A three‐year follow‐up study of the psychosocial predictors of delayed and unresolved post‐traumatic stress disorder in Taiwan Chi‐Chi earthquake survivors

Abstract

Aims:To predict the longitudinal course of posttraumatic stress disorder (PTSD) in survivors three years following a catastrophic earthquake using multivariate data presented six months after the earthquake.Methods: Trained assistants and psychiatrists used the Disaster-related Psychological Screening Test (DRPST) to interview earthquake survivors 16 years and older and to assess current and incidental psychopathology. A total of 1756 respondents were surveyed over the three-year follow-up period.Results: A total of 38 (9.1%) of the original 418 PTSD subjects and 40 of the original 1338 (3.0%) non-PTSD subjects were identified as having PTSD at the 3-year post-earthquake follow up. Younger age, significant financial loss, and memory/attention impairment were predictive factors of unresolved PTSD and delayed PTSD. Conclusions:The longitudinal course of PTSD three years after the earthquake could be predicted as early as six months after the earthquake on the basis of demographic data, PTSD-related factors, and putative factors for PTSD.Key words: Disaster-related Psychological Screening Test, earthquake survivors, post-traumatic stress disorder. N ATURAL DISASTERS, such as earthquakes and hurricanes, and man-made disasters, such as terrorism and wars, can cause mental trauma with longlasting consequences. Post-traumatic stress disorder (PTSD) is one of the most common psychiatric disorders in victims of natural disasters 1 and is continuing to gain attention in trauma outcome research. According to the DSM-IV diagnostic criteria, PTSD has three core psychopathologies: (i) re-experience; (ii) numbness and avoidance; and (iii) hyper arousal.The DSM-IV diagnostic criteria for PTSD allow clinicians to specify whether or not the disorder is chronic (if the symptoms have lasted three months or more) or exhibits delayed onset (if the onset of the symptoms was six months or more after the stressful event). In a systemic review, Andrews et al. found that delayed-onset PTSD in the absence of any prior symptoms was rare, whereas delayed onsets that represented exacerbations or reactivations of prior symptoms accounted on average for 38.2% and 15.3%, respectively, of military and civilian cases of PTSD. Earthquake is one of the major natural disasters of the contemporary era. 4 Risk factors for PTSD (such as demographic data, psychological factors and psychiatric symptoms) and post-trauma social resource factors have been studied by some researchers. *Correspondence: Frank Huang-Chih Chou, MD, MS, PhD, Department of Community Psychiatry, Kai-Suan Psychiatric Hospital, 130, Kai-Suan 2RD, Ling-Ya District, Kaohsiung 802, Taiwan, ROC. Email: f50911.tw@yahoo.com.tw Received 4 March 2009; revised 22 December 2009; accepted 8 March 2010. Psychiatry and Clinical Neurosciences 2010; 64: 239-248 doi:10.1111/j.1440-1819.2010 Demographic dataSome studies examining gender differences suggest that female subjects are more likely to develop PSTD than male subjects. 5-8 A possible explanation is the specific reactions resulting f...

Trajectories of posttraumatic stress symptomatology in older persons affected by a large-magnitude disaster

“…Results of the current study corroborate a growing body of prior disaster mental health research, which found that post-disaster life stressors and traumas (Brewin et al, 2000; Cerda et al, 2012, in press; Kessler et al, 2012; Norris & Uhl, 1993; Norris et al, 2002a; Norris et al, 2002b; Tracy et al, 2011), including financial losses (Acierno et al, 2006; Galea et al, 2008; Rajkumar et al, 2011, in press; Su et al, 2010), are linked to severity, probable diagnoses, and chronicity of PTSD and related disorders. The finding that greater education was negatively related to a chronic symptom trajectory also accords with previous studies demonstrating the protective effect of this variable on risk for disaster-related PTSD and related mental disorders (Armenian et al, 2000; Norris et al, 2002a; Norris et al, 2002b; North et al, 2012; Yuan et al, 2012, in press).…”

Prevalence and risk factors of posttraumatic stress disorder among teachers 3 months after the Lushan earthquake

“…However, younger age as one of the risk factors of PTSD has also been reported. [15,46–49] In the present study, our results showed that age was not associated with the development of PTSD, which should be further verified in future.…”

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