Can Community Social Cohesion Prevent Posttraumatic Stress Disorder in the Aftermath of a Disaster? A Natural Experiment From the 2011 Tohoku Earthquake and Tsunami.
Can Community Social Cohesion Prevent Posttraumatic Stress Disorder in the Aftermath of a Disaster? A Natural Experiment From the 2011 Tohoku Earthquake and Tsunami.
复制标题
社区社会凝聚力能否预防灾难后的创伤后应激障碍？ 2011 年东北地震和海啸的自然实验。
DOI：
10.1093/aje/kwv335
复制
发表时间：
2016-05-15
影响因子：
5
通讯作者：
Kawachi I
中科院分区：
文献类型：
--
作者：
Hikichi H;Aida J;Tsuboya T;Kondo K;Kawachi I
在灾难之后，创伤后应激障碍（PTSD）的风险很高。我们试图研究2011年3月11日日本东北地区地震和海啸后，灾前社区社会凝聚力水平是否与PTSD风险降低相关。我们自然实验的基线是在对居住在震中以西80公里处的社区老年人的调查中建立的，这些老年人在地震和海啸发生前7个月居住在震中以西80公里处。在灾难发生后大约2.5年进行了一次后续调查。我们使用了空间杜宾模型来研究社区层面的社会凝聚力与PTSD的个体风险之间的关系。在我们的分析样本（n = 3，567）中，11.4%的受访者报告了严重的PTSD症状。在Durbin空间模型中，灾难前个人和社区层面的社会凝聚力与PTSD症状的风险降低显著相关（比值比= 0.87，95%置信区间：0.77，0.98和比值比= 0.75，95%置信区间：0.63，0.90），即使在调整了基线时的抑郁症状和灾难期间的经历（包括失去亲人，房屋损坏和中断获得医疗保健）。社区一级的社会凝聚力可加强社区居民在灾后的复原力。
In the aftermath of a disaster, the risk of posttraumatic stress disorder (PTSD) is high. We sought to examine whether the predisaster level of community social cohesion was associated with a lower risk of PTSD after the earthquake and tsunami in Tohoku, Japan, on March 11, 2011. The baseline for our natural experiment was established in a survey of older community-dwelling adults who lived 80 kilometers west of the epicenter 7 months before the earthquake and tsunami. A follow-up survey was conducted approximately 2.5 years after the disaster. We used a spatial Durbin model to examine the association of community-level social cohesion with the individual risk of PTSD. Among our analytic sample (n = 3,567), 11.4% of respondents reported severe PTSD symptoms. In the spatial Durbin model, individual- and community-level social cohesion before the disaster were significantly associated with lower risks of PTSD symptoms (odds ratio = 0.87, 95% confidence interval: 0.77, 0.98 and odds ratio = 0.75, 95% confidence interval: 0.63, 0.90, respectively), even after adjustment for depression symptoms at baseline and experiences during the disaster (including loss of loved ones, housing damage, and interruption of access to health care). Community-level social cohesion strengthens the resilience of community residents in the aftermath of a disaster.