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      High Prevalence of Post-Traumatic Stress Symptoms in Relation to Social Factors in Affected Population One Year after the Fukushima Nuclear Disaster

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          Abstract

          Objective

          This study investigated post-traumatic stress symptoms in relation to the population affected by the Fukushima Nuclear Disaster, one year after the disaster. Additionally, we investigated social factors, such as forced displacement, which we hypothesize contributed to the high prevalence of post-traumatic stress. Finally, we report of written narratives that were collected from the impacted population.

          Design and Settings

          Using the Impact of Event Scale-Revised (IES-R), questionnaires were sent to 2,011 households of those displaced from Fukushima prefecture living temporarily in Saitama prefecture. Of the 490 replies; 350 met the criteria for inclusion in the study. Multiple logistic regression analysis was performed to examine several characteristics and variables of social factors as predictors of probable post-traumatic stress disorder, PTSD.

          Results

          The mean score of IES-R was 36.15±21.55, with 59.4% having scores of 30 or higher, thus indicating a probable PTSD. No significant differences in percentages of high-risk subjects were found among sex, age, evacuation area, housing damages, tsunami affected, family split-up, and acquaintance support. By the result of multiple logistic regression analysis, the significant predictors of probable PTSD were chronic physical diseases (OR = 1.97), chronic mental diseases (OR = 6.25), worries about livelihood (OR = 2.27), lost jobs (OR = 1.71), lost social ties (OR = 2.27), and concerns about compensation (OR = 3.74).

          Conclusion

          Although there are limitations in assuming a diagnosis of PTSD based on self-report IES-R, our findings indicate that there was a high-risk of PTSD strongly related to the nuclear disaster and its consequent evacuation and displacement. Therefore, recovery efforts must focus not only on medical and psychological treatment alone, but also on social and economic issues related to the displacement, as well.

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          Most cited references 22

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          Reliability and validity of the Japanese-language version of the impact of event scale-revised (IES-R-J): four studies of different traumatic events.

          The authors developed the Japanese-language version of the Impact of Event Scale-Revised (IES-R-J) and investigated its reliability and validity in four different groups: workers with lifetime mixed traumatic events, survivors of an arsenic poisoning case, survivors of the Hanshin-Awaji earthquake, and survivors of the Tokyo Metro sarin attack. Evidence includes retest reliability and internal consistency of the IES-R-J. Posttraumatic stress disorder (PTSD) and partial PTSD cases indicated significantly higher scores than non-PTSD cases. The IES-R-J can be a useful self-rating diagnostic instrument particularly for survivors with PTSD symptoms as a clinical concern (PTSD + partial PTSD) by using a 24/25 cutoff in total score. In analysis of scale structure, the majority of intrusion and hyperarousal items were subsumed under the same cluster, whereas avoidance items made up a separate cluster. Female patients indicated higher scores than male patients. A negative weak correlation between age and the score was found only among female earthquake survivors. The IES-R-J can be used as a validated instrument in future international comparative research.
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            Psychometric properties of the Impact of Event Scale - Revised.

            This study investigated the psychometric properties of the Impact of Event Scale -- Revised (IES-R) in two samples of male Vietnam veterans: a treatment-seeking sample with a confirmed posttraumatic stress disorder (PTSD) diagnosis (N = 120) and a community sample with varying levels of traumatic stress symptomatolgy (N = 154). The scale showed high internal consistency (alpha = 0.96). Confirmatory factor analysis did not provide support for a three-factor solution corresponding to the three subscales of intrusion, avoidance, and hyperarousal. Exploratory factor analysis suggested that either a single, or a two-factor solution (intrusion/hyperarousal and avoidance), provide the best account of date. However, correlations among the subscales were higher in the community sample than in the treatment sample, suggesting that the IES-R may be sensitive to a more general construct of traumatic stress in those with lower symptom levels. The correlation between the IES-R and the PTSD Checklist was high (0.84) and a cutoff of 1.5 (equivalent to a total score of 33) was found to provide the best diagnostic accuracy.
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              Mental health in complex emergencies

              Mental health is becoming a central issue for public health complex emergencies. In this review we present a culturally valid mental health action plan based on scientific evidence that is capable of addressing the mental health effects of complex emergencies. A mental health system of primary care providers, traditional healers, and relief workers, if properly trained and supported, can provide cost-effective, good mental health care. This plan emphasises the need for standardised approaches to the assessment, monitoring, and outcome of all related activities. Crucial to the improvement of outcomes during crises and the availability to future emergencies of lessons learned from earlier crises is the regular dissemination of the results achieved with the action plan. A research agenda is included that should, in time, fill knowledge gaps and reduce the negative mental health effects of complex emergencies.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                22 March 2016
                2016
                : 11
                : 3
                Affiliations
                [1 ]Faculty of Human Sciences, Waseda University, Tokorozawa-shi, Saitama, Japan
                [2 ]Waseda Institute of Medical Anthropology on Disaster Reconstruction, Shinjuku, Tokyo, Japan
                [3 ]Harvard Program in Refugee Trauma, Harvard Medical School, Cambridge, Massachusetts, United States of America
                [4 ]Department of Social Welfare, The International University of Kagoshima, Kagoshima, Kagoshima, Japan
                [5 ]Idente Foundation for Studies and Research, Rome, Italy
                [6 ]Shinsai Shien Network Saitama, Saitama Sogo Law Firm, Saitama-shi, Saitama, Japan
                [7 ]Graduate School of Asia-Pacific Studies, Waseda University, Shinjuku-ku, Tokyo, Japan
                University of Geneva, SWITZERLAND
                Author notes

                Competing Interests: The authors have following interest. TI is employed by Saitama Sogo Law Firm. There are no patents, products in development or marketed products to declare. This does not alter their adherence to all the PLOS ONE policies on sharing data and materials, as detailed online in the guide for authors.

                Conceived and designed the experiments: TT MY KM TI HK. Performed the experiments: TT MY KM TI HK. Analyzed the data: TT MY KM. Wrote the paper: TT MT HK EA. Monitored and supervised study progress: HK YK EA RM.

                Article
                PONE-D-15-42997
                10.1371/journal.pone.0151807
                4803346
                27002324
                © 2016 Tsujiuchi et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                Page count
                Figures: 0, Tables: 3, Pages: 14
                Product
                Funding
                This work was supported by the grant of “Disaster Relief Volunteer & Nonprofit Organization Support Fund” 2012 by Central Community Chest of Japan, and “Japan Society for the Promotion of Science KAKENHI” Grant Number 25460915, partially supported by “Ministry of Education, Culture, Sports, Science and Technology Japan” KIBANKEISEI 2012. Saitama Sogo Law Firm provided support in the form of salaries for author [TI], but did not have any additional role in the study design data collection and analysis, decision to publish, or preparation of the manuscript. The specific role of this author is articulated in the ‘authors contributions' section.
                Categories
                Research Article
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Neuropsychiatric Disorders
                Anxiety Disorders
                Post-Traumatic Stress Disorder
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Neuroses
                Anxiety Disorders
                Post-Traumatic Stress Disorder
                People and Places
                Geographical Locations
                Asia
                Japan
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Mood Disorders
                Depression
                Earth Sciences
                Geography
                Human Geography
                Housing
                Social Sciences
                Human Geography
                Housing
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Suicide
                Research and Analysis Methods
                Mathematical and Statistical Techniques
                Statistical Methods
                Regression Analysis
                Physical Sciences
                Mathematics
                Statistics (Mathematics)
                Statistical Methods
                Regression Analysis
                Physical Sciences
                Physics
                Nuclear Physics
                Nuclear Power
                Custom metadata
                All relevant data are within the paper and its Supporting Information files.

                Uncategorized

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