Thordardottir Edda Bjork, Valdimarsdottir Unnur Anna, Hansdottir Ingunn, Hauksdóttir Arna, Dyregrov Atle, Shipherd Jillian C, Elklit Ask, Resnick Heidi, Gudmundsdottir Berglind
Centre of Public Health Sciences, Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland;
Centre of Public Health Sciences, Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland.
Eur J Psychotraumatol. 2016 Aug 16;7:30995. doi: 10.3402/ejpt.v7.30995. eCollection 2016.
Every year a substantial number of children are affected by natural disasters worldwide. However, data are scarce on long-term psychological impact of natural disasters on children's health. Identifying risk factors and outcomes associated with the long-term sequelae of posttraumatic stress disorder (PTSD) can provide a gateway to recovery as well as enhancement of preventive measures.
Among childhood avalanche survivors, we aimed to investigate risk factors for PTSD symptoms and the relationship between socioeconomic status (SES) and PTSD symptoms in adulthood.
Childhood survivors (aged 2-19 at the time of exposure) of two avalanches were identified through nationwide registers 16 years later. The Posttraumatic Diagnostic Scale was used to assess current PTSD symptoms. One-way ANOVA was used to explore PTSD symptoms by background and trauma-specific factors, as well as associations with current SES. Predictors of PTSD symptoms were examined by multivariable regression analysis.
Response rate was 66% (108/163). Results from univariate ANOVA analysis revealed that female sex was associated with PTSD symptoms (F=5.96, p<0.05). When adjusted for age and sex, PTSD symptoms were associated with lower education (F=7.62, p<0.001), poor financial status (F=12.21, p<0.001), and unemployment and/or disability (F=3.04, p<0.05). In a multivariable regression model, when adjusting for age and sex, lack of social support (t=4.22, p<0.001) and traumatic reactions of caregivers (t=2.49, p<0.05) in the aftermath of the disaster independently predicted PTSD 16 years post-trauma.
Lingering PTSD symptoms after childhood exposure to a disaster may negatively influence socioeconomic development in adulthood. Strengthening children's support systems post-disaster may prevent the long-term sequelae of symptoms.
全球每年有大量儿童受到自然灾害影响。然而，关于自然灾害对儿童健康的长期心理影响的数据却很匮乏。识别与创伤后应激障碍（PTSD）长期后遗症相关的风险因素和后果，可为康复以及加强预防措施提供途径。
在儿童雪崩幸存者中，我们旨在调查PTSD症状的风险因素以及成年期社会经济地位（SES）与PTSD症状之间的关系。
通过全国性登记系统在16年后识别出两次雪崩的儿童幸存者（暴露时年龄为2至19岁）。使用创伤后诊断量表评估当前的PTSD症状。采用单因素方差分析来探讨PTSD症状与背景及创伤特异性因素的关系，以及与当前SES的关联。通过多变量回归分析检查PTSD症状的预测因素。
回复率为66%（108/163）。单因素方差分析结果显示，女性与PTSD症状相关（F = 5.96，p < 0.05）。在调整年龄和性别后，PTSD症状与较低的教育程度（F = 7.62，p < 0.001）、较差的经济状况（F = 12.21，p < 0.001）以及失业和/或残疾（F = 3.04，p < 0.05）相关。在多变量回归模型中，调整年龄和性别后，灾难后缺乏社会支持（t = 4.22，p < 0.001）和照顾者的创伤反应（t = 2.49，p < 0.05）独立预测创伤后16年的PTSD。
儿童期遭受灾难后持续存在的PTSD症状可能对成年期的社会经济发展产生负面影响。加强灾后儿童支持系统可能预防症状的长期后遗症。
