Gaither Rachel, Zandstra Tamsin, Linnstaedt Sarah D, McLean Samuel A, Lechner Megan, Bell Kathy, Black Jenny, Buchanan Jennie A, Ho Jeffrey D, Platt Melissa A, Riviello Ralph J, Beaudoin Francesca L
Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA.
Institute for Trauma Recovery, University of North Carolina, Chapel Hill, North Carolina, USA.
J Trauma Stress. 2024 Dec;37(6):877-889. doi: 10.1002/jts.23056. Epub 2024 Jun 5.
In the United States, 8,000,000 people seek emergency care for traumatic injury annually. Motor vehicle collisions (MVCs) and sexual assault are two common sources of trauma, with evidence that reduced neighborhood-level socioeconomic characteristics increase posttraumatic pain and stress after an MVC. We evaluated whether neighborhood disadvantage was also associated with physical and mental posttrauma outcomes after sexual assault in a sample of adult women (N = 656) who presented for emergency care at facilities in the United States following sexual assault and were followed for 1 year. Neighborhood characteristics were assessed via the Area Deprivation Index, and self-reported pain, anxiety, depression, and posttraumatic stress disorder (PTSD) symptoms were collected at 6 weeks posttrauma. Adjusted log-binomial regression models examined the association between each clinical outcome and neighborhood disadvantage. Women in more disadvantaged neighborhoods were more likely to be non-White and have lower annual incomes. At 6 weeks posttrauma, the prevalence of clinically significant pain, anxiety, and depressive symptoms more than doubled from baseline (41.7% vs. 18.8%, 62.4% vs. 23.9%, and 55.2% vs. 22.7%, respectively); 40.7% of women also reported PTSD symptoms. Black, Hispanic, and lower-income participants were more likely to report pre- and postassault pain, anxiety, and depression. After adjusting for race, ethnicity, and income, no significant association existed between neighborhood disadvantage and any outcome, ps = .197 - .859. Although neighborhood disadvantage was not associated with posttrauma outcomes, these findings highlight the need for continued research in diverse populations at high risk of adverse physical and mental health symptoms following sexual assault.
在美国，每年有800万人因创伤性损伤寻求急诊治疗。机动车碰撞（MVC）和性侵犯是两种常见的创伤来源，有证据表明社区层面社会经济特征的降低会增加MVC后创伤后疼痛和压力。我们评估了社区劣势是否也与性侵犯后成年女性（N = 656）的创伤后身体和心理健康结果相关，这些女性在美国的医疗机构因性侵犯接受急诊治疗，并被随访1年。通过地区剥夺指数评估社区特征，并在创伤后6周收集自我报告的疼痛、焦虑、抑郁和创伤后应激障碍（PTSD）症状。调整后的对数二项回归模型检验了每种临床结果与社区劣势之间的关联。处于更弱势社区的女性更有可能是非白人且年收入较低。在创伤后6周，临床上显著的疼痛、焦虑和抑郁症状的患病率比基线水平增加了一倍多（分别为41.7%对18.8%、62.4%对23.9%和55.2%对22.7%）；40.7%的女性还报告了PTSD症状。黑人、西班牙裔和低收入参与者更有可能报告袭击前后的疼痛、焦虑和抑郁。在调整种族、民族和收入后，社区劣势与任何结果之间均无显著关联，p值 = 0.197 - 0.859。尽管社区劣势与创伤后结果无关，但这些发现凸显了对遭受性侵犯后有出现不良身心健康症状高风险的不同人群持续进行研究的必要性。
