title: Sources of perceived social support associated with reduced psychological distress at 1 year after the Great East Japan Earthquake: Nationwide cross-sectional survey in 2012.
abstract: OBJECTIVE
  Lack of social support has been associated with a higher level of psychological distress after disasters, but its relative associations with sources of support such as neighbors, friends, family, and others, are underreported. The present study assessed the associations of social support with psychological distress according to support source among the general population 1 year after the Great East Japan Earthquake.
  
  
  METHODS
  An online survey was completed by a Japanese national sample of 10 469 participants in 2012, from which 8777 were analyzed. Psychological distress was measured using the Kessler Psychological Distress Scale (K6), and the associations between social support from family, friends, or neighbors and psychological distress score were estimated using a proportional odds model. This model was separately fitted for house-damage certification from the disaster (573 participants were certified, 8204 were uncertified).
  
  
  RESULTS
  Prevalence of K6 ≥ 13 points was 8.4% for house-damage certified and 9.0% for uncertified participants. K6 ≥ 5 points was observed among 49.9% of the house-damaged certified group and in 47.7% of the uncertified group. Lack of support from family, friends, and neighbors was similarly associated with higher K6 score among house-damage certified and uncertified participants. Similar patterns were observed from participants who received house-damage certificates and those who did not experience damage to their homes.
  
  
  CONCLUSIONS
  Enhancing perceived sources of social support among the general population, not limited to people with house damage, can be an effective way to reduce psychological distress following a disaster.
authors.affiliation: Department of Health Technology Assessment and Public Policy, Graduate School of Public Policy, The University of Tokyo, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Sugimoto
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: Maki
authors.initials: M
authors.lastname: Umeda
authors.affiliation: Departments of Biostatistics, School of Public Health, The University of Tokyo, Tokyo, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Shinozaki
authors.affiliation: Community Health Nursing, The University of Tokyo, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Naruse
authors.affiliation: Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Miyamoto
mesh_terms: D003430:Cross-Sectional Studies; D004190:Disasters; D055866:Earthquakes; D005260:Female; D006306:Health Surveys; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012944:Social Support; D013315:Stress, Psychological / Q000453:epidemiology* / Q000523:psychology
keywords: community integration; disaster; mental health; residence characteristics; social support