{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:43:49Z","timestamp":1792543429706,"version":"4.5.0"},"reference-count":64,"publisher":"American Medical Association (AMA)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Psychiatry"],"published-print":{"date-parts":[[2024,11,1]]},"abstract":"<jats:sec id=\"ab-yoi240045-4\"><jats:title>Importance<\/jats:title><jats:p>Research on resilience after trauma has often focused on individual-level factors (eg, ability to cope with adversity) and overlooked influential neighborhood-level factors that may help mitigate the development of posttraumatic stress disorder (PTSD).<\/jats:p><\/jats:sec><jats:sec id=\"ab-yoi240045-5\"><jats:title>Objective<\/jats:title><jats:p>To investigate whether an interaction between residential greenspace and self-reported individual resources was associated with a resilient PTSD trajectory (ie, low\/no symptoms) and to test if the association between greenspace and PTSD trajectory was mediated by neural reactivity to reward.<\/jats:p><\/jats:sec><jats:sec id=\"ab-yoi240045-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>As part of a longitudinal cohort study, trauma survivors were recruited from emergency departments across the US. Two weeks after trauma, a subset of participants underwent functional magnetic resonance imaging during a monetary reward task. Study data were analyzed from January to November 2023.<\/jats:p><\/jats:sec><jats:sec id=\"ab-yoi240045-7\"><jats:title>Exposures<\/jats:title><jats:p>Residential greenspace within a 100-m buffer of each participant\u2019s home address was derived from satellite imagery and quantified using the Normalized Difference Vegetation Index and perceived individual resources measured by the Connor-Davidson Resilience Scale (CD-RISC).<\/jats:p><\/jats:sec><jats:sec id=\"ab-yoi240045-8\"><jats:title>Main Outcome and Measures<\/jats:title><jats:p>PTSD symptom severity measured at 2 weeks, 8 weeks, 3 months, and 6 months after trauma. Neural responses to monetary reward in reward-related regions (ie, amygdala, nucleus accumbens, orbitofrontal cortex) was a secondary outcome. Covariates included both geocoded (eg, area deprivation index) and self-reported characteristics (eg, childhood maltreatment, income).<\/jats:p><\/jats:sec><jats:sec id=\"ab-yoi240045-9\"><jats:title>Results<\/jats:title><jats:p>In 2597 trauma survivors (mean [SD] age, 36.5 [13.4] years; 1637 female [63%]; 1304 non-Hispanic Black [50.2%], 289 Hispanic [11.1%], 901 non-Hispanic White [34.7%], 93 non-Hispanic other race [3.6%], and 10 missing\/unreported [0.4%]), 6 PTSD trajectories (resilient, nonremitting high, nonremitting moderate, slow recovery, rapid recovery, delayed) were identified through latent-class mixed-effect modeling. Multinominal logistic regressions revealed that for individuals with higher CD-RISC scores, greenspace was associated with a greater likelihood of assignment in a resilient trajectory compared with nonremitting high (Wald <jats:italic>z<\/jats:italic> test\u2009=\u2009\u22123.92; <jats:italic>P<\/jats:italic>\u2009&amp;amp;lt;\u2009.001), nonremitting moderate (Wald <jats:italic>z<\/jats:italic> test\u2009=\u2009\u22122.24; <jats:italic>P<\/jats:italic>\u2009=\u2009.03), or slow recovery (Wald <jats:italic>z<\/jats:italic> test\u2009=\u2009\u22122.27; <jats:italic>P<\/jats:italic>\u2009=\u2009.02) classes. Greenspace was also associated with greater neural reactivity to reward in the amygdala (n\u2009=\u2009288; <jats:italic>t<\/jats:italic><jats:sub>277<\/jats:sub>\u2009=\u20092.83; adjusted <jats:italic>P<\/jats:italic> value\u2009=\u20090.02); however, reward reactivity did not differ by PTSD trajectory.<\/jats:p><\/jats:sec><jats:sec id=\"ab-yoi240045-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>In this cohort study, greenspace and self-reported individual resources were significantly associated with PTSD trajectories. These findings suggest that factors at multiple ecological levels may contribute to the likelihood of resiliency to PTSD after trauma.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamapsychiatry.2024.2148","type":"journal-article","created":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T15:03:44Z","timestamp":1722438224000},"page":"1090","source":"Crossref","is-referenced-by-count":15,"title":["Neighborhood Resources Associated With Psychological Trajectories and Neural Reactivity to Reward After Trauma"],"prefix":"10.1001","volume":"81","author":[{"given":"E. 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