Neighborhood Resources Associated With Psychological Trajectories and Neural Reactivity to Reward After Trauma

Published in JAMA Psychiatry. Here is a link to the article.

Regenstrief Institute authors: Paul I. Musey, M.D., M.S.

This cohort study explored how individual resilience and neighborhood greenspace interact to influence PTSD outcomes after trauma. Among 2,597 trauma survivors recruited from U.S. emergency departments, researchers identified six PTSD symptom trajectories over six months. Participants with higher self-reported resilience (CD-RISC scores) and greater residential greenspace exposure were significantly more likely to follow a resilient (low/no symptoms) trajectory compared to those with more persistent PTSD symptoms.

Greenspace exposure was also linked to increased neural reactivity to reward in the amygdala, although this neural activity did not directly differ across PTSD trajectories. These results suggest that both individual and environmental factors—particularly access to greenspace—play important roles in promoting psychological resilience after trauma.

Overall, the study highlights the value of multi-level interventions to support recovery and prevent chronic PTSD, integrating personal resilience-building with urban planning and environmental design.

Authors:

E Kate Webb ^1 2, Jennifer S Stevens ³, Timothy D Ely ³, Lauren A M Lebois ^1 2, Sanne J H van Rooij ³, Steven E Bruce ⁴, Stacey L House ⁵, Francesca L Beaudoin ^6 7, Xinming An ⁸, Thomas C Neylan ⁹, Gari D Clifford ^10 11, Sarah D Linnstaedt ⁸, Laura T Germine ^1 12 13, Kenneth A Bollen ^14 15, Scott L Rauch ^1 12 16, John P Haran ¹⁷, Alan B Storrow ¹⁸, Christopher Lewandowski ¹⁹, Paul I Musey Jr ²⁰, Phyllis L Hendry ²¹, Sophia Sheikh ²¹, Christopher W Jones ²², Brittany E Punches ^23 24, Robert A Swor ²⁵, Vishnu P Murty ²⁶, Lauren A Hudak ²⁷, Jose L Pascual ^28 29, Mark J Seamon ^29 30, Elizabeth M Datner ^31 32, Claire Pearson ³³, David A Peak ³⁴, Robert M Domeier ³⁵, Niels K Rathlev ³⁶, Brian J O’Neil ³⁷, Paulina Sergot ³⁸, Leon D Sanchez ^39 40, Jutta Joormann ⁴¹, Diego A Pizzagalli ^1 2, Steven E Harte ^42 43, Ronald C Kessler ⁴⁴, Karestan C Koenen ⁴⁵, Kerry J Ressler ^1 2, Samuel A McLean ^46 47, Nathaniel G Harnett ^1 2

Affiliations

¹Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.

²Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, Massachusetts.

³Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia.

⁴Department of Psychological Sciences, University of Missouri-St Louis, St Louis.

⁵Department of Emergency Medicine, Washington University School of Medicine, St Louis, Missouri.

⁶Department of Epidemiology, Brown University, Providence, Rhode Island.

⁷Department of Emergency Medicine, Brown University, Providence, Rhode Island.

⁸Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill.

⁹Departments of Psychiatry and Neurology, University of California San Francisco, San Francisco.

¹⁰Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, Georgia.

¹¹Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta.

¹²Institute for Technology in Psychiatry, McLean Hospital, Belmont, Massachusetts.

¹³The Many Brains Project, Belmont, Massachusetts.

¹⁴Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill.

¹⁵Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill.

¹⁶Department of Psychiatry, McLean Hospital, Belmont, Massachusetts.

¹⁷Department of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester.

¹⁸Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.

¹⁹Department of Emergency Medicine, Henry Ford Health System, Detroit, Michigan.

²⁰Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis.

²¹Department of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville.

²²Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, New Jersey.

²³Department of Emergency Medicine, Ohio State University College of Medicine, Columbus.

²⁴Ohio State University College of Nursing, Columbus.

²⁵Department of Emergency Medicine, Oakland University William Beaumont School of Medicine, Rochester, Michigan.

²⁶Department of Psychology, Temple University, Philadelphia, Pennsylvania.

²⁷Department of Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia.

²⁸Department of Surgery, Department of Neurosurgery, University of Pennsylvania, Philadelphia.

²⁹Perelman School of Medicine, University of Pennsylvania, Philadelphia.

³⁰Department of Surgery, Division of Traumatology, Surgical Critical Care and Emergency Surgery, University of Pennsylvania, Philadelphia.

³¹Department of Emergency Medicine, Jefferson Einstein Hospital, Jefferson Health, Philadelphia, Pennsylvania.

³²Department of Emergency Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania.

³³Department of Emergency Medicine, Wayne State University, Ascension St John Hospital, Detroit, Michigan.

³⁴Department of Emergency Medicine, Massachusetts General Hospital, Boston.

³⁵Department of Emergency Medicine, Trinity Health-Ann Arbor, Ypsilanti, Michigan.

³⁶Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield.

³⁷Department of Emergency Medicine, Wayne State University, Detroit Receiving Hospital, Detroit, Michigan.

³⁸Department of Emergency Medicine, McGovern Medical School at UTHealth, Houston, Texas.

³⁹Department of Emergency Medicine, Brigham and Women’s Hospital, Boston, Massachusetts.

⁴⁰Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts.

⁴¹Department of Psychology, Yale University, New Haven, Connecticut.

⁴²Department of Anesthesiology, University of Michigan Medical School, Ann Arbor.

⁴³Department of Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor.

⁴⁴Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts.

⁴⁵Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts.

⁴⁶Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill.

⁴⁷Institute for Trauma Recovery, Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill.