Massachusetts General Hospital, United States.
J Anxiety Disord. 2011 Dec;25(8):1072-8. doi: 10.1016/j.janxdis.2011.07.004. Epub 2011 Jul 19.
Poor social support in the aftermath of a traumatic event is a well-established risk factor for posttraumatic stress disorder (PTSD) among adult trauma survivors. Yet, a great deal about the relationship between social support and PTSD remains poorly understood. In this study, we analyzed data from 102 survivors of a serious motor vehicle accident (MVA) at 4 weeks (Time 1) and 16 weeks (Time 2) post-MVA. We assessed the role of perceived dyadic social support, positive dyadic interaction, and negative dyadic interaction in the development and maintenance of PTSD. In addition, we examined how these social support constructs work together with negative post-trauma cognitions to affect the maintenance of PTSD. Neither perceived social support nor the quality of social interaction (i.e., positive or negative) was associated with PTSD symptom severity at Time 1. However, among those with elevated PTSD symptom severity at Time 1, greater social support and positive social interaction and lower negative social interaction were each associated with reductions in PTSD symptom severity from Time 1 to Time 2. For social support and negative social interaction, this association ceased to be significant when jointly assessed with negative post-trauma cognitions, suggesting that perceived social support and negative dyadic interaction were associated with maintenance of PTSD symptom severity because of their association with negative post-trauma cognitions. These results provide support to models and treatments of PTSD that emphasize the role of negative post-trauma cognitions in maintenance of PTSD.
创伤后不良的社会支持是成人创伤幸存者发生创伤后应激障碍(PTSD)的一个公认的风险因素。然而,关于社会支持与 PTSD 之间的关系,仍有很多方面尚未得到充分理解。在这项研究中,我们分析了 102 名严重机动车事故(MVA)幸存者在 MVA 后 4 周(时间 1)和 16 周(时间 2)的数据。我们评估了感知的二元社会支持、积极的二元互动和消极的二元互动在 PTSD 的发展和维持中的作用。此外,我们还研究了这些社会支持结构如何与消极的创伤后认知一起影响 PTSD 的维持。在时间 1 时,无论是感知到的社会支持还是社会互动的质量(即积极或消极)都与 PTSD 症状严重程度无关。然而,在那些时间 1 时 PTSD 症状严重程度较高的患者中,较高的社会支持、积极的社会互动和较低的消极社会互动与 PTSD 症状严重程度从时间 1 到时间 2 的降低有关。对于社会支持和消极的社会互动来说,当与消极的创伤后认知一起进行联合评估时,这种关联不再具有统计学意义,这表明感知到的社会支持和消极的二元互动与 PTSD 症状严重程度的维持有关,因为它们与消极的创伤后认知有关。这些结果为强调消极的创伤后认知在 PTSD 维持中的作用的 PTSD 模型和治疗方法提供了支持。