Posttraumatic stress disorders in the Nanai after pollution of the Amur River: ethnocultural analysis.

OBJECTIVES: Chemical pollution of the Amur River has seriously damaged traditions and caused posttraumatic stress disorder (PTSD) among the Nanai, the indigenous people living along this river. This study was performed to clarify the ethnographic characteristics of PTSD in this unique population. METHODS: The study group consisted of 75 male and 112 female randomly selected volunteers. PTSD severity measured using scores of the Impact of Event Scale--Revised (Total-I) and Clinical-Administered PTSD Scale (Total-C) was estimated according to demographic and ethnocultural backgrounds, clinical status, and ethnopsychological attitudes toward the Amur River. RESULTS: The differences in averages of Total-I and Total-C were not always the same in the groups divided by ethnographic information. Logistic regression analysis with a dependent variable, possibly without PTSD (Total-I <34 and Total-C <40)/possibly with PTSD (either Total-I ≥34 or Total-C ≥40), and categorical independent variables using ethnographic information extracted a low score when 'priority values' and 'the Amur River for me is' was "profession" and a high score when 'dominant role in spousal relationship' was "self," when 'predominant forms of response in stressful situations' was "try to organize," when 'preferred method of medical treatment' was specific for the Nanai, when "rely on something mystical" was manifested, and when the Amur River was believed to be "sacred". CONCLUSION: Those with a pragmatic attitude were less likely to have PTSD. However, those who were required to make decisions within close relationships and were intimate with the Nanai tradition and the Amur River had increased likelihood of PTSD.