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

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Abstract

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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Acknowledgments

We thank the many Detroit residents who chose to participate in the DNHS and Jorge Delva, Larry Gant, and Bob Marans, Trivellore Raghunathan for contributing to the conceptual development of the DNHS. This study was supported by National Institutes of Health Grant DA022720.

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Authors and Affiliations

  1. Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, 48109, USA

    Lauren E. Johns, Allison E. Aiello & Caroline Cheng

  2. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA

    Sandro Galea & Karestan C. Koenen

  3. Department of Psychiatry and Behavioral Neurosciences, Center for Molecular Medicine and Genetics, Wayne State University School of Medicine, 540 E. Canfield Ave., 3309 Scott Detroit, Detroit, MI, 48201, USA

    Monica Uddin

Authors
  1. Lauren E. Johns
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  2. Allison E. Aiello
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  3. Caroline Cheng
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  4. Sandro Galea
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  5. Karestan C. Koenen
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  6. Monica Uddin
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Correspondence to Monica Uddin.

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Johns, L.E., Aiello, A.E., Cheng, C. et al. Neighborhood social cohesion and posttraumatic stress disorder in a community-based sample: findings from the Detroit Neighborhood Health Study. Soc Psychiatry Psychiatr Epidemiol 47, 1899–1906 (2012). https://doi.org/10.1007/s00127-012-0506-9

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  • DOI: https://doi.org/10.1007/s00127-012-0506-9

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