Delgadillo, J. orcid.org/0000-0001-5349-230X and Richardson, T. orcid.org/0000-0002-5357-4281 (2025) On poverty and trauma: associations between neighbourhood socioeconomic deprivation, post-traumatic stress disorder severity and treatment response. European Journal of Psychotraumatology, 16 (1). 2547549. ISSN: 2000-8066
Abstract
Aims: To determine if neighbourhood socioeconomic deprivation is associated with post-traumatic stress disorder (PTSD) severity and psychological treatment response.
Methods: This was a retrospective cohort study based on the analysis of electronic health records for N = 2064 patients treated for PTSD across 16 psychological therapy services in England. The Revised Impact of Events Scale (IES-R) scale was used to measure PTSD severity and associations were examined with the neighbourhood-level index of multiple deprivation (IMD) using non-parametric correlations and multilevel modelling.
Results: Three times more PTSD cases (33.6% vs. 9.7%) were clustered within the most deprived IMD quintile compared to the least deprived quintile. A small and statistically significant correlation between IMD and IES-R baseline severity (r = −0.16, p < .001), indicated that patients living in the most deprived neighbourhoods had more severe symptoms. Post-treatment IES-R severity was also significantly associated with IMD (B = −0.74, p < .001), after controlling for baseline severity of PTSD and comorbid depression symptoms, adjusting for between-service variability in treatment outcomes (ICC = 0.023). Treatment duration was a moderator of the association between IMD and treatment outcomes.
Conclusions: Neighbourhood deprivation is associated with a higher prevalence of PTSD, higher symptom severity at the start of treatment and poorer treatment response. A longer course of therapy mitigated the adverse impact of deprivation on treatment outcomes.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2025 The Author(s). This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent. |
Keywords: | Humans; Treatment Outcome; Severity of Illness Index; Retrospective Studies; Stress Disorders, Post-Traumatic; Residence Characteristics; Poverty; Socioeconomic Factors; Adult; Middle Aged; England; Female; Male; Neighborhood Characteristics |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Science (Sheffield) > Department of Psychology (Sheffield) |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 26 Sep 2025 11:11 |
Last Modified: | 26 Sep 2025 11:11 |
Status: | Published |
Publisher: | Taylor and Francis Group |
Refereed: | Yes |
Identification Number: | 10.1080/20008066.2025.2547549 |
Sustainable Development Goals: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:232090 |