These associa- Thus, the low scores reported may not be a sign of coping, but rather that the psychological impact of the earthquakes was not severe enough. The interviews were conducted by the same research team as in 2005. In the figures, we display estimated marginal means of the total IES-R scores by the level of education in the mother (We were able to include 558 mothers from the original sample of 600. This is about the same level as the estimated incidence of PTSD after earthquakes in a recent meta-analysis, however, somewhat lower than the mean level among woman (Exposure variables including the death of close family and the belief that own, or the life of someone close was in danger, were consistently related to higher PTSD symptoms in the present study. Of the total sample, only 2% reported that they did not move after the earthquakes, while 16.8% (92) reported that they have stayed more than 4 places during the past 20 months. Six women did not answer the earthquake exposure questionnaire, and 552 mothers are included in the regression models. Eight people had died, 23 were not contactable and 39 refused to take part. This study was approved by the ethics committee of the Marche Region (CERM-2018 64 F99-F99).Socio-demographic characteristics (gender, age, school education, living situation, employment status) were recorded. Therefore, the reported PTSD (16.9%) in the 2017 sample would perhaps have been similar even if they had not experienced an earthquake in 1997, particularly as the symptom level reported after the second exposure is still lower than that reported in other studies mentioned above. One can only speculate as to whether the factors that had been considered as helpful for long-term outcomes after the first earthquakes might not have been sufficient to prevent short-term distress and lower SQOL in at least some people, but have helped many others to avoid negative consequences of the experiences for the overall quality of their lives. Despite low symptom levels several years after an earthquake, people can show psychological distress after a new exposure, whilst average quality of life levels are not affected.Exposure to earthquakes can lead to lasting psychological symptoms, often diagnosed as Post-Traumatic Stress Disorder (PTSD), and impaired quality of life [In the small town of Camerino in central Italy the last major earthquakes in the past two centuries occurred in 1997 and 2016. Despite low symptom levels several years after an earthquake, people can show psychological distress after a new exposure, whilst average quality of life levels are not affected. However, perhaps these protective factors may have led to more positive long-term outcomes in 2005. Our findings are consistent with other studies describing the long-lasting impacts of earthquakes (Approximately 24% of the mothers report PTSD symptoms that give rise to clinical concern or indicating a probable diagnosis. SR, MU, and RC participated in the data collection. A longitudinal study was conducted, 130 participants were re-interviewed between July and December 2017. In addition, we find that lower levels of education in both mothers and their husbands were associated with increased symptoms of PTSD, while participating in rescue efforts after the earthquakes were associated with less PTSD symptoms.The mothers in the present study report of severe, widespread and long-lasting impact of the earthquakes, including loss of family members, damaged and collapsed houses forcing the family to move several times, and negative impact on their practical family life in areas such as economy, food security and employment. Finally, a limitation to the current study is that our sample may not be representative of the total population as we targeted families with mildly stunted children which may have resulted in a sample of relative low SES families. symptoms among older survivors of the Great East Japan Earthquake after taking into account predisaster mental health status. Psychological symptom levels were low and only one person had current Post-Traumatic Stress Disorder (PTSD). Psychol., 02 April 2019

Data was collected using paper format questionnaires that were completed by members of the research team whilst with the participant.

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