title: Neighborhood social cohesion and posttraumatic stress disorder in a community-based sample: findings from the Detroit Neighborhood Health Study.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA.
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Johns
authors.forename: Allison E
authors.initials: AE
authors.lastname: Aiello
authors.forename: Caroline
authors.initials: C
authors.lastname: Cheng
authors.forename: Sandro
authors.initials: S
authors.lastname: Galea
authors.forename: Karestan C
authors.initials: KC
authors.lastname: Koenen
authors.forename: Monica
authors.initials: M
authors.lastname: Uddin
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008016:Life Change Events; D016015:Logistic Models; D008297:Male; D008824:Michigan / Q000453:epidemiology; D008875:Middle Aged; D011446:Prospective Studies; D012111:Residence Characteristics; D012307:Risk Factors; D057566:Self Report; D012931:Social Environment; D012959:Socioeconomic Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D011795:Surveys and Questionnaires; D015599:Trauma Severity Indices; D014505:Urban Population; D055815:Young Adult