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Posttraumatic stress disorder symptoms among child survivors of the 2008 Wenchuan earthquake: a comparison between Chinese ethnic Han and Hui groups.

ABSTRACT:

Background

Relatively few studies have compared posttraumatic stress disorder (PTSD) symptoms following a disaster among children of different ethnicities. We sought to investigate the differences in PTSD symptoms between the ethnic Hui and Han child survivors of the 2008 Wenchuan earthquake in China.

Methods

This study collected data from 1,951 Han and 247 Hui child survivors of the 2008 Wenchuan earthquake in China. The children ranged from 7 to 15 years of age. Earthquake-related exposures were measured using a modified version of the PsySTART Rapid Triage System. PTSD symptoms were evaluated using the University of California, Los Angeles PTSD-Reaction Index (UCLA PTSD-RI). Personality characteristics were assessed using the Junior Eysenck Personality Questionnaire (JEPQ). Multiple linear regression was used to investigate the association between the ethnicity and the severity of PTSD symptoms. Multiple logistic regression was used to investigate the association between the ethnicity and the percentage of screening positive for PTSD symptoms.

Results

The average UCLA PTSD-RI total score of the ethnic Hui group (27.01 ± 9.24) was significantly higher than that of the ethnic Han group (25.12 ± 9.17) (t = -3.05, p = 0.002), as were the avoidance/numbness (Hui: 10.02 ± 4.82; Han: 9.04 ± 4.60, t = -3.12, p = 0.002) and arousal scores (Hui: 9.36 ± 3.64; Han: 8.79 ± 3.42, t = -2.44, p = 0.015). The percentage of screening positive for D criteria (arousal symptoms) also differed significantly between the ethnic Han (41.9%, 95% CI [39.7-44.1%]) and Hui (48.6%, 95% CI [42.3-54.9%]) groups (χ² = 3.97, p = 0.046). Ethnicity was associated with the avoidance/numbness symptom score following adjustments for sex, age, personality traits and earthquake exposure experiences by multiple linear regression (B: 0.61, 95% CI [0.04-1.17], p = 0.035). The initial significant associations between the ethnicity and the arousal symptoms score and the PTSD total score disappeared while adjusting for the subjective earthquake exposure experiences (Model 5: arousal symptoms, B = 0.41, 95% CI [-0.01 to 0.83], p = 0.056; PTSD, B = 1.00, 95% CI [-0.07 to 2.07], p = 0.066). The initial significant association between the ethnicity and the percentage of screening positive for D criteria disappeared while adjusting for the objective earthquake exposure experiences (Model 4: OR = 1.32, 95% CI [1.00-1.75], p = 0.052).

Conclusion

This study is the first to report the relationship between the ethnicity and PTSD symptoms among child survivors following a disaster. The findings of this study suggest that the trauma-focused cognitive behavior therapy could also be an effective treatment for Chinese ethnic Hui and Han children who are suffering from PTSD. Future research could be designed to examine whether cultural differences in perceptions and interpretations may account for the variations in subjective experiences. More attention should be paid to the ethnic minority children with PTSD in the future.

SUBMITTER: Chen X

PROVIDER: S-EPMC8364314 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:IntroductionMultiple injuries have been highlighted as an important clinical dimension of the injury profile following earthquakes, but studies are scarce. We investigated the pattern and combination of injuries among patients with two injuries following the 2008 Wenchuan earthquake. We also described the general injury profile, causes of injury and socio-demographic characteristics of the injured patients.MethodsA retrospective hospital-based analysis of 1,871 earthquake injured patients, totaling 3,177 injuries, admitted between 12 and 31 May 2008 to the People's Hospital of Deyang city (PHDC). An electronic, webserver-based database with International Classification of Diseases (ICD)-10-based classification of earthquake-related injury diagnoses (IDs), anatomical sites and additional background variables of the inpatients was used. We analyzed this dataset for injury profile and number of injuries per patient. We then included all patients (856) with two injuries for more in-depth analysis. Possible spatial anatomical associations were determined a priori. Cross-tabulation and more complex frequency matrices for combination analyses were used to investigate the injury profile.ResultsOut of the 1,871 injured patients, 810 (43.3%) presented with a single injury. The rest had multiple injuries; 856 (45.8%) had two, 169 (9.0%) patients had three, 32 (1.7%) presented with four injuries, while only 4 (0.2%) were diagnosed with five injuries. The injury diagnoses of patients presenting with two-injuries showed important anatomical intra-site or neighboring clustering, which explained 49.1% of the combinations. For fractures, the result was even more marked as spatial clustering explained 57.9% of the association pattern. The most frequent combination of IDs was a double-fracture, affecting 20.7% of the two-injury patients (n = 177). Another 108 patients (12.6%) presented with fractures associated with crush injury and organ-soft tissue injury. Of the 3,177 injuries, 1,476 (46.5%) were fractures. Most injuries were located in the head (22.9%) and lower extremities (30.8%).ConclusionsMultiple injuries are put forward as an important component of the injury profile after this earthquake. A pattern of injury combinations and spatial aggregation of injuries was also found. Clinical diagnosis and treatment should be adapted to care of these patients. More studies are needed to generalize these findings.