Neighborhood social cohesion and posttraumatic stress disorder in a community-based sample: findings from the Detroit Neighborhood Health Study

Lauren E Johns, Allison E Aiello, Caroline Cheng, Sandro Galea, Karestan C Koenen, Monica Uddin
Social Psychiatry and Psychiatric Epidemiology 2012, 47 (12): 1899-906

PURPOSE: Posttraumatic stress disorder (PTSD) is common and debilitating. Although research has identified individual-level risk factors for PTSD, the role of macro-social factors in PTSD etiology remains unknown. This study tests whether perceived neighborhood social cohesion (NSC), measured at the both the individual and neighborhood levels, plays a role in determining past-year risk of PTSD among those exposed to trauma.

METHODS: Data (n = 1,221) were obtained from an ongoing prospective epidemiologic study in the city of Detroit. Assessment of traumatic event exposure and PTSD was consistent with DSM-IV criteria. Generalized estimating equations (GEE) and logistic regression models were used to estimate the association of neighborhood-level perceived NSC with the risk of PTSD, adjusting for individual-level perceptions of NSC and other covariates.

RESULTS: The odds of past-year PTSD were significantly higher among those residing in a neighborhood with low social cohesion compared to high (OR = 2.44, 95 % CI: 1.58, 3.78), independent of individual sociodemographic characteristics, number of traumas, and individual-level perceptions of NSC. The odds of past-year PTSD were not significantly associated with individual-level perceptions of NSC.

CONCLUSIONS: These results demonstrate that social context shapes risk of PTSD and suggest that changing the social context may shift vulnerability to this disorder.

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