Associations among trauma exposure, post-traumatic stress disorder, and depression symptoms in adolescent survivors of the 2013 Lushan earthquake

Background: Post-traumatic stress disorder (PTSD) frequently occurs in survivors of natural disasters, while symptom of depression is related mostly to interpersonal trauma. These conditions are highly correlated and strongly impact adolescent quality of life. This study aimed to explore the relationship among trauma exposure, PTSD symptoms, and/or depression symptoms in adolescent survivors of the 2013 Lushan (China) earthquake. Methods: A cross-sectional survey of 2921 adolescents in the Longmenshan seismic fault zone was conducted three years after the Lushan earthquake. Participants were evaluated using the Earthquake Experience Scale, the Adolescent Self-rating Life Events Checklist (ASLEC), the Children's Revised Impact of Event Scale (CRIES-13), and the Depression Self-Rating Scale (KADS-6). Stepwise regression was used to explore relationships between trauma exposure and PTSD or depression symptoms. Results: There was a strong correlation between PTSD and depression symptoms, with a 10.7% comorbidity. Earthquake-related exposure, negative life events, prior exposure to the 2008 Wenchuan (China) earthquake, and being left behind by parents all contributed to PTSD and depressive symptoms. Earthquake exposures contributed mainly to PTSD symptoms, while interpersonal traumas contributed mainly to depression symptoms. Conclusion: PTSD and depression symptoms strongly correlate in adolescent survivors of the 2013 Lushan earthquake. The high comorbidity between PTSD and depression symptoms may reflect shared risk factors. Natural disasters are more likely to cause PTSD symptoms, while interpersonal traumas are more likely to cause depression symptoms.