Post-traumatic stress disorder and depression symptoms of adolescents survived from a seriously-hit area in China: A 3-year follow-up study.

The objective of this study is to analyze the prevalence of probable PTSD and depression after earthquake and to find the risk factors. Adolescents having experienced an earthquake were recruited (n = 330) and assessed within 1 month of the trauma. Follow-up surveys were conducted 12 months, 24 months and 36 months later, respectively. Symptoms were assessed by the Children's Revised Impact of Event Scale and the Depression Self-Rating Scale for Children. Results indicate that the prevalence of probable PTSD in different stages was 42.2%, 20.1%, 30.3% and 11.2%. The corresponding rate of depression was 32.3%, 20.7%, 31.0% and 30.3%. The sub-symptoms of PTSD, intrusion and arousal, tended to decrease at the 1st year, followed by a rebound at the 2nd year, then dropping again at the 3rd year. The avoidance showed a consistent diminishing. The PTSD symptoms were significantly associated with gender and the degree of earthquake exposure. However, the gender, family relationship and despair played crucial roles in the development of depressive symptoms. Despite of the tendency of timing abatement, the prevalence of probable PTSD and depression might show rebound at the second year, which remind us a vital threshold for psychological intervention.

[Reliability and Validity of the Abridged Chinese Version of Autism Spectrum Quotient-Child form in China].

OBJECTIVE: To determine the reliability and validity of the abridged Chinese version of the autism spectrum quotient (AQ) -child form. METHODS: A total of 86 children with autism spectrum disorder (ASD) were recruited from the West China Hospital from July 2014 to December 2016, along with 6 896 children recruited from three schools in Chengdu. The participants completed the AQ scale under instructions from a trained interviewer. Then 170 school children were selected and repeated the AQ scale within one month. RESULTS: All subscale scores were correlated with the scale score, but with weak inter-subscale correlations. The total AQ score of the control group was continuously distributed in the population, which was similar to the normal distribution. The skewness was -0.127 and the kurtosis was -0.124, indicating that the total AQ score was negatively skewed and slightly flat in the population.There were differences in AQ scores between different genders in community children (P<0.01), with male group (42.09±9.92) higher than female group (40.07±9.94).There was no gender difference in the ASD individuals. There was a correlation between age and AQ score (R=0.06).The autistic children had a higher AQ score (54.49±14.16) than the school children (41.12±9.98)(P<0.01). Similar results were found in the subscale scores, except for"attention to detail". The AQ scale had a Cronbach α coefficient of 0.71: ranging from 0.21 to 0.69 for the subscales. The test-retest reliability was good for the scale and the subscales (all P>0.05) . The sensitivity and specificity of AQ for screening ASD was both 0. 71. CONCLUSION: The abridged Chinese version of the AQ-child scale has good psychometrics properties and may be a valid and reliable instrument for ASD screening with a cut-off score of 48.

Comparison of family functioning in families of depressed patients and nonclinical control families in China using the Family Assessment Device and the Family Adaptability and Cohesion Evaluation Scales II.

BACKGROUND: Family functioning influences the course and long-term outcome for patients with depression. It is important to understand the family functioning of depressed patients from the viewpoint both of patients and their family members. The objective of this study was to explore the association between family functioning and depression in a sample of Chinese families, using the Family Assessment Device (FAD) and the Family Adaptability and Cohesion Evaluation Scales II (FACES II). METHOD: This study was conducted in a sample of 61 depressed patients and their family members and 61 nonclinical controls in mainland China. It compared the perception of depressed patients and their family members and evaluated agreement between family members. RESULTS: Results indicate that in mainland China, functioning among families with a depressed family member is poorer than that of control families. Depressed patients reported less satisfaction than did their family members. There were significant differences on 4 of the 7 FAD scales among depressed patients and their family members, whereas no discrepancies were found on the FACES II. For the FAD, low agreement between patients and family members was found on all scales except behavioral control. Moderate agreement appeared on all dimensions of FACES II except for ideal cohesion and dissatisfaction with cohesion for the families of depressed patients. CONCLUSIONS: Depression is associated with impaired family functioning in families in mainland China. When applying the FAD and FACES II to samples of Chinese families, clinicians should be aware that the FAD may be more sensitive to detecting problems in some areas than the FACES II.

[Personality traits of Chinese adolescents with non-suicidal self injury and suicide attempt ].

OBJECTIVE: To examine the personality traits of Chinese adolescents with non-suicidal self-injury (NSSI) and suicide attempt (SA). METHODS: A cross-sectional survey on 2 131 middle school students in Dujiangyan city was conducted using the Eysenck Personality Questionnaire (EPQ, Children's Version) and Self- harm Behaviors Questionnaire (SHQ). The sample was stratified selected, comprising 1 085 boys and 1 046 girls with an average age of (13. 92±1. 63) years. The study population was categorized into four groups according to their non-suicidal and suicidal behaviors measured by the SHQ: those without self-harm (NoSH), those with non suicidal self-injury exclusively (NSSI only), those only with suicide attempts (SA only) and those with both NSSI and SA (NSSI+ SA). A MANCOVA model was constructed, with age and gender treated as covariates. We compared the four subscales of EPQ (Neuroticism, Psychoticism, Extraversion, Lie) between the four groups of study populations. RESULTS: NSSI was reported by 23. 2% (n 494) of respondents, and 3. 2% (n= 68) reported having at least one SA. A total of 1 617 (75.88%) respondents were identified as NoSH; 446 (20. 93%) as NSSI only; 20 (0.94%) as SA only, and 48 (2.25%) as NSSI+SA. Psychoticism, extraversion, and neuroticism were risk factors for self-harm behaviors. The NSSI+ SA group showed significantly higher psychoticism scores than respondents only with NSSI (P<0. 008 3,d=0. 59). The NSSI+SA group had a higher extraversion score than the NSSI group (P>0. 008 3,d=0. 38). CONCLUSION: Personality traits are closely associated with self-harm behaviors. Prevention of self harm behaviors should consider personality characteristics of middle school students.

[Study on the detection rate and risk factors regarding non-suicidal self-injurious behavior in middle school students].

OBJECTIVE: To understand the prevalence and risk factors of non-suicidal self-injury in middle school students. METHODS: 1312 middle school students of Pengzhou and Santai were selected to fill in a Risky Behavior Questionnaire for Adolescence (RBQ-A), Family Environment Scale (FES), Center for Epidemiological Survey, Depression Scale (CES-D), Adolescent Self-Rating Life Events Check List (ASLEC), Social Support Scale for Adolescents (SSSA) and self-administered questionnaire. In all the research subjects, 1288 were qualified for the study in April 2011 before the risk factors for non-suicidal self-injury were identified by logistic regression. RESULTS: In 1288 middle school students, 22.67% had a history of non-suicidal self-injury, with 22.70% in boys and 22.64% in girls. 63.36% of students had injured themselves through variously ways, more seen in boys (26.88%) than in girls (11.36%) who cut or burnt themselves. The scores of ASLEC and CES-D in non-suicidal self-injury group appeared higher than that in the control group and the score of SSSA was found higher in the control group. The main risk factors for non-suicidal self-injuries were family conflict, depressive emotion, negative life events and receiving less social support. CONCLUSION: The prevalence of non-suicidal self-injury among middle school students in Pengzhou was high, which called for more attention.

[Influence factors of post-traumatic stress disorder (PTSD) and depression symptoms in children and adolescents after Wenchuan earthquake in China].

OBJECTIVE: This study was to analyze the mental health status of the children and adolescents from the areas struck by Wenchuan earthquake and to understand the factors that may have impact on their mental health after exposing to the earthquake. METHODS: Subjects of this survey were students (8 - 16 years old) from Chendu, Dujiangyan, Beichuan and Wenchuan districts which were the most severely affected areas in the earthquake. We analyzed the subjects' mental health conditions after Wenchuan earthquake by using a general questionnaire that was composed of the Children's Revised Impact of Event Scale (CRIES-13) and Depression Self-rating Scale for Children (DSRSC). Students are investigated 7341 case, 7387 case, 7395 case after 3, 6, 24 months. The data were analyzed with logistic regression model. RESULTS: The CRIES-13 scores were (27.51 ± 12.26), (23.54 ± 12.79) and (21.35 ± 12.59) (F = 28.842, P ≤ 0.05) and the DSRSC scores were (11.79 ± 5.73), (10.94 ± 5.50) and (10.75 ± 5.27) (F = 17.084, P ≤ 0.05) 3, 6 and 24 months after the earthquake, respectively. The risk factors associated with depression 3, 6, 24 months after the earthquake were gender (female) (OR values were 2.14, 2.72, 2.31; 95%CI values were 1.01 - 3.03, 1.10 - 5.01, 1.02 - 4.58), age (less than 12 years old) (OR values were 1.97, 2.22, 1.93; 95%CI values were 1.43 - 3.17, 1.02 - 3.54, 1.32 - 3.27), having family member injury and death (OR values were 2.19, 2.45, 2.35; 95%CI values were 1.04-2.89, 1.16-2.08, 1.02 - 2.79), desperation (OR values were 2.24, 2.09, 2.16; 95%CI values were 1.00 - 2.54, 1.70 - 2.58, 1.00 - 4.56). The risk factors associated with PTSD 3, 6, 24 months after the earthquake were gender (OR values were 2.16, 2.94, 1.96; 95%CI values were 1.36 - 2.53, 1.36 - 2.53, 1.06 - 3.92), age (less than 12 years old) (OR values were 3.51, 2.62, 1.92; 95%CI values were 1.22 - 5.40, 1.14 - 4.93, 1.08 - 3.35), having teachers and schoolmates injury and death (OR values were 2.32, 2.48, 2.36; 95%CI values were 1.17 - 2.48, 1.30 - 2.72, 1.02 - 2.85), having family member injury and death (OR values were 2.73, 2.21, 1.85;95%CI values were 1.67 - 3.61, 1.04 - 3.15, 1.05 - 2.38), witnessing injury (OR values were 2.17, 2.36, 2.34; 95%CI values were 1.15 - 3.65, 1.17 - 2.67, 1.02 - 3.67), witnessing death (OR values were 1.98, 2.39, 1.71;95%CI values were 1.10 - 2.56, 1.14 - 3.70, 1.57 - 3.88), desperation (OR values were 2.02, 1.94, 2.02; 95%CI values were 1.67 - 2.35, 1.66 - 2.27, 1.82 - 2.26). CONCLUSION: The symptoms of PTSD and depression of young survivors from the earthquake-struck areas had gradually alleviated 3, 6, 24 months after the earthquake. Age (less than 12 years old), gender (female), having family member injury and death, witnessing injury and death, and desperation were the main risk factors that affected the children and adolescents mental health.

[The effect of genetic and environmental factors on externalizing behaviors of twin children].

OBJECTIVE: To explore the effect of genetic and environmental factors on externalizing behaviors of children. METHODS: A total of 168 twin pairs aged 6-16 years were recruited. Their parents completed Achenbach Child Behavior Checklist (CBCL) to evaluate the children's externalizing behaviors. The parents also completed FACESII-CV and GHQ-12 to assess their family environment. Structural equation modeling was performed to evaluate the effects of additive genetic factors (A), common environmental factors (C) and individual-specific environmental factors (E) on the externalizing behaviors. RESULTS: The effect of A, C, and E on externalizing behaviors were 0.39 (95% CI: 0.22-0.62), 0.51 (95% CI: 0.28-0.67), and 0.10 (95% Cl: 0.07-0.15), respectively. Significant correlations were found between the children's externalizing behaviors and the total GHQ-12 scores of their fathers and mothers (r = 0.24, P < 0.05; r = 0.30, P < 0.05). The externalizing behaviors were also correlated with family adaptability (r = 0.27, P< 0.01). The logistic regression identified mother's habits, such as smoking and drinking as risk factors of their children's externalizing behaviors. CONCLUSION: Externalizing behaviors are mainly affected by shared environmental factors. Externalizing behaviors are related to general mental health of fathers and mothers and the family adaptability.

[A twin study on genetic and environmental factors of children's prosocial behavior].

OBJECTIVE: Using quantitative genetic analysis of twin study design to explore the impact of genetic and environmental factors on the prosocial behaviors of children. METHODS: One hundred and forty-seven twin pairs from Chengdu area aged 6-16 were studied using parental information of Strengths and Difficulties Questionnaire (SDQ). SPSS13.0 and Mx software were used to analyze data, including nonparametric test, Pearson correlation, genetic analyses, etc. RESULTS: (1) Female children score higher than males on their prosocial behavior (Ps< 0.05), except less than 11 age group; (2) Shared environmental factors were the most important for children's prosocial behaviors(C=0.48,95%CI:0.09-0.73),then the genetic factors (A=0.27,95%CI:0-0.66) and the unshared environmental factors(E=0.25,95%CI:0.18-0.35); (3)Female and those who scored higher on their fact/ideal family adaptability and cohesion scored higher in their prosocial behaviors (r:0.17-0.29). On the contrary, those who had extreme conditions during pregnancy/ perinatal period or whose caretaker had discordant opinions on parenting scored lower (r: -0.16 to 0.28). CONCLUSION: Children's prosocial behaviors were influenced by genetic and environmental factors including family function and parenting environment, and genetic impact differs in different age and sex.

[The mental health of children and adolescents from earthquake affected areas].

OBJECTIVE: To examine the mental health status of 11-16 years old children exposed to the 5.12 WenChuan earthquake and to help develop post-traumatic psychological interventions. METHODS: The self-reported Strengths and Difficulties Questionnaire (SDQ) was administered to 540 children (mean age: 13.82+/-0.98, male/female ratio 1.06:1) from the earthquake affected areas one month after the earthquake. RESULTS: (1) The children had an average difficulty score (T score) of 13.41+/-5.71, with 74.6% reporting at least minor perceived difficulties. (2) The children with higher levels of exposure had higher emotional subscale scores (z=-2.323, P=0.020). The female students had higher emotional subscale scores than the male students (z=-4.985, P=0.000). (4) The impact of the difficulties on the children's learning increased with age (z=9.106, P=0.011). (5) The longer the children lived in the transferred safe places, the more likely the children got an abnormal (OR=1.233, P=0.003). CONCLUSION: The mental health status of the children from the earthquake affected areas are influenced by their exposure levels, gender, age and the length of living in transferred safe places. These factors should be taken into considerations when post-traumatic psychological interventions are planned.

[A twin study on intelligence and processing speed heritability of children and adolescent].

OBJECTIVE: To explore the effects of the genetic and environmental factors on intelligence of children and adolescent from the Southwest China Prospective Twin Registry (SCPT). METHODS: The intelligence was investigated by using the Wechsler Intelligence Scale for Children (C-WISC) in 333 twin pairs aged 6-16 years. The effects of genetic and environmental factors on IQ were analyzed by using structural equation modeling (SEM) and correlation analysis method. The effects in different sex and age groups in this population were also investigated. RESULTS: Genetic influence accounted for 0.43 of total IQ variance and 0.37 of verbal IQ in 6-16 years old children and adolescent, but there was no significant genetic effect on performance IQ. The heritability of children aged 10-16 years was higher than that of those aged 6-10 years (total IQ: 0.82 vs 0.00, verbal IQ: 0.80 vs 0.00, performance IQ:0.51 vs 0.00). In males the heritability of verbal IQ (0.47) was higher than that in females (0.05). The shared environmental influences accounted fo r the majority of variance of performance IQ in both males and females. CONCLUSION: There is moderate heritability on the total IQ and verbal IQ, while shared environmental factors played important roles on the variance of performance IQ. The heritability of IQ, verbal IQ and performance IQ are higher in older children and adolescent than that in younger children.

[Quality of life of children with attention deficit hyperactivity disorders].

OBJECTIVE: To assess the quality of life of children with attention deficit hyperactivity disorders (ADHD). METHODS: The PedsQL 4.0 generic core scales (Chinese Version) were administered to 73 ADHD children and 98 gender and age-matched healthy children. The parents of the children completed the Conners Parent Symptom Questionnaire. RESULTS: A total of 169 out of 171 recruited families completed the questionnaires, with a response rate of 98.8%. The ADHD children had significantly lower scores (72.7 +/- 13.0) of PedsQL 4.0 than that of the healthy children (83.7 +/- 12.0, t = -49.3, P = 0.000). The Parent Proxy-Report total score of the ADHD children (70.0 +/- 12.4) was also lower than the normal controls (82.4 +/- 11.2, t = -57.7, P = 0.000). The psychosocial health functioning of ADHD children (Children Self-Report 68.6 +/- 14.5, Parent Proxy-Report 64.9 +/- 15.4) was consistently poorer than the Physical Functioning (Children Self-Report 81.2 +/- 14.0, Parent Proxy- Report 81.7 +/- 15.6) (P = 0.000). The ADHD children had significantly higher scores in Conners Parent Symptom Questionnaire (44.54 +/- 17.89) than the normal controls (16.09 +/- 9.23, t = 100.08, P = 0.000). The PedsQL 4.0 scores were negatively correlated with school functioning scores, learning problems, hyperactivity index and the total scores of Conners Parent Symptom Questionnaire (r = -0.650, -0.630, and -0.599 respectively, P = 0.000). CONCLUSION: ADHD children suffer from poor quality of life and learning difficulties.