There is a general recognition that there will often be an adverse psychological consequence associated with disasters. Many researchers have sought to elucidate the connection between the period following a disaster and adverse psychological outcomes (Murphy, 1988; Shikai et al., 2007). However, there have been few studies focused on the adolescent survivors of natural disasters, especially in the early stages. Of the many factors that can mediate between stress and psychological problems, the most commonly mentioned in research are self-efficacy, social support, and coping strategies. The aim in this paper was to find out the mediating effects of these factors on the psychological health of adolescent survivors in the early stage of a natural disaster.

According to Bandura (1977), in order to carry out and maintain a particular behavior, one needs to believe that this behavior will lead to the desired outcome, and also that the behavior can be successfully executed to produce the outcome (high self-efficacy expectancy). Since its first introduction, both specific and general self-efficacy have been used and studied in many kinds of areas. For example, Murphy (1988) investigated the mediating effects of self-efficacy and social support on mental health in a longitudinal study, finding that self-efficacy was a significant predictor of health outcome. In a cross-sectional study of adolescents, Ehrenberg, Cox, and Koopman (1991) found a negative correlation between perceived self-efficacy and depression. Vieno, Santinello, Pastore, and Perkins (2007) found that self-efficacy and a sense of community in school contributed to mediating effects of social support on psychosocial adjustment. There are many other studies in which the relationship between self-efficacy and psychological problems, such as depression and anxiety, has been explored. The results were in agreement that self-efficacy served as a protective or resilient factor in the relationship between stress and psychological health.

The positive effect of social support on health was established by Durkheim (1951). It was defined as the process “through which the social relationships promote health and well-being” (Cohen et al., 2000, p. 4). This kind of effect has been supported by many researchers (Cohen & Wills, 1985; Miller & Ingram, 1979). Cohen (1988) also viewed social support as a protective factor among adolescents. However, within different cultures and circumstances, the relationship between social support and psychological well-being has become complex (Cohen et al.). In studies by Schonert-Reichl (1994) and Ayman and Antani (2008) the protective effects of social support on psychological well- being were found. However, Murphy (1988) found that the F value for social support was not of sufficient magnitude to appear in any of the analyses. Its effect for Chinese adolescent survivors was affirmed in this study.

In addition to self-efficacy and social support, another important factor is coping strategy (Hallis & Slone, 1999). Throughout history countless natural disasters have affected a great number of people whose reactions and outcomes have varied greatly. Some developed symptoms of posttraumatic stress disorder (PTSD) which persisted for the rest of their lives. Most people continued their lives normally, while some became more successful. Coping strategy may have been an important mediating factor (Langley & Jones, 2005). As shown in the theories of Lazarus and Folkman (1984), stressors do not inevitably lead to depression or other negative outcomes. The outcome depends upon the efficacy of a person’s coping efforts. According to Lazarus and Folkman (1984), there are two broad ways of coping: problem-focused and emotion-focused. Problem-focused coping is directed at dealing with the problem causing the distress. This form of coping is more likely to be used when harmful, threatening, or challenging environmental conditions are considered to be amenable to change. Emotion-focused coping is directed at regulating emotional responses to a problem. This form of coping is more likely to be used when a person believes that nothing can be done to modify the harmful, threatening, or challenging environmental conditions (Folkman & Lazarus, 1980). Many researchers have used this kind of category to analyze the effects of coping strategies (Littrell & Beck, 2001). However, the relationship between coping strategies and psychological well-being is very complicated. Different coping styles result in different outcomes, and the relationship could also be influenced by the controllability of the stressors and other factors such as self-efficacy (Forsythe & Compas, 1987; Littrell & Beck, 2001). In most of the above literature, problem-focused coping was more likely to correlate with a positive outcome when the stressor was relatively controllable, and it was more likely to correlate with a negative outcome when the stressor was uncontrollable. Emotion-focused coping was a predictor of negative outcomes when the stressor was controllable and a predictor of positive outcomes when the stressor was uncontrollable. However, the focus of this concept in most studies was on ordinary life events and stressors that were not so devastating. In addition, in only a few of these studies were the conclusions based on adolescents’ results (Langley et al., 2005).

This study was undertaken one month after the May 12, 2008 earthquake measuring 8.0 on the Richter scale in Wenchuan, China. This severe earthquake resulted in more than 69,000 deaths and 370,000 injuries, of which adolescents were a significant number. Students were ready to begin classes when the earthquake happened, and the complete chaos affected them greatly. According to the results of an 18-month consensus building process by the Early Psychological Intervention Subcommittee (EPI) of the National Volunteer Organizations Active in Disaster (NVOAD), early psychological intervention is valuable (Everly, Hamilton, Tyiska, & Ellers, 2008). Thus, identifying the resilience factors and the relationship between them is very important for early intervention. It is clear from the above literature review that the mediating factors of self-efficacy, social support, and coping strategies can all have direct and indirect effects during the process of dealing with stress. We therefore analyzed and compared three models, with a different mediating factor used in each model.

Method

Sample

Four of 31 classes of senior students from a major middle school in the earthquake stricken area in Sichuan province, China were randomly selected to complete the questionnaires during their first class after the earthquake. After being introduced by their headmaster and teachers, we told the students the aim in our study and they were informed that participation was voluntary.

The total number of participants was 172, of whom 167 (82 male, 85 female) completed the scales. They were all of Han nationality with a mean age of 18.6 and a standard deviation of 2.2. All the students were in their classrooms when the earthquake happened, and their classrooms were severely damaged. All of their families were severely affected, but none had lost relatives.

Measures

Four frequently used scales (Chinese versions) were used in this study, as follows:

Social Support Rating Scale (SSRS) was developed on the basis of the theory of social support and Chinese culture by Xiao (1987). The psychometric characteristics were excellent, with a test-retest reliability of 0.92, and good predictive validity. The scale is a 10-item measure consisting of three dimensions of social support: subjective support, objective support, and availability of support. In the present study we employed two dimensions of this scale, subjective support and objective support, involving seven items. One item question was: “How many intimate friends do you have, from whom you can get support and help? (1) none; (2) 1-2; (3) 3-5; (4) 6 or more”. Subjective support focuses on subjective and perceived support from others, that is, the perceived degree of being esteemed, supported, and understood in a social relationship (Cronbach’s α = 0.63, in this study). Objective support focuses on objective and actual support in a social relationship (Cronbach’s α = 0.67, in this study).

Coping Style Scale for Middle School Students (CSS-MSS), which was developed by Chen, Zheng, Pan, and Zhen (2000), is based on Folkman’s theory of coping (Folkman, Lazarus, Gruen, & DeLongis, 1986) and actual situations of Chinese middle school students. There are two main parts in this scale, problem-focused coping and emotion-focused coping, and seven subscales. An example of an item was “I make use of the experience of myself and others to get through difficulties”. The psychometric characteristics were sound, its test-retest reliability was 0.89, and all the subscales accounted for 73% of total variance. Cronbach’s α of problem-focused coping was 0.78, and Cronbach’s α of emotion-focused coping was 0.76, in this study. Respondents were asked to rate to what extent a statement is true for them on a 4-point Likert scale.

Generalized Perceived Self-efficacy Scale (GSES), which was developed by Schwarzer and Jerusalem (1995), contains 10 items that measure participants’ generalized self-efficacy, or beliefs about one’s general ability to successfully reach goals. Respondents were asked to rate to what extent a statement is true for them on a 4-point Likert scale. The higher the score the higher degree of general self-efficacy is indicated. The Chinese version of this scale was completed by Zhang and Schwarzer (1995). An example of an item question was “I can always manage to solve difficult problems if I try hard enough”. The psychometric characteristics of this scale are well-established with a test-retest reliability of 0.82, and good construct validity (Wang, Hu, & Liu, 2001). Cronbach’s α was 0.85 in this study.

Symptom Checklist 90 (SCL-90), was developed by Derogatis (1975). It is a 90-item 5-point Likert rating scale with nine primary symptom dimensions. It is a self-report tool to measure general psychological condition. Each item of this scale represents one common symptom, for example, headache, that is relevant to one’s psychological status. We used the general symptomatic index, which involves dividing the sum of the total scores of all the 90 items by 90, as the index of the psychological problems (Cronbach’s α = 0.96, in this study).

In order to testify the hypotheses, we used path analysis to analyze the data. Descriptive analysis was carried out using SPSS version 13.0, and path analysis using LISREL version 8.50.

Results

Descriptive Analysis

The means, standard deviations, and the correlation matrix between all variables included in this study are presented in Table 1. According to a series of analyses of variance (ANOVA), males reported significantly fewer psychological symptoms than did females (M = 1.87 versus 2.05, respectively, F(1,167) = 5.01, p = 0.027). They also reported lower objective social support (M = 7.80 versus 8.78, respectively, F(1,167) = 7.93, p = 0.005) and lower emotion-focused coping strategies (M = 33.78 versus 36.23, respectively, F(1,167) = 6.05, p = 0.015). No other significant differences were noticed regarding gender.

Path Analysis

The main hypothesis was tested through the application of path analysis employing LISREL version 8.50. Three different models were compared. In Model 1, self-efficacy served as a partial mediator between psychological problems, and social support and coping strategies. According to this model, psychological problems were partially predicted by self-efficacy, and self-efficacy was predicted by social support and coping strategies, while social support and coping strategies could also directly predict psychological problems. In Model 2, social support (including both subjective and objective social support) served as a partial mediator between psychological problems, and self-efficacy and coping strategies (i.e., self-efficacy and coping strategies predicted social support, which in turn predicted psychological problems, while self-efficacy and coping strategies could also predict psychological problems directly). In Model 3, coping strategies were the partial mediators (i.e., self-efficacy and social support predicted coping strategies, which in turn predicted psychological problems, while self-efficacy and social support could also predict psychological problems directly). The summary of fit indices of these models, and the tests of the models’ comparisons are presented in Table 2. The results showed that Models 1 and 3 both differed from Model 2 significantly, which indicated that Model 2 had the least fit to the data. Model 1 also differed from Model 3 significantly, so Model 1 presented the best fit to the data, in which self-efficacy served as a partial mediator.

Figure 1 presented the maximum likelihood estimates of Model 1. Nonsignificant estimates were not presented. According to this path model (c² = 2.85, df = 10, p = 0.98, AGFI = 0.99, RMSEA = 0.0), self-efficacy was positively and significantly predicted by subjective social support and problem-focused coping, and psychological problems were predicted positively and significantly only by emotion-focused coping. However, no significant correlation between self-efficacy and psychological problems was found, and objective social support did not predict self-efficacy or psychological problems in any significant way.

Discussion

In stressful situations, a person needs to find resources to support him/herself to cope with the negative effects, and to regulate his/her emotions. Self-efficacy, social support, and coping strategies were found to be very important mediators among such resources. In this study we looked into the possible roles of these factors in dealing with the stress by examining a sample of adolescent survivors of the earthquake, Wenchuan, China, which occurred in 2008.

The results of the descriptive analysis showed that female students were more negatively affected than were males. Females felt less objective social support, employed more emotion-focused coping strategies, and had more psychological problems. According to Model 1, as psychological problems were significantly predicted by emotion-focused coping, the latter may be the reason for the female students’ worse psychological condition. Resources like self-efficacy, social support, and coping strategies did not make a significant contribution to the participants’ psychological condition in the early stage after the disaster. The most important factor at this stage was an adjustment of their emotions.

A number of researchers found that self-efficacy served as a buffer to reduce the negative effects of stress. However, this was not supported in our study. Consistent with the result of Karademas’ (2006) study, the mediating effect of self-efficacy was negative. This may be because the situation was so devastating that even the most optimistic person could not find a bright side in the early stage of this disaster. As a result, self-efficacy could not adjust the participants’ psychological well-being in these circumstances. On the other hand, there was a significant positive correlation between subjective social support, problem-focused coping, and self-efficacy. This information might present the beginning of the participants’ positive adjustment. Proper social support and coping strategies could ensure that one’s self-efficacy may begin to be enhanced, and furthermore, his/her psychological condition might be adjusted in the long run. However, this is just a hypothesis, which needs the support of longitudinal evidence.

Previous researchers have found that problem-focused coping was more likely to correlate with a negative outcome when the stressor was uncontrollable, while emotion-focused coping was more a positive predictor. However, in our study, in which the devastating earthquake was completely uncontrollable, the results were inconsistent with previous findings. Problem-focused coping did not significantly correlate with psychological problems, and emotion-focused coping was significantly and positively correlated with psychological problems, with the correlation coefficient being 0.92. This meant that for the adolescents in this situation, problem-focused coping had little effect on their psychological condition, while emotion-focused coping could make them feel more pessimistic. In addition, no significant correlation was found between social support and psychological problems in our study. However, these findings require further evidence to support them.

In our study we were significantly limited by being totally reliant on self-reported data. A study with a prospective methodology conducted on other populations in the early stage after a natural disaster would provide us with more concrete results regarding the relationship between people’s psychological condition and mediating factors, for example self-efficacy, social support, and coping strategies.

Studying the relationship between psychological health and self-efficacy, social support, and coping strategies under different circumstances is important because it allows us to understand the ways that social relationships relate to personal expectations in shaping outcomes. The variables included in this study were part of the broader cognitive appraisal process. The mapping of the relationship between these representations will provide us with the opportunity not only to outline underlying processes, but also to use all relevant information in order to design effective intervention models, in both the early and later stages after a disaster.

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Appreciation is due to reviewers including

Sibel Erkal

PhD

Department of Family and Consumer Sciences

Faculty of Economics and Administrative Sciences

Hacettepe University

Samanpazarı

Ankara

Turkey

Email

[email protected]

Xia Zhu or Danmin Miao, Department of Psychology, School of Aerospace Medicine, Fourth Military Medical University, Chang Le Western Street No. 17, Xi’an Shannxi, CO.710032, People’s Republic of China. Phone: +86-029-8477-4814; Email: [email protected]