Center for Social Security Studies, Wuhan University, Hubei, China.
New York University Shanghai, Shanghai, China; Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, USA.
J Psychiatr Res. 2021 Oct;142:117-124. doi: 10.1016/j.jpsychires.2021.07.034. Epub 2021 Jul 26.
Posttraumatic stress symptoms and depressive symptoms are prevalent after natural disasters. However, in a Chinese trauma context, little research examined the long-term trajectories of these two symptoms with a gender perspective.
Data came from an 8-year longitudinal survey of 3522 Wenchuan earthquake adult survivors. We used multilevel growth-curve models to investigate the trajectories of PTSS and depressive symptoms; adopted conditional growth-curve models to explore the gender differences in trajectories together with gendered factors associated with mental health symptoms; conducted Chow tests to examine the significance of gender differences. Standardized coefficients, P values, and effect sizes were reported.
With covariates controlled, both linear (β = -1.33, p < 0.001, Cohen's d = 0.79) and quadratic effects (β = 1.03, p < 0.001, Cohen's d = 0.59) of time were significant in PTSS trajectory, whereas quadratic effect (β = 0.27, p < 0.001, Cohen's d = 0.14) in the declining depressive trajectory was clinically nonsignificant. Compared with men, women are at higher risk of PTSS (β = 0.12, p < 0.001, Cohen's d = 0.21) and depressive symptoms (β = 0.10, p < 0.001, Cohen's d = 0.20), but also with a faster-declining rate in PTSS within first five years after the disaster. No gender difference was found regarding depressive trajectory. Additionally, poor education and income associate with more PTSS in women, while sickness predicts severer depression in women and more PTSS in men.
This study proposes a gendered U-shape trajectory for PTSS and a declining depressive trajectory without gender difference. The findings of this study shed light on mental health intervention in future natural disasters.
创伤后应激症状和抑郁症状在自然灾害后普遍存在。然而，在中国的创伤背景下，很少有研究从性别角度探讨这两种症状的长期轨迹。
数据来自对 3522 名汶川地震成年幸存者进行的 8 年纵向调查。我们使用多层次增长曲线模型来研究 PTSD 症状和抑郁症状的轨迹；采用条件增长曲线模型来探讨轨迹的性别差异以及与心理健康症状相关的性别因素；进行 Chow 检验以检验性别差异的显著性。报告了标准化系数、P 值和效应大小。
在控制了协变量后，PTSD 轨迹的线性（β=-1.33，p<0.001，Cohen's d=0.79）和二次效应（β=1.03，p<0.001，Cohen's d=0.59）以及下降的抑郁轨迹的二次效应（β=0.27，p<0.001，Cohen's d=0.14）均具有统计学意义，但下降的抑郁轨迹的二次效应在临床上无显著意义。与男性相比，女性患 PTSD 症状（β=0.12，p<0.001，Cohen's d=0.21）和抑郁症状（β=0.10，p<0.001，Cohen's d=0.20）的风险更高，但在灾难后前五年内 PTSD 症状的下降速度更快。在抑郁轨迹方面，没有发现性别差异。此外，较差的教育和收入与女性 PTSD 症状的增加有关，而疾病则预示着女性的抑郁程度更严重，男性的 PTSD 症状更严重。
本研究提出了 PTSD 呈性别化 U 型轨迹和无性别差异的下降抑郁轨迹。本研究的结果为未来自然灾害中的心理健康干预提供了启示。
