Social Support May Protect Against Development of Posttraumatic Stress Disorder: Findings From the Heart and Soul Study
ABSTRACT Abstract Purpose . No prospective studies have examined the association of poor social support and development of posttraumatic stress disorder (PTSD) in patients with chronic illness. This study addresses this knowledge gap. Design . This prospective study examines the relationship of social support to the subsequent development of PTSD during a 5-year period. Setting . San Francisco Veterans Affairs Medical Center. Subjects . A total of 579 participants with cardiovascular disease did not have PTSD at baseline and returned for the 5-year follow-up examination. Measures . PTSD measured by Computerized Diagnostic Interview Schedule for DSM-IV. Social support measured by Interpersonal Support Evaluation List (ISEL). Analysis . Unconditional ordered logistic regression analyses were performed to yield the odds ratio of developing PTSD for a one-standard-deviation change in ISEL score. Results . Of 579 participants who did not have PTSD at baseline, approximately 6.4% (n = 37) developed PTSD. Higher baseline perceived social support was strongly protective against development of PTSD (OR = .60, p = .001). Results remained significant after adjustment for age, sex, race, income, and depression (OR = .69, p = .04). Of social support types examined, the "tangible" and "belonging" domains were most strongly associated with future PTSD status. Conclusion . Social support may impact development of PTSD. Interventions that optimize social support may be part of a PTSD prevention program designed to help individuals at risk of developing PTSD.
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ABSTRACT: Despite continued outreach efforts, levels of mental health care utilization for posttraumatic stress disorder (PTSD) remain low. As such, it is important to identify factors that may promote or discourage treatment engagement. This study was designed to examine the association between perceived social support and utilization of several types of PTSD services.Psychiatric services (Washington, D.C.) 10/2014; DOI:10.1176/appi.ps.201400029 · 1.99 Impact Factor
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ABSTRACT: A series of recent articles has reported on well-designed studies examining base rates of posttraumatic stress disorder (PTSD) screenings within the Operation Enduring Freedom (Afghanistan conflict)/Operation Iraqi Freedom (Iraq conflict) (OEF/OIF) military population. Although these studies have a number of strengths, this line of research points out several key areas in need of further examination. Many OEF/OIF Veterans do not use available Veterans Affairs (VA) services, especially mental health care. This highlights the need to understand the differences between those who use and do not use the VA, especially as research with pre-OEF/OIF Veterans suggests that these two groups differ in significant ways. The high rates of PTSD-related concerns in non-VA users also points to a need to understand whether-and where-Veterans are seeking care outside the VA and the accessibility of evidence-based, trauma-focused treatments in the community and private sectors. Careful examination of relationship status is also paramount as little research has examined relationship status or other relationship context issues. Social support, especially from a spouse, can buffer the development of PTSD; however, relationship discord has the potential to greatly exacerbate PTSD symptomatology. Furthermore, given the additional risk factors for sexual minority Veterans to be exposed to trauma, the 2011 repeal of the US Military "Don't Ask, Don't Tell" policy, and the emergence of the VA as likely the largest health care provider for sexual minority Veterans, it will be critically important to study the trauma and mental health experiences of this group. Studies that examine prevalence rates of PTSD in the returning cohort contribute significantly to our understanding of the US OEF/OIF military population. Further study of PTSD in relation to demographic variables such as VA and non-VA use, relationship status, and sexual orientation will provide rich data that will enhance our ability to develop policy and practice to provide the best care to this population.European Journal of Psychotraumatology 05/2015; 6:27322. DOI:10.3402/ejpt.v6.27322 · 2.40 Impact Factor