Patterns and predictors of trajectories of depression after an urban disaster.

摘要

PURPOSE: To identify and understand the patterns and predictors of depressive symptom trajectories over time after mass traumatic events. METHODS: Data were used from a prospective, representative sample of adult residents of the New York City metropolitan area (N=2,282) followed up across four survey waves between 2001 (after the September 11 attacks) and 2004. Semi-parametric group-based modeling was used to identify trajectories, as well as the time-fixed and time-varying predictors of distinct depressive trajectories. RESULTS: Five distinct trajectories of depression were characterized: minimal symptomatology at all time points (group 1, 39% of sample), mild delayed depression (group 2, 34% of sample), recovery (group 3, 6% of sample), severe delayed depression (group 4, 13% of sample), and chronic severe depression (group 5, 8% of sample). Among members of distinct trajectories, lower household income, exposure to ongoing stressors, and exposure to traumatic events were commonly associated with an increased number of depressive symptoms. CONCLUSIONS: Ongoing socioeconomic adversity appears to be centrally associated with a worse course of depression after exposure to traumatic events. Identifying distinct trajectories of depression and the preventable factors that are associated with them may facilitate the development of interventions that aim to promote better mental health.