title: Mapping concentrations of posttraumatic stress and depression trajectories following Hurricane Ike.
abstract: 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.
authors: Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, Boston, MA, USA.
authors: Oliver
authors: O
authors: Gruebner
authors: Montclair State University, Department of Psychology, Montclair, NJ, USA.
authors: Sarah R
authors: SR
authors: Lowe
authors: University at Albany, State University of New York, School of Public Health, Department of Epidemiology and Biostatistics, Albany, NY, USA.
authors: Melissa
authors: M
authors: Tracy
authors: University of Minnesota Twin Cities, Division of Epidemiology and Community Health, Minneapolis, MN, USA.
authors: Spruha
authors: S
authors: Joshi
authors: University of California at Davis, Department of Emergency Medicine, Sacramento, CA, USA.
authors: Magdalena
authors: M
authors: Cerdá
authors: Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
authors: Fran H
authors: FH
authors: Norris
authors: Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, Boston, MA, USA.
authors: S V
authors: SV
authors: Subramanian
authors: Boston University, School of Public Health, Boston, MA, USA.
authors: Sandro
authors: S
authors: Galea
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D055867:Cyclonic Storms; D004190:Disasters; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D013781:Texas / Q000453:epidemiology