title: A multilevel analysis of long-term psychological distress among Belarusians affected by the Chernobyl disaster.
abstract: BACKGROUND
  Radiation contamination and sociopolitical instability following the Chernobyl nuclear power plant disaster have had a profound impact on Belarus.
  
  
  OBJECTIVE
  To investigate the factors that impact long-term mental health outcomes of this population almost 20 years after the disaster.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  In-person interviews were conducted with 381 men and women from two geographic areas of differing radiation contamination within Belarus. Participants completed surveys of demographics, psychosocial factors and psychological distress. Individual-level characteristics were combined with household-level measures of radiation contamination exposure and family characteristics to create multilevel predictive models of psychological distress.
  
  
  RESULTS
  Between-household effects accounted for 20% of variability in depression and anxiety scores, but only 8% of variability in somatization scores. Degree of chronic daily stressors showed a significant positive relationship with psychological distress, whereas mastery/controllability showed a significant inverse relationship with distress. At household level, perceived family problems, but not level of residential radiation contamination, was the best predictor of distress.
  
  
  CONCLUSIONS
  Multilevel modelling indicates that long-term psychological distress among Belarusians affected by the Chernobyl disaster is better predicted by stress-moderating psychosocial factors present in one's daily life than by level of residential radiation contamination.
authors.affiliation: Roswell Park Cancer Institute, Buffalo, NY, USA. gregory.beehler@va.gov
authors.forename: G P
authors.initials: GP
authors.lastname: Beehler
authors.forename: J A
authors.initials: JA
authors.lastname: Baker
authors.forename: K
authors.initials: K
authors.lastname: Falkner
authors.forename: T
authors.initials: T
authors.lastname: Chegerova
authors.forename: A
authors.initials: A
authors.lastname: Pryshchepava
authors.forename: V
authors.initials: V
authors.lastname: Chegerov
authors.forename: M
authors.initials: M
authors.lastname: Zevon
authors.forename: E
authors.initials: E
authors.lastname: Bromet
authors.forename: J
authors.initials: J
authors.lastname: Havenaar
authors.forename: H
authors.initials: H
authors.lastname: Valdismarsdottir
authors.forename: K B
authors.initials: KB
authors.lastname: Moysich
mesh_terms: D000293:Adolescent; D000328:Adult; D047852:Chernobyl Nuclear Accident; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007953:Leukemia, Radiation-Induced / Q000150:complications / Q000453:epidemiology; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data*; D008875:Middle Aged; D011210:Power Plants; D011584:Psychology; D011829:Radiation Dosage; D018788:Radioactive Hazard Release; D002094:Republic of Belarus / Q000453:epidemiology; D012307:Risk Factors; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000453:epidemiology*; D013997:Time Factors; D014455:Ukraine; D055815:Young Adult