Association between posttraumatic stress disorder (PTSD) severity and ego structure of the Nanai people
Ota et al. Environmental Health and Preventive Medicine
Association between posttraumatic stress disorder (PTSD) severity and ego structure of the Nanai people
Yoko Ota 0
Natalia Korshunova 0
Masashi Demura 0
Midori Katsuyama 0
Hironobu Katsuyama 1
Sri Ratna Rahayu 0
Kiyofumi Saijoh 0
0 Department of Hygiene, School of Medicine, Kanazawa University , Kanazawa , Japan
1 Department of Public Health, Kawasaki Medical University , Kurashiki , Japan
Background: A man-made chemical disaster occurred in the Amur River, leading to posttraumatic stress disorder (PTSD) in the Nanai people indigenous to the river's surrounding area. PTSD severity measured by the total scores of Impact of Event Scale-Revised (IES-R) (Total-I) and Clinician-Administered PTSD Scale (CAPS) (Total-C) were not always identical in terms of demographic and ethnocultural characters. It is possible that the results derived using the Total-I and Total-C may differ for persons with different backgrounds and/or individual characteristics. In this study, the associations between PTSD severity and personal characteristics were evaluated. Methods: The study was a field-type survey including 187 randomly selected participants (75 males and 112 females). In addition to Total-I/Total-C, scores for each IES-R/CAPS item, Intrusion, Avoidance, and Hyperarousal, and Ego Structure Test by Ammon (ISTA) score were examined to evaluate their personal characteristics. Results: No specific trends in ISTA score were obvious among four groups defined according to Total-I/Total-C. The results of principal component analysis showed that all IES-R/CAPS items contributed positively to the 1st axis but to the 2nd axis in a different manner. ISTA items did not always show correlations to each other, but principal component analysis suggested that Construct contributed positively and Destruct and Deficient (with the exception of Destruct sexuality) contributed negatively. High IES-R scores were associated with Construct Aggression and Deficient Inner demarcation, but high CAPS score was less likely to exhibit Construct Narcissism. Conclusion: To avoid the misdiagnosis of PTSD, usage of both IES-R/CAPS may be required. Simultaneous application of personality/ego tests may be helpful, but appropriate numbers of their questions would be important.
Post-traumatic Stress Disorder; Ego structure Test by Ammon; A man-made chemical disaster; indigenous Nanai people
Background
In December 2005, an accident at a chemical factory
caused the release of toxic substances into the Songhua
River (Jilin, China); these substances then polluted the
downstream Amur River, which lies in the Russian
territory [
1
]. The serious subsequent pollution of the river
water caused several adverse outcomes, including the
sedimentation of chemicals into the riverbed, forest fires
[
2
], the prohibition of fishing and hunting, and a
reduction in the forest area. Many of the Nanai people
that lived along the middle reaches of the Amur River
Valley lost their traditional ways of obtaining staple food
and performing their traditional and religious activities
and suffered from posttraumatic stress disorder (PTSD).
Previously [
3
], PTSD severity has been assessed in this
population using the Impact of Event Scale-Revised
(IES-R) [
4–6
] and the Clinician-Administered PTSD
Scale (CAPS) [
7, 8
]. Both the IES-R and the CAPS
consist of questions regarding Intrusion (compulsion to
repeat), Avoidance of traumatic events, and Hyperarousal
to physiological symptoms of irritability. Severity was
determined by assessing their total scores, IES-R total
(Total-I) and CAPS total (Total-C). The results were not
always identical and depended upon the participants’
demographic and ethnocultural background, clinical
examination results, and ethnopsychological attitudes
toward the Amur River [3]. The comparison of the results
derived using the Total-I and the Total-C alone seemed
to be insufficient to understand the severity of PTSD in
this population. Moreover, interactions between personal
characteristics differentially affected on Intrusion,
Avoidance, and Hyperarousal may have existed. In fact, when
attempting to obtain a better understanding of PTSD
severity, the effects of an individual’s personality profile on
his or her PTSD severity were of interest in various
situations [
9–12
]. In the present study, the Ego Structure
Test by Ammon (ISTA) [13] was utilized to gain a better
understanding of the participants’ personality profiles,
because it was available in Russian, and we analyzed the
interactions between ISTA, IES-R and CAPS items, and
PTSD severity.
Methods
Subjects
The participants and field-type survey have been
described previously [
3
]. That is, 187 indigenous adult
Nanai volunteers over the age of 18 years were randomly
selected from the general civilian population in eight
villages in the Nanai Regional District of Khabarovsk
Territory located in the Far East of the Russian Federa (...truncated)