CHILDRENS MENTAL HEALTH AFTER THE CHERNOBYL DISASTER

这份修订后的提案关注撤离儿童的心理健康 他们来自切尔诺贝利周围30公里的地区，现在居住在基辅。 研究问题和研究设计借鉴了我们对心理的研究， 生活在三里岛（TMI）附近的儿童的健康， 儿童对灾难、其他生活压力源和慢性疾病的反应 疾病，对压力过程的研究，以及可行性研究 我们在1992年进行的。这项研究在随机抽样中回答了六个问题 在基辅的300名撤离者和300名年龄性别匹配的社区对照中， 1980-1986年：（1）与对照组相比，撤离儿童是否有 可诊断的重度抑郁症和焦虑症 疾病，抑郁症的症状，绝望，焦虑，愤怒，或后- 创伤压力还是注意力和记忆力受损(2)相比 对照组中，撤离儿童的 行为障碍，表现为旷课、学习成绩差 行为障碍和药物滥用(3)被疏散者 儿童的躯体症状水平明显较高， 医学疾病比对照组？(4)母亲们的恐惧是否与 切尔诺贝利和/或搬迁到基辅与他们的精神状况密切相关。 健康（特别是抑郁、焦虑、躯体症状、绝望， 和愤怒），对孩子症状的敏感性，以及家庭 压力？(5)孩子们对切尔诺贝利事故影响的看法 与疾病和损伤直接相关的灾难？这些影响 受年龄、性别、心理控制源和社会支持的调节？(6)是什么 修正的脆弱性模型在解释损害方面的效用 和精神紊乱我们建议测试一个模型，其中 母亲的恐惧程度与她的心理和 躯体症状、家庭冲突和对症状的敏感性 孩子（目标4），反过来，这些变量与心理 孩子们的健康。虽然具体的调查结果已经 不一致，我们将再次检查压力调节作用的 儿童的年龄、性别、心理控制源和社会支持。我们还将 判断孩子的个人压力水平是否会带来后遗症 切尔诺贝利核事故起到了缓和作用。 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常规 将由经过培训的当地医生进行血液筛查 并由一名美国家庭医生进行监测， 在莫斯科的经历。这项研究代表了 美国和乌克兰科学家。它的成功将决定 进行后续评估或扩大规模的可行性， 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.