Posttraumatic stress disorder in Chinese methamphetamine patients: Prevalence, demographics, and clinical correlates.

BACKGROUND AND OBJECTIVES: The aim of this study was to investigate the prevalence of posttraumatic stress disorder (PTSD) and clinical correlates in Chinese methamphetamine patients. METHODS: We analyzed 481 Chinese methamphetamine patients. RESULTS: The prevalence of PTSD among Chinese methamphetamine patients was 7.90% (38/481), which was higher than in western countries. Binary logistic regression showed that age, smoking, abstinence time, age of onset, and DDQ control dimensions were associated with PTSD. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: Our results indicated that some demographic and clinical variables were associated with PTSD in Chinese methamphetamine patients, which provided evidence for PTSD comorbidity with methamphetamine.

The Relationship between Metacognition, Rumination, and Sleep in University Students with a Tendency toward Generalized Anxiety Disorder.

People with generalized anxiety disorder tend to have sleep problems, and studies have found correlations between metacognition, rumination, and sleep, but it is unclear how metacognition and rumination work in people with a tendency towards generalized anxiety disorder. The goal of this paper is to investigate the correlation between metacognition, rumination, and sleep in university students with a tendency towards generalized anxiety disorder, and the mediating role of rumination in the effect of metacognition on sleep. The Generalized Anxiety Disorder Scale (GAD-7), the Meta-Cognition Questionnaire (MCQ-30), the Ruminative Responses Scale (RRS), and the Insomnia Severity Index (ISI) were used to investigate and psychometrically measure 566 university students in Anyang Normal College. The results of correlation analysis showed significant positive correlations between metacognition and sleep, ruminative thinking and sleep, and metacognition and rumination in university students with a tendency towards generalized anxiety disorder. Mediation analysis showed that rumination partially mediated the effect of metacognition on sleep, with the mediating effect accounting for 51.1% of the total effect. There is a strong correlation between metacognition, rumination, and sleep in university students with a tendency towards generalized anxiety disorder, and both metacognition and rumination can predict sleep, while metacognition can affect sleep through the mediating effect of rumination.

Latent structure of posttraumatic stress disorder symptoms in an adolescent sample one month after an earthquake.

Increasing empirical studies suggest that the tripartite posttraumatic stress disorder (PTSD) model described in the DSM-IV does not accurately account for the underlying PTSD factor structure, and several alternative models have been proposed. The present study investigated a newly refined, five-factor model of PTSD symptoms in a sample of Chinese adolescent survivors of an earthquake. A total of 1198 middle school students (653 females, 526 males) with a mean age of 14.4 years (SD = 1.1, range: 11-18) participated in this study one month after an earthquake. The novel five-factor model comprised of intrusion, avoidance, numbing, dysphoric arousal, and anxious arousal demonstrated significantly better fit than two alternative four-factor models. Further analyses revealed differentiable relations between the PTSD factors and external measures of anxiety and depression. These findings provide empirical support for the robustness of five-factor model, and carry implications for further reorganization of PTSD criteria.

The Mini-IPIP Scale: psychometric features and relations with PTSD symptoms of Chinese earthquake survivors.

The present purpose was to validate the Mini-IPIP scale, a short measure of the five-factor model personality traits, with a sample of Chinese earthquake survivors. A total of 1,563 participants, ages 16 to 85 years, completed the Mini-IPIP scale and a measure of posttraumatic stress disorder (PTSD) symptoms. Confirmatory factor analysis supported the five-factor structure of the Mini-IPIP with adequate values of various fit indices. This scale also showed values of internal consistency, Cronbach's alphas ranged from .79 to .84, and McDonald's omega ranged from .73 to .82 for scores on each subscale. Moreover, the five personality traits measured by the Mini-IPIP and those assessed by other big five measures had comparable patterns of relations with PTSD symptoms. Findings indicated that the Mini-IPIP is an adequate short-form of the Big-Five factors of personality, which is applicable with natural disaster survivors.

Effects of comorbid posttraumatic stress disorder on cognitive dysfunction in Chinese male methamphetamine patients.

OBJECTIVES: Cognitive dysfunction and posttraumatic stress disorder (PTSD) are common in methamphetamine patients. However, few studies have investigated the cognitive performance of methamphetamine patients with PTSD. The purpose of this study was to investigate the impact of comorbid PTSD on cognitive function in Chinese male methamphetamine patients. METHODS: We analyzed 464 methamphetamine patients and 156 healthy volunteers. The PTSD Screening Scale (PCL-5) was used to assess PTSD and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was used to assess cognitive function. RESULTS: Compared with healthy controls, methamphetamine patients had more cognitive dysfunction in immediate memory, visuospatial/constructional, language, attention and delayed memory. Moreover, methamphetamine patients with PTSD had less cognitive dysfunction in immediate memory, attention, and delayed memory than methamphetamine patients without PTSD. Further stepwise regression analysis showed that PTSD alterations in arousal and reactivity cluster were risk predictors for language, and PTSD negative alteration in cognition and mood cluster were risk predictors for delayed memory. CONCLUSIONS: Our results indicate that methamphetamine patients without PTSD have poorer cognitive dysfunction than those with PTSD. Some demographic and PTSD symptom clusters are protective or risk factors for cognitive dysfunction in methamphetamine patients.

Testing the dimensionality of posttraumatic stress responses in young Chinese adult earthquake survivors: further evidence for "dysphoric arousal" as a unique PTSD construct.

BACKGROUND: This study investigated an alternative five-factor diagnostic model for posttraumatic stress disorder (PTSD) symptoms, and tested external convergent and discriminant validity of the model in a young Chinese sample of earthquake survivors. METHODS: A total of 938 participants (456 women, 482 men) aged 15-20 years were recruited from a vocational school originally located in Beichuan County Town which was almost completely destroyed by the "Wenchuan Earthquake." The participants were administrated with the PTSD Checklist and the Hopkins Symptoms Checklist-25 12 months after the earthquake. RESULTS: The results of confirmatory factor analysis showed that the five-factor intercorrelated model (intrusion, avoidance, numbing, dysphoric arousal, and anxious arousal) fit the data significantly better than the four-factor numbing model proposed by King et al. (1998: Psychol Assess 10:90-96) and the four-factor dysphoria model proposed by Simms et al. (2002: J Abnorm Psychol 111:637-647). Further analyses indicated that four out of five PTSD factors yielded significantly different correlations with external measures of anxiety versus depression. CONCLUSIONS: The findings provide further empirical evidence in favor of the five-factor diagnostic model of PTSD, and carry implications for the upcoming DSM-5.

Psychometric properties of the 10-item Connor-Davidson Resilience Scale in Chinese earthquake victims.

AIM: Resilience refers to positive adaption in the face of stress or trauma. Assessing resilience is crucial in trauma-related research and practice. The 10-item Connor-Davidson Resilience Scale (CD-RISC) has been demonstrated to be a valid and reliable tool to achieve this goal. This study was designed to examine the psychometric properties of the 10-item CD-RISC in a sample of Chinese earthquake victims. METHODS: A total of 341 participants (185 women, 156 men) aged 20-63 years were recruited from a psychological relief program supported by the Institute of Psychology, Chinese Academy of Sciences following the 'Wenchuan' earthquake. The participants were given the 10-item CD-RISC and the 17-item post-traumatic stress disorder (PTSD) subscale of the Los Angeles Symptom Checklist (LASC) 4 months after the earthquake. RESULTS: The results of exploratory factor analysis indicated that a single-factor model consistent with the original design of the 10-item CD-RISC was support. The scale was also demonstrated to have good internal consistency (Cronbach's alpha = 0.91) and test-retest reliability (r = 0.90 for a two-week interval). Scores on the scale could reflect different levels of resilience in populations that are thought to be differentiated (probable PTSD vs healthy controls, t(339) = -7.60, P < 0.01, Cohen's d = 0.84). Moreover, the total resilience scores were significantly negatively correlated with scores on total PTSD scale and its three subscales for all participants. CONCLUSION: The Chinese version of the 10-item CD-RISC has excellent psychometric properties, and is applicable for Chinese people.

Symptoms of posttraumatic stress disorder among health care workers in earthquake-affected areas in southwest China.

The symptoms of posttraumatic stress disorder and associated risk factors were investigated among health care workers in earthquake-affected areas in southwest China. 343 health care workers completed the Chinese version of the Impact of Event Scale-Revised 3 mo. after the Wenchuan Earthquake. The prevalence of probable PTSD was 19%. The significant risk factors identified for PTSD severity included being female, being bereaved, being injured, and higher intensity of initial fear. These findings suggest that PTSD is a common mental health problem among health care workers in earthquake-affected areas. The present information can be useful in directing, strengthening, and evaluating disaster-related mental health needs and interventions after an earthquake.

Diagnostic utility of the PTSD Checklist in detecting ptsd in Chinese earthquake victims.

By using the posttraumatic stress disorder (PTSD) module of the Mini International Neuropsychiatric Interview (MINI) as the gold standard to identify PTSD, the current study investigated the diagnostic efficiency of the PTSD Checklist (PCL) as a screening questionnaire in a sample of 152 Chinese victims of the Wenchuan earthquake. The results showed that the area under the receiver operating characteristic (ROC) curve was .96 (SE = .02), and the optimally efficient cutoff score was 44. The findings provide preliminary support of the PCL as a screening questionnaire among Chinese earthquake victims. The present study may contribute to further PTSD-related research and practices in Chinese disaster settings.

Symptoms of posttraumatic stress disorder among adult survivors three months after the Sichuan earthquake in China.

The study investigated the symptoms of posttraumatic stress disorder (PTSD) and associated risk factors among adult survivors 3 months after the 2008 Sichuan earthquake in China. One thousand five hundred sixty-three earthquake survivors in two communities participated in the study. The prevalence of probable PTSD was 37.8% and 13.0%, respectively, in the two communities that were affected differently by the earthquake. The significant predictive factors for the severity of PTSD symptoms were female gender, subnationality, lower educational level, lower social support, and higher initial exposure level. The results indicate that PTSD is also a common mental health problem among earthquake survivors in China. Given inadequate knowledge and practices concerning the mental health of disaster victims in China, the information provided by this study is useful for directing, strengthening, and evaluating disaster-related mental health needs and interventions after the earthquake.

Age-related change in emotional experience in a sample of Chinese adults: a preliminary study.

Age-related change in emotional experience was explored in a Chinese community sample. 968 healthy adults (483 women, 485 men) ranging in age from 18 to 66 years (M = 37.5, SD = 12.3) took part. The frequency of experiencing negative and positive emotion was self-reported on the general dimension scales of Positive and Negative Affect Scale-Expanded Form (PANAS-X). Regression analyses indicated that the frequency of negative affect decreased with age, and the frequency of positive affect was not significantly associated with age. These findings are similar to those found in Western samples, as discussed in relation to socioemotional selectivity theory.

Symptoms of posttraumatic stress disorder among adult survivors two months after the Wenchuan earthquake.

This study investigated the symptoms of Posttraumatic Stress Disorder (PTSD) and associated risk factors among adult survivors 2 mo. after the Wenchuan earthquake in China. 228 survivors completed the Chinese version of the Impact of Event Scale-Revised. The prevalence of probable PTSD was 43%. The significant predictive factors for the severity of PTSD symptoms included being female, having lower educational level, being bereaved, and witnessing death. Findings of this study suggest that PTSD is a common mental health problem among earthquake survivors in China. Given inadequate knowledge and practices concerning the mental health of disaster victims in China, the information provided by this study is useful for directing, strengthening, and evaluating disaster-related mental health needs and interventions after earthquakes.

Prevalence and risk factors of complicated grief among Sichuan earthquake survivors.

BACKGROUND: Disasters usually involves massive casualties, yet few post-disaster studies explore the prevalence of complicated grief (CG) among survivors. Complicated grief is a distinct psychological disorder, and is associated with impaired physical and psychological functions. Given such gap in the literature and the significance of this topic, this study is hoped to offer more information of complicated grief among survivors who lost their loved ones in disaster. Adopting a large scale survey, the prevalence and risk factors of CG among bereaved survivors one year after the Sichuan earthquake in China were explored. METHODS: In total 803 bereaved survivors participated the study by filling a questionnaire on measuring CG symptoms, posttraumatic stress disorder (PTSD) symptoms, intrapersonal factors, earthquake related factors, bereavement related factors, and an interpersonal factor. RESULTS: There were 71.1% of the participants scored higher than the cutoff point of CG symptoms. Close relationship with the deceased, PTSD symptoms, losing means of livelihood, physical injury, and terrifying experience in the earthquake, were identified to be risk factors for CG. LIMITATIONS: The study was cross-sectional and the data was collected through a self-reported questionnaire. The sample was recruited from one of the most severely affected counties, thus the generalizability of the results should be interpreted with caution. CONCLUSIONS: A large portion of bereaved earthquake survivors suffered from CG symptoms one year after the disaster. Risk factors found in this study can be used to identify high risk groups, who need special care, support, and bereavement interventions.

Mental health problems among the survivors in the hard-hit areas of the Yushu earthquake.

BACKGROUND: On April 14, 2010, an earthquake registering 7.1 on the Richter scale shook Qinghai Province in southwest China. The earthquake caused numerous casualties and much damage. The epicenter, Yushu County, suffered the most severe damage. As a part of the psychological relief work, the present study evaluated the mental health statuses of the people affected and identified the mental disorder risk factors related to earthquakes. METHODS: Five hundred and five earthquake survivors living in Yushu County were investigated 3-4 months after the earthquake. Participant demographic data including gender, age, marital status, ethnicity, educational level, and religious beliefs were collected. The Earthquake-Specific Trauma Exposure Indicators assessed the intensity of exposure to trauma during the earthquake. The PTSD Checklist-Civilian version (PCL-C) and the Hopkins Symptoms Checklist-25 (HSCL-25) assessed the symptoms and prevalence rates of probable Posttraumatic Stress Disorder (PTSD) as well as anxiety and depression, respectively. The Perceived Social Support Scale (PSSS) evaluated subjective social support. RESULTS: The prevalence rates of probable PTSD, anxiety, and depression were 33.7%, 43.8% and 38.6%, respectively. Approximately one fifth of participants suffered from all three conditions. Individuals who were female, felt initial fear during the earthquake, and had less social support were the most likely to have poor mental health. CONCLUSIONS: The present study revealed that there are serious mental problems among the hard-hit survivors of the Yushu earthquake. Survivors at high risk for mental disorders should be specifically considered. The present study provides useful information for rebuilding and relief work.

Post-traumatic stress disorder, anxiety and depression among the elderly: a survey of the hard-hit areas a year after the Wenchuan earthquake.

Few studies to date have examined psychological sequelae of natural disasters among the elderly in China. The aim of this study was to investigate the prevalence rates of probable post-traumatic stress disorder (PTSD), anxiety and depression in the elderly survivors a year after the Wenchuan earthquake as well as to analyse related risk factors. The community-based sample of the study consisted of 284 elderly survivors (≥60 years). PTSD was assessed by the PTSD Checklist--Civilian version, and anxiety and depression were assessed by the Hopkins Symptoms Checklist. In total, the estimated prevalence rates of probable PTSD, anxiety and depression were 26.3%, 42.9% and 35.2%, respectively. Nearly a fifth of the elderly participants reported symptoms that meet the criteria for all three of these mental disorders. Results indicated that some factors associated with earthquake-exposure intensity, which included loss of livelihood, bereavement, injury and initial fear during the earthquake, were among the significant risk factors for these mental disorders. Women had a higher risk of suffering from probable anxiety as compared to men. Finally, the significance and limitations of this study were also discussed.

Mental health problems among children one-year after Sichuan earthquake in China: a follow-up study.

BACKGROUND: On May 12, 2008, a destructive earthquake registering 8.0 on the Richter scale struck Sichuan Province, southwest China. Beichuan County was the epicenter which was one of the areas nearly completely destroyed by the earthquake. In Beichuan, about 15000 people died and 3000 people were missing. Specially, the earthquake took 1587 students' and 214 teachers' lives from the elementary and middle schools there. The main purpose of the study was to provide a better understanding of mental health problems and associated risk factors among children after earthquake. METHOD: Three hundred and thirty grades 3-5 children completed the questionnaire of disaster -related experience and the Trauma Symptom Checklist for Children-Alternate Version (TSCC-A). The first survey was carried out six months after the earthquake, and the second one was carried out six months later. The measurements and methodology applied in the two sessions were identical. RESULTS: The prevalence rates of the problems at two time-points were 23.3% and 22.7% for anxiety, 14.5% and 16.1% for depression, and 11.2% and 13.4% for PTSD, respectively. Among demographic variables, no significant age difference existed, while it was found that 6 months after the earthquake, symptoms of anxiety, depression and PTSD were significantly more common among students in grades 4 and 5 than those in grade 3, Initial exposure to death, bereavement and extreme fear were significant predictive factors for the occurrence of anxiety, depression and PTSD. CONCLUSIONS: Findings of this study suggest that posttraumatic mental health problems after natural disaster in children may have reached epidemic proportions and remain high for a long period. Psychologist and social workers should pay more attention to children who experienced more traumatic stresses and provide appropriate mental health interventions. Implications and limitations of these findings were discussed.

Confirmatory factor analysis of posttraumatic stress symptoms assessed by the Impact of Event Scale-Revised in Chinese earthquake victims: examining factor structure and its stability across sex.

The current study investigated the factor structure of posttraumatic stress symptoms assessed by the Impact Event Scale-Revised (IES-R) in a large sample of individuals from China who recently experienced a destructive earthquake. The results of the confirmatory factor analysis indicated that a four-factor structure (intrusion, avoidance-numbing, hyperarousal, and sleep disturbance) emerged as the model best fit in total sample, female and male subsamples, respectively. Moreover, multiple-group confirmatory factor analysis further demonstrated that the four-factor model was quite stable across sex. Implication and limitations for the results are discussed.

Comparing alternative factor models of PTSD symptoms across earthquake victims and violent riot witnesses in China: evidence for a five-factor model proposed by Elhai et al. (2011).

The present study investigated the factor structure of posttraumatic stress disorder (PTSD) symptoms measured by the PTSD Checklist (PCL) in two large samples exposed to different traumatic events (an earthquake and a violent riot) from China. Despite the samples' difference in type of trauma, demographics, symptom severity, and elapsed time since trauma exposure, the results of a series of confirmatory factor analyses indicate that a five-factor intercorrelated model (intrusion, avoidance, numbing, dysphoric arousal, and anxious arousal) fit the data significantly better than the other alternative models including: the three-factor DSM-IV model, the four-factor numbing model (King et al., 1998), and the four-factor dysphoria model (Simms et al., 2002) in both samples. Implications and limitations regarding the results are discussed.

Response inhibition in adolescent earthquake survivors with and without posttraumatic stress disorder: a combined behavioral and ERP study.

The aim of this study was to investigate whether adolescent patients with posttraumatic stress disorder (PTSD) show an impairment of executive control in a response inhibition task and to investigate its neurophysiological correlates using event-related potentials (ERPs). We analyzed data from 25 Wenchuan earthquake survivors between 15 and 19 years of age (16 diagnosed with PTSD) using a Go/NoGo task. The PTSD group made more commission errors than the non-PTSD group, indicating impairment in response inhibition. The PTSD group responded faster to Go trials and there was a significant negative correlation between their reaction time and commission/omission errors, reflecting a speed-accuracy tradeoff for the PTSD group. The PTSD group exhibited a shorter NoGo-N2 latency than the non-PTSD group, suggesting faster monitoring or detection of the response conflict. These results suggest that the impairment of response inhibition in adolescent participants with PTSD is related to their impulsive cognitive functioning.