Department of Epidemiology, Columbia University, Mailman School of Pubic Health, 722 West 168 St, New York, NY 10032, USA.
Psychiatry Res. 2010 Mar 30;176(1):55-61. doi: 10.1016/j.psychres.2008.10.035. Epub 2010 Jan 15.
Previous studies concerned with the relation of proximity to the September 11, 2001 terrorist attacks and subsequent psychopathology have produced conflicting results. The goals of this analysis are to assess the appropriateness of using Bayesian hierarchical spatial techniques to answer the question of the role of proximity to a mass trauma as a risk factor for psychopathology. Using a set of individual-level Medicaid data for New York State, and controlling for age, gender, median household income and employment-related exposures, we applied Bayesian hierarchical modeling methods for spatially aggregated data. We found that distance from the World Trade Center site in the post-attack time period was associated with increased risk of anxiety-related diagnoses. In the months following the attack, each 2-mile increment in distance closer to the World Trade Center site was associated with a 7% increase in anxiety-related diagnoses in the population. No similar association was found during a similar time period in the year prior to the attack. We conclude that spatial variables help more fully describe post-terrorism psychiatric risk and may help explain discrepancies in the existing literature about these attacks. These methods hold promise for the characterization of disease risk where spatial patterning of ecologic-level exposures and outcomes merits consideration.
先前有关与 2001 年 9 月 11 日恐怖袭击的接近程度以及随后的精神病理学之间关系的研究得出了相互矛盾的结果。本分析的目的是评估使用贝叶斯层次空间技术来回答接近大规模创伤作为精神病理学风险因素的问题是否合适。我们使用了纽约州的一套个人层面的医疗补助数据，并控制了年龄、性别、家庭中位数收入和与就业相关的暴露因素，我们对空间聚集的数据应用了贝叶斯层次建模方法。我们发现，在袭击后的时间里，距离世界贸易中心遗址越近，与焦虑相关诊断的风险增加有关。在袭击发生后的几个月里，距离世界贸易中心遗址每增加 2 英里，人群中与焦虑相关的诊断就会增加 7%。在袭击发生前一年的类似时间内，没有发现类似的关联。我们的结论是，空间变量有助于更全面地描述恐怖主义后的精神风险，并且可能有助于解释关于这些袭击的现有文献中的差异。这些方法有望用于描述疾病风险，因为生态级暴露和结果的空间模式值得考虑。
