title: Did parents and teachers struggle with child survivors 20 months after the 2011 earthquake and tsunami in Japan? A retrospective observational study.
abstract: BACKGROUND
  On March 11, 2011, Japan was struck by the earthquake and tsunami. Twenty months after the disaster, we collected information on the difficulties faced by parents and teachers in dealing with the post-traumatic symptoms of child survivors. The aim of this study was to evaluate the relationship between post-traumatic symptoms in children and parents' and teachers' difficulties in dealing with children who survived the huge disaster.
  
  
  METHODS
  The subjects included 12,524 children from elementary, middle, and junior high schools in Ishinomaki City. The Post Traumatic Stress Symptoms for Children 15 items (PTSSC-15), a self-rating questionnaire on post-traumatic symptoms, was distributed among the children, and Strength and Difficulties Questionnaire (SDQ), a self-rating questionnaire on difficulties in dealing with children, was given to their parents and teachers. With PTSSC-15, a valid response was obtained from 10,909 (89.5%) participants. With SDQ for teachers and parents, valid responses were obtained from 10,577 (86.7%) and 7052 (83.9%) participants, respectively.
  
  
  RESULTS
  PTSSC-15 scores were significantly higher (P<0.001) in girls than in boys from the junior high school. These effect sizes were less than 0.30. Correlations of teachers' SDQ scores and PTSSC-15 scores were significantly low (r<0.21, P<0.001) for both genders and all children. Likewise, correlations between SDQ scores assigned by parents (excluding "prosocial behavior") and PTSSC-15 scores were significantly low (r<0.21, P<0.001) for both genders and at all school levels.
  
  
  CONCLUSIONS
  This study elucidated that the difficulties faced by parents and teachers while dealing with child survivors significantly low correlate with the child's post-traumatic symptoms caused by the 2011 earthquake and tsunami. Thus, it is important that clinicians should not only evaluate post-traumatic symptoms with a self-rating questionnaire but also try to objectively evaluate whether there were day-to-day difficulties caused by the post-traumatic symptoms.
authors.affiliation: Department of Child and Adolescent Psychiatry, National Center for Global Health and Medicine, Kohnodai Hospital, Ichikawa, Japan.
authors.forename: Masahide
authors.initials: M
authors.lastname: Usami
authors.affiliation: Department of Child and Adolescent Psychiatry, National Center for Global Health and Medicine, Kohnodai Hospital, Ichikawa, Japan.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Iwadare
authors.affiliation: Department of Child Mental Health, Imperial Gift Foundation, Aiiku Hospital, Minato Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Kodaira
authors.affiliation: Department of Child and Adolescent Psychiatry, National Center for Global Health and Medicine, Kohnodai Hospital, Ichikawa, Japan.
authors.forename: Kyota
authors.initials: K
authors.lastname: Watanabe
authors.affiliation: Department of Child and Adolescent Psychiatry, National Center for Global Health and Medicine, Kohnodai Hospital, Ichikawa, Japan.
authors.forename: Hirokage
authors.initials: H
authors.lastname: Ushijima
authors.affiliation: Department of Child and Adolescent Psychiatry, National Center for Global Health and Medicine, Kohnodai Hospital, Ichikawa, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Tanaka
authors.affiliation: Division of Neuropsychiaty, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan.
authors.forename: Maiko
authors.initials: M
authors.lastname: Harada
authors.affiliation: Institute of Women's Health, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Tanaka
authors.affiliation: Department of Psychiatry, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Sasaki
authors.affiliation: Department of Child Mental Health, Imperial Gift Foundation, Aiiku Hospital, Minato Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Saito
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D002648:Child; D059026:Diagnostic Self Evaluation; D004190:Disasters; D055866:Earthquakes; D005178:Faculty; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D010290:Parents; D012189:Retrospective Studies; D012574:Schools; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000523:psychology; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D063189:Symptom Assessment; D057192:Tsunamis