邻里贫困可预测创伤后六个月的创伤后应激障碍症状

Meghna Ravi, Abigail Powers, Barbara O. Rothbaum, Jennifer S. Stevens, Vasiliki Michopoulos
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摘要

生活在贫困率较高地区的人受创伤后应激障碍(PTSD)的影响尤为严重。尽管存在这种关联,但人们对邻里贫困率如何影响创伤后应激障碍的发病风险知之甚少。在当前的前瞻性研究中,我们以不同种族、性别和社会经济地位的样本为研究对象,确定了邻里贫困率与创伤后应激障碍症状之间的关系。参与者(N = 252)在经历创伤事件后到医院急诊科就诊。他们在急诊室接受了人口统计学信息(包括居住地邮编)、创伤后应激障碍症状基线和创伤史基线评估。创伤后 6 个月再次评估创伤后应激障碍症状。邻里贫困率是通过美国社区调查确定的。相关分析表明,邻里贫困率与创伤后应激障碍症状基线(r = 0.181,p = 0.004)和创伤后 6 个月的创伤后应激障碍症状(r = 0.163,p = 0.009)显著相关。控制基线创伤暴露、临床医生评定的创伤严重程度和个人社会经济状况的回归分析表明,邻里贫困可预测创伤后 6 个月的创伤后应激障碍症状(R2 = 0.099,B = 0.15,p = 0.04),但如果将基线创伤后应激障碍症状作为额外的协变量(R2 = 0.304,B = 0.07,p >0.05),这种关系不再显著。总之,研究结果表明,邻里贫困通常会增加创伤后应激障碍症状的严重程度,因此在对创伤后应激障碍的风险进行概念化时,应考虑到个人的生活环境。
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Neighborhood poverty prospectively predicts PTSD symptoms six-months following trauma exposure

Individuals living in areas with high rates of poverty are disproportionately affected by posttraumatic stress disorder (PTSD). Despite this association, little is known about how neighborhood poverty rates impact risk for PTSD development. In the current prospective study, we determined the relationship between neighborhood poverty rate and PTSD symptoms 6-months after experiencing a traumatic event in a sample of varied race, gender, and socioeconomic status. Participants (N = 252) were enrolled in a hospital emergency department after experiencing a traumatic event. Demographic information (including zip code of residence), baseline PTSD symptoms, and baseline trauma history was assessed in the emergency department. PTSD symptoms were again assessed 6-months posttrauma. Neighborhood poverty rate was determined using the American Community Survey. Correlation analyses revealed that neighborhood poverty was significantly associated with baseline PTSD symptoms (r = 0.181, p = 0.004) and PTSD symptoms 6-months posttrauma (r = 0.163, p = 0.009). A regression analysis controlling for baseline trauma exposure, clinician-rated trauma severity, and individual socioeconomic status demonstrated that neighborhood poverty predicted PTSD symptoms six-months posttrauma (R2 = 0.099, B = 0.15, p = 0.04), but this relationship was no longer significant when baseline PTSD symptoms was added as an additional covariate (R2 = 0.304, B = 0.07, p > 0.05). Overall, results suggest that neighborhood poverty generally increases PTSD symptom severity, and the context in which an individual lives should be considered when conceptualizing risk for PTSD.

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