title: Longitudinal trajectories of post-traumatic stress disorder symptoms among adolescents after the Wenchuan earthquake in China.
abstract: BACKGROUND
  This study examines the patterns and predictors of post-traumatic stress disorder (PTSD) symptom trajectories among adolescent survivors following the Wenchuan earthquake in China.
  
  
  METHODS
  A total of 1573 adolescent survivors were followed up at 6, 12, 18 and 24 months post-earthquake. Participants completed the Posttraumatic Stress Disorder Self-Rating Scale (PTSD-SS), Adolescent Self-Rating Life Events Checklist, Social Support Rate Scale, and the Simplified Coping Style Questionnaire. Distinct patterns of PTSD symptom trajectories were established through grouping participants based on time-varying changes of developing PTSD (i.e. reaching the clinical cut-off on the PTSD-SS). Multivariate logistic regressions were used to examine predictors for trajectory membership.
  
  
  RESULTS
  PTSD prevalence rates at 6, 12, 18 and 24 months were 21.0, 23.3, 13.5 and 14.7%, respectively. Five PTSD symptom trajectories were observed: resistance (65.3% of the sample), recovery (20.0%), relapsing/remitting (3.3%), delayed dysfunction (4.2%) and chronic dysfunction (7.2%). Female gender and senior grade were related to higher risk of developing PTSD symptoms in at least one time point, whereas being an only child increased the possibility of recovery relative to chronic dysfunction. Family members' injury/loss and witness of traumatic scenes could also cause PTSD chronicity. More negative life events, less social support, more negative coping and less positive coping were also common predictors for not developing resistance or recovery.
  
  
  CONCLUSIONS
  Adolescents' PTSD symptoms showed an anniversary reaction. Although many adolescents remain euthymic or recover over time, some adolescents, especially those with the risk factors noted above, exhibit chronic, delayed or relapsing symptoms. Thus, the need for individualized intervention with these adolescents is indicated.
authors.affiliation: School of Psychology,South China Normal University,Guangzhou,Guangdong,People's Republic of China.
authors.forename: F
authors.initials: F
authors.lastname: Fan
authors.affiliation: School of Psychology,South China Normal University,Guangzhou,Guangdong,People's Republic of China.
authors.forename: K
authors.initials: K
authors.lastname: Long
authors.affiliation: School of Psychology,South China Normal University,Guangzhou,Guangdong,People's Republic of China.
authors.forename: Y
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: School of Psychology,South China Normal University,Guangzhou,Guangdong,People's Republic of China.
authors.forename: Y
authors.initials: Y
authors.lastname: Zheng
authors.affiliation: School of Psychology,South China Normal University,Guangzhou,Guangdong,People's Republic of China.
authors.forename: X
authors.initials: X
authors.lastname: Liu
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D002648:Child; D002681:China / Q000453:epidemiology; D055866:Earthquakes; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008016:Life Change Events; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009863:Only Child / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012737:Sex Factors; D012944:Social Support; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D017741:Survivors / Q000706:statistics & numerical data*
keywords: Adolescent survivors; longitudinal studies; post-traumatic stress disorder; predictors; trajectories