Cohen Joseph R, Adams Zachary W, Menon Suvarna V, Youngstrom Eric A, Bunnell Brian E, Acierno Ron, Ruggiero Kenneth J, Danielson Carla Kmett
Department of Psychology, University of Illinois Urbana-Champaign, IL, United States.
National Crime Victims Research and Treatment Center, Medical University of South Carolina, Charleston, SC, United States.
J Affect Disord. 2016 Sep 15;202:102-9. doi: 10.1016/j.jad.2016.05.034. Epub 2016 May 24.
The present study's aim was to provide the foundation for an efficient, empirically based protocol for depression screening following a natural disaster. Utilizing a Receiver Operating Characteristic (ROC) analytic approach, the study tested a) what specific disaster-related stressors (i.e., property damage, loss of basic services) and individual-related constructs (i.e., PTSD symptoms, trauma history, social support) conveyed the greatest risk for post-natural disaster depression, b) specific cutoff scores across these measures, and c) whether the significance or cutoff scores for each construct varied between adolescents and adults.
Structured phone-based clinical interviews were conducted with 2000 adolescents who lived through a tornado and 1543 adults who survived a hurricane.
Findings suggested that in both adolescents and adults, individual-related constructs forecasted greater risk for depressive symptoms following a natural disaster compared to disaster-related stressors. Furthermore, trauma history and PTSD symptoms were particularly strong indicators for adolescent depressive symptoms compared to adult depressive symptoms. Adolescents and adults who reported vulnerable scores for social support, trauma history, and lifetime PTSD symptoms were approximately twice as likely to present as depressed following the natural disaster.
Findings from the present study were limited to post-disaster assessments and based on self-reported functioning 6-12 months following the natural disaster.
The present study synthesizes the extensive body of research on post-disaster functioning by providing a clear framework for which questions may be most important to ask when screening for depression following a natural disaster.
本研究的目的是为自然灾害后抑郁症筛查制定一个基于实证的高效方案奠定基础。该研究采用接受者操作特征（ROC）分析方法，测试了：a）哪些特定的与灾害相关的应激源（即财产损失、基本服务丧失）和与个体相关的因素（即创伤后应激障碍症状、创伤史、社会支持）对自然灾害后抑郁症构成最大风险；b）这些测量指标的具体临界值；c）各因素的显著性或临界值在青少年和成年人之间是否存在差异。
对2000名经历过龙卷风的青少年和1543名经历过飓风的成年人进行了基于电话的结构化临床访谈。
研究结果表明，在青少年和成年人中，与灾害相关的应激源相比，与个体相关的因素对自然灾害后抑郁症状的预测风险更大。此外，与成人抑郁症状相比，创伤史和创伤后应激障碍症状是青少年抑郁症状的特别有力指标。报告社会支持、创伤史和终生创伤后应激障碍症状得分较低的青少年和成年人在自然灾害后出现抑郁症状的可能性大约是其他人的两倍。
本研究的结果仅限于灾后评估，且基于自然灾害发生6至12个月后的自我报告功能。
本研究通过提供一个清晰的框架，综合了关于灾后功能的大量研究，该框架明确了在自然灾害后筛查抑郁症时哪些问题可能最为重要。
