title: Associations between disaster exposures, peritraumatic distress, and posttraumatic stress responses in Fukushima nuclear plant workers following the 2011 nuclear accident: the Fukushima NEWS Project study.
abstract: BACKGROUND
  The 2011 Fukushima Daiichi Nuclear Power Plant accident was the worst nuclear disaster since Chernobyl. The nearby Daini plant also experienced substantial damage but remained intact. Workers for the both plants experienced multiple stressors as disaster victims and workers, as well as the criticism from the public due to their company's post-disaster management. Little is known about the psychological pathway mechanism from nuclear disaster exposures, distress during and immediately after the event (peritraumatic distress; PD), to posttraumatic stress responses (PTSR).
  
  
  METHODS
  A self-report questionnaire was administered to 1,411 plant employees (Daiichi, n = 831; Daini, n = 580) 2-3 months post-disaster (total response rate: 80.2%). The socio-demographic characteristics and disaster-related experiences were assessed as independent variables. PD and PTSR were measured by the Japanese versions of Peritraumatic Distress Inventory and the Impact of Event Scale-Revised, respectively. The analysis was conducted separately for the two groups. Bivariate regression analyses were performed to assess the relationships between independent variables, PD, and PTSR. Significant variables were subsequently entered in the multiple regression analyses to explore the pathway mechanism for development of PTSR.
  
  
  RESULTS
  For both groups, PTSR highly associated with PD (Daiichi: adjusted β, 0.66; p<0.001; vs. Daini: adjusted β, 0.67; p<0.001). PTSR also associated with discrimination/slurs experience (Daiichi: 0.11; p<0.001; vs. Daini, 0.09; p = 0.005) and presence of preexisting illness(es) (Daiichi: 0.07; p = 0.005; vs. Daini: 0.15; p<.0001). Other disaster-related variables were likely to be associated with PD than PTSR.
  
  
  CONCLUSIONS
  Among the Fukushima nuclear plant workers, disaster exposures associated with PD. PTSR was highly affected by PD along with discrimination/slurs experience.
authors.affiliation: Department of Psychiatry, National Defense Medical College, Tokorozawa, Saitama, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Shigemura
authors.affiliation: Department of Public Health, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tanigawa
authors.affiliation: Department of Mental Health Policy and Evaluation, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Nishi
authors.affiliation: Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan ; Department of Psychiatry, National Disaster Medical Center, Tachikawa, Tokyo, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Matsuoka
authors.affiliation: Department of Psychiatry, National Defense Medical College, Tokorozawa, Saitama, Japan.
authors.forename: Soichiro
authors.initials: S
authors.lastname: Nomura
authors.affiliation: Department of Psychiatry, National Defense Medical College, Tokorozawa, Saitama, Japan.
authors.forename: Aihide
authors.initials: A
authors.lastname: Yoshino
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004190:Disasters; D005260:Female; D062406:Fukushima Nuclear Accident; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology*; D013315:Stress, Psychological / Q000209:etiology*; D011795:Surveys and Questionnaires; D055815:Young Adult