title: Effect of 11 September 2001 terrorist attacks in the USA on suicide in areas surrounding the crash sites.
abstract: BACKGROUND
  The terrorist attacks in the USA on 11 September 2001 affected suicide rates in two European countries, whereas overall US rates remained stable. The effect on attack site rates, however, has not been studied.
  
  
  OBJECTIVE
  To examine post-attack suicide rates in areas surrounding the three airline crash sites.
  
  
  METHODS
  Daily mortality rates were modelled using time series techniques. Where rate change was significant, both duration and geographic scope were analysed.
  
  
  RESULTS
  Around the World Trade Center, post-attack 180-day rates dropped significantly (t = 2.4, P = 0.0046), whereas comparison condition rates remained stable. No change was observed for Pentagon or Flight 93 crash sites.
  
  
  CONCLUSIONS
  The differential effect by site suggests that proximity may be less important that other event characteristics. Both temporal and geographic aspects of rate fluctuation after sentinel events appear measurable and further analyses may contribute valuable knowledge about how sociological forces affect these rates.
authors.affiliation: Clinical Research Core, VISN 2 Center of Excellence for Suicide Prevention, and Department of Psychiatry, University of Rochester, New York, USA. Cindy.Claassen@va.gov
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Claassen
authors.forename: Thomas
authors.initials: T
authors.lastname: Carmody
authors.forename: Sunita M
authors.initials: SM
authors.lastname: Stewart
authors.forename: Robert M
authors.initials: RM
authors.lastname: Bossarte
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Larkin
authors.forename: Wayne A
authors.initials: WA
authors.lastname: Woodward
authors.forename: Madhukar H
authors.initials: MH
authors.lastname: Trivedi
mesh_terms: D006801:Humans; D008873:Mid-Atlantic Region / Q000453:epidemiology; D009511:New England / Q000453:epidemiology; D009657:North Carolina / Q000453:epidemiology; D047851:September 11 Terrorist Attacks / Q000523:psychology*; D013022:South Carolina / Q000453:epidemiology; D013405:Suicide / Q000706:statistics & numerical data*; D013997:Time Factors; D014903:West Virginia / Q000453:epidemiology