Impact of earthquake exposure, family adversity and peer problems on anxiety-related emotional disorders in adolescent survivors three years after the Ya'an earthquake.
BACKGROUND
Traumatic experiences often give rise to an increased risk of anxiety problems in adolescents. This study investigated the anxiety prevalence in adolescent earthquake survivors and the effect of secondary stressors such as bullying, poverty, or being "left behind" by parents working in the cities.


METHODS
This cross-sectional study was conducted three years after the 2013 Ya'an (China) earthquake on 6,132 adolescents aged 9 to 18 years from 11 public schools in three severely earthquake affected counties. The participants completed self-report questionnaires that assessed anxiety, earthquake exposure, poverty level, left-behind duration and bullying.


RESULTS
Separation anxiety (38.7%) and panic symptoms (32.2%) were found to be the primary contributors to anxiety in this adolescent sample. The regression and structural equation modeling indicated that adolescents who had suffered from high earthquake exposure, peer bullying, being left-behind, or poverty were more likely to report problems in all anxiety subcategories, with females reporting more anxiety symptoms than males. The likelihood of all anxiety disorders except separation anxiety was found to increase with age.


CONCLUSIONS
This study highlighted the need for post-disaster interventions aimed at minimizing post-earthquake adversity such as peer bullying and specialized psychological services that target subgroups that might be more susceptible to anxiety-related emotional problems. The results could be used to identify possible markers for anxiety problems in children who had not experienced any major traumas.
['Tang|Wanjie|W|', 'Xu|Dun|D|', 'Xu|Jiuping|J|']
D000293:Adolescent D001007:Anxiety D001008:Anxiety Disorders D002648:Child D002681:China D003430:Cross-Sectional Studies D003863:Depression D055866:Earthquakes D005260:Female D006801:Humans D008297:Male D012307:Risk Factors D013313:Stress Disorders, Post-Traumatic D011795:Surveys and Questionnaires D017741:Survivors
Earthquake Anxiety Poverty Peer bullying Left-behind children