Posttraumatic Stress Disorder among Survivors Five and a Half Years after the Wenchuan Earthquake: Based on DSM-5 Diagnostic Criteria

Abstract

Abstract: In the current study we investigated prevalence of DSM-5 PTSD in a sample of Wenchuan earthquake survivors five and a half years after the disaster. 1196 people completed the investigation including demographic information, PCL-5 and traumatic exposure. The prevalence of probable PTSD was 13.8%. The significant predictive factors for severity of PTSD included older age, lower educational level, witness of mutilated bodies and death of family member. Findings of this study indicated that PTSD was a common mental health problem among survivors after disaster and its effects still existed for a long time.

Key words: posttraumatic stress disorder, earthquake survivors, wenchuan earthquake, prevalence

摘要： 在汶川地震发生5年半后，基于《精神疾病诊断与统计手册》第五版（DSM-5）诊断标准，调查了地震幸存者中可能的创伤后应激障碍（PTSD）的流行情况。本研究调查了1196名汶川地震幸存者，调查内容包括幸存者的人口统计学信息、当前的PTSD症状情况和在汶川地震中的创伤性暴露情况。本研究发现在接受调查者中，可能的PTSD患病率为13.8％；PTSD的风险因素包括：年龄较大、文化程度较低，地震中目睹支离破碎的尸体和家庭成员因地震死亡等。这些结果表明，PTSD是灾后幸存者常见的心理健康问题，且其影响长期存在。

关键词: 创伤后应激障碍, 地震幸存者, 汶川地震, 流行率

CLC Number:

B846

FANG Ruojiao, CAO Chengqi, LI Gen, ZHANG Jianxin, WANG Li. Posttraumatic Stress Disorder among Survivors Five and a Half Years after the Wenchuan Earthquake: Based on DSM-5 Diagnostic Criteria[J]. Studies of Psychology and Behavior, 2019, 17(1): 107-113.

方若蛟, 曹成琦, 李根, 张建新, 王力. 汶川地震5年半后幸存者的创伤后应激障碍症状调查：基于DSM-5的诊断标准[J]. 心理与行为研究, 2019, 17(1): 107-113.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Association.
Blevins, C. A., Weathers, F. W., Davis, M. T., Witte, T. K., & Domino, J. L. (2015). The posttraumatic stress disorder checklist for DSM-5 (PCL-5): Development and initial psychometric evaluation. Journal of Traumatic Stress, 28, 489-498, doi: 10.1002/jts.22059.
Breslau, N. (2009). The epidemiology of trauma, PTSD, and other posttrauma disorders. Trauma, Violence, & Abuse, 10(3), 198-210.
Chou, F. H. C., Wu, H. C., Chou, P., Su, C. Y., Tsai, K. Y., Chao, S. S., … Ou-Yang, W. C. (2007). Epidemiologic psychiatric studies on post-disaster impact among Chi-Chi earthquake survivors in Yu-Chi, Taiwan. Psychiatry and Clinical Neurosciences, 61, 370-378, doi: 10.1111/pcn.2007.61.issue-4.
Dai, W., Long, C., Lai, Z., Li, Y., Wang, J., & Liu, A. (2016). The incidence of post-traumatic stress disorder among survivors after earthquakes: A systematic review and meta-analysis. BMC Psychiatry, 16, 188, doi: 10.1186/s12888-016-0891-9.
Dominguez, M. D. G., Saka, M. C., Lieb, R., Wittchen, H. U., & van Os, J. (2010). Early expression of negative/disorganized symptoms predicting psychotic experiences and subsequent clinical psychosis: A 10-year study. American Journal of Psychiatry, 167(9), 1075-1082, doi: 10.1176/appi.ajp.2010.09060883.
Furr, J. M., Comer, J. S., Edmunds, J. M., & Kendall, P. C. (2010). Disasters and youth: A meta-analytic examination of posttraumatic stress. Journal of Consulting and Clinical Psychology, 78(6), 765-780, doi: 10.1037/a0021482.
Hoven, C. W., Duarte, C. S., Turner, J. B., & Mandell, D. J. (2009). Child mental health in the aftermath of disaster: A review of PTSD studies. In Y. Neria, S. Galea, & F. Norris (Eds.), Mental health and disasters (pp. 218-232). New York: Cambridge University Press.
Kilpatrick, D. G., Resnick, H. S., Milanak, M. E., Miller, M. W., Keyes, K. M., & Friedman, M. J. (2013). National estimates of exposure to traumatic events and PTSD prevalence using DSM-IV and DSM-5 criteria. Journal of Traumatic Stress, 26(5), 537-547, doi: 10.1002/jts.2013.26.issue-5.
Kuo, C. J., Tang, H. S., Tsay, C. J., Lin, S. K., Hu, W. H., & Chen, C. C. (2003). Prevalence of psychiatric disorders among bereaved survivors of a disastrous earthquake in Taiwan. Psychiatric Services, 54(2), 249-251, doi: 10.1176/appi.ps.54.2.249.
La Greca, A. M., Silverman, W. K., 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 and Clinical Psychology, 78(6), 794-805, doi: 10.1037/a0020775.
Lai, T. J., Chang, C. M., Connor, K. M., Lee, L. C., & Davidson, J. R. T. (2004). Full and partial PTSD among earthquake survivors in rural Taiwan. Journal of Psychiatric Research, 38(3), 313-322, doi: 10.1016/j.jpsychires.2003.08.005.
Liu, P., Wang, L., Cao, C., Wang, R., Zhang, J., Zhang, B., … Elhai, J. D. (2014). The underlying dimensions of DSM-5 posttraumatic stress disorder symptoms in an epidemiological sample of Chinese earthquake survivors. Journal of Anxiety Disorders, 28(4), 345-351, doi: 10.1016/j.janxdis.2014.03.008.
Mcmillen, J. C., North, C. S., & Smith, E. M. (2000). What parts of PTSD are normal: Intrusion, avoidance, or arousal? Data from the Northridge, California, earthquake. Journal of Traumatic Stress, 13(1), 57-75, doi: 10.1023/A:1007768830246.
Olatunji, B. O., Cisler, J. M., & Tolin, D. F. (2007). Quality of life in the anxiety disorders: A meta-analytic review. Clinical Psychology Review, 27(5), 572-581, doi: 10.1016/j.cpr.2007.01.015.
Perkonigg, A., Kessler, R. C., Storz, S., & Wittchen, H. U. (2000). Traumatic events and post-traumatic stress disorder in the community: Prevalence, risk factors and comorbidity. Acta Psychiatrica Scandinavica, 101(1), 46-59, doi: 10.1034/j.1600-0447.2000.101001046.x.
Perkonigg, A., Pfister, H., Stein, M. B., Höfler, M., Lieb, R., Maercker, A., & Wittchen, H. U. (2005). Longitudinal course of posttraumatic stress disorder and posttraumatic stress disorder symptoms in a community sample of adolescents and young adults. America Journal of Psychiatry, 162(7), 1320-1327, doi: 10.1176/appi.ajp.162.7.1320.
Perkonigg, A., Yonkers, K. A., Pfister, H., Lieb, R., & Wittchen, H. U. (2004). Risk factors for premenstrual dysphoric disorder in a community sample of young women: The role of traumatic events and posttraumatic stress disorder. Journal of Clinical Psychiatry, 65(10), 1314-1322, doi: 10.4088/JCP.v65n1004.
Roussos, A., Goenjian, A. K., Steinberg, A. M., Sotiropoulou, C., Kakaki, M., Kabakos, C., … Manouras, V. (2005). Posttraumatic stress and depressive reactions among children and adolescents after the 1999 earthquake in Ano Liosia, Greece. American Journal of Psychiatry, 162(3), 530-537, doi: 10.1176/appi.ajp.162.3.530.
Schnurr, P. P., Lunney, C. A., Bovin, M. J., & Marx, B. P. (2009). Posttraumatic stress disorder and quality of life: Extension of findings to veterans of the wars in Iraq and Afghanistan. Clinical Psychology Review, 29(8), 727-735, doi: 10.1016/j.cpr.2009.08.006.
Schutters, S. I. J., Dominguez, M. D. G., Knappe, S., Lieb, R., Van Os. J., Schruers, K. R. J., & Wittchen, H. U. (2012). The association between social phobia, social anxiety cognitions and paranoid symptoms. Acta Psychiatrica Scandinavica, 125(3), 213-227, doi: 10.1111/acps.2012.125.issue-3.
Shalev, A., Liberzon, I., & Marmar, C. (2017). Post-traumatic stress disorder. The New England Journal of Medicine, 376(25), 2459-2469, doi: 10.1056/NEJMra1612499.
Spauwen, J., Krabbendam, L., Lieb, R., Wittchen, H., & Van Os, J. (2006). Impact of psychological trauma on the development of psychotic symptoms: Relationship with psychosis proneness. British Journal of Psychiatry, 188, 527-533, doi: 10.1192/bjp.bp.105.011346.
Thienkrua, W., Cardozo, B. L., Chakkraband, M. L. S., Guadamuz, T. E., Pengjuntr, W., Tantipiwatanaskul, P., … Van Griensven, F. (2006). Symptoms of posttraumatic stress disorder and depression among children in tsunami-affected areas in southern Thailand. Journal of the American Medical Association, 296(5), 549-559, doi: 10.1001/jama.296.5.549.
Thompson, M. P., Norris, F. H., & Hanacek, B. (1993). Age differences in the psychological consequences of hurricane Hugo. Psychology and Aging, 8(4), 606-616, doi: 10.1037/0882-7974.8.4.606.
Tolin, D. F., & Foa, E. B. (2006). Sex differences in trauma and posttraumatic stress disorder: A quantitative review of 25 years of research. Psychological Bulletin, 132(6), 959-992, doi: 10.1037/0033-2909.132.6.959.
Trickey, D., Siddaway, A. P., Meiser-Stedman, R., Serpell, L., & Field, A. P. (2012). A meta-analysis of risk factors for posttraumatic stress disorder in children and adolescents. Clinical Psychology Review, 32(2), 122-138, doi: 10.1016/j.cpr.2011.12.001.
Udomratn, P. (2008). Mental health and the psychosocial consequences of natural disasters in Asia. International Review of Psychiatry, 20(5), 441-444, doi: 10.1080/09540260802397487.
Van Griensven, F., Chakkraband, M. L. S., Thienkrua, W., Pengjuntr, W., Cardozo, B. L., Tantipiwatanaskul, P., … Tappero, J. W. (2006). Mental health problems among adults in tsunami-affected areas in southern Thailand. Journal of the American Medical Association, 296(5), 537-548, doi: 10.1001/jama.296.5.537.
Von Sydow, K., Lieb, R., Pfister, H., Höfler, M., & Wittchen, H. U. (2002). What predicts incident use of cannabis and progression to abuse and dependence? A 4-year prospective examination of risk factors in a community sample of adolescents and young adults. Drug and Alcohol Dependence, 68(1), 49-64, doi: 10.1016/S0376-8716(02)00102-3.
Wang, L., Zhang, Y., Shi, Z., & Wang, W. (2009). Symptoms of posttraumatic stress disorder among adult survivors two months after the Wenchuan earthquake. Psychological Reports, 105(3), 879-885, doi: 10.2466/PR0.105.3.879-885.
Wang, L., Zhang, Y., Wang, W., Shi, Z., Shen, J., Li, M., & Xin, Y. (2009). Symptoms of posttraumatic stress disorder among adult survivors three months after the Sichuan earthquake in China. Journal of Traumatic Stress, 22(5), 444-450, doi: 10.1002/jts.20439.
Wang, L., Zhang, J., Zhou, M., Shi, Z., & Liu, P. (2010). Symptoms of posttraumatic stress disorder among health care workers in earthquake-affected areas in southwest China. Psychological Reports, 106(2), 555-561, doi: 10.2466/pr0.106.2.555-561.
Wang, L., Cao, C., Wang, R., Zhang, J., & Li, Z. (2012). The dimensionality of PTSD symptoms and their relationship to health-related quality of life in Chinese earthquake survivors. Journal of Anxiety Disorders, 26(7), 711-718, doi: 10.1016/j.janxdis.2012.06.005.
Wigman, J. T. W., Van Nierop, M., Vollebergh, W. A. M., Lieb, R., Beesdo-Baum, K., Wittchen, H. U., & Van Os, J. (2012). Evidence that psychotic symptoms are prevalent in disorders of anxiety and depression, impacting on illness onset, risk, and severity--implications for diagnosis and ultra-high risk research. Schizophrenia Bulletin, 38(2), 247-257, doi: 10.1093/schbul/sbr196.
Wittchen, H. U., Perkonigg, A., & Pfister, H. (2003). Trauma and PTSD-An overlooked pathogenic pathway for premenstrual dysphoric disorder? Archives of Women's Mental Health, 6(4), 293-297, doi: 10.1007/s00737-003-0028-2.
Zhang, Z., Shi, Z., Wang, L., & Liu, M. (2011). One year later: Mental health problems among survivors in hard-hit areas of the Wenchuan earthquake. Public Health, 125(5), 293-300, doi: 10.1016/j.puhe.2010.12.008.
Zhou, X., Wu, X. C., & Zhen, R. (2017). Assessing the latent structure of DSM-5 PTSD among Chinese adolescents after the Ya'an earthquake. Psychiatry Research, 254, 33-39, doi: 10.1016/j.psychres.2017.04.029.
Zimmermann, P., Brückl, T., Lieb, R., Nocon, A., Ising, M., Beesdo, K., & Wittchen, H. U. (2008). The interplay of familial depression liability and adverse events in predicting the first onset of depression during a 10-year follow-up. Biological Psychiatry, 63(4), 406-414, doi: 10.1016/j.biopsych.2007.05.020.
Zimmermann, P., Brückl, T., Nocon, A., Pfister, H., Binder, E. B., Uhr, M., … Isi. (2011). Interaction of FKBP5 gene variants and adverse life events in predicting depression onset: Results from a 10-Year prospective community study. American Journal of Psychiatry, 168(10), 1107-1116, doi: 10.1176/appi.ajp.2011.10111577.

[1]	XIONG Sicheng, ZHANG Bin, JIANG Yongzhi, JIANG Huaibin, CHENG Yun. Global Prevalence of Mobile Phone Addiction: A Meta-Analysis [J]. Studies of Psychology and Behavior, 2021, 19(6): 802-808.
[2]	SUN Xiaoran, ZHAO Yue, LI Wenhao, AN Yuanyuan. The Effect of Breast Cancer Survivors’ Body Image on Posttraumatic Stress Disorder and Posttraumatic Growth: The Mediating Effect of Rumination [J]. Studies of Psychology and Behavior, 2020, 18(5): 693-699.
[3]	XIN Yong, BAI Ke, CHEN Xieping, ZHU Dianqing, LIU Chuanjun. The Effect of Social Support on Posttraumatic Growth of Adolescents: the Mediating Role of Resilience [J]. Studies of Psychology and Behavior, 2019, 17(6): 817-823.
[4]	Chen Meixiang, Bai Xuejun. The Impact of target prevalence in Medical Image Visual Searching of Novice and Expert Radiologists: Evidence from Eye Movement [J]. Studies of Psychology and Behavior, 2017, 15(3): 302-308.
[5]	Zheng Xianliang, Gu Haigen. Relationship Between Internet Altruistic Behavior of Undergraduates and Internet-Behavior Preference: Effects of Class Environments [J]. Studies of Psychology and Behavior, 2013, 11(5): 690-696.