Abstract
BACKGROUND: The psychological reactions to catastrophic events are not known well in children. PURPOSE: The present study was performed to quantify the core features of post-traumatic stress reactions in schoolchildren after the Kobe earthquake. METHODS: Children's psychological reactions to the Kobe earthquake were examined in a total of 8,800 schoolchildren attending the third, fifth, or eighth grade in the disaster areas. The control subjects were 1,886 schoolchildren in the same grades in distant areas minimally affected by the earthquake. A self-report questionnaire was developed with reference to the Diagnostic and Statistical Manual of Mental Disorders-IV and the post-traumatic stress disorder reaction index and was used to score psychological reactions rating them from 1 to 4 depending on the frequency of the symptom. The survey was conducted four times, from 4 months to 2 years after the earthquake. RESULTS: Three factors were consistently extracted by factor analysis on the results of each study. Factor 1 was interpreted as relating to direct fear of the disaster and general anxiety, factor 2 as relating to depression and physical symptoms, and factor 3 as social responsibility such as feelings of sympathy for those who are suffering more severely and guilt for surviving. Young schoolchildren displayed particularly high scores on these factors. Furthermore, these factors were significantly associated with injuries of the children themselves, fatalities/injuries of family members, and the experience of being rescued or staying in shelters. CONCLUSIONS: Psychological and comprehensive interventions should be directed at the most vulnerable populations of young children after future earthquakes.