Contents lists available at ScienceDirect Asian Journal of Psychiatry journal homepage: www.elsevier.com/locate/ajp Did kindergarteners who experienced the Great East Japan earthquake as infants develop traumatic symptoms? Series of questionnaire-based cross- sectional surveys A concise and informative title: traumatic symptoms of kindergarteners who experienced disasters as infants Masahide Usami a, ⁎ , Yoshitaka Iwadare a , Hirokage Ushijima a , Kumi Inazaki a , Tetsuya Tanaka b , Masaki Kodaira c , Kyota Watanabe d , Kazuhiro Kawahara e , Mako Morikawa f , Keiko Kontani g , Kanako Murakami h , Remie Ogata i , Seiko Okamoto j , Keisuke Sekine k , Masako Sato l , Yoshinori Sasaki m , Hiromi Tanaka n , Maiko Harada o , Sonoko Imagi p , Kumi Matsuda q , Chiaki Katsumi r , Momoko Aoki s , Kazunori Makino s , Kazuhiko Saito t a Department of Child and Adolescent Psychiatry, Kohnodai Hospital, National Center for Global Health and Medicine, Ichikawa, Chiba, Japan b Department of Psychiatry, Gunma Hospital, Takasaki, Gunma, Japan c The Department of Child and Adolescent Mental Health, AIIKU Clinic, Maternal and Child Health Center, Imperial Gift Foundation Boshi-Aiiku-Kai, Minato, Tokyo, Japan d Hiroshima City Center for Children’s Health and Development, Hiroshima, Hiroshima, Japan e Department of psychiatry, Kumamoto University, Kumamoto, Japan f Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan g Department of Psychiatry, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa, Japan h Jiundou Byouin, Nerima, Tokyo, Japan i Department of Neuropsychiatry, Oita University, Faculty of Medicine, Yufu, Ohita, Japan j Ayase Mental Clinic, Adachi, Tokyo, Japan k Yashio Hospital, Yashio, Saitama, Japan l Tokyo Child Guidance Office, Shinjyuku, Tokyo, Japan m Department of Child and Adolescent Psychiatry, Komagino Hospital, Hachioji, Tokyo, Japan n Department of Psychiatry, Dokkyo Medical University School of Medicine, Shimotsuga, Tochigi, Japan o Department of Psychiatry, Nishikawa Hospital. Hamada, Yamaguchi, Japan p Eda Memorial Hospital, Yokohama, Kanagawa, Japan q Department of Psychiatry, Japanese Red Cross Narita Hospital, Narita, Chiba, Japan r Department of Psychiatry, Kitasato University, Sagamihara, Kanagawa, Japan s Department of child and adolescent psychiatry, Saitama Prefectual Psychiatric Hospital, Saitama, Saitama, Japan t Aiiku Counselling Office, Aiiku Research Institute, Imperial Gift Foundation Boshi-Aiiku-Kai, Minato, Tokyo, Japan ARTICLE INFO Keywords: Child Earthquake Tsunami Trauma ABSTRACT Background: The Great East Japan Earthquake (GEJE) and tsunami of March 11, 2011 left behind many sur- vivors, including children. This study aimed to assess changes in traumatic symptoms with time among kin- dergarteners who experienced GEJE as infants and to discuss the relationship between these symptoms and the disaster experience. Methods: The 15-item Post-Traumatic Stress Symptoms for Children (PTSSC-15) questionnaire were distributed to the parents of kindergarteners (children aged 4–5 years) at 8, 20, 30, and 42 months after GEJE. Questionnaires regarding environmental damage conditions affecting the children were distributed to teachers 8 months after the tsunami. Results: The number of kindergarteners was 262, 255, 236, and 202 at 8, 20, 30, and 42 months after the disaster. The PTSSC-15 total score was not different between kindergartners with and without environmental https://doi.org/10.1016/j.ajp.2019.07.011 Received 16 February 2019; Received in revised form 18 May 2019; Accepted 5 July 2019 ⁎ Corresponding author at: Department of Child and Adolescent Psychiatry, National Center of Global Health and Medicine, Kohnodai Hospital, 1-7-1 Kohnodai, Ichikawa, Chiba, 272-8516, Japan. E-mail address: usami.masahide@hospk.ncgm.go.jp (M. Usami). Asian Journal of Psychiatry 44 (2019) 38–44 1876-2018/ © 2019 Published by Elsevier B.V. T