Neighborhood context: Understanding the relationship between national indices of neighborhood risk, individual perception, and posttraumatic stress

Although understudied, emerging research suggests an important link between neighborhood environments and posttraumatic stress disorder (PTSD). National indices of neighborhood disadvantage offer a unique way to objectively assess neighborhoods by linking indices of risk to geocoded residential addresses and research suggests living in a more disadvantaged neighborhood is associated with poorer mental health. Self-report measures offer a subjective appraisal of the circumstances in one's neighborhood yet it is unclear how well perception maps onto objective indices of risk. This study examined the association between three national indices of neighborhood disadvantage and neighborhood perceptions of cohesion, disorder, and danger and whether these relationships were impacted by prior trauma history or PTSD in a sample of 3378 U.S. veterans enrolled in the Longitudinal Investigation of Gender Health, and Trauma (LIGHT) study. Veterans with PTSD resided in more disadvantaged neighborhoods and reported poorer neighborhood cohesion, greater neighborhood disorder, and greater neighborhood danger compared to trauma exposed veterans without PTSD and non-trauma exposed veterans. Findings additionally highlight the ways in which trauma exposure and PTSD symptomology impact the relationship between objective neighborhood indices and perceptions of contextual neighborhood factors and point to important future directions investigating the salience of community level conditions on traumatic stress.