Sippel Lauren M, Liebman Rachel E, Schäfer Sarah K, Ennis Naomi, Mattern Alexandra C, Rozek David C, Monson Candice M
Department of Veterans Affairs Northeast Program Evaluation Center, West Haven, CT 06516, USA.
Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH 03755, USA.
Behav Sci (Basel). 2024 Mar 29;14(4):284. doi: 10.3390/bs14040284.
Although the association between post-traumatic stress disorder (PTSD) and social support is well documented, few studies have tested the causal pathways explaining this association at several points in the acute post-trauma recovery period or examined whether the association varies for different sources of social support. To address these gaps, 151 community individuals (mean age = 37.20 years, 69.5% women) exposed to trauma within the previous 6 months were recruited to complete measures of PTSD and social support from intimate partners, friends, and relatives four times in 1 year. In line with recent recommendations for research on social support and PTSD symptoms, random intercept cross-lagged panel modeling (RI-CLPM) was used to examine dynamic changes between PTSD severity and social support over time. The pattern of RI-CLPM cross-lagged coefficients indicated that positive deviations from one's expected stable level of total social support (across all sources) sped up the recovery of PTSD symptoms at the end of the post-trauma year, and more severe PTSD symptoms than expected based on one's expected stable level of PTSD started eroding social support midway through the assessment year. When specific sources of social support were analyzed separately, the association between within-person increases in social support from friends at any given time point accelerated the recovery from PTSD across the entire year. Among participants with intimate partners ( = 53), intimate partner support did not predict PTSD symptoms, but more severe PTSD symptoms at any given time point predicted less support at the following time point. Results from this longitudinal study provide additional support for the bidirectional relationship between PTSD and social support over time and suggest that perceived social support from friends may be especially helpful during trauma recovery.
尽管创伤后应激障碍(PTSD)与社会支持之间的关联已有充分记录,但很少有研究在创伤后急性恢复期的多个时间点测试解释这种关联的因果途径,也没有研究这种关联是否因不同社会支持来源而有所不同。为了填补这些空白,招募了151名在过去6个月内遭受创伤的社区个体(平均年龄 = 37.20岁,69.5%为女性),在1年内分四次完成创伤后应激障碍和来自亲密伴侣、朋友及亲属的社会支持的测量。根据近期关于社会支持与创伤后应激障碍症状研究的建议,采用随机截距交叉滞后面板模型(RI-CLPM)来检验创伤后应激障碍严重程度与社会支持随时间的动态变化。RI-CLPM交叉滞后系数的模式表明,与个人预期的总社会支持稳定水平(所有来源)的正向偏差加速了创伤后一年末创伤后应激障碍症状的恢复,并且基于个人预期的创伤后应激障碍稳定水平,比预期更严重的创伤后应激障碍症状在评估年中期开始侵蚀社会支持。当分别分析社会支持的特定来源时,在任何给定时间点来自朋友的社会支持在个体内的增加与全年创伤后应激障碍的恢复加速相关。在有亲密伴侣的参与者中(n = 53),亲密伴侣的支持不能预测创伤后应激障碍症状,但在任何给定时间点更严重的创伤后应激障碍症状预测下一个时间点的支持会减少。这项纵向研究的结果为创伤后应激障碍与社会支持随时间的双向关系提供了更多支持,并表明在创伤恢复期间,来自朋友的感知社会支持可能特别有帮助。