Abstract: Exposure to a disaster such as an earthquake is closely linked with mental disorders. Anxiety is one of the most common psychological problems among adolescents exposed to serious earthquakes. Adolescence is a vulnerable and critical period of physical and mental development. If mental health problems, such as depressive disorders, are not treated in time after a disaster, adolescents may suffer a lifelong psychological crisis. Based on the spatial perspective, prior studies have explored the psychological outcome caused by disaster events and have indicated some controversial results such as the “Psychological Typhoon Eye Effect” and “Ripple Effect”. However, limited studies have used the geographical method to evidence spatial distribution characteristics of mental health symptoms and their correlates. Furthermore, prior studies mainly focused on the spatial distribution of mental health issues among adult populations after hurricanes or floods. Few studies have investigated the geospatial distribution of mental disorders among Chinese adolescents after an earthquake, although it is one of the most frequent disasters in the world. Further research is urgently needed to identify and understand the spatial distribution of anxiety symptoms and relevant influencing factors, which benefit filling research gaps. This study aimed to explore the spatial distribution characteristics and influencing factors (e.g., distance to the epicenter, rate of depressive symptoms, sibling rate, mental health course attendance rate, and distance to the medical center) for anxiety symptoms among Chinese adolescents after the earthquake.
There were two datasets from geographic data (such as government databases, Amap and Baidu Map) and a self-report questionnaire. One month after the earthquake, a total of 1761 questionnaires were sent out to five schools in Luxian, and 1425 valid questionnaires were received (response rate = 80.92%). Participants reported demographic information, including age, sex, siblings, mental health course attendance, and residence information. The Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) were used to screen the depression and anxiety, respectively. Based on the computer software of SPSS20.0, Arcgis10.2, and MGWR2.2, spatial autocorrelation, ordinary least squares regression, geographically weighted regression, and multi-scale geographically weighted regression were used to study spatial distribution characteristics, influencing factors, and spatial variability of anxiety symptoms.
Based on a sample of 1425 Chinese adolescents (Mage=15.32 years old; SD=1.18 years old; 44.21% are female), the prevalence of anxiety symptoms was 21.75%. The results showed that the spatial distribution of anxiety incidence rates among adolescents showed a decreasing trend from the center of the disaster to the peripheral areas of the earthquake. The spatial distribution of anxiety incidence rates among adolescents showed a psychological ripple effect. Furthermore, a cluster of high anxiety was observed at the border of intensity areas eight and seven, whereas a cluster of low anxiety was observed at the edge of intensity area six. Moreover, the results of the ordinary least squares regression model indicated that the depression rate positively influenced the anxiety rate and was the most influential factor, followed by distance to medical care, one-child rate, and the rate of having attended a mental health course, all of which were positively associated with the anxiety rate. Distance from the disaster center, the second most influential factor, was negatively associated with anxiety rates. Additionally, the results of spatial variability displayed that regression coefficients of depression rates were highest in the western and northern parts of Luxian. The anxiety rate in villages or communities close to the Second People’s Hospital of Luxian was more likely to be influenced by the distance to medical care.
Based on the spatial differences of anxiety-influencing factors, more medical and psychological resources should be allocated to the center of the disaster but they should also be extended to the areas on the periphery of the earthquake’s impact. The study benefits the efficient allocation of first-aid psychological support and the development of related mental health interventions after a disaster.

Key words: earthquake, anxiety symptoms, adolescents, geospatial distribution, psychological ripple effect

摘要： 以中国地震灾区1425名青少年为研究样本,结合地理空间和实践调研数据,利用空间地理学方法,探索震后青少年焦虑症状的空间分布规律及关键影响因素。结果显示从整体空间上看,震后青少年灾民的焦虑症状呈现“心理涟漪效应”,即越靠近地震中心地带,焦虑症状的筛出率越高,其次,灾中距离、抑郁比率、独生子女率、是否参加过心理健康课程率、就医距离5个因素均对焦虑症状呈显著影响,并存在空间差异性。研究结果支持了震后针对青少年的心理救助资源分配,应该更集中于地震灾害发生的中心位置,但医疗资源应同时关注到震中和边缘地区。研究结果从地理空间视角拓展了灾后青少年心理病症的研究,为灾后心理救助资源的有效调配提供科学依据。

关键词: 地震, 焦虑症状, 青少年, 空间地理分布, 心理涟漪效应