Long-Term Impact of Parental Post-Traumatic Stress Disorder Symptoms on Mental Health of Their Offspring After the Great East Japan Earthquake

Abstract

Longitudinal studies of the long-term psychological impact of the Great East Japan Earthquake (GEJE) on parents and their children have been limited. The current study aimed to monitor parents’ post-traumatic stress disorder (PTSD) symptoms and behavioral problems among their children over time and to analyze their long-term associations among the survivors of the GEJE. We used data from the GEJE Follow-up for Children study, which recruited 4- to 6-year-old children and those children’s parents immediately after the GEJE in March 2011, with ongoing follow-up. Children’s total, internalizing, and externalizing behavioral problems were assessed using the Child Behavior Checklist (CBCL), and parental probable PTSD was assessed using the Impact of Event Scale-R (IES-R), in 2012 (baseline) and 2014 (follow-up). Parental PTSD symptoms and children’s behavioral problems declined slightly over time, and both showed a significant correlation between the surveys (r = 0.55–0.77, P < 0.001). The association between parental PTSD symptoms and children’s behavioral problems was investigated using multivariate logistic regression analysis adjusting for baseline children’s behavioral problems and other potential confounders. Cross-sectionally, while no significant association was detected in 2012, all types of children’s behavioral problems exhibited significant positive associations with parental PTSD symptoms in multiple logistic regression analysis adjusted odds ratio (AOR) = 3.03, 3.30, and 5.34 for total, internalizing, and externalizing behavior problems, respectively. Maternal educational attainment level (higher than high school education) showed a significant negative association with children’s total and externalizing behavioral problems (AOR = 0.30 and 0.13, respectively) in 2014. Longitudinally, parental PTSD symptoms in 2012 showed a significant association with children’s internalizing behavioral problems in 2014 after adjusting for children’s behavioral problems in 2012 and parental PTSD symptoms in 2014 (AOR = 4.62). These results suggest that the effect of the GEJE on parental PTSD symptoms and children’s behavioral problems was long-term, lasting for at least 3 years. These possibilities should be carefully considered in mental health support for parents and their offspring in areas affected by the GEJE.

The Association between Child and Parent Psychiatric Disorders in Families Exposed to Flood and/or Dioxin

“…This study’s finding that disaster mental health outcomes in children is linked to their parents’ mental health responses has also been found in other studies. Other studies have reported that children’s posttraumatic stress symptoms, other psychiatric symptoms, and difficulties functioning were associated with parental posttraumatic stress symptoms [ 11 , 12 , 31 , 32 , 33 , 34 , 35 , 36 ]. Prior studies have also reported that children’s posttraumatic stress symptoms, school behavior and academic problems, and/or diminished school functioning were associated with parental postdisaster psychopathology [ 13 , 14 , 15 , 21 ].…”

“…Few studies have used research designs appropriate to examine causal relationships within the associations between children’s and their parent’s disaster mental health outcomes by collecting prospective longitudinal data on child and parent outcomes. For example, studies have found that parents’ posttraumatic stress symptoms at one year were associated with their children’s psychiatric symptoms approximately three years after the disaster, possibly representing a causal relationship between the earlier parental symptoms and their children’s later symptoms [ 11 , 35 ]. A study of the Great East Japan Earthquake found that parent posttraumatic stress symptoms one year after the disaster were associated with child internalizing behavioral problems at two years, suggesting effects of parents’ reactions on their children [ 11 ].…”

“…For example, studies have found that parents’ posttraumatic stress symptoms at one year were associated with their children’s psychiatric symptoms approximately three years after the disaster, possibly representing a causal relationship between the earlier parental symptoms and their children’s later symptoms [ 11 , 35 ]. A study of the Great East Japan Earthquake found that parent posttraumatic stress symptoms one year after the disaster were associated with child internalizing behavioral problems at two years, suggesting effects of parents’ reactions on their children [ 11 ]. Other studies have examined the association of children’s and parents’ symptoms in the opposite temporal direction.…”

“…Children, considered particularly vulnerable to psychosocial consequences, have been the subject of a number of recent reports [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 ]. Few rigorous studies have examined mental health consequences of disaster on children and parents within family units, and even fewer have assessed fathers as well as mothers [ 11 , 12 , 13 , 14 , 15 , 16 ].…”

The mental health status of children who have been evacuated or migrated from rural areas in Fukushima prefecture after the Fukushima daiichi nuclear power station accident:results from the Fukushima health management survey

“…Previous studies have pointed out the problem of children’s poor mental health status, but the effects of disasters on their mental health are not always consistent 18 - 21) , and differences in mental health status relative to environmental radiation levels have not been recognized 17) . Also, despite improvements in overall mental health 22) , long-term PTSD after a nuclear disaster and mental health problems associated with evacuation and migration have been pointed out 23) . Furthermore, it should be noted that previous studies have reported that the mental health status of children living in rural areas is worse than that of children in urban areas 24 , 25) .…”