earthquake, the Impact of Event Scale-Revised (IES-R), and the Eysenck Personality Questionnaires (EPQ), to find the consequences of the Wenchuan earthquake on the survivors and the potential factors related to the long-term morbidity of PTSD. Result: Traumatic experiences, such as witnessing someone being seriously injured, having your house seriously damaged, and having close relatives severely injured, were associated with developing PTSD. Personality measured by EPQ was also closely related to PTSD. Regression analyses indicated that a potential linear model characterized the relationship between PTSD, neuroticism and psychoticism, yet extraversion/introversion were not significant factors. In the multivariate logistic regression, neuroticism (a continuous variable measured by EPQ) was of more significance in predicting the morbidity of long-term PTSD, compared with other variables [odds ratio (OR) = 1.113, 95% confidence interval (CI) = 1.081-1.146, Wald Value = 50.467, P < 0.001]. The final path diagram built a model indicated the moderating role of personality in the relationship between traumatic experiences and PTSD (CMIN/DF = 2.324, P < 0.001; CFI = 0.879 < 0.8; RMSEA = 0.05 < 0.08). Conclusion: This study demonstrated the role of personality traits and subjective exposure experiences regarding the vulnerability associated with PTSD after earthquake. Among all personality traits, neuroticism is considered a vulnerability factor of PTSD, and other personality traits also moderate the effects of traumatic experiences associated with PTSD. These findings might be useful for psychologists to develop intervention strategies for people suffered natural disasters, and to help individuals with PTSD to heal fully.

Introduction: One year after the Coronavirus disease 2019 (COVID-19) outbreak, China has made substantial progress in the prevention and control of the pandemic, while the epidemic situation remains grim in China since virus may easily survive with the falling temperature in winter. The present study aimed to compare the prevalence and associated factors of anxiety between high-risk and low-risk nurses 1 year after the COVID-19 outbreak, and examine the association between resilience and anxiety and its underlying mechanisms.Method: Connor-Davidson Resilience scale, Perceived Social Support Scale and Generalized Anxiety Disorder Scale were administrated to 701 nurses from Jiangsu Province, China, 1 year after the COVID-19 outbreak. The mediating effect was examined by Mackinnon's four-step procedure, while the moderated mediation model was tested by Hayes PROCESS macro.Results: The findings presented the prevalence of anxiety among nurses was 21.4% 1 year after the COVID-19 pandemic. High-risk nurses presented a higher prevalence of anxiety (24.5 vs. 19.3%) than low-risk nurses. Age and professional title were significantly associated with anxiety only in high-risk nurses (all P &lt; 0.05). Perceived social support mediated the association between resilience and anxiety and the indirect effect was stronger for high-risk nurses than low-risk nurses.Conclusion: Anxiety remains prevalent among nurses 1 year after the COVID-19 outbreak, and resilience plays a protective role against anxiety. Programs that enhance resilience and social support should be designed and special attention should be paid to nurses from high-risk units.