A national survey of pandemic fear and cyberchondria after ending zero-COVID policy: The chain mediating role of alexithymia and psychological distress.

BACKGROUND: More than half the domestic population in China were infected with COVID-19 in two months after ending "zero-infection policy", which severely overwhelmed frontline healthcare providers with stress and fear. However, there is no study to date investigating the associations between nurses' fear of pandemic and cyberchondria. This study aimed to 1) investigate the correlations between fear pandemic and cyberchondria among frontline nurses, and 2) discover its potential mechanism. METHODS: A cross-sectional sample of frontline nurses (N = 8161) was recruited from 98 hospitals across China in February 2023. Participants were invited to complete an online, self-rated standardized questionnaire focused on pandemic fear, alexithymia, psychological distress, and cyberchondria. Environmental, clinical and socioeconomic information were collected for adjustment while conducting chain mediation analysis. RESULTS: When other covariates were controlled, it was found that fear of the pandemic significantly contributed to cyberchondria (b = 0.58, 95%CI [0.56, 0.60], p < .001). The chain mediation model suggested that both alexithymia and psychological distress were mediating factors between pandemic fear and cyberchondria. CONCLUSIONS: The higher the perceived fear, the greater the cyberchondria, which suggests that reducing fear about the pandemic and providing adequate support could reduce the incidence of cyberchondria. As alexithymia and psychological distress may be transdiagnostic mechanisms between fear and cyberchondria, targeted interventions focused on expression dysregulation and emotional identification could be useful.

Predictive effects of organizational justice on job satisfaction in bus drivers: the moderating effects of role overload and proactive personality.

BACKGROUND: There have been few longitudinal studies on Chinese bus drivers and the individual differences in the relationships between organizational justice and job satisfaction. This study examined the organizational justice and job satisfaction in bus drivers and the individual differences in this relationship. METHODS: A two-wave longitudinal study design was employed. A first survey was conducted on 513 Chinese bus drivers in October 2021 that collected socio-demographic information and asked about their perceptions of organizational fairness. A second survey was conducted six months later that asked about role overload and job satisfaction and assessed their proactive personality type. An effect model was then used to explore the moderating effects of role overload and proactive personality type on the relationships between organizational justice and job satisfaction. RESULTS: Both procedural and interactive justice predicted the bus drivers' job satisfaction. Proactive personalities and role overload were found to enhance this relationship. CONCLUSIONS: Organizations could benefit from screening at the recruitment stage for drivers with highly proactive personalities. Relevant training for drivers with low proactive personalities could partially improve employee job satisfaction. When viewed from a Chinese collectivist cultural frame, role overload could reflect trust and a sense of belonging, which could enhance job satisfaction. Finally, to improve employee job satisfaction, organizations need to ensure procedural and interactive justice.

Physical-cyber-human framework-based resilience evaluation toward urban power system: Case study from China.

Because the increased frequency, intensity, and duration of extreme weather events have significantly challenged power systems, there has been an increased interest in resilient power systems. This article establishes a multicriteria resilience evaluation framework for urban power systems from a physical-cyber-human system perspective, in which the two principal elements responsible for power system function degradation are described, the three major domains comprising urban power systems are explained, four core capacities that positively contribute to power system resilience are proposed, and 15 (11 objective and four subjective) power system resilience evaluation indicators are identified. Fuzzy hesitant judgment and a Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) aggregation method are employed to minimize the expert divergence and maximize the group consensus. A validation method is designed and a comparison with commonly applied performance-based and attributes-based evaluation methods is conducted. The applicability of the evaluation framework is verified using data from four Chinese municipalities: Shanghai, Beijing, Chongqing, and Tianjin. It was found that Shanghai's resilience was the best, and Chongqing's physical resistance disadvantages would result in the greatest difficulties in coping with extreme event disturbances. Physical, cyber, and human domain resilience enhancement strategies are given for different cities separately. This study provides a practical tool to evaluate, compare, and enhance power system resilience for governments and public utilities.

The role of alexithymia in the mental health problems of home-quarantined university students during the COVID-19 pandemic in China.

OBJECTIVE: While it is well known that mental health problems are common consequences of deadly pandemics, the association with alexithymia is less clear. This study examined this association in an evaluation of home-quarantined university students during the 2019/2020 COVID-19 pandemic in China. METHODS: In total, 2501 home-quarantined students from six southwest Chinese universities completed the following questionnaires: the 20-item Toronto Alexithymia Scale (TAS-20), the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C), and the Patients Health Questionnaire-9 (PHQ-9), after which structural equation modeling (SEM) and mediation analyses were employed to extract and evaluate the possible associations. RESULTS: It was found that participants with probable depression or PTSD also reported more severe alexithymia features, such as difficulties in identifying feelings (DIF) or describing feelings (DDF). Alexithymia was also found to partially mediate the effect of number of exposures on mental health problems. CONCLUSION: These results suggested that implementing strategies to assist young people identify and deal with their own emotions and those of others could prevent or mitigate the mental health problems associated with deadly pandemic events. However, future longitudinal studies are needed to examine the specific involvement of DIF or DDF in people with mental health problems.

Associations of Suicidality with Adverse Life Events, Psychological Distress and Somatic Complaints in a Chinese Medical Student Sample.

The present study aimed to examine the associations of suicidality with psychological distress, somatic symptoms, and stressors in medical school students. We conducted a cross-sectional survey of medical students at a large, top-ranked medical school. A total sample of 662 medical students (269 men) completed a battery of self-reported questionnaire. Of the respondents, 136 (20.5%) reported having suicidal ideation, 40 (6.0%) reported having planned suicide, and 10 (1.5%) reported having attempted suicide during the previous year. Students from rural areas and the 3rd year of study reported higher levels of suicidal ideation than their counterparts. General pain/fatigue was associated with suicidal ideation and planning, while interpersonal difficulties were associated only with suicidal ideation. This study provides evidence linking severe psychological distress, general pain/fatigue, interpersonal stress and psychosocial factors with suicide risk among Chinese medical students which provides targets for future psychological interventions.

Negative life events and post-traumatic stress disorder symptoms: a moderated mediation model of only-child status and depressive symptoms.

OBJECTIVES: Post-traumatic stress disorder symptoms (PTSS) and depressive symptoms are the most common adolescent psychological effects from earthquakes, with negative life events significantly influencing PTSS prolongation. However, the underlying mediating and moderating mechanisms that connect negative life events with PTSS remain unclear. The purpose of this study was to investigate (i) the mediating role of depressive symptoms on negative life events and PTSS and (ii) the moderating role of only-child status in the direct and indirect relationship between negative life events and PTSS, 3 years after the 2013 Ya'an earthquake in China. STUDY DESIGN: Quantitative study using data from the Ya'an earthquake. METHODS: Three years after the 2013 Ya'an earthquake, 4402 adolescent survivors in Lushan county were surveyed using the Adolescent Self-Rating Life Events Check list to assess the psychological effects of negative life events in the previous 12 months. In addition, the short Mood and Feeling Questionnaire and The Children's Revised Impact of Event Scale were used to assess depressive symptoms and PTSS severity, respectively. RESULTS: After controlling for gender and age, negative life events were found to be significantly positively associated with PTSS. The mediation analyses revealed that depressive symptoms mediated the association between negative life events and PTSS; however, the moderated mediation analysis found the association was much weaker for only children. CONCLUSION: The findings supported and clarified the interrelations and associations between negative life events, depressive symptoms and PTSS. The conditional process analyses found that only-child status moderated not only the direct associations but also the relationship between negative life events and depressive symptoms. Our findings highlight the need for intervention programmes targeting adolescents, especially for children with siblings.

Risk Factors of Post-traumatic Stress and Depressive Disorders in Longmenshan Adolescents After the 2013 Lushan Earthquake.

This study examined the severity of post-traumatic stress and depressive disorders in Longmenshan adolescents after the 2013 Lushan earthquake, as well as relationships among earthquake-related exposure, post-earthquake negative factors, previous exposure to the 2008 Wenchuan earthquake, and level of earthquake impact (city). A cross-sectional survey was conducted among adolescents in Lushan (n = 1416), Baoxing (n = 1102) and Tianquan (n = 1265) at 3 years after the Lushan earthquake. Respondents were evaluated using the Earthquake Experience Scale, the Adolescent Self-rating Life Events Checklist (ASLEC), the Children's Revised Impact of Event Scale (CRIES-13), and the Depression Self-Rating Scale (KADS-6). High levels of post-traumatic stress and depression symptoms were found among adolescents in the most heavily affected cities, and these symptoms were more severe in respondents exposed to the 2008 earthquake. PTSD correlated most strongly with earthquake exposure, whereas depression correlated most strongly with psychosocial stressors following the event.

The Prevalence of PTSD Symptoms and Depressive Symptoms and Related Predictors in Children and Adolescents 3 Years After the Ya'an Earthquake.

The objectives of this study were to investigate the prevalence of post-traumatic stress disorder (PTSD) symptoms and depressive symptoms in teenage survivors three years after the Ya'an earthquake to assess the differences between left-behind (LBC) and non-left-behind (non-LBC) children, and to explore predictors for PTSD symptoms and depressive symptoms. The participants were assessed using children's revised impact of event scale (CRIES) and short mood and feelings questionnaire (SMFQ), after which t tests, Chi square tests, and a multivariate logistic regression were conducted to examine the differences in the LBC and identify the associated predictors. It was found that the PTSD and depressive symptom prevalences were 13.10% and 20.75%, with the LBC having a significantly higher prevalence than the non-LBC. The PTSD and depression symptoms tended to be highly comorbid (r = .52, p < .001). Being female, being aged less than 15, having siblings, being an LBC, and having higher exposure were found to be associated with PTSD and depressive symptoms.

Leader-follower game-theoretic method towards carbon-economy trade-off in a key construction project group.

Due to rapid urbanization and modernization, the construction sector now generates one third of all greenhouse gas emissions in China. Using an equilibrium strategy combined with the carbon allowance allocation, this study presents a synergistic Stackelberg model based on a construction project planning framework to deal with cumulative CO2 emissions. The bi-level model simultaneously considers the sequential decision-making relationship between the authority (leader) and the enterprises' interactive objectives and constraints. Unlike previous research, this bi-level model gives a holistic analysis of the interactivity of multiple stakeholders, thereby enabling the inherent conflicts and equilibrium between environmental protection and decision makers' profits to be reconciled and balanced. To deal with the bi-level model complexity, an interactive solution method that integrates an evolutionary mechanism and improved particle swarm optimization (IPSO) is designed for solving a construction supply planning problem. The robustness and practicality of the proposed methodology are then validated in a real world case, and sensitivity analyses under different carbon emissions quotas are also given. The results indicate that the methodology can systematically reduce carbon emissions in the Chinese construction sector, and when the authority has a strict emissions reduction altitude, construction practitioners are able to attain high carbon efficiencies; therefore, the model provides valuable strategy guidance for policymakers and business executives.

Long-term low-dose morphine for patients with moderate cancer pain is predominant factor effecting clinically meaningful pain reduction.

PURPOSE: Patients with cancer often experience pain that affects their daily activities and quality of life. The analgesic ladder recommended by the World Health Organization has proved insufficient for many, and its scientific basis has been questioned. This retrospective study investigated factors related to adherence to long-term opioid therapy for patients with moderate cancer pain, including an evaluation of low-dose morphine relative to tramadol. METHODS: Clinical data were collected of patients with moderate cancer pain (n = 353) who received either low-dose morphine or tramadol and were followed for ≥ 27 weeks. Factors related to regime adherence were investigated, including the analgesia type, cancer therapy (antitumor therapy or palliative care), pain type (nociceptive, neuropathic, or mixed), and living distance to the hospital. Factors related to clinically meaningful pain reduction (≥ 30% reduction in pain from baseline) were also investigated. RESULTS: Patients taking tramadol, receiving antitumor therapy, experiencing neuropathic pain, and living far from the hospital were more likely to change analgesic strategy compared with, respectively, patients receiving low-dose morphine, palliative care, experiencing nociceptive pain, and living nearby. Factors that increased the likelihood of adherence to the analgesic regime were also associated with the likelihood of clinically meaningful pain reduction. Among adverse effects, a significantly higher percentage of patients experienced constipation in the tramadol group compared with those given morphine. CONCLUSIONS: Among patients with moderate cancer pain, long-term low-dose morphine was safe and more effective than tramadol for clinically meaningful pain reduction, and patients were less likely to change the analgesic strategy.

Post-traumatic stress disorder, anxiety and depression symptoms among adolescent earthquake victims: comorbidity and associated sleep-disturbing factors.

PURPOSE: Our study aimed to examine the prevalence of psychiatric symptoms and their comorbidity and correlation with sleep problems among adolescent survivors 3 years after the 2013 Ya'an earthquake. METHODS: A representative sample of 6132 adolescent students was analysed from 11 primary and high schools in the three counties most severely affected by the earthquake. Students were invited to complete the Pittsburgh Sleep Quality Index, Children's Revised Impact of Event Scale-13, Short Mood and Feelings Questionnaire, the Adolescent Self-Rating Life Events Checklist, and Screen for Child Anxiety-Related Emotional Disorders. RESULTS: Three years after this major earthquake, 1-month prevalence of mental health problems was 13.1% for PTSD, 37.3% for anxiety, and 19.8% for depression. Among the participants who reported PTSD, 71.5% also reported anxiety, and 49.7% also reported depression. At least half of those with any type of mental health problem reported concurrent sleeping problems. Specific sleep risk factors were independently associated with increased risk of PTSD, depression or anxiety. Girls were more likely than boys to exhibit symptoms of PTSD, depression or anxiety. Older adolescents were more likely to have depression and anxiety. CONCLUSIONS: Mental health problems are prevalent with high comorbidity and are associated with sleep-related problems among adolescent survivors, even years after the occurrence of a major earthquake. Nightmares and difficulty initiating sleep are independently associated with PTSD. Insufficient sleep is independently associated with anxiety and depression. Sleep-related problems may be effective targets of preventive interventions, which may need to be optimised for gender and age.

Equilibrium approach towards water resource management and pollution control in coal chemical industrial park.

In this study, an integrated water and waste load allocation model is proposed to assist decision makers in better understanding the trade-offs between economic growth, resource utilization, and environmental protection of coal chemical industries which characteristically have high water consumption and pollution. In the decision framework, decision makers in a same park, each of whom have different goals and preferences, work together to seek a collective benefit. Similar to a Stackelberg-Nash game, the proposed approach illuminates the decision making interrelationships and involves in the conflict coordination between the park authority and the individual coal chemical company stockholders. In the proposed method, to response to climate change and other uncertainties, a risk assessment tool, Conditional Value-at-Risk (CVaR) and uncertainties through reflecting parameters and coefficients using probability and fuzzy set theory are integrated in the modeling process. Then a case study from Yuheng coal chemical park is presented to demonstrate the practicality and efficiency of the optimization model. To reasonable search the potential consequences of different responses to water and waste load allocation strategies, a number of scenario results considering environmental uncertainty and decision maker' attitudes are examined to explore the tradeoffs between economic development and environmental protection and decision makers' objectives. The results are helpful for decision/police makers to adjust current strategies adapting for current changes. Based on the scenario analyses and discussion, some propositions and operational policies are given and sensitive adaptation strategies are presented to support the efficient, balanced and sustainable development of coal chemical industrial parks.

Mental health problems among children and adolescents experiencing two major earthquakes in remote mountainous regions: A longitudinal study.

OBJECTIVE: Millions of children were exposed to major earthquake in China, with serious psychological and developmental consequences. To obtain accurate rate of post-disaster related disorder and identify predictors may help inform post-disaster rescue and rehabilitation efforts. The present longitudinal study explored correlations of demographic and socioeconomic characteristics of juvenile survivors of the Ya'an and Wenchuan earthquakes in China with their trajectories of post-disaster related disorder. METHODS: A total of 435 Chinese children and adolescents who survived the 2013 Ya'an earthquake were recruited from six primary, secondary and high schools in Baoxing County. All survivors were assessed at 12months after the disaster, when a trained psychiatrist assessed mental health problems in a face-to-face structured interview, and 153 survivors were followed up at 30months after the earthquake via telephone. RESULTS: The 12-month assessment indicated a post-traumatic stress disorder (PTSD) prevalence of 43.9% as well as depression (20.9%) or the criteria for both PTSD and depression (18.2%) and the other disorder (0.9%). The 30-month assessment indicated that 15.7% of subjects met the criteria for PTSD, 21.6% met the criteria for depression. No subjects met the criteria for other affective or anxiety disorders. Significant predictors of PTSD and depression were death in the family, previous earthquake experience, a poor parent-child relationship and economic pressure or poverty. LIMITATIONS: Clinical interview face to face is quite different from via telephone and the attrition rate in the longitudinal cohort is high, which would directly affect our results of the assessment. CONCLUSIONS: PTSD and depression may be as prevalent and persistent in disaster victims in China as elsewhere, and high co-comorbidities remain poorly understood. Although many adolescents recover over time, some exhibit chronic, delayed-onset PTSD and depression, especially those with poor relationships with their parents or those living in precarious economic conditions. Family-based therapy may be needed to support child and adolescent trauma survivors in order to prevent mental illness.

Association Between Resilience and Quality of life in Wenchuan Earthquake Shidu parents: The Mediating Role of Social Support.

Of the Wenchuan earthquake victims, there was a special group who lost their only child, known as the Shidu parents. The purpose of this paper is to examine social support as a moderator between resilience and quality of life (QOL) in Shidu parents. A cross-sectional sample survey was conducted to collect data from 22 earthquake-stricken counties in Sichuan province. Of the Shidu parents from the Wenchuan earthquake, being of Han ethnicity, receiving a high monthly income, having a high education, having lost a younger child (18-27), and having lost a male child were all risk factors for a lower QOL (p < 0.05). This study highlighted that different types of social support have different roles in building resilience and improving QOL. The results emphasized the importance of developing suitable social support strategies as mediators to improve resilience and the QOL in Shidu parents.

Carbon emission allowance allocation with a mixed mechanism in air passenger transport.

Air passenger transport carbon emissions have become a great challenge for both governments and airlines because of rapid developments in the aviation industry in recent decades. In this paper, a mixed mechanism composed of a cap-and-trade mechanism and a carbon tax mechanism is developed to assist governments in allocating carbon emission allowances to airlines operating on the routes. Combined this mixed mechanism with an equilibrium strategy, a bi-level multi-objective model is proposed for an air passenger transport carbon emission allowance allocation problem, in which a government is considered as a leader and the airlines as the followers. An interactive solution approach integrating a genetic algorithm and an interactive evolutionary mechanism is designed to search for satisfactory solutions of the proposed model. A case study is then presented to show its practicality and efficiency in mitigating carbon emissions. Sensitivity analyses under different tradable and taxable levels are also conducted, which can give the government insights as to the tradeoffs between lowering carbon intensity and improving airlines' operations. The computational results demonstrate that the mixed mechanism can assist greatly in carbon emission mitigation for air passenger transport and therefore, it should be established as part of air passenger transport carbon emission policies.

Mental health problems among survivors in hard-hit areas of the 5.12 Wenchuan and 4.20 Lushan earthquakes.

BACKGROUND: Earthquake exposure has often been associated with psychological distress. However, little is known about the cumulative effect of exposure to two earthquakes on psychological distress and in particular, the effect on the development of post-traumatic stress disorder (PTSD), anxiety and depression disorders. AIMS: This study explored the effect of exposure on mental health outcomes after a first earthquake and again after a second earthquake. METHODS: A population-based mental health survey using self-report questionnaires was conducted on 278 people in the hard-hit areas of Lushan and Baoxing Counties 13-16 months after the Wenchuan earthquake (Sample 1). 191 of these respondents were evaluated again 8-9 months after the Lushan earthquake (Sample 2), which struck almost 5 years after the Wenchuan earthquake. RESULTS: In Sample 1, the prevalence rates for PTSD, anxiety and depression disorders were 44.53, 54.25 and 51.82%, respectively, and in Sample 2 the corresponding rates were 27.27, 38.63 and 36.93%. Females, the middle-aged, those of Tibetan nationality, and people who reported fear during the earthquake were at an increased risk of experiencing post-traumatic symptoms. CONCLUSIONS: Although the incidence of PTSD, anxiety and depression disorders decreased from Sample 1 to Sample 2, the cumulative effect of exposure to two earthquakes on mental health problems was serious in the hard-hit areas. Therefore, it is important that psychological counseling be provided for earthquake victims, and especially those exposed to multiple earthquakes.

The association between exposure and psychological health in earthquake survivors from the Longmen Shan Fault area: the mediating effect of risk perception.

BACKGROUND: In this study, exposure refers to survivors who suffered from life-changing situations, such as personal injuries, the deaths or injury of family members, relatives or friends or the loss of or damage to personal or family property, as a result of the earthquake. The mediating effect of risk perception on the exposure and psychological health in survivors from the Longmen Shan Fault area and the moderating effect of social support on the relationship between risk perception and psychological health were both examined. METHOD: A cross-sectional survey was conducted in a local Longmen Shan Fault area near the epicenter of the 2008 Wenchuan earthquake. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), the standard Chinese 12-item Short Form (SF-12v2), and the Social Support Rating Scale (SSRS) were used to interview 2,080 earthquake survivors in the period one-year after the earthquake. Based on the environment and the characteristics of the Longmen Shan Fault area, a risk perception questionnaire was developed to evaluate survivor risk perception. Factor and regression analyses were conducted to determine the hypothetical relations. RESULTS: The analyses provided effective support for the hypothesized model. Survivor risk perception was classified into direct risk perception and indirect risk perception. Survivor direct risk perception was found to play a partial mediating role in the relationship between exposure and the two domains (Physical component summary (PCS) and the Mental component summary (MCS)) of psychological health. Survivor indirect risk perception was found to have a only partial mediating effect on the association between exposure and MCS. Social support was found to moderate the influence of risk perception on psychological health. CONCLUSION: Risk communication should be considered in future post-earthquake psychological assistance programs and social support strategies could also be useful in improving psychological health.

NGO collaboration in community post-disaster reconstruction: field research following the 2008 Wenchuan earthquake in China.

The number of communities affected by disasters has been rising. As a result, non-governmental organisations (NGOs) that attend community post-disaster reconstruction are often unable to deliver all requirements and have to develop cooperative approaches. However, this collaboration can cause problems because of the complex environments, the fight for limited resources and uncoordinated management, all of which result in poor service delivery to the communities, adding to their woes. From extensive field research and case studies conducted in the post-Wenchuan earthquake-stricken communities, this paper introduces an integrated collaboration framework for community post-disaster reconstruction with the focus on three types of NGOs: international, government organised and civil. The proposed collaboration framework examines the three interrelated components of organisational structure, operational processes and reconstruction goals/implementation areas. Of great significance in better promoting collaborative participation between NGOs are the crucial concepts of participatory reconstruction, double-layer collaborative networks, and circular review and revision.

Equilibrium strategy-based optimization method for the coal-water conflict: A perspective from China.

Environmental water problems have become increasingly severe, with the coal-water conflict becoming one of the most difficult issues in large scale coal mining regions. In this paper, a bi-level optimization model based on the Stackelberg-Nash equilibrium strategy with fuzzy coefficients is developed to deal with environmental water problems in large scale coal fields, in which both the groundwater quality and quantity are considered. Using the proposed model, and fully considering the relationship between the authority and the collieries and also the equilibrium between economic development and environmental protection, an environmental protection based mining quotas competition mechanism is established. To deal with the inherent uncertainties, the model is defuzzified using a possibility measure, and a solution approach based on the Karush-Kuhn-Tucker condition is designed to search for the solutions. A case study is presented to demonstrate the practicality and efficiency of the model, and different constraint violation risk levels and related results are also obtained. The results showed that under the environmental protection based mining quotas competition mechanism, collieries attempt to conduct environmentally friendly exploitation to seek greater mining quotas. This demonstrates the practicality and efficiency in the proposed model of reducing the coal-water conflict. Finally, a comprehensive discussion is provided and some propositions is given as a foundation for the proposed management recommendations.

Psychological consequences and associated risk factors among adult survivors of the 2008 Wenchuan earthquake.

BACKGROUND: In 2008, a devastating earthquake measuring 8.0 on the Richter scale struck Wenchuan, China. Following this disaster, several studies were conducted which assessed the degree of mental disorders in the affected population, but very few considered that several disorders may occur at the same time. This paper aims to investigate the psychological effects and risk factors among adult survivors one-year after the earthquake event. METHODS: 2080 adult earthquake survivors from 19 counties in the affected areas were interviewed. A stratified sampling strategy was used to collect the information. Earthquake survivors completed self-report questionnaires, which included a post-traumatic stress disorder (PTSD) checklist, a self-rating depression scale and a self-rating anxiety scale. RESULTS: Fifty nine percent of the participants were male. The prevalence of probable PTSD in the sample was 40.1% (based on the DSM-IV criteria). Significant differences in the demographic variables were found in the levels of anxiety, depression, and PTSD. Anxiety levels were found to be positively correlated with depression (r = 0.438, p < 0.01) and PTSD (r = 0.322, p < 0.01). Risk factors for each symptom were also identified. Being female, having a low income level and having a low perceived level of social support were found to be the risk factors associated with anxiety, depression, and PTSD. There appeared to be no obvious relationship between the distance from the epicenter of the earthquake event and the severity of the psychological problems. CONCLUSIONS: PTSD, anxiety, and depression were prevalent among the survivors. Most findings on the predictors were found to be consistent with current research. Positive adjustment and social support were found to be needed for the highest-risk population.