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Sense of Community and Depressive Symptoms among Older Earthquake Survivors Following the 2008 Earthquake in Chengdu China

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Title: Sense of Community and Depressive Symptoms among Older Earthquake Survivors Following the 2008 Earthquake in Chengdu China
Language: English
Authors: Li, Yawen, Sun, Fei, He, Xusong, Chan, Kin Sun
Source: Journal of Community Psychology. Sep 2011 39(7):776-785.
Availability: John Wiley & Sons, Inc. Subscription Department, 111 River Street, Hoboken, NJ 07030-5774. Tel: 800-825-7550; Tel: 201-748-6645; Fax: 201-748-6021; e-mail: subinfo@wiley.com; Web site: http://www3.interscience.wiley.com/browse/?type=JOURNAL
Peer Reviewed: Y
Page Count: 10
Publication Date: 2011
Document Type: Journal Articles
Reports - Research
Descriptors: Foreign Countries, Depression (Psychology), Natural Disasters, Symptoms (Individual Disorders), Older Adults, Role, Surveys, Coping, Social Support Groups, Trauma, Trust (Psychology), Correlation
Geographic Terms: China
DOI: 10.1002/jcop.20469
ISSN: 0090-4392
Abstract: This study examined the impact of an earthquake as well as the role of sense of community as a protective factor against depressive symptoms among older Chinese adults who survived an 8.0 magnitude earthquake in 2008. A household survey of a random sample was conducted 3 months after the earthquake and 298 older earthquake survivors participated in it. The results showed that earthquake-associated distress had a direct effect on depression controlling for coping, informal support, and sense of community. The results also showed that the effect of earthquake-associated distress is contingent upon the level of sense of community. The findings highlighted the role of individuals' sense of community as a protective factor against traumatic experiences and suggested that attempts to build trust and form a sense of belonging to the new community among older earthquake survivors would help them reduce distress and facilitate a smooth recovery. (Contains 1 figure and 3 tables.)
Abstractor: As Provided
Number of References: 29
Entry Date: 2011
Accession Number: EJ940730
Database: ERIC
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  Value: <anid>AN0064487208;59b01sep.11;2019May30.11:54;v2.2.500</anid> <title id="AN0064487208-1">Sense of community and depressive symptoms among older earthquake survivors following the 2008 earthquake in Chengdu China. </title> <p>This study examined the impact of an earthquake as well as the role of sense of community as a protective factor against depressive symptoms among older Chinese adults who survived an 8.0 magnitude earthquake in 2008. A household survey of a random sample was conducted 3 months after the earthquake and 298 older earthquake survivors participated in it. The results showed that earthquake‐associated distress had a direct effect on depression controlling for coping, informal support, and sense of community. The results also showed that the effect of earthquake‐associated distress is contingent upon the level of sense of community. The findings highlighted the role of individuals' sense of community as a protective factor against traumatic experiences and suggested that attempts to build trust and form a sense of belonging to the new community among older earthquake survivors would help them reduce distress and facilitate a smooth recovery. © 2011 Wiley Periodicals, Inc.</p> <p>An earthquake measuring a magnitude of 8.0 on the Richter Scale struck Sichuan, China, on May 12, 2008. According to the national statistics, the death toll was 69,227 with 374,643 injured and 17,923 missing. In addition, about 4.8 million were left homeless (State Council Information Office of the People's Republic of China, [<reflink idref="bib24" id="ref1">24</reflink>]). It was one of the most deadly earthquakes in recent decades in China.</p> <p>Many survivors of natural disasters experience psychosocial problems (e.g., posttraumatic distress) in their adjustment to the loss of resources (e.g., housing, belongings) or loved ones (e.g., family members). Older survivors are particularly vulnerable because their psychosocial distress is often exacerbated by their deteriorated health and declined capacity to adjust to new environments (Chiu, Hu, Lue, Chen, & Hsieh, [<reflink idref="bib5" id="ref2">5</reflink>]; Jia et al., [<reflink idref="bib12" id="ref3">12</reflink>]). These age‐related changes and associated disease processes put older survivors at a heightened risk following a disaster. It is therefore important to examine the psychosocial impact of earthquake on older survivors and identify those at high risk.</p> <p>After the earthquake, 1.69 million transitional shelters were built to house millions of earthquake survivors in Sichuan province (Sichuan Provincial People's Government, [<reflink idref="bib23" id="ref4">23</reflink>]). As a result of this massive building project, new housing blocks were formed and new communities evolved in the quake‐affected areas. Earthquake survivors live in these transitional shelters until their houses are rebuilt and ready to moved into. However, little is known about whether older survivors can adapt to these new environments in transitional housing and whether those newly formed communities can help them cope with their losses, thereby reducing their distress.</p> <p>Research has consistently shown that sense of community, defined as sense of belonging to a community, closeness with community members, and shared faith that the needs of the members will be satisfied through their commitment of being together (McMillan, [<reflink idref="bib17" id="ref5">17</reflink>]), are associated with psychological outcomes (Mak, Cheung, & Law, [<reflink idref="bib16" id="ref6">16</reflink>]; Prezza, Amici, Roberti, & Tedeschi, [<reflink idref="bib21" id="ref7">21</reflink>]). Sense of community has been found to moderate the association between traumatic experiences and psychological distress among children (Greenfield & Marks, [<reflink idref="bib8" id="ref8">8</reflink>]) and women (Banyard & Williams, [<reflink idref="bib2" id="ref9">2</reflink>]). However, very limited information was available on its relevance to the older population. Much less was known about its potential effects to buffer the impact of traumatic events among earthquake survivors. There is also a dearth of knowledge on the impact of earthquakes on the Chinese population (Kun, Han, Chen, & Yao, [<reflink idref="bib13" id="ref10">13</reflink>]; Wang et al., [<reflink idref="bib27" id="ref11">27</reflink>]), and even less on older Chinese adults (Jia et al., [<reflink idref="bib12" id="ref12">12</reflink>]). To the best of our knowledge, this study was the first that examined the impact of an earthquake on depressive symptoms among older Chinese earthquake survivors and tested the roles of indivdiuals' sense of community in relation to their felt earthquake impact and depressive symptoms. Given the earthquake in Japan in March 2011, we are more aware that helping vicitms of natural disators (e.g., earthquake) is a pressing globle issue that involves the efforts of citizens on the earth. This study is intended to provide information that would assist helping professionals in their relief work with older earthquake surviors in China, and to possibly inspire those who work with a similar populaiton in other countries.</p> <hd id="AN0064487208-2">METHOD</hd> <p></p> <hd id="AN0064487208-3">Participants</hd> <p>This study used household survey data collected on a sample of 298 Chinese older adults aged 55 or above who survived the 2008 Sichuan earthquake. The survey was conducted in one of the largest transitional communities 3 months after the earthquake occurred. The community hosted 12,000 earthquake survivors from Du Jiangyan city and its surrounding areas. It was estimated that there were more than 3,000 older adults living in this community. This community, which comprised 500 blocks of buildings, was built on a piece of farmland 2 weeks after the earthquake. Among the 500 blocks, 20 were designated for nonresidential use, such as public common rooms, offices, cafeterias, and public bathrooms. The other 480 blocks were assigned as residential housing for earthquake survivors. In each block, there were six to seven rooms measuring around 200 square feet, each accommodating up to four persons.</p> <p>The sampling took place in two stages. First, using the 480 residential blocks as the sampling frame, we randomly selected 60 blocks as the recruitment sites. Second, interviewers visited the 60 blocks to identity eligible participants. Those who were aged 55 years or older at the time of the interview and had a score of 24 or above on the Mini Mental Status Exams (Folstein, Folstein, & McHugh, [<reflink idref="bib7" id="ref13">7</reflink>]) were invited to participate in the survey. The response rate was 95%.</p> <hd id="AN0064487208-4">Procedure</hd> <p>Questionnaires were written in Mandarin Chinese. Interviewers were social work students who spoke local dialects and had been volunteering in the community since the earthquake. Each interviewer received 4 hours of training to ensure they fully comprehended the study purposes, understood questionnaire contents, and grasped essential interview skills. Questionnaires were administered to participants by interviewers in a face‐to‐face setting. Each interview lasted about 40 to 80 minutes. Among 320 collected questionnaires, 22 questionnaires were not completed. We were able to obtain 298 questionnaires with complete data.</p> <hd id="AN0064487208-5">Instruments</hd> <p></p> <hd id="AN0064487208-6">Depressive symptoms</hd> <p>A 9‐item Chinese version of the Center for Epidemiological Studies‐Depression (CES‐D) based on Chi and Boey's ([<reflink idref="bib4" id="ref14">4</reflink>]) work was used. The original 20‐item CES‐D has been validated among older adults living in Hong Kong (Boey, [<reflink idref="bib3" id="ref15">3</reflink>]) and mainland China (Yan, [<reflink idref="bib29" id="ref16">29</reflink>]). An abbreviated version of the 10‐item CES‐D has been used among Hong Kong older adults and was found to have good reliability and validity levels (Chi & Boey). We used six items to assess the negative emotions (a Cronbach alpha of.68) and three items to assess positive feelings (a Cronbach alpha of.67). The alpha values were lower compared with the studies reported elsewhere, as respondents rated their experience on a 3‐point Likert scale, ranging from 1 (<emph>none</emph>), 2 <emph>(sometimes</emph>), to 3 <emph>(often</emph>) rather than a 5‐point Likert scale used elsewhere.</p> <hd id="AN0064487208-7">Impact of earthquake</hd> <p>The impact of earthquake was measured by the revised 15‐item Impact of Event Scale (Horowitz, Wilner, & Alvarez, [<reflink idref="bib11" id="ref17">11</reflink>]). This scale has been widely used to measure stress reaction to traumatic events such as earthquakes, combat exposure, and threat of violence and death of family members (Sundin & Horowitz, [<reflink idref="bib25" id="ref18">25</reflink>]). It is recommended as an appropriate instrument for subjective responses to a specific traumatic event (Norris & Murrell, [<reflink idref="bib19" id="ref19">19</reflink>]), and has been translated and validated in the Chinese population (Guo‐Ping, Ya‐Lin, & Hui, [<reflink idref="bib9" id="ref20">9</reflink>]; Guo, Xin, & Geng, [<reflink idref="bib10" id="ref21">10</reflink>]). The revised 15‐item scale assessed respondents along two dimensions of response to traumatic events: intrusion (intrusive thoughts, nightmares, intrusive feelings and imagery, dissociative‐like re‐experiencing) and avoidance (numbing of responsiveness, avoidance of feelings, situations, and ideas). Respondents answered each question on a 4‐point Likert scale, ranging from 0 (<emph>not at all</emph>), 1 (<emph>rarely</emph>), 2 (<emph>sometimes</emph>), to 3 (<emph>often</emph>). The total score of the 15 items is calculated and used in our analyses. The possible range of the aggregated score is 0 to 45, with a higher score indicating higher levels of psychosocial distress. Internal consistency of the scale in this study was.92.</p> <hd id="AN0064487208-8">Resource variables</hd> <p>Sense of community was measured by the Sense of Community Index (SCI) developed by McMillan and Chavis ([<reflink idref="bib18" id="ref22">18</reflink>]). The SCI has been widely used in studies on diverse groups (Long & Perkins, [<reflink idref="bib14" id="ref23">14</reflink>]; Perkins, Florin, Rich, Wandersman, & Chavis, [<reflink idref="bib20" id="ref24">20</reflink>]), including Chinese populations (Mak et al., [<reflink idref="bib16" id="ref25">16</reflink>]). The questionnaire, comprising 12 true/false items, assessed four domains: feelings of membership (e.g., "I feel at home in this town"), influence (e.g., "If there is a problem in this town, people who live here can get it solved"), fulfillment of needs (e.g., "I think this town is a good place for me to live"), and shared emotional connection (e.g., "I expect to live in this town for a long time."). Respondents answered the 12 questions on a 4‐point Likert scale, ranging from 1 (<emph>strongly disagree</emph>) to 4 (<emph>strongly agree</emph>). In light of the suggestions of Mak et al., we tested the reliability of the 12‐item scales on this sample and then conducted a factor analysis, for which we found seven items loaded on one factor. We then used these total scores of the seven items to indicate sense of community, with a higher score indicating a higher level of sense of community.</p> <p>Social support was measured by the six‐item Lubben's Social Network Scale‐6 (LSNS‐6), which has been widely used as a screener for social isolation in health‐screening clinics, to identify cases deemed worthy of moreextensive assessment and possible clinical interventions (Lubben & Gironda, [<reflink idref="bib15" id="ref26">15</reflink>]). Three items assessed the number of supportive family members and three others measured the number of supportive friends, respectively, on a 6‐point Likert scale. The total score with a possible range from 0 to 36 was used in the analyses. The Cronbach alpha of this scale was.88 on this sample.</p> <p>Coping was measured by the Ways of Coping Questionnaire (WCQ) by Folkman and Lazarus ([<reflink idref="bib6" id="ref27">6</reflink>]). The scale contains 20 items tapping into different dimensions of coping. We conducted a factor analysis that distinguished two types of coping: deliberate coping and avoidance coping. Seven items significantly loaded on deliberate coping (factor coefficient greater than.40) had a Cronbach alpha of.83; nine items loaded on avoidance coping had a Cronbach alpha of.79. Total scores were calculated for each coping style, with higher scores indicating higher levels of involvement in this particular coping style.</p> <hd id="AN0064487208-9">Control variables</hd> <p>Control variables include age, gender, income adequacy, and self‐rated health status that were underscored in literature as important covariates of depressive symptoms among victims of natural disasters (Armenian et al., [<reflink idref="bib1" id="ref28">1</reflink>]; Ticehurst, Webster, Carr, & Lewin, [<reflink idref="bib26" id="ref29">26</reflink>]). Age and gender were measured in conventional ways. Income adequacy was measured by individuals' perception of income relative to others on a 5‐point Likert scale, ranging from 1 (<emph>very poor</emph>) to 5 (<emph>very good</emph>). Self‐rated health was measured by a one‐item question on a 5‐point Likert scale, ranging from 1 (<emph>very poor</emph>) to 5 (<emph>very good</emph>). Other important demographics assessed in the survey include educational levels, living arrangement, and marital status.</p> <hd id="AN0064487208-10">Data Analysis</hd> <p>Analyses involved in this study are missing value analyses, descriptive analyses, correlation analyses, and hierarchical linear regression analyses using PASW 18.0 (formerly, SPSS). The missing values of cases are from 0% to 5%. For missing values on multiple‐item scales, we imputed missing values using existent values on other items with the Expectation Maximization (EM) algorithm method (Schafer & Graham, [<reflink idref="bib22" id="ref30">22</reflink>]). For missing values on single‐item questions (i.e., self‐rated health, income adequacy), we replaced the missing values with means. We first provided descriptive analyses of variables in this study. Second, we ran correlation analyses of resource variables and depressive symptoms. Finally, we conducted a three‐step hierarchical linear regression analyses to examine the relation of earthquake distress, sense of community, and depressive symptoms with covariates controlled. The hierarchical linear regression analyses examined three models. Model 1 estimated the association between the impact of the earthquake and depressive symptoms controlling for demographic variables and self‐rated health status. Model 2 included the resource variables including sense of community, social support, and coping styles as predictors for depressive symptoms. Model 3 added an interaction term between sense of community and earthquake distress in the analyses. We assessed the variance explained by each model and focused on how the sense of community helped explain variation in depressive symptoms.</p> <hd id="AN0064487208-11">RESULTS</hd> <p>Table 1 shows the demographic characteristics of the sample. The mean age of participants was 69.30 (standard deviation [<emph>SD</emph>]=7.47) years old, and slightly more than half were female. About two thirds of this group had an education level below high school. Slightly less than three quarters (73.80%) of the sample were married at the time of interview.</p> <p>1 Demographic Characteristics of the Sample</p> <p> <ephtml> <table><thead valign="bottom"><tr><th align="left" /><th align="center"><italic>N=298</italic></th></tr><tr><th align="left" /><th align="center"><italic>M (SD) / %</italic></th><th align="center"><italic>Observed range</italic></th></tr></thead><tbody valign="top"><tr><td align="left">Age</td><td align="char" char=".">69.30 (7.47)</td><td align="center">54 to 92</td></tr><tr><td align="left">Female</td><td align="center">56.20%</td><td align="left" /></tr><tr><td align="left">Less than high school</td><td align="center">67.20%</td><td align="left" /></tr><tr><td align="left">Income adequacy<sup>*</sup></td><td align="char" char=".">2.42 (.73)</td><td align="center">1 to 4</td></tr><tr><td align="left">Married at time of interview</td><td align="center">73.80%</td><td align="left" /></tr><tr><td align="left">Self‐rated health</td><td align="char" char=".">2.86 (.74)</td><td align="center">1 to 5</td></tr><tr><td align="left">Impact of earthquake</td><td align="char" char=".">14.40 (9.59)</td><td align="center">0 to 45</td></tr><tr><td align="left">Sense of community</td><td align="char" char=".">24.61(3.00)</td><td align="center">14 to 33</td></tr><tr><td align="left">Social support</td><td align="char" char=".">16.80 (7.77)</td><td align="center">0 to 30</td></tr><tr><td align="left">Avoidance coping</td><td align="char" char=".">3.19 (2.07)</td><td align="center">0 to 6</td></tr><tr><td align="left">Deliberate coping</td><td align="char" char=".">6.32 (2.36)</td><td align="center">0 to 9</td></tr><tr><td align="left">Depressive symptoms</td><td align="char" char=".">16.12 (2.86)</td><td align="center">9 to 25</td></tr></tbody></table> </ephtml> </p> <p>1 <emph>Note</emph>: M=mean; SD=standard deviation. Income adequacy with a mean of 2.42 means a self‐assessed income adequacy between "poor" and "average."</p> <p>Table 2 presents the correlation coefficients between resource variables and depressive symptoms at bivariate levels. As expected, both sense of community (<emph>r</emph>=−.15, <emph>p</emph><.05) and social support (<emph>r</emph>=−.18, <emph>p</emph><.01) were negatively related to depressive symptoms. Deliberate coping was not related to depressive symptoms, but avoidance coping was positively related to depressive symptoms (<emph>r</emph>=.16, <emph>p</emph><.05). Thus, we did not include the deliberate coping in the multiple regression models. It is surprising, yet interesting, that there is a positive relationship between deliberate coping and avoidance coping. Typically, participants tend to choose one primary coping type. Yet in times of facing distressful events like an earthquake, we suspect that people who use many deliberate coping strategies may also use many avoidance coping strategies.</p> <p>2 Correlations Between Resource Variables and Depressive Symptoms</p> <p> <ephtml> <table><thead valign="bottom"><tr><th align="left" /><th align="center"><italic>1</italic></th><th align="center"><italic>2</italic></th><th align="center"><italic>3</italic></th><th align="center"><italic>4</italic></th><th align="center"><italic>5</italic></th></tr></thead><tbody valign="top"><tr><td align="left">1. Sense of community</td><td align="char" char=".">1.00</td><td align="left" /><td align="left" /><td align="left" /><td align="left" /></tr><tr><td align="left">2. Social support</td><td align="char" char=".">.28<sup>**</sup></td><td align="char" char=".">1.00</td><td align="left" /><td align="left" /><td align="left" /></tr><tr><td align="left">3. Deliberate coping</td><td align="char" char=".">.06</td><td align="char" char=".">.08</td><td align="char" char=".">1.00</td><td align="left" /><td align="left" /></tr><tr><td align="left">4. Avoidance coping</td><td align="char" char=".">−.06</td><td align="char" char=".">.04</td><td align="char" char=".">.36<sup>**</sup></td><td align="char" char=".">1.00</td><td align="left" /></tr><tr><td align="left">5. Depressive symptoms</td><td align="char" char=".">−.15<sup>*</sup></td><td align="char" char=".">−.18<sup>**</sup></td><td align="char" char=".">.01</td><td align="char" char=".">.16<sup>*</sup></td><td align="char" char=".">1.00</td></tr></tbody></table> </ephtml> </p> <p>2 <sups>*</sups><emph>p</emph><.05; <sups>**</sups><emph>p</emph><.01.</p> <p>Table 3 shows the results of the three‐step hierarchical regression models. The first model includes the impact of earthquake along with demographic and self‐rated health. As expected, self‐rated health and income adequacy were associated with fewer depressive symptoms, while the impact of earthquake was related to more depressive symptoms. Gender and age were not related to depressive symptoms. The first model explained about 11% of the variance in CES‐D.</p> <p>3 Results of Hieratical Regression Analyses Predicting Depressive Symptoms</p> <p> <ephtml> <table><thead valign="bottom"><tr><th align="left" /><th align="center"><italic>Model 1</italic></th><th align="center"><italic>Model 2</italic></th><th align="center"><italic>Model 3</italic></th></tr><tr><th align="left" /><th align="center"><italic>B</italic></th><th align="center"><italic>SE</italic></th><th align="center"><italic>B</italic></th><th align="center"><italic>SE</italic></th><th align="center"><italic>B</italic></th><th align="center"><italic>SE</italic></th></tr></thead><tbody valign="top"><tr><td align="left">Age</td><td align="char" char=".">−.01</td><td align="char" char=".">.02</td><td align="char" char=".">−.02</td><td align="char" char=".">.02</td><td align="char" char=".">−.02</td><td align="char" char=".">.02</td></tr><tr><td align="left">Female</td><td align="char" char=".">.07</td><td align="char" char=".">.33</td><td align="char" char=".">.23</td><td align="char" char=".">.33</td><td align="char" char=".">.23</td><td align="char" char=".">.32</td></tr><tr><td align="left">Self‐rated health</td><td align="char" char=".">−.85<sup>**</sup></td><td align="char" char=".">.23</td><td align="char" char=".">−.76<sup>**</sup></td><td align="char" char=".">.23</td><td align="char" char=".">−.76<sup>**</sup></td><td align="char" char=".">.23</td></tr><tr><td align="left">Income adequacy</td><td align="char" char=".">−.09</td><td align="char" char=".">.23</td><td align="char" char=".">−.12</td><td align="char" char=".">.23</td><td align="char" char=".">−.11</td><td align="char" char=".">.23</td></tr><tr><td align="left">Impact of earthquake</td><td align="char" char=".">.60<sup>**</sup></td><td align="char" char=".">.17</td><td align="char" char=".">.53<sup>**</sup></td><td align="char" char=".">.18</td><td align="char" char=".">.57<sup>**</sup></td><td align="char" char=".">.18</td></tr><tr><td align="left"><italic>Resource variables</italic></td><td align="left" /><td align="left" /><td align="left" /><td align="left" /><td align="left" /><td align="left" /></tr><tr><td align="left">Sense of community</td><td align="left" /><td align="left" /><td align="char" char=".">−.35<sup>*</sup></td><td align="char" char=".">.17</td><td align="char" char=".">−.49<sup>*</sup></td><td align="char" char=".">.17</td></tr><tr><td align="left">Social support</td><td align="left" /><td align="left" /><td align="char" char=".">−.35<sup>*</sup></td><td align="char" char=".">.17</td><td align="char" char=".">−.39<sup>*</sup></td><td align="char" char=".">.17</td></tr><tr><td align="left">Avoidance coping</td><td align="left" /><td align="left" /><td align="char" char=".">.04</td><td align="char" char=".">.08</td><td align="char" char=".">.04</td><td align="char" char=".">.08</td></tr><tr><td align="left"><italic>Interaction effect</italic></td><td align="left" /><td align="left" /><td align="left" /><td align="left" /><td align="left" /><td align="left" /></tr><tr><td align="left">Sense of community<sup>*</sup>Impact of earthquake</td><td align="left" /><td align="left" /><td align="left" /><td align="left" /><td align="char" char=".">−.37<sup>*</sup></td><td align="char" char=".">.17</td></tr><tr><td align="left">Adjusted R square</td><td align="char" char=".">.11</td><td align="char" char=".">.15</td><td align="char" char=".">.17</td><td align="left" /><td align="left" /><td align="left" /></tr></tbody></table> </ephtml> </p> <p>3 <emph>Note</emph>: SE=standard error. The change of <emph>R</emph> squares across models is significant (<emph>p</emph><.05).</p> <p>The second model, with the addition of three resource variables, explained 4% more variance in CES‐D. Those who reported a stronger sense of community and those who reported having a large size of social support were found to have fewer depressive symptoms (<emph>p</emph><.05). Avoidance coping was not significantly related to depressive symptoms.</p> <p>Given the significance of social support and sense of community, it is possible that both of them could moderate the relationship between the impact of earthquake and CES‐D. We then added two interaction terms in the next model. The interaction effect of social support was not significant (data not shown), and for the purpose of achieving the most parsimonious model, we reported only the results of the one interaction effect in Model 3. The interaction effect of sense of community is significant, suggesting that the influence of earthquake distress on depressive symptoms was contingent upon the level of individuals' sense of community. To better illustrate, we supplied a plot (see Fig. 1). The protective impact of sense of community against depressive symptoms tended to become more salient as the perceived earthquake distress level increased.</p> <p>Graph: 1 The moderation effect of sense of communitybetween impact of earthquake and depressive symptoms. Note. Standardized sores were used for the impact of earthquake and sense of community.</p> <hd id="AN0064487208-12">DISCUSSION</hd> <p>This study examined the impact of earthquake on depressive symptoms among older survivors 3 months after the 2008 Sichuan earthquake in China. It also investigated whether respondents' sense of community served as a protective factor against depressive symptoms. Findings provide evidence that those who reported a higher level of earthquake‐related distress had more depressive symptoms three months after earthquake. The impact of earthquake was found to be robust, not being mediated by any resource variables examined in this study. A possible explanation is that the associated loss due to a natural disaster could be devastating for a great amount of time. Three months might be a short time window to observe any resource variables start reducing the impact of earthquake.</p> <p>This study also found that those who had a stronger sense of community reported fewer depressive symptoms. Moreover, sense of community moderates the relationship between earthquake‐related distress and depression, suggesting a protective effect of sense of community against depression. These results are congruent with findings from previous studies, in which sense of community is found to be a factor that can promote psychological well‐being and moderate the association between traumatic experience and mental health among individuals who experienced childhood abuse (Banyard & Williams, [<reflink idref="bib2" id="ref31">2</reflink>]; Greenfield & Marks, [<reflink idref="bib8" id="ref32">8</reflink>]). As suggested in the above‐mentioned studies, individuals with a strong sense of community are often those with social support and the opportunity to positively influence the lives of others. It is possible that older survivors who quickly develop a strong sense of community in these transitional shelters are those who are more involved and better connected in the community. Our initial analyses of qualitative data collected 18 months after the earthquake confirmed this suspicion: Older survivors expressed that volunteering to help others and participating in some type of community groups after the earthquake helped them to better cope with the disaster and gain greater satisfaction with their life.</p> <p>In addition, this study found that those who had a larger amount of social support reported fewer depressive symptoms, echoing similar results found among displaced older adults following the 1999 Taiwan earthquake (Watanabe, Okumura, Chiu, & Wakai, [<reflink idref="bib28" id="ref33">28</reflink>]). This suggests that it is essential for community organizers or helping professionals to offer support to those whose supportive network size shrunk because of a loss of a loved one in the earthquake.</p> <p>An interesting finding of this study (mentioned earlier) was that deliberate coping was not related to depressive symptoms, but avoidance coping was positively related to depressive symptoms. It might be true that deliberate coping might not be enough to help individuals get over the distress associated with the earthquake, and yet avoidance coping entails negative thinking, which often leads to depressive thoughts. The positive relationship between deliberate coping and avoidance coping indicates a need for future studies to examine the patterns of coping strategies (e.g., multiple coping strategies) in adjusting to earthquake impact. Several limitations to this study should be noted. The results of this study may not be readily generalized to other areas. The survey was conducted in one of the largest transitional housing communities after the 2008 earthquake. It is primarily a government‐sponsored housing project, and, therefore, the level of organized support from both governments and other civil relief organizations is higher compared with other naturally evolved communities after the earthquake. We suspect that the distress level among older survivors in other communities may be higher compared with those surveyed in this study. The fact that the government built and managed activities in this community could contribute to a strong sense of community among residents, and possibly lead to a lower distress level.</p> <p>Although many measures (e.g., social support, impact of earthquake) used in this study showed respectable reliability for this sample of the Chinese older population, it is unfortunate that two scales, CES‐D and Sense of Community, had lower Cronbach alphas. The lower Cronbach alpha of sense of community was reported and discussed in Mak et al.'s study (2009), which pointed out that those negatively worded items may lead to measurement error. Other than measurement error, we also suspect that low internal consistency could be because of the vague concept of community many respondents have. In traditional communities in China, particularly many rural areas, residents living in the same communities are often related to each other by blood relationship, shared family name, or by working for the same state‐owned enterprises. Community is often referred to as their villages, their street neighborhoods, or their Chinese quadrangles. However, urbanization has gradually changed this traditional setting by having residents live in more condensed and crowded high‐rise buildings and by having a more mobile population. Community, either by geographic boundary or by social connection standard, becomes more difficult to define. Community becomes such a vague concept that when asked about their sense of community, respondents may feel confused at what community is referred to. This suggests room for future improvement in constructing more indigenous and relevant items to define community and to capture the dimensions of sense of community within a Chinese context.</p> <p>In this study, we reported an acceptable but low Cronbach alpha of CES‐D. One reason as mentioned earlier could be the small variation in the CES‐D scores because of the narrowed range response category used (i.e., 3‐point vs. 5‐point Likert scale used elsewhere). Another possible reason could be related to the training of interviewers. This is a scale most young interviewers are afraid to ask because of the sensitivity of the topic. Some of the interviewers may change the wording or meaning when they pose the questions. Another limitation is that there is a lack of control of participants' trauma exposure such as physical injuries, loss of loved ones, or exposure to the death of others. Varying levels of trauma exposure could influence how individuals appraise others or their relationship with others and thereby react differently.</p> <p>Notwithstanding these limitations, this study is one of the first studies that investigated the impact of an earthquake on depression among older survivors after the 2008 earthquake in China. Such findings have important practice implications for social workers and other helping professionals working with older natural disaster victims. Providing a place for older survivors is far from sufficient to meet their psychosocial needs. As implied in our findings, attempts to build trust and form a sense of belonging to the new communities among survivors would help reduce their distress and facilitate a smooth recovery.</p> <ref id="AN0064487208-13"> <title> REFERENCES </title> <blist> <bibl id="bib1" idref="ref28" type="bt">1</bibl> <bibtext> Armenian, H.K., Morikawa, M., Melkonian, A.K., Hovanesian, A., Akiskal, K., & Akiskal, H.S. (2002). Risk factors for depression in the survivors of the 1988 earthquake in Armenia. Journal of Urban Health, 79 (3), 373 – 382.</bibtext> </blist> <blist> <bibl id="bib2" idref="ref9" type="bt">2</bibl> <bibtext> Banyard, V.L., & Williams, L.M. (2007). Women's voices on recovery: A multi‐method study of the complexity of recovery from child sexual abuse. Child Abuse & Neglect, 31 (3), 275 – 290.</bibtext> </blist> <blist> <bibl id="bib3" idref="ref15" type="bt">3</bibl> <bibtext> Boey, K.W. (1999). Cross validation of a short form of the CES‐D in Chinese elderly. 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Hong Kong : Sau Po Centre on Ageing, The University of Hong Kong.</bibtext> </blist> </ref> <aug> <p>By Yawen Li; Fei Sun; Xusong He and Kin Sun Chan</p> <p>Reported by Author; Author; Author; Author</p> </aug> <nolink nlid="nl1" bibid="bib24" firstref="ref1"></nolink> <nolink nlid="nl2" bibid="bib12" firstref="ref3"></nolink> <nolink nlid="nl3" bibid="bib23" firstref="ref4"></nolink> <nolink nlid="nl4" bibid="bib17" firstref="ref5"></nolink> <nolink nlid="nl5" bibid="bib16" firstref="ref6"></nolink> <nolink nlid="nl6" bibid="bib21" firstref="ref7"></nolink> <nolink nlid="nl7" bibid="bib13" firstref="ref10"></nolink> <nolink nlid="nl8" bibid="bib27" firstref="ref11"></nolink> <nolink nlid="nl9" bibid="bib29" firstref="ref16"></nolink> <nolink nlid="nl10" bibid="bib11" firstref="ref17"></nolink> <nolink nlid="nl11" bibid="bib25" firstref="ref18"></nolink> <nolink nlid="nl12" bibid="bib19" firstref="ref19"></nolink> <nolink nlid="nl13" bibid="bib10" firstref="ref21"></nolink> <nolink nlid="nl14" bibid="bib18" firstref="ref22"></nolink> <nolink nlid="nl15" bibid="bib14" firstref="ref23"></nolink> <nolink nlid="nl16" bibid="bib20" firstref="ref24"></nolink> <nolink nlid="nl17" bibid="bib15" firstref="ref26"></nolink> <nolink nlid="nl18" bibid="bib26" firstref="ref29"></nolink> <nolink nlid="nl19" bibid="bib22" firstref="ref30"></nolink> <nolink nlid="nl20" bibid="bib28" firstref="ref33"></nolink>
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  Data: Sense of Community and Depressive Symptoms among Older Earthquake Survivors Following the 2008 Earthquake in Chengdu China
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  Data: <searchLink fieldCode="AR" term="%22Li%2C+Yawen%22">Li, Yawen</searchLink><br /><searchLink fieldCode="AR" term="%22Sun%2C+Fei%22">Sun, Fei</searchLink><br /><searchLink fieldCode="AR" term="%22He%2C+Xusong%22">He, Xusong</searchLink><br /><searchLink fieldCode="AR" term="%22Chan%2C+Kin+Sun%22">Chan, Kin Sun</searchLink>
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  Data: <searchLink fieldCode="SO" term="%22Journal+of+Community+Psychology%22"><i>Journal of Community Psychology</i></searchLink>. Sep 2011 39(7):776-785.
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  Data: John Wiley & Sons, Inc. Subscription Department, 111 River Street, Hoboken, NJ 07030-5774. Tel: 800-825-7550; Tel: 201-748-6645; Fax: 201-748-6021; e-mail: subinfo@wiley.com; Web site: http://www3.interscience.wiley.com/browse/?type=JOURNAL
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  Data: 10
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  Data: 10.1002/jcop.20469
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  Data: 0090-4392
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  Data: This study examined the impact of an earthquake as well as the role of sense of community as a protective factor against depressive symptoms among older Chinese adults who survived an 8.0 magnitude earthquake in 2008. A household survey of a random sample was conducted 3 months after the earthquake and 298 older earthquake survivors participated in it. The results showed that earthquake-associated distress had a direct effect on depression controlling for coping, informal support, and sense of community. The results also showed that the effect of earthquake-associated distress is contingent upon the level of sense of community. The findings highlighted the role of individuals' sense of community as a protective factor against traumatic experiences and suggested that attempts to build trust and form a sense of belonging to the new community among older earthquake survivors would help them reduce distress and facilitate a smooth recovery. (Contains 1 figure and 3 tables.)
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        Value: 10.1002/jcop.20469
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      – SubjectFull: Foreign Countries
        Type: general
      – SubjectFull: Depression (Psychology)
        Type: general
      – SubjectFull: Natural Disasters
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      – SubjectFull: Symptoms (Individual Disorders)
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      – SubjectFull: Social Support Groups
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      – SubjectFull: Trauma
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      – SubjectFull: China
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      – TitleFull: Sense of Community and Depressive Symptoms among Older Earthquake Survivors Following the 2008 Earthquake in Chengdu China
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