TY - JOUR
T1 - Neighborhood Resources Associated with Psychological Trajectories and Neural Reactivity to Reward after Trauma
AU - Webb, E. Kate
AU - Stevens, Jennifer S.
AU - Ely, Timothy D.
AU - Lebois, Lauren A.M.
AU - Van Rooij, Sanne J.H.
AU - Bruce, Steven E.
AU - House, Stacey L.
AU - Beaudoin, Francesca L.
AU - An, Xinming
AU - Neylan, Thomas C.
AU - Clifford, Gari D.
AU - Linnstaedt, Sarah D.
AU - Germine, Laura T.
AU - Bollen, Kenneth A.
AU - Rauch, Scott L.
AU - Haran, John P.
AU - Storrow, Alan B.
AU - Lewandowski, Christopher
AU - Musey, Paul I.
AU - Hendry, Phyllis L.
AU - Sheikh, Sophia
AU - Jones, Christopher W.
AU - Punches, Brittany E.
AU - Swor, Robert A.
AU - Murty, Vishnu P.
AU - Hudak, Lauren A.
AU - Pascual, Jose L.
AU - Seamon, Mark J.
AU - Datner, Elizabeth M.
AU - Pearson, Claire
AU - Peak, David A.
AU - Domeier, Robert M.
AU - Rathlev, Niels K.
AU - O'Neil, Brian J.
AU - Sergot, Paulina
AU - Sanchez, Leon D.
AU - Joormann, Jutta
AU - Pizzagalli, Diego A.
AU - Harte, Steven E.
AU - Kessler, Ronald C.
AU - Koenen, Karestan C.
AU - Ressler, Kerry J.
AU - McLean, Samuel A.
AU - Harnett, Nathaniel G.
N1 - Publisher Copyright:
© 2024 Webb EK et al. JAMA Psychiatry.
PY - 2024/11/6
Y1 - 2024/11/6
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85200629146&partnerID=8YFLogxK
U2 - 10.1001/jamapsychiatry.2024.2148
DO - 10.1001/jamapsychiatry.2024.2148
M3 - Article
C2 - 39083325
AN - SCOPUS:85200629146
SN - 2168-622X
VL - 81
SP - 1090
EP - 1100
JO - JAMA psychiatry
JF - JAMA psychiatry
IS - 11
ER -