Assessment of Factors Associated With Long-term Posttraumatic Stress Symptoms Among 56 388 First Responders After the 2011 Great East Japan Earthquake

Nagamine, Masato; Giltay, Erik J.; Shigemura, Jun; Wee, Nic J. van der; Yamamoto, Taisuke; Takahashi, Yoshitomo; Saito, Taku; Tanichi, Masaaki; Koga, Minoru; Toda, Hiroyuki; Shimizu, Kunio; Yoshino, Aihide; Vermetten, Eric

doi:10.1001/jamanetworkopen.2020.18339

Cited by 14 publications

(11 citation statements)

References 59 publications

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“…89,92,94,100,102,106 Other articles on mental health included a group of studies that focused on the identification of sociodemographic characteristics associated with increased risk of adverse mental health outcomes following multiple disasters (eg, by age, 48,51 gender, educational attainment, financial hardship, 35,57 and temporary housing experiences 111 ), with mixed results. Another group of articles focused on mental health risks faced by disaster responders 86,103,104 and public health workers 62,64 in the face of multiple disasters. There was also a group of studies that described alcohol-related and tobacco-related…”

Section: Direct Implications For Public Health Mental Healthmentioning

confidence: 99%

Public health implications of multiple disaster exposures

Leppold

Gibbs

Block

et al. 2022

The Lancet Public Health

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Disasters are an important public health issue; however, there is scarce evidence to date on what happens when communities and populations experience more than one disaster. This scoping review identifies literature on the effects of multiple disasters published until Aug 2, 2021, 1425 articles were identified, of which 150 articles were included. We analysed direct and indirect public health implications of multiple disasters. Our analysis suggests that exposure to multiple disasters can affect mental health, physical health, and wellbeing, with some evidence that the potential risks of multiple disaster exposure exceed those of single disaster exposure. We also identified indirect public health implications of multiple disaster exposure, related to changes in health-care facilities, changes in public risk perception, and governmental responses to multiple disasters. We present findings on community recovery and methodological challenges to the study of multiple disasters, and directions for future research.

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Section: Direct Implications For Public Health Mental Healthmentioning

confidence: 99%

Public health implications of multiple disaster exposures

Leppold

Gibbs

Block

et al. 2022

The Lancet Public Health

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show abstract

“…The risk factors for symptomatic trajectories identified in this study were largely consistent with the results from two previous studies on the current cohort, which examined the risk factors for probable PTSD manifested in the first year of follow-up 7 and for the late-onset trajectory in up to 6 years of follow-up. 8…”

Section: Discussionmentioning

confidence: 99%

“…This study was part of a prospective longitudinal cohort study, the details of the design and participants have been described in prior research. 7,8 Of the 56 753 individuals who participated in the initial study, we only included those with organisational service numbers and complete data on all predictor variables resulting in a sample of 55 632 JGSDF personnel (98.0% of the participants included in the initial study. See Supplementary Figure 1).…”

Section: Methodsmentioning

confidence: 99%

“…The characteristics of the psychological measures used are described in prior research. 7,8 PTSD symptoms were investigated using the Japanese version of the Impact of Event Scale-Revised (IES-R), 15,16 which has good test–retest reliability ( r = 0.86, P < 0.001) and high internal consistency (Cronbach's α = 0.92–0.95). 15 The IES-R was completed at up to nine time points.…”

Section: Methodsmentioning

confidence: 99%

“…In two earlier studies on this cohort, we focused on the underlying risk factors for people with first-year probable PTSD and for probable PTSD after 6 months to 6 years of follow-up. 7,8 In this study, we sought to identify PTSD symptom severity trajectories and the underlying risk factors in first responders after the GEJE.…”

Section: Aimsmentioning

confidence: 99%

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Risk and resilience in trajectories of post-traumatic stress symptoms among first responders after the 2011 Great East Japan Earthquake: 7-year prospective cohort study

et al. 2022

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Background First responders to disasters are at risk of developing post-traumatic stress disorder (PTSD). The trajectories of post-traumatic stress symptom severity differ among individuals, even if they are exposed to similar events. These trajectories have not yet been reported in non-Western first responders. Aims We aimed to explore post-traumatic stress symptom severity trajectories and their risk factors in first responders to the 2011 Great East Japan Earthquake (GEJE) – a historically large earthquake that resulted in a tsunami and a nuclear disaster. Method A total of 55 632 Japan Ground Self-Defense Force (JGSDF) personnel dispatched to the GEJE were enrolled in this 7-year longitudinal cohort study. PTSD symptom severity was measured using the Impact of Event Scale-Revised. Trajectories were identified using latent growth mixture models (LGMM). Nine potential risk factors for the symptom severity trajectories were analysed using multinomial logistic regression. Results Five symptom severity trajectories were identified: ‘resilient’ (54.8%), ‘recovery’ (24.6%), ‘incomplete recovery’ (10.7%), ‘late-onset’ (5.7%), and ‘chronic’ (4.3%). The main risk factors for the four non-resilient trajectories were older age, personal disaster experiences and working conditions. These working conditions included duties involving body recovery or radiation exposure risk, longer deployment length, later or no post-deployment leave and longer post-deployment overtime. Conclusions The majority of first responders to GEJE were resilient and developed few or no PTSD symptoms. A substantial minority experienced late-onset and chronic symptom severity trajectories. The identified risk factors can inform policies for prevention, early detection and intervention in individuals at risk of developing symptomatic trajectories.

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