Mapping concentrations of posttraumatic stress and depression trajectories following Hurricane Ike.
Mapping concentrations of posttraumatic stress and depression trajectories following Hurricane Ike.
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DOI：
10.1038/srep32242
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发表时间：
2016-08-25
影响因子：
4.6
通讯作者：
Galea S
中科院分区：
文献类型：
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作者：
Gruebner O;Lowe SR;Tracy M;Joshi S;Cerdá M;Norris FH;Subramanian SV;Galea S
我们在一项对德克萨斯州加尔维斯顿和钱伯斯县受飓风艾克影响的人群进行的纵向研究（N = 561）中，调查了一系列慢性创伤后应激症状（PTSS）和抑郁症状灾后轨迹风险升高的地理集中情况。使用未经调整的空间扫描统计，我们发现集群的PTSS轨迹的风险升高，但不是抑郁轨迹，在加尔维斯顿岛。然后，我们测试了PTSS和抑郁症每个轨迹中成员资格的预测因子（例如，人口统计学变量、创伤暴露、社会支持），不考虑数据的地理性质。在调整了空间扫描统计中的显著预测因素后，我们注意到PTSS的空间集群持续存在，并且出现了更多的抑郁轨迹集群。这是第一项研究表明，灾后心理健康问题的纵向轨迹可能会因地理位置以及这些位置存在的个人和社区因素而异。这些知识对于确定脆弱地区和其中的人口、为早期应对者提供指导以及通过早期发现人口中的心理健康需求来减轻心理健康后果至关重要。随着人为灾害的增加，我们的方法也可能在世界其他地区类似的情况下有用。
We investigated geographic concentration in elevated risk for a range of postdisaster trajectories of chronic posttraumatic stress symptom (PTSS) and depression symptoms in a longitudinal study (N = 561) of a Hurricane Ike affected population in Galveston and Chambers counties, TX. Using an unadjusted spatial scan statistic, we detected clusters of elevated risk of PTSS trajectories, but not depression trajectories, on Galveston Island. We then tested for predictors of membership in each trajectory of PTSS and depression (e.g., demographic variables, trauma exposure, social support), not taking the geographic nature of the data into account. After adjusting for significant predictors in the spatial scan statistic, we noted that spatial clusters of PTSS persisted and additional clusters of depression trajectories emerged. This is the first study to show that longitudinal trajectories of postdisaster mental health problems may vary depending on the geographic location and the individual- and community-level factors present at these locations. Such knowledge is crucial to identifying vulnerable regions and populations within them, to provide guidance for early responders, and to mitigate mental health consequences through early detection of mental health needs in the population. As human-made disasters increase, our approach may be useful also in other regions in comparable settings worldwide.