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25-year follow-up of treated and not-treated adolescents after the Spitak earthquake: course and predictors of PTSD and depression—ERRATUM
- Armen K. Goenjian, Alan M. Steinberg, David Walling, Sheryl Bishop, Ida Karayan, Robert Pynoos
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- Journal:
- Psychological Medicine / Volume 51 / Issue 6 / April 2021
- Published online by Cambridge University Press:
- 08 May 2020, pp. 989-990
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25-year follow-up of treated and not-treated adolescents after the Spitak earthquake: course and predictors of PTSD and depression
- Armen K. Goenjian, Alan M. Steinberg, David Walling, Sheryl Bishop, Ida Karayan, Robert Pynoos
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- Journal:
- Psychological Medicine / Volume 51 / Issue 6 / April 2021
- Published online by Cambridge University Press:
- 14 January 2020, pp. 976-988
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Background
There is a paucity of long-term prospective disaster studies of the psychological sequelae among survivors.
MethodsAt 1½ and 25 years after the Spitak earthquake, 142 early adolescents from two cities were assessed: Gumri (moderate–severe exposure) and Spitak (very severe exposure). The Gumri group included treated and not-treated subjects, while the Spitak group included not-treated subjects. Instruments included: DSM-III-R PTSD-Reaction Index (PTSD-RI); DSM-5 PTSD-Checklist (PCL); Depression Self-Rating Scale (DSRS); and Center for Epidemiological Studies-Depression Scale (CES-D).
Results(1) Between 1½ and 25 years, PTSD rates and mean scores decreased significantly in the three groups (over 50%). However, at 25 years 9.1–22.4% met DSM-5 PTSD criteria. (2) At 1½ years, the Spitak group had higher PTSD-RI (p < 0.001) and DSRS scores (p < 0.001) compared to the Gumri-not-treated group. At 25 years, the Spitak group that had experienced fewer post-earthquake adversities (p < 0.03), had a greater decrease in PTSD-RI scores (p < 0.02), and lower CES-D scores (p < 0.01). (3) Before treatment, PTSD-RI and DSRS scores did not differ between the Gumri-treated and not-treated groups. At 25-years, the Gumri-treated group showed a greater decrease in PTSD-RI scores (p < 0.03), and lower mean PTSD-RI (p < 0.02), PCL (p < 0.02), and CES-D (p < 0.01) scores. (4) Predictors of PTSD symptom severity at 25-years included: home destruction, treatment, social support, post-earthquake adversities, and chronic medical illnesses.
ConclusionPost-disaster PTSD and depressive symptoms can persist for decades. Trauma-focused treatment, alleviation of post-disaster adversities, improving the social ecology, and monitoring for chronic medical illnesses are essential components of recovery programs.
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Wolterstorff, Rega Wood, W. Jay Wood, Paul Woodruff, Alison Wylie, Gideon Yaffe, Takashi Yagisawa, Yutaka Yamamoto, Keith E. Yandell, Xiaomei Yang, Dean Zimmerman, Günter Zoller, Catherine Zuckert, Michael Zuckert, Jack A. Zupko (J.A.Z.)
- Edited by Robert Audi, University of Notre Dame, Indiana
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- The Cambridge Dictionary of Philosophy
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- 05 August 2015
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- 27 April 2015, pp ix-xxx
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3 - Children and disasters: public mental health approaches
- from Part II - Foundations of disaster psychiatry
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- By Robert S. Pynoos, Center Director National Center for Child Traumatic Stress, Alan M. Steinberg, Associate Director University of California, Melissa J. Brymer, Director Terrorism and Disaster Programs National Center for Child Traumatic Stress USA
- Edited by Robert J. Ursano, Uniformed Services University of the Health Sciences, Maryland, Carol S. Fullerton, Uniformed Services University of the Health Sciences, Maryland, Lars Weisaeth, Universitetet i Oslo, Beverley Raphael, University of Western Sydney
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- Textbook of Disaster Psychiatry
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- 09 August 2009
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- 01 November 2007, pp 48-68
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Summary
This chapter reviews the importance of maintaining a child and adolescent developmental perspective. Studies of the biological, psychological, and behavioral impact of natural disasters on children and adolescents have been growing steadily, with earthquakes and hurricanes being the most widely investigated disasters. A modern public mental health approach to the postdisaster recovery of children, adolescents, adults, and families recognizes the importance of conceptualizing stages of disaster response. A three-tier model for providing postdisaster mental health interventions for children and families includes general psychosocial support to a broad population, specialized interventions for those with severe, persistent distress and impairment, and specialized treatment for high-risk cases that need more intensive psychiatric care. Clinical evaluation and intervention outcome data involve the rigorous clinical evaluation of affected individuals, and are used to examine the contribution of interventions to the course of recovery.
Overview of Methodologic Issues for Pharmacologic Trials in Mild, Moderate, and Severe Alzheimer's Disease
- Barry Reisberg, Emile H. Franssen, Maciej Bobinski, Stefanie Auer, Isabel Monteiro, Istvan Boksay, Jerzy Wegiel, Emma Shulman, Gertrude Steinberg, Liduïn E. M. Souren, Alan Kluger, Carol Torossian, Elia Sinaiko, Henry M. Wisniewski, Steven H. Ferris
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- International Psychogeriatrics / Volume 8 / Issue 2 / June 1996
- Published online by Cambridge University Press:
- 07 January 2005, pp. 159-193
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To address the issue of mild, moderate, and severe Alzheimer's disease (AD), it is necessary to initially establish some agreement on terminology. In recent decades, these terms have frequently been defined using screening instrument scores with measures such as the Mini-Menal State Examination (MMSE). There are many problems with this approach, perhaps the most salient of which is that it has contributed to the total and tragic neglect of patients with severe AD. An alternative approach to the classification of AD severity is staging. This approach has advanced to the point where moderately severe and severe AD can be described in detail. Procedures for describing this previously neglected latter portion of AD have recently been extensively validated. Staging is also uniquely useful at the other end of the severity spectrum, in differentiating early aging brain/behavior changes, incipient AD, and mild AD. Temporally, with staging procedures, it is possible to track the course of AD approximately three times more accurately than with the MMSE. The net result of the advances in AD delineation is that issues such as prophylaxis, modification of course, treatment of behavioral distrubances, loss of ambulation, progressive rigidity, and the development of contractures in AD patients can now be addressed in a scientifically meaningful way that will hopefully bestow much benefit in AD patients and those who care for them.
Post-traumatic Stress Reactions in Children After the 1988 Armenian Earthquake
- Robert S. Pynoos, Armen Goenjian, Madeline Tashjian, Meline Karakashian, Raffi Manjikian, Gagik Manoukian, Alan M. Steinberg, Lynn A. Fairbanks
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- The British Journal of Psychiatry / Volume 163 / Issue 2 / August 1993
- Published online by Cambridge University Press:
- 02 January 2018, pp. 239-247
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- August 1993
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One and a half years after the devastating earthquake in Armenia in 1988, 231 children from three cities at increasing distances from the epicentre were randomly screened in their schools to determine the frequency and severity of post-traumatic stress reactions, using the Children's Post-traumatic Stress Disorder Reaction Index (CPTSD-RI). A systematic clinical assessment of PTSD based on DSM-III-R criteria was also conducted on approximately half of this sample. A high CPTSD-RI score was strongly correlated with a clinical diagnosis of PTSD. A strong positive correlation was found between proximity to the epicentre and overall severity of post-traumatic stress reaction, as well as severity of core component symptoms of PTSD. High rates of chronic, severe post-traumatic stress reactions were found among children in the two most damaged cities, Spitak and Gumri. Analyses controlling for exposure revealed that girls reported more persistent fears than boys. These findings indicate that after catastrophic natural disaster, post-traumatic reactions in children may reach epidemic proportions, remain high for a prolonged period, and jeopardise the well-being of the child population of a large region. Systematic screening of children for PTSD can provide critical information for a rational public mental health programme after such a disaster.