Psychological distress after the Great East Japan Earthquake: two multilevel 6-year prospective analyses
Psychological distress after the Great East Japan Earthquake: two multilevel 6-year prospective analyses
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DOI：
10.1192/bjp.2019.251
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发表时间：
2020-03-01
影响因子：
10.5
通讯作者：
Ben-Ezra, Menachem
中科院分区：
文献类型：
--
作者：
Goodwin, Robin;Sugiyama, Kemmyo;Ben-Ezra, Menachem
背景 2011 年 3 月 11 日的东日本大地震导致 30 万幸存者搬迁。灾害后的研究主要关注灾后立即收集的数据，而忽略了更广泛的社区因素的影响。目标 一项三级前瞻性研究，探讨复杂灾难后 6 年内幸存者心理困扰与个人和社会层面因素之间的关联。方法 我们利用了地震后 6 年内两次多波数据收集，使用了来自不同住房形式的居民。样本1包括2011年至2016年期间的六波私人住房居民（每波n = 1084人），样本2包括2012年至2016年的五波居住在活动板房的居民（每波n = 1515人）。我们分析了痛苦与时间（第 1 级）、先前存在的疾病和灾难经历和行为（第 2 级）以及全市支持和身体活动指标（第 3 级）之间的前瞻性关联。结果 具有随机系数的多级模型显示，早期波（分别为样本 1 和 2，调整后 beta = -15 和 beta = -0.16，P < 0.001）、女性受访者（beta = 0.58，P = 0.01 和 beta = 1.74，P = 0.001）以及有既往精神病史的受访者（beta = 2.76，beta = 2.06，P < 0.001）有更大的痛苦。 0.001），震后活动水平降低（β = 1.40，β = 1.51，P < 0.001），以及缺乏社会支持（β = 1.95，β = 1.51，P < 0.001）。配偶和朋友的支持对心理健康最有保护作用。城市层面的支持与困境呈负相关，但仅限于预制住房中。结论 心理困扰随着时间的推移而减少，但因性别、精神病史、住房、活动水平和社会支持的可用性而异。从业者在设计有效的干预措施时应考虑个人和城市层面的因素。
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 beta = -15 and beta = -0.16, P < 0.001), among female respondents (beta = 0.58, P = 0.01 and beta = 1.74, P = 0.001), in those with a previous psychiatric history (beta = 2.76, beta = 2.06, P < 0.001) with diminished levels of activity post-earthquake (beta = 1.40, beta = 1.51, P < 0.001) and those lacking in social support (beta = 1.95, beta = 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.