Psychological distress after the Great East Japan Earthquake: two multilevel 6-year prospective analyses.

BACKGROUND: The Great East Japan Earthquake of 11 March 2011 led to the relocation of 300 000 survivors. Studies following disasters focus primarily on data collected in the immediate aftermath and neglect the influence of wider community factors. AIMS: A three-level prospective study examining associations between survivors' psychological distress and individual- and social-level factors in the 6 years following a complex disaster. METHOD: We drew on two multi-wave data collections in the 6 years after the earthquake, using residents from different forms of housing. Sample 1 included six waves of private-housing residents from 2011 to 2016 (n = 1084 per wave), sample 2 five waves of residents living in prefabricated housing from 2012 to 2016 (n = 1515 per wave). We analysed prospective associations between distress and time (level 1), pre-existing disorders and disaster experiences and behaviours (level 2) and city-wide measures of support and physical activity (level 3). RESULTS: Multilevel models with random coefficients demonstrated greater distress in earlier waves (samples 1 and 2 respectively, adjusted ß = -15 and ß = -0.16, P < 0.001), among female respondents (ß = 0.58, P = 0.01 and ß = 1.74, P = 0.001), in those with a previous psychiatric history (ß = 2.76, ß = 2.06, P < 0.001) with diminished levels of activity post-earthquake (ß = 1.40, ß = 1.51, P < 0.001) and those lacking in social support (ß = 1.95, ß = 1.51, P < 0.001). Support from spouses and friends was most protective of psychological health. City-level support was negatively associated with distress, but only among those in prefabricated housing. CONCLUSIONS: Psychological distress diminished with time, but varied across gender, psychiatric history, housing, levels of activity and availability of social support. Practitioners should consider individual- and city-level factors when devising effective interventions.

Exploring the influence of culture on hearing help-seeking and hearing-aid uptake.

OBJECTIVE: The purpose of this paper was to highlight the importance of cultural influence in understanding hearing-help seeking and hearing-aid uptake. DESIGN: Information on audiological services in different countries and 'theories related to cross-culture' is presented, followed by a general discussion. STUDY SAMPLE: Twenty-seven relevant literature reviews on hearing impairment, cross-cultural studies, and the health psychology model and others as secondary resources. RESULTS: Despite the adverse consequences of hearing impairment and the significant potential benefits of audiological rehabilitation, only a small number of those with hearing impairment seek professional help and take up appropriate rehabilitation. Therefore, hearing help-seeking and hearing-aid uptake has recently become the hot topic for clinicians and researchers. Previous research has identified many contributing factors for hearing help-seeking with self-reported hearing disability being one of the main factors. Although significant differences in help-seeking and hearing-aid adoption rates have been reported across countries in population studies, limited literature on the influence of cross-cultural factors in this area calls for an immediate need for research. CONCLUSIONS: This paper highlights the importance of psychological models and cross-cultural research in the area of hearing help-seeking and hearing-aid uptake, and consequently some directions for future research are proposed.

Gender differences in psychological reactions to Hurricane Sandy among New York Metropolitan Area residents.

Hurricane Sandy was a natural disaster of large proportions--a category 3 storm at its peak intensity that struck New York Metropolitan Area on October, 2012. The death and destruction caused by a hurricane can rise numerous of mental health vulnerabilities such as, acute stress disorder, posttraumatic stress disorder, depression, and anxiety. Gender has been identified as one critical variable that can impact vulnerability to adverse effects of trauma, as well as how these reactions are managed. The present research provides an evaluation of gender differences regarding posttraumatic stress symptoms, recollections of national disasters and fears of future negative life events. It also aims to explore information seeking and sources of assistance that were utilized during Hurricane Sandy. An online survey sample of 1,000 people from New York Metropolitan Area completed a battery of self-report questionnaires four weeks after the storm. Results revealed that recollections of national disaster and fear of future events were found to be significantly different among women compared to men. Additionally, women were more inclined toward information seeking through Facebook than men, although no gender differences emerged when examining sources of support. The results indicate that disaster practitioners should tailor gender sensitive interventions.

Early responses to H7N9 in southern Mainland China.

BACKGROUND: H7N9 posed potentially serious health challenges for Chinese society. The previous SARS outbreak in this country was accompanied by contradictory information, while worries about wide-spread influenza led to discrimination worldwide. Early understanding of public threat perceptions is therefore important for effective public health communication and intervention. METHODS: We interviewed 1011 respondents by phone two weeks after the first case. Questions examined risk awareness and media use, beliefs about the emergence of the threat and those most at risk, anxiety about infection and preventive and avoidant behaviours. RESULTS: Results demonstrate moderate levels of anxiety but relatively high levels of trust towards government officials. Threat emergence was associated with hygiene levels, temperature change, floating pigs in the Huangpu River and migration to the city. Anxiety predicted both recommended and non-recommended behavioural changes. CONCLUSIONS: Comparatively high levels of trust in Chinese government advice about H7N9 contrast positively with previous pandemic communications in China. Anxiety helped drive both recommended and non-recommended behaviours, with potentially important economic and social implications. This included evidence of 'othering' of those associated with the threat (e.g. migrants). Findings emphasise the need to manage public communications early during new influenza outbreaks.

Not so close but still extremely loud: recollection of the World Trade Center terror attack and previous hurricanes moderates the association between exposure to hurricane Sandy and posttraumatic stress symptoms.

BACKGROUND: The present study examined whether recollections of the World Trade Center (WTC) terror attack and previous hurricanes moderated the relationship between exposure to Hurricane Sandy and related posttraumatic stress disorder (PTSD) symptoms. METHODS: An online sample of 1000 participants from affected areas completed self-report questionnaires a month after Hurricane Sandy hit the East Coast of the United States. Participants reported their exposure to Hurricane Sandy, their PTSD symptoms, and recollections of the WTC terror attack and previous hurricanes elicited due to Hurricane Sandy. RESULTS: Exposure to Hurricane Sandy was related to PTSD symptoms among those with high level of recollections of the WTC terror attack and past hurricanes, but not among those with low level of recollections. CONCLUSIONS: The aftermath of exposure to Hurricane Sandy is related not only to exposure, but also to its interaction with recollections of past traumas. These findings have theoretical and practical implications for practitioners and health policy makers in evaluating and interpreting the impact of past memories on future natural disasters. This may help in intervention plans of social and psychological services.

The long-term effects of war exposure on psychological health: An experimental study with Turkish conscript veterans.

The study of the effects of war exposure on the psychological health of combatants has so far been constrained by possible selection biases which limits the establishment of causality, the clear identification of dynamics, and the generalizability of findings. In this study, we make use of a population-level natural experiment enabled by the strict military conscription system in Turkey which uses a draft lottery to randomly allocate conscripts to bases across the country, including those south-eastern areas experiencing a long running civil conflict. We build on this setting with a representative field survey of 5024 adult males. Our results indicate that those exposed to high intensity armed conflict environments during their service are more likely to experience depressive symptoms even long after their discharge. Further detailing conflict exposure, we find war traumas to be the primary drivers of the effects we observe.

Effectiveness of online social networking interventions on social isolation and quality of life of people with psychosis: A systematic review.

BACKGROUND: Social isolation is frequent in people with psychosis, contributing to negative health outcomes. Interventions including online social networking (OSN) may overcome some psychosis-related barriers and facilitate social interactions. However, evidence is currently sparse and needs to be collated in a systematic review to better understand effectiveness. METHOD: Following PRISMA guidelines, this review yielded 9835 results. Eleven publications, reporting data from five RCTs and six non-controlled studies, met the inclusion criteria. Two independent reviewers undertook data extraction and quality assessment, with results narratively synthesised. RESULTS: This review looked broadly at interventions including either purpose-build platforms for peer-to-peer interactions or existing OSN tools. Yet, we only identified interventions utilising purpose-designed platforms. Early small-scale studies suggested OSN interventions reduced social isolation, but larger effectiveness studies did not confirm these effects. No improvements in quality-of-life outcomes were identified. CONCLUSION: Higher quality and longer-term studies did not support effectiveness of current OSN interventions in reducing social isolation or improving quality of life of people with psychosis. These interventions used purpose-built platforms and encouraged OSN between selected individuals, which may explain these outcomes. Future research may explore promoting safe use of mainstream OSN platforms to expand the social networks of individuals with psychosis.

Level and factors of support for the Living with the Virus policy in a Chinese adult general population: a mediation analysis via positive and negative attitudes toward the policy.

Background: This study investigated the public's support for the Living with the Virus (LWV) policy, its associated factors, and related mediations at a time when more countries were considering adopting the LWV policy amid the COVID-19 pandemic. Methods: A random, population-based telephone survey was conducted among 500 Chinese adults in Hong Kong during March/April 2022. Results: 39.6% of the participants were supportive/strongly supportive of the LWV policy. Perceived efficacy of the control measures was negatively associated with the support and was partially mediated via the perception that the policy would greatly improve the economy/daily life of the policy. Perceived physical harms of the Omicron variant was negatively associated with the support and was fully mediated via perceived negative impacts of the policy. 26.2%/54.6% believed that the policy would improve the economy/daily life greatly; about 40% perceived negative impacts on deaths and the medical system due to the policy. COVID-19 ever infection did not significantly moderate the studied associations. Conclusion: The public was split regarding the support for the LWV policy and whether it would cause better economy/daily life, unnecessary deaths, and the collapse of the medical system. Health communication is needed in shifting toward the LWV policy.

Values and love styles in Turkey and Great Britain: an intercultural and intracultural comparison.

Little previous research has examined the relationship between values and love styles, and none has done so across cultures or intracultural regions. This research was the first attempt to explore the correlation between individual-level values and love styles, and examined both within- and between-cultural variations in love styles. In this study 224 participants from Turkey and Britain, from urban or rural locations, completed the Portrait Values Questionnaire and the Love Attitudes Scale measure of love styles. Pancultural analyses demonstrated significant correlations between certain value dimensions and love styles. In particular, agape (selfless love) was positively correlated with self-transcendence, ludus (game-playing love) was positively correlated with self-enhancement, and pragma (realistic love) was positively correlated with conservation. The inclusion of location and nationality and their interactions with values in the multiple regression analyses significantly increased the variance explained by values for five of the six love styles. Multivariate analyses indicated that ludus, storge, mania, and pragma were all significantly higher among Turkish respondents; pragma, mania, and agape all higher amongst rural respondents. Eros was highest among rural British respondents; storge, pragma, and agape highest among rural Turks. When these culture effects were explored, conservation significantly mediated the relationship between the groups of more conservative rural Turks (versus other participants) and both pragmatic and storgic love styles. Findings are discussed in the light of disparities in values and relationship styles within cultures, and the need to include both intracultural and intercultural variations in cross cultural research.

A cross-disasters comparison of psychological distress: Symptoms network analysis.

Large-scale traumatic events have the potential to trigger psychological distress, particularly among those in the affected areas. However, the manifestation of psychological distress may vary across different types of disasters. This study thus aimed to compare the symptoms network structure of psychological distress as assessed by the Kessler Psychological Distress Scale across three types of disasters: Terror (n = 5842), COVID-19 (n = 2428), and a nature-related disaster (n = 1001). Across disasters, two communities representing depression and anxiety symptoms were revealed. However, while after a nature-related disaster and the COVID-19 pandemic depression and anxiety items were interconnected via hopelessness, a terror attack resulted in more separated manifestations of anxiety and depression. Examination of symptom centrality showed that while in the Terror and the COVID-19 networks "depressed/no cheering up" was most connected to other symptoms, for the nature-related disaster network, two items were most central: "depressed/no cheering up" and "restless or fidgety". The results may point to different mechanisms of psychological distress structures after different disasters. Depending on the type of disaster, trauma-focused interventions may require targeted support and treatment.

PTSD symptoms among civilians being displaced inside and outside the Ukraine during the 2022 Russian invasion.

The 2022 Russian invasion of the Ukraine created a large-scale humanitarian crisis. PTSD symptoms are common amongst refugees but there is less information on the mental health of internally displaced peoples. We examined a national sample of 2,000 Ukrainians during the Russian invasion, assessing PTSD symptoms using the recent ICD-11 Results showed that displacement was associated with PTSD symptoms (non-displaced M = 11.02 [SD = 4.88], displaced within the Ukraine M = 12.55 [SD = 4.94]; displaced outside the Ukraine M = 12.90 [SD = 4.61]; F (2,1999) = 21.93; p <0.001). Findings underline the risk to those displaced inside their own country in addition to those displaced overseas.

Disability and post-traumatic stress symptoms in the Ukrainian General Population during the 2022 Russian Invasion.

AIMS: Previous research has shown that people with disabilities are disproportionately vulnerable to symptoms of psychological distress after exposure to armed conflict. Past work has also shown that individuals displaced by conflict are at heightened risk of post-traumatic stress. Using a national online sample of Ukrainians in the early weeks of the 2022 Russian invasion, we aim to examine associations between functional disability and symptoms of post-traumatic stress. METHODS: We examined the association between levels of functional disability in the Ukrainian population and symptoms of post-traumatic stress during the 2022 Russian invasion of Ukraine. We analysed data from a national sample of 2000 participants from across this country, assessing disability using the 12-item World Health Organization Disability Assessment Schedule (WHODAS-12)(six domains of disability) and the International Trauma Questionnaire assessment of post-traumatic stress disorder (PTSD) symptomatology according to the Eleventh Edition of The International Classification of Diseases (ICD-11). Moderated regression examined the impact of displacement status on the disability-post-traumatic stress relationship. RESULTS: Different domains of disability predicted post-traumatic stress symptoms (PTSSs) to varying extents, with overall disability score significantly associated with PTSSs. This relationship was not moderated by displacement status. Consistent with previous research, females reported higher levels of post-traumatic stress. CONCLUSIONS: In a study of a general population during a time of armed conflict, individuals with more severe disabilities were at greater risk of PTSSs. Psychiatrists and related professionals should consider pre-existing disability as a risk factor for conflict-related post-traumatic stress.

The Ukraine-Russia war: A symptoms network of complex posttraumatic stress disorder during continuous traumatic stress.

OBJECTIVE: This study is aimed to test the symptoms network of International Classification of Diseases, 11th Revision (ICD-11) complex posttraumatic stress disorder (CPTSD) symptoms, using data collected from Ukrainian civilians during the 2022 Russia-Ukraine war. Findings can inform our understanding of the stress response in individuals exposed to continuous trauma and give insight into the nature of CPTSD during the war. METHOD: A network analysis was conducted on CPTSD symptoms as assessed by the International Trauma Questionnaire using data from a nationally representative sample of 2,000 Ukrainians. RESULTS: While PTSD and disturbances in self-organization clusters did not enmesh, several communities within these clusters were merged. Results highlight that in terms of strength centrality, emotional dysregulation (emotional numbing) and a heightened sense of threat (SoT) were most prominent. CONCLUSION: The results confirm the ICD-11 structure of CPTSD but suggest that continuous traumatic stress manifests in more condensed associations between CPTSD symptoms and that emotional regulation may play a vital role in activating the CPTSD network. War-exposed populations could be provided with scalable, brief self-help materials focused on fostering emotion regulation and an SoT. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Anxiety, past trauma and changes in relationships in Japan during COVID-19.

Widely shared traumas have the potential to both improve and impair our relationships with others. During COVID-19 anxiety has been seen as a major individual vulnerability associated with relationship change, as have the wider economic, situational factors facing families and communities. In this national sample of 997 Japanese respondents we assessed perceived relationship changes in couple relations, neighbourhood relations, and wider relations with Japanese nationals, alongside anxiety, exposure to previous mass traumas, household economics, education, and vulnerability to COVID-19. Whilst most respondents reported little change in their relationships during this year there was a small overall improvement in couple relationships and a decline in relations with wider communities. Participant's economic resources were positively associated with an improvement in couple relationships, while anxiety was associated with a decline in relations with both the neighbourhood and the wider society. While neither prior experience of mass trauma, nor education or health vulnerability to COVID-19, were associated with relationship change, having time to talk, and younger age, was positively associated with improvement in couple relations. Findings suggest that anxiety can function to distance relationships during a time of stress, but perceived changes in relationships are little effected by experience of previous trauma. Relationship growth is likely to be greatest in those with better economic conditions. Practitioners need to be mindful of the impact of enhanced anxiety during the pandemic on interpersonal relations, and a potential threat to the relationships of older couples during this time of pandemic threat.

Legal restrictions and mitigation strategies amongst a disabled population during COVID-19.

The impact of physical disability on protective behaviors during COVID-19 has been little studied. This retrospective study compared the 699 the self-declared behaviors of 699 people with disabilities before and after the relaxation of COVID-19 restrictions in England. We found that people with disabilities in England showed high compliance with protective behaviors and mitigation strategies during a period of legal restrictions. Following the lifting of restrictions, respondents engaged in less social mixing, fewer distancing and hygiene behaviors and were less likely to use face coverings. Hierarchical regressions revealed that socio-economic status, age, and gender moderated protective behaviors: while those with higher socio-economic status were more relaxed with regard to hygiene and distancing behaviors, they were more cautious about mixing with others after the end of restrictions. Age, (male) gender, and being unvaccinated were positively associated with relaxation in the use of facemasks in public places, not needing a carer with fewer out-of-home visits. Taken together these findings suggest that the removal of restrictions had an unequal impact on the population of England, placing a disproportionate burden on some people with disabilities.

Can patriotism be a protective factor for symptoms of post-traumatic stress disorder? The case of the Russia - Ukraine 2022 war.

The 2022 Russian invasion of the Ukraine created a large-scale humanitarian crisis that has intensified as the conflict persists. The impact of armed conflict, such as forced migration, exposure to violence, supply shortages, destruction of infrastructure, and interruption of essential services, can have serious negative consequences for the mental health and wellbeing of Ukrainians living through the invasion and its aftermath. At the same time threat to a nation can trigger a wave of patriotism. Such feelings of patriotic belonging, love, pride and caring for a country can help maintain national group cohesion and respect for civic authorities. We studied demographic and war related factors associated with patriotic attitudes and posttraumatic stress disorder (PTSD) symptoms in a national Ukraine sample of 2000 respondents six weeks into this crisis. Respondents completed an online inventory assessing patriotic attitudes, PTSD symptoms, having relatives wounded or killed, having relatives who left Ukraine due to the war, alongside key demographics. Hierarchical regressions found that having relatives that were wounded or that left Ukraine because of the war and those coming from a Ukrainian speaking region were associated with patriotic attitudes. Patriotic attitudes were positively associated with elevated risk for PTSD symptoms. Mental health professionals should consider the potential mental health burden of existential national conflicts amongst civilian populations with strongly patriotic attitudes.