Prospective study of posttraumatic stress, anxiety, and depressive reactions after earthquake and political violence.
OBJECTIVE
The authors sought to assess the severity and longitudinal course of posttraumatic stress, anxiety, and depressive reactions among two groups of adults differentially exposed to severe and mild earthquake trauma and a third group exposed to severe violence. They also examined interrelationships among these reactions and predictors of outcome and compared posttraumatic stress disorder (PTSD) symptom category profile and course between those exposed to earthquake and those exposed to violence.


METHODS
Seventy-eight non-treatment-seeking subjects were assessed with self-report instruments approximately 1.5 and 4.5 years after the 1988 Spitak earthquake in Armenia and the 1988 pogroms against Armenians in Azerbaijan.


RESULTS
The two groups that had been exposed to severe trauma (earthquake or violence) had high initial and follow-up PTSD scores that did not remit over the 3-year interval. Overall, depressive symptoms subsided. Posttraumatic stress, anxiety, and depressive reactions were highly intercorrelated within and across both time intervals. No significant differences in PTSD severity, profile, or course were seen between subjects exposed to severe earthquake trauma versus those exposed to severe violence.


CONCLUSIONS
After exposure to severe trauma, either an earthquake or violence, adults are at high risk of developing severe and chronic posttraumatic stress reactions that are associated with chronic anxiety and depressive reactions. Clinical evaluation and therapeutic intervention should include specific attention to these reactions. Early mental health intervention is recommended to prevent their chronicity.
Goenjian
A K
AK
Trauma Psychiatry Program, Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, USA.
Steinberg
A M
AM
Najarian
L M
LM
Fairbanks
L A
LA
Tashjian
M
M
Pynoos
R S
RS
D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis*; D001136:Armenia; D001382:Azerbaijan; D002908:Chronic Disease; D003866:Depressive Disorder / Q000175:diagnosis*; D004190:Disasters; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008016:Life Change Events; D008297:Male; D010555:Personality Inventory / Q000706:statistics & numerical data; D011057:Politics; D011379:Prognosis; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis*; D013315:Stress, Psychological / Q000175:diagnosis / Q000523:psychology; D014754:Violence / Q000523:psychology*