Gender differences in trajectories of mental health symptoms among Chinese earthquake survivors.

Background: Posttraumatic stress symptoms and depressive symptoms are prevalent after natural disasters. However, in a Chinese trauma context, little research examined the long-term trajectories of these two symptoms with a gender perspective.

Methods: Data came from an 8-year longitudinal survey of 3522 Wenchuan earthquake adult survivors. We used multilevel growth-curve models to investigate the trajectories of PTSS and depressive symptoms; adopted conditional growth-curve models to explore the gender differences in trajectories together with gendered factors associated with mental health symptoms; conducted Chow tests to examine the significance of gender differences. Standardized coefficients, P values, and effect sizes were reported.

Results: With covariates controlled, both linear (β = -1.33, p < 0.001, Cohen's d = 0.79) and quadratic effects (β = 1.03, p < 0.001, Cohen's d = 0.59) of time were significant in PTSS trajectory, whereas quadratic effect (β = 0.27, p < 0.001, Cohen's d = 0.14) in the declining depressive trajectory was clinically nonsignificant. Compared with men, women are at higher risk of PTSS (β = 0.12, p < 0.001, Cohen's d = 0.21) and depressive symptoms (β = 0.10, p < 0.001, Cohen's d = 0.20), but also with a faster-declining rate in PTSS within first five years after the disaster. No gender difference was found regarding depressive trajectory. Additionally, poor education and income associate with more PTSS in women, while sickness predicts severer depression in women and more PTSS in men.

Conclusions: This study proposes a gendered U-shape trajectory for PTSS and a declining depressive trajectory without gender difference. The findings of this study shed light on mental health intervention in future natural disasters.