School of Population Health, Curtin University, Perth, Australia.
FXB Center for Health and Human Rights, Harvard University, Boston, Massachusetts, USA.
J Trauma Stress. 2022 Dec;35(6):1721-1733. doi: 10.1002/jts.22876. Epub 2022 Sep 6.
Postdisaster daily stressors, the economic and social challenges caused or exacerbated by disasters, have significant consequences for mental health but are rarely investigated in child and adolescent populations. We assessed posttraumatic stress symptoms (PTSS), depression, and anxiety among adolescents affected by disasters in China and Nepal and examined the specific contributions of disaster-related trauma exposure and daily stressors across mental health outcomes. A school-based, cross-sectional study was conducted with a stratified random sampling design. Adolescents living in disaster-affected areas of southern China and Nepal (N = 4,215, 52.7% female, age range: 15-19 years) completed translated, validated measures. Mixed effects logistic regression analyses were conducted using a priori risk factors. PTSS were reported by 22.7% of participants and were higher among Nepali adolescents but did not differ between genders. Depressive symptoms were reported by 45.2% of the sample and were higher among Nepali adolescents and girls in both countries. Across all settings, disaster-related trauma exposure was a significant risk factor for PTSS, depressive, and anxiety symptoms, China: odds ratios (ORs) = 1.44-2.06, Nepal, ORs = 1.21-2.53. High levels of household and interpersonal daily stressors further improved the models and contributed significantly to all mental health difficulties, China: ORs = 1.77-1.98, Nepal: ORs = 1.49-1.90. Postdisaster economic insecurity and interpersonal stressors are thus, likely to worsen adolescent mental health outcomes. Programs that identify and address structural inequalities for adolescents in disaster-affected settings will have cascading effects for mental health.
灾后日常压力源，以及灾害引发或加剧的经济和社会挑战，对心理健康有重大影响，但在儿童和青少年群体中很少得到研究。我们评估了中国和尼泊尔受灾青少年的创伤后应激症状（PTSS）、抑郁和焦虑，并考察了灾难相关创伤暴露和日常压力源对各种心理健康结果的具体贡献。采用分层随机抽样设计进行了一项基于学校的横断面研究。居住在中国和尼泊尔受灾地区的青少年（N=4215 人，52.7%为女性，年龄范围：15-19 岁）完成了经过翻译和验证的测量。使用先验风险因素进行了混合效应逻辑回归分析。PTSS 的报告率为 22.7%，尼泊尔青少年的报告率更高，但性别之间无差异。45.2%的样本报告了抑郁症状，尼泊尔青少年和两国女孩的报告率更高。在所有环境中，灾难相关创伤暴露是 PTSS、抑郁和焦虑症状的重要危险因素，中国：比值比（ORs）=1.44-2.06，尼泊尔：ORs=1.21-2.53。家庭和人际日常压力源水平较高进一步改善了模型，并对所有心理健康问题都有显著贡献，中国：ORs=1.77-1.98，尼泊尔：ORs=1.49-1.90。因此，灾后经济不安全和人际压力源可能会使青少年心理健康状况恶化。在受灾地区为青少年确定和解决结构性不平等问题的项目将对心理健康产生连锁影响。
