Negative life events and post-traumatic stress disorder symptoms: a moderated mediation model of only-child status and depressive symptoms

Public Health. 2019 Jul:172:31-39. doi: 10.1016/j.puhe.2019.04.005. Epub 2019 May 31.

Abstract

Objectives: Post-traumatic stress disorder symptoms (PTSS) and depressive symptoms are the most common adolescent psychological effects from earthquakes, with negative life events significantly influencing PTSS prolongation. However, the underlying mediating and moderating mechanisms that connect negative life events with PTSS remain unclear. The purpose of this study was to investigate (i) the mediating role of depressive symptoms on negative life events and PTSS and (ii) the moderating role of only-child status in the direct and indirect relationship between negative life events and PTSS, 3 years after the 2013 Ya'an earthquake in China.

Study design: Quantitative study using data from the Ya'an earthquake.

Methods: Three years after the 2013 Ya'an earthquake, 4402 adolescent survivors in Lushan county were surveyed using the Adolescent Self-Rating Life Events Check list to assess the psychological effects of negative life events in the previous 12 months. In addition, the short Mood and Feeling Questionnaire and The Children's Revised Impact of Event Scale were used to assess depressive symptoms and PTSS severity, respectively.

Results: After controlling for gender and age, negative life events were found to be significantly positively associated with PTSS. The mediation analyses revealed that depressive symptoms mediated the association between negative life events and PTSS; however, the moderated mediation analysis found the association was much weaker for only children.

Conclusion: The findings supported and clarified the interrelations and associations between negative life events, depressive symptoms and PTSS. The conditional process analyses found that only-child status moderated not only the direct associations but also the relationship between negative life events and depressive symptoms. Our findings highlight the need for intervention programmes targeting adolescents, especially for children with siblings.

Keywords: Depressive symptoms; Moderated mediation model; Negative life events; Only-child status; PTSS.

MeSH terms

  • Adolescent
  • Child
  • China / epidemiology
  • Depression / epidemiology
  • Depression / psychology*
  • Earthquakes*
  • Female
  • Humans
  • Life Change Events*
  • Male
  • Models, Psychological
  • Only Child / psychology*
  • Only Child / statistics & numerical data
  • Risk Factors
  • Stress Disorders, Post-Traumatic / epidemiology
  • Stress Disorders, Post-Traumatic / psychology*
  • Surveys and Questionnaires
  • Survivors / psychology
  • Survivors / statistics & numerical data