Liu Yan, Liu Yating, Wang Yantao, Li Zhuo, Luo Yanan
Institute of Population Research, Peking University, Beijing, China.
School of Nursing, Peking University, Beijing, China.
SSM Popul Health. 2023 Aug 11;23:101490. doi: 10.1016/j.ssmph.2023.101490. eCollection 2023 Sep.
This study aimed to examine the association between exposure to the 1976 Great Tangshan Earthquake (GTE) in adolescence and later-life depressive symptoms and to investigate the potential mechanisms underlying this association.
Data were from the 2015 China Health and Retirement Longitudinal Study (CHARLS). The 10-item short form of the Center for Epidemiologic Studies Depression scale (CESD-10) was chosen to measure depressive symptoms. We used the difference-in-difference (DID) method, binary logistic regression models, and multilevel logistic regression models to explore the association of earthquake exposure during adolescence with later-life depressive symptoms. Additionally, multilevel mediation analysis with structural equation modeling (MMSEM) was conducted to investigate potential mechanisms.
We identified that adolescent exposure to earthquakes was related to a lower risk of depressive symptoms in later life (OR = 0.90, P = 0.019; OR = 0.48, P = 0.031; OR = 0.47, P = 0.034, respectively). However, this significant association was observed only in females (OR = 0.83, P = 0.028; OR = 0.46, P = 0.053; OR = 0.42, P = 0.037, respectively). Moreover, social activity participation played a mediating role in the association between exposure to earthquakes in adolescence and later-life depressive symptoms.
We observed a lower risk of depressive symptoms in later life in survivors of earthquake exposure during adolescence. Further, we found the mediating role of social participation in the association between earthquake exposure in adolescence and later-life depressive symptoms, which gives support for the posttraumatic growth (PTG) theory. Our findings imply that, in order to lower the risk of depression in later life following exposure to a natural disaster in adolescence, it is necessary to take into account the buffering effect of social participation.
本研究旨在探讨青少年时期经历1976年唐山大地震（GTE）与晚年抑郁症状之间的关联，并调查这种关联背后的潜在机制。
数据来自2015年中国健康与养老追踪调查（CHARLS）。选择流行病学研究中心抑郁量表的10项简表（CESD-10）来测量抑郁症状。我们使用差分法（DID）、二元逻辑回归模型和多水平逻辑回归模型来探讨青少年时期经历地震与晚年抑郁症状之间的关联。此外，还进行了结构方程模型的多水平中介分析（MMSEM）以研究潜在机制。
我们发现青少年时期经历地震与晚年抑郁症状风险较低有关（OR分别为0.90，P = 0.019；OR = 0.48，P = 0.031；OR = 0.47，P = 0.034）。然而，这种显著关联仅在女性中观察到（OR分别为0.83，P = 0.028；OR = 0.46，P = 0.053；OR = 0.42，P = 0.037）。此外，社会活动参与在青少年时期经历地震与晚年抑郁症状之间的关联中起中介作用。
我们观察到青少年时期经历地震的幸存者晚年患抑郁症状的风险较低。此外，我们发现社会参与在青少年时期经历地震与晚年抑郁症状之间的关联中起中介作用，这为创伤后成长（PTG）理论提供了支持。我们的研究结果表明，为了降低青少年时期经历自然灾害后晚年患抑郁症的风险，有必要考虑社会参与的缓冲作用。
