CHILDRENS MENTAL HEALTH AFTER THE CHERNOBYL DISASTER

这项修订后的提案侧重于被疏散儿童的心理健康。 目前居住在基辅的切尔诺贝利周围30公里范围内。 研究问题和研究设计借鉴了我们对心理健康的研究。 生活在三里岛(TMI)附近的儿童的健康，基于 儿童对灾难、其他生活压力源和慢性疾病的反应 疾病、应激过程的研究和可行性研究 我们在1992年进行了。这项研究在随机样本中回答了六个问题 在基辅的300名疏散人员和300名年龄性别匹配的社区控制组中 1980-1986年间：(1)与对照组相比，被疏散儿童是否有 可诊断的重度抑郁症和焦虑症的发生率显著提高 精神障碍、抑郁症状、绝望、焦虑、愤怒或后 创伤应激，还是注意力和记忆力受损？(2)与 对照组，被疏散的儿童是否有明显更高的 行为障碍，表现为旷课，糟糕的学校 表现、行为障碍和药物滥用？(3)疏散 儿童经历显著更高的躯体症状和 母亲的恐惧是否与母亲的恐惧有关？ 切尔诺贝利和/或迁往基辅与他们的精神状态密切相关 健康(尤其是抑郁、焦虑、躯体症状、绝望、 和愤怒)，对孩子的症状敏感，以及家族性 压力？(5)孩子们对切尔诺贝利核事故影响的看法 灾难与紊乱和损伤有直接关系吗？其效果是 受年龄、性别、心理控制点和社会支持的影响？(6)什么是 改进的脆弱性模型对解释损伤的实用性 以及被疏散儿童的混乱？我们建议测试一个模型，在该模型中 母亲的恐惧程度与她的心理和心理状态直接相关 她的躯体症状、家庭冲突和对症状的敏感性 儿童(目标4)，反过来，这些变量与心理 孩子们的健康。尽管具体的调查结果是 不一致，我们将再次检查压力缓和效果 儿童的年龄、性别、心理控制点和社会支持。我们还将 确定孩子的个人压力水平是否来自后遗症 切尔诺贝利的影响起到了调节作用。 面对面评估将使用翻译版本的 标准的心理健康评估工具。体格检查和例行检查 血液筛查将由受过培训的当地医生进行 并由一名美国家庭执业医生进行监测， 在莫斯科的经历。这项研究代表了两国之间的合作 美国和乌克兰的科学家。它的成功将决定 是否适宜进行后续评估或扩大规模或 样品的性质。

This revised proposal focuses on the mental health of children evacuated from the 30-kilometer area surrounding Chernobyl who now reside in Kiev. The research questions and study design draw on our research on the mental health of children living near Three Mile Island (TMI), on studies of children's responses to disasters, other life stressors, and chronic illness, on research on the stress process, and on the feasibility study we conducted in 1992. The study addresses six questions in a random sample of 300 evacuees in Kiev and 300 age-sex matched neighborhood controls born between 1980-1986: (1) Compared to controls, do evacuee children have significantly higher rates of diagnosable major depression and anxiety disorders, symptoms of depression, hopelessness, anxiety, anger, or post- traumatic stress, or concentration and memory impairment? (2) Compared to controls, do evacuee children have significantly higher rates of behavioral disturbance, as evidenced by absenteeism, poor school performance, conduct disorders, and substance abuse? (3) Are evacuee children experiencing significantly higher levels of somatic symptoms and medical illness than controls? (4) Are the mothers' fears associated with Chernobyl and/or relocation to Kiev significantly related to their mental health (particularly depression, anxiety, somatic symptoms, hopelessness, and anger), sensitivity to symptoms in their children, and familial stress? (5) Are the children's beliefs about the effects of the Chernobyl disaster directly related to disorder and impairment? Are the effects moderated by age, sex, locus of control, and social support? (6) what is the utility of a modified vulnerability model for explaining impairment and disorder in evacuee children? We propose to test a model in which the mother's level of fear is directly related to her psychological and somatic symptoms, family conflict, and sensitivity to symptoms in her child (Aim 4) and in turn, these variables are associated with the mental health of the children. Although the specific findings have been inconsistent, we will again examine the stress-moderating effects of the child's age, gender, locus of control and social support. We will also determine whether the child's personal level of stress from the sequelae of Chernobyl serve a moderating function. Face-to-face assessments will be administered using translated versions of standard mental health assessment tools. Physical examinations and routine blood screening will be performed by local physicians who will be trained and monitored by an American family practice physician with similar experience in Moscow. The study represents a collaboration between American and Ukrainian scientists. Its success will determine the advisability of conducting follow-up assessments or expanding the size or nature of the sample.