Prospective study of posttraumatic stress, anxiety, and depressive reactions after earthquake and political violence

Objective: The authors sought to assess the severity and longitudinal cours e of posttraumatic stress, anxiety, and depressive reactions among two grou ps of adults differentially exposed to severe and mild earthquake trauma an d a third group exposed to severe violence. They also examined interrelatio nships among these reactions and predictors of outcome and compared posttra umatic stress disorder (PTSD) symptom category profile and course between t hose exposed to earthquake and those exposed to violence. Method: Seventy-eight non-treatment-seeking subjects were assessed with sel f-report instruments approximately 1.5 and 4.5 years after the 1988 Spitak earthquake in Armenia and the 1988 pogroms against Armenians in Azerbaijan. Results: The two groups that had been exposed to severe trauma (earthquake or violence) had high initial and follow-up PTSD scores that did not remit over the 3-year interval. Overall, depressive symp; toms subsided. Posttrau matic stress, anxiety, and depressive reactions were highly intercorrelated within and across both time intervals. No significant differences in PTSD severity, profile, or course were seen between subjects exposed to severe e arthquake trauma versus those exposed to severe violence. Conclusions: After exposure to severe trauma, either an earthquake or viole nce, adults are at high risk of developing severe and chronic posttraumatic stress reactions that are associated with chronic anxiety and depressive r eactions. Clinical evaluation and therapeutic intervention should include s pecific attention to these reactions. Early mental health intervention is r ecommended to prevent their chronicity.