%0 Journal Article %T Neighborhood resources associated with psychological trajectories and neural reactivity to reward after trauma %J JAMA Psychiatry %D 2024 %A Webb, E. Kate %A Stevens, Jennifer S. %A Ely, Timothy D. %A Lebois, Lauren A. M. %A van Rooij, Sanne J. H. %A Bruce, Steven E. %A House, Stacey L. %A Beaudoin, Francesca L. %A An, Xinming %A Neylan, Thomas C. %A Clifford, Gari D. %A Linnstaedt, Sarah D. %A Germine, Laura T. %A Bollen, Kenneth A. %A Rauch, Scott L. %A Haran, John P. %A Storrow, Alan B. %A Lewandowski, Christopher %A Musey, Paul I. Jr %A Hendry, Phyllis L. %A Sheikh, Sophia %A Jones, Christopher W. %A Punches, Brittany E. %A Swor, Robert A. %A Murty, Vishnu P. %A Hudak, Lauren A. %A Pascual, Jose L. %A Seamon, Mark J. %A Datner, Elizabeth M. %A Pearson, Claire %A Peak, David A. %A Domeier, Robert M. %A Rathlev, Niels K. %A O'Neil, Brian J. %A Sergot, Paulina %A Sanchez, Leon D. %A Joormann, Jutta %A Pizzagalli, Diego A. %A Harte, Steven E. %A Kessler, Ronald C. %A Koenen, Karestan C. %A Ressler, Kerry J. %A McLean, Samuel A. %A Harnett, Nathaniel G. %V ePub %N ePub %P ePub-ePub %X IMPORTANCE: Research on resilience after trauma has often focused on individual-level factors (eg, ability to cope with adversity) and overlooked influential neighborhood-level factors that may help mitigate the development of posttraumatic stress disorder (PTSD).

OBJECTIVE: To investigate whether an interaction between residential greenspace and self-reported individual resources was associated with a resilient PTSD trajectory (ie, low/no symptoms) and to test if the association between greenspace and PTSD trajectory was mediated by neural reactivity to reward. DESIGN, SETTING, AND PARTICIPANTS: As part of a longitudinal cohort study, trauma survivors were recruited from emergency departments across the US. Two weeks after trauma, a subset of participants underwent functional magnetic resonance imaging during a monetary reward task. Study data were analyzed from January to November 2023. EXPOSURES: Residential greenspace within a 100-m buffer of each participant's home address was derived from satellite imagery and quantified using the Normalized Difference Vegetation Index and perceived individual resources measured by the Connor-Davidson Resilience Scale (CD-RISC). MAIN OUTCOME AND MEASURES: PTSD symptom severity measured at 2 weeks, 8 weeks, 3 months, and 6 months after trauma. Neural responses to monetary reward in reward-related regions (ie, amygdala, nucleus accumbens, orbitofrontal cortex) was a secondary outcome. Covariates included both geocoded (eg, area deprivation index) and self-reported characteristics (eg, childhood maltreatment, income).

RESULTS: In 2597 trauma survivors (mean [SD] age, 36.5 [13.4] years; 1637 female [63%]; 1304 non-Hispanic Black [50.2%], 289 Hispanic [11.1%], 901 non-Hispanic White [34.7%], 93 non-Hispanic other race [3.6%], and 10 missing/unreported [0.4%]), 6 PTSD trajectories (resilient, nonremitting high, nonremitting moderate, slow recovery, rapid recovery, delayed) were identified through latent-class mixed-effect modeling. Multinominal logistic regressions revealed that for individuals with higher CD-RISC scores, greenspace was associated with a greater likelihood of assignment in a resilient trajectory compared with nonremitting high (Wald z test = -3.92; P < .001), nonremitting moderate (Wald z test = -2.24; P = .03), or slow recovery (Wald z test = -2.27; P = .02) classes. Greenspace was also associated with greater neural reactivity to reward in the amygdala (n = 288; t277 = 2.83; adjusted P value = 0.02); however, reward reactivity did not differ by PTSD trajectory.

CONCLUSIONS AND RELEVANCE: In this cohort study, greenspace and self-reported individual resources were significantly associated with PTSD trajectories. These findings suggest that factors at multiple ecological levels may contribute to the likelihood of resiliency to PTSD after trauma.

Language: en

%G en %I American Medical Association %@ 2168-622X %U http://dx.doi.org/10.1001/jamapsychiatry.2024.2148