Shioyama A, Uemoto M, Shinfuku N, Ide H, Seki W, Mori S, Inoue S, Natsuno R, Asakawa K, Osabe H
Hyogo Prefectural Kofu Hospital.
Seishin Shinkeigaku Zasshi. 2000;102(5):481-97.
We conducted surveys to investigate the nature of the recovery processes and psychological reactions of children and adolescents affected by the Great Hanshin Awaji Earthquake. The investigations were carried out 4 times at 4 months, 6 months, one year and two years after the disaster.
About 9000 school children in the 3rd grade, the 5th grade, the 8th grade living in the disaster area.
The questionnaire consisted of 9-12 items regarding situation and behavior when the earthquake occurred, and 22 items regarding mental health condition, and was filled out in the classroom under supervision by the teacher in charge. The responses were rated from 1 to 4 depending on the frequency of the symptoms, and statistically analyzed.
By factor analysis, three factors were elicited. Factor 1 was interpreted as being related to fear and anxiety, factor 2 as related to depression and physical symptoms, and factor 3 as related to pro-social tendencies. These 3 factors were distinct and stable throughout all 4 surveys and each of them showed unique recovery processes. The mean score of factor 1 was highest at 4 months after the earthquake, and decreased as time passed. This factor shows that fear and anxiety seem to be directly related to the experience of the earthquake. According to the severity of the disaster, more severe damage brought about a higher mean score of factor 1. Furthermore, younger children and girls were more strongly affected. Each of the differences in the severity of disaster, in age, and in gender decreased as time passed. The mean score of factor 2 peaked at 6 months, and it slightly recovered after one year. However, the score at the 1st year was still higher than that of the 4th month. At two years the score returned to almost the same level as that of the 4th month. We think that factor 2, involving depressive mood and psychophysical symptoms, may be a secondary phenomenon to fear and anxiety. Other possibilities are that they may be caused by environmental changes after the disaster, inconveniences of daily life, loss of jobs of parents, or masked by hypomanic mood which covered over the disaster area soon after the earthquake (so-called heroic phase). Older children have a greater tolerance for depressive mood and psychophysical symptoms, but those symptoms occurring in older children have a tendency to continue for a longer time. Girls are more heavily affected and need more time to recover from trauma than boys. The mean score of factor 3 showed a gradual decrease as time passed. There was no difference in the way of decrease according to the severity of disaster, age and gender. It may be natural that, since the interest in the earthquake decreased as time passed, consideration for the victims decreased.
The problems of mental health of children and adolescents after the disaster may consist of at least 2 different components; "fear and anxiety," which appeared just after the disaster and decreased earlier; "depressive and psychophysical symptoms" appeared later and stayed longer.
我们开展了多项调查，以探究受阪神淡路大地震影响的儿童及青少年的恢复过程及心理反应的本质。调查在灾难发生后的4个月、6个月、1年及2年进行了4次。
居住在灾区的约9000名三年级、五年级、八年级学童。
问卷包括9 - 12项关于地震发生时的情况及行为，以及22项关于心理健康状况的内容，由班主任在课堂监督下填写。根据症状出现频率将回答从1到4评分，并进行统计分析。
通过因子分析，得出三个因子。因子1被解释为与恐惧和焦虑有关，因子2与抑郁及身体症状有关，因子3与亲社会倾向有关。这三个因子在所有4次调查中都是独特且稳定的，且每个因子都呈现出独特的恢复过程。因子1的平均分在地震后4个月时最高，随后随时间推移而下降。该因子表明恐惧和焦虑似乎与地震经历直接相关。根据灾难的严重程度，破坏越严重，因子1的平均分越高。此外，年幼的儿童和女孩受影响更强烈。随着时间推移，灾难严重程度、年龄及性别的差异均有所减小。因子2的平均分在6个月时达到峰值，1年后略有恢复。然而，1年时的分数仍高于4个月时的分数。2年时分数恢复到几乎与4个月时相同的水平。我们认为，涉及抑郁情绪和身心症状的因子2可能是恐惧和焦虑的继发现象。其他可能性包括它们可能由灾难后的环境变化、日常生活不便、父母失业引起，或者被地震后不久覆盖灾区的轻躁狂情绪所掩盖（所谓的英雄阶段）。年龄较大的儿童对抑郁情绪和身心症状有更大的耐受性，但这些症状在年龄较大的儿童中往往持续更长时间。女孩受影响更严重，且比男孩需要更多时间从创伤中恢复。因子3的平均分随时间逐渐下降。根据灾难严重程度、年龄和性别，下降方式没有差异。随着时间推移，对地震的关注度降低，对受害者的关心减少，这可能是自然的。
灾难后儿童及青少年的心理健康问题可能至少由2个不同成分组成；“恐惧和焦虑”，在灾难后立即出现且较早减轻；“抑郁及身心症状”出现较晚且持续时间更长。
