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Videnscenter for Psykotraumatologi

Social støtte

Social støtte har i forskningssammenhænge fået en del opmærksomhed, grundet denne variables potentiale til at fungere som beskyttende faktor. Social støtte er bl.a. blevet undersøgt i sammenhæng med kroniske syge børn og deres forældre.

Når social støtte optræder som en medierende variabel, så betyder det at sammenhængen mellem sygdom og den psykologiske belasting kan variere som funktion af social støtte. Social støtte er på denne måde en beskyttende faktor for de sygdomsrelaterede stressorer, ligesom at en manglende social støtte kan fungere modsatrettet.


Forskningsresultater i pædiatrisk onkologi har generelt fundet at den oplevede sociale støtte har en stress-medierende rolle på forældrene. Ligeledes er der i denne sammenhæng fundet, at det er den oplevede sociale støtte der betyder mest for graden af PTSD-symptomer hos forældrene, sammenlignet med størrelsen af det sociale netværk og de sociale interaktioner.


Videnscenteret bidrager med forskning om den sociale støttes rolle i en lang række sammenhænge. Dem kan du læse om på siden her



Relevante publikationer:
Laugesen, K., Baggesen, L. M., Schmidt, S. A. J., Glymour, M. M., Lasgaard, M., Milstein, A., ... Ehrenstein, V. (2018). Social isolation and all-cause mortality: a population-based cohort study in Denmark. Scientific Reports, 8. Doi: 10.1038/s41598-018-22963-w

Parents bereaved by infant death experience a wide range of symptomatology, including posttraumatic stress disorder (PTSD) that may persist for years after the loss. Little research has been conducted on PTSD in fathers who have lost an infant. Mothers report most symptoms to a greater extent than fathers, but not much is known about other sex differences following infant death. The present cross-sectional study examined sex differences in PTSD and sex differences in the relationship between PTSD severity and related variables. Subjects were 361 mothers and 273 fathers who had lost an infant either late in pregnancy, during birth or in the first year of life. Participants filled out questionnaires between 1.2 months and 18 years after the loss (M = 3.4 years). Mothers reported significantly more PTSD symptoms, attachment anxiety, emotion-focused coping and feeling let down, but significantly lower levels of attachment avoidance than fathers. Attachment anxiety, attachment avoidance and emotion-focused coping were significantly more strongly associated with PTSD severity in mothers than fathers, but only when examined alone. When all variables and time since the loss were examined together, there were no longer any significant moderation effects of sex. Persistent posttraumatic symptomatology exists in both mothers and fathers long after the loss. There are several sex differences in severity and correlates of PTSD, and a few moderation effects were identified for attachment and emotion-focused coping. Overall, more similarities than differences were found between mothers and fathers in the associations between PTSD and covariates.

Relevante publikationer:
Christiansen, D., Olff, M. & Elklit, A.: (2014). Parents bereaved by infant death: Sex differences and moderation in PTSD, attachment, coping, and social support. General Hospital Psychiatry, 36, 655–66136. Doi: 10.1016/j.genhosppsych.2014.07.012.

This study examined level of acute psychological distress and perceived social support in 64 victims of rape and the association with police case decisions and victims' willingness to participate in the investigation. The results of independent-sample t tests revealed that victims' unwillingness to participate in the investigation was significantly associated with a higher level of psychological distress in the acute phase following the assault. The results suggest that victims of rape who disengage with the police investigation may do so because of a high level of acute psychological distress. Clinical implications are discussed.

Relevante publikationer:
Hansen, N.B, Hansen, M., Nielsen, L.H., Bramsen, R.H., Elklit, A. & Campbell, R. (2017): Rape crimes: Are victims’ acute psychological distress and perceived social support associated with police case decision and victim unwillingness to participate in the investigation? Violence against Women, 24(6), 684-696. Doi: 10.1177/1077801217710002

Research has documented severe mental health problems in female victims of intimate partner violence (IPV). Therefore, providing effective treatment is pivotal. Few studies have investigated the effects of intervention programs on reducing the harmful consequences of IPV. The present study examined the effects of a specific three-phase intervention program for female victims of IPV on psychological symptoms (PTSD, anxiety, and depression) and perceived social support. Given that many of the women dropped out before and during the intervention program, potential differences in initial levels of psychological symptoms, perceived social support, as well as descriptive variables were explored between the women who completed the whole program and the groups of women who dropped out prematurely. The initial sample consisted of 212 female victims of IPV. Symptoms of PTSD, depression, anxiety, and level of perceived social support were measured with validated scales before the start of the intervention and after completion of each treatment phase. Results showed a significant effect of the intervention program on reducing psychological symptoms and increasing levels of perceived social support. Effect sizes ranged from medium to very high. Significant positive effects were found for each of the treatment phases. There were no significant differences between the women who completed the whole program and those women who dropped out prematurely in terms of initial level of symptoms and perceived social support as well as descriptive characteristics. Specifically developed intervention programs for female victims of IPV are effective in reducing the harmful personal consequences of IPV. Future studies should consider employing controlled study designs and address the issue of high drop out rates found in intervention studies.

Relevante publikationer:
Hansen, N. B., Eriksen, S. B. & Elklit, A. (2014). Effects of an intervention program for female victims of intimate partner violence on psychological symptoms and perceived social support. European Journal of Psychotraumatology, 5: 24797. Doi: 10.3402/ejpt.v5.24797

To (1) identify long-term trajectories of combat-induced posttraumatic stress disorder (PTSD) symptoms over a 20-year period from 1983 to 2002 in veterans with and without combat stress reaction (CSR) and (2) identify social predictors of these trajectories. A latent growth mixture modeling analysis on PTSD symptoms was conducted to identify PTSD trajectories and predictors. PTSD was defined according to DSM-III and assessed through the PTSD Inventory. Israeli male veterans with (n = 369) and without (n = 306) CSR were queried at 1, 2, and 20 years after war about combat exposure, military unit support, family environment, and social reintegration. For both study groups, we identified 4 distinct trajectories with varying prevalence across groups: resilience (CSR = 34.4%, non-CSR = 76.5%), recovery (CSR = 36.3%, non-CSR = 10.5%), delayed onset (CSR = 8.4%, non-CSR = 6.9%), and chronicity (CSR = 20.9%, non-CSR = 6.2%). Predictors of trajectories in both groups included perception of war threat (ORs = 1.59-2.47, P values ≤ .30), and negative social reintegration (ORs = 0.24-0.51, P values ≤ .047). Social support was associated with symptomatology only in the CSR group (ORs = 0.40-0.61, P values ≤ .045), while family coherence was predictive of symptomatology in the non-CSR group (OR = 0.76, P = .015) but not in the CSR group. Findings confirmed heterogeneity of long-term sequelae of combat, revealing 4 trajectories of resilience, recovery, delay, and chronicity in veterans with and without CSR. Symptomatic trajectories were more prevalent for the CSR group, suggesting that acute functional impairment predicts pathological outcomes. Predictors of symptomatic trajectories included perceived threat and social resources at the family, network, and societal levels.

Relevante publikationer:
Karstoft, K.-I., Armour, C., Elklit, A. & Solomon, Z. (2013): Long-term trajectories of PTSD in veterans: the role of social resources. Journal of Clinical Psychiatry, 74(12):e1163–e1168. Doi: 10.4088/JCP.13.m084822013

The purpose of the study was to investigate psychological distress and the prevalence of PTSD among Icelandic parents of chronically ill children, and the potential effects of social support on distress, at two points in time. The Impact on Family scale (IFS), the Trauma Symptom Checklist (TSC), the Harvard Trauma Questionnaire (HTQ) and the Crisis Support Scale (CSS) were completed by 105 parents of children with various diseases (69 mothers and 36 fathers). Despite the heterogeneity of the sample in terms of disease type, PTSD was present in 13.2% of the parents and an additional 28.6% had subclinical PTSD. Time since diagnosis, length of hospitalizations and disease‐related daily care predicted 40% of the HTQ total score.

Relevante publikationer:
Guðmundsdóttir, H. S., Elklit, A. & Guðmundsdóttir, D.B. (2006). PTSD and psychological distress in Icelandic parents of chronically ill children: Does social support have an effect on parental distress? Scandinavian Journal of Psychology, 47, 303-312. Doi: 10.1111/j.1467-9450.2006.00512.x

Objective: In a non-clinical adolescent sample, the present study investigated the predictive and the mediating effects of several rudimentary risk factors for post-traumatic stress. The study had three objectives: 1) to identify predictors of posttraumatic stress, 2) to explore the mediating effect of diverse psychosocial factors on posttraumatic stress, and 3) to explore the mediating effect of body-image on posttraumatic stress across trauma types.
Conclusion: Previous traumas, peritraumatic response and body-image were found to impact the development of posttraumatic stress. The present study additionally indicated that risk factors may influence the development of posttraumatic stress disorder in different ways, following certain types of events. This underlines the importance of considering the type of trauma in combination with other potential risk factors such as body-image. Future research is needed to further investigate factors which may mediate the development of posttraumatic stress disorder, especially about different trauma types.

Relevante publikationer:
Bjerre, L., Dokkedahl, S. & Elklit, A. (2017): Risk Factors for Post-traumatic Stress Disorder:  The Role of Previous Traumas, Peri-traumatic Response, Social Support and Body-image. Journal of Child & Adolescent Behavior, 5(4). Doi: 10.4172/2375-4494.1000349

Young refugees from the former Yugoslavia commonly testify to having been exposed to multiple, traumatic experiences, which may contribute to the development of serious mental health problems such as posttraumatic stress disorder (PTSD), anxiety, and depression. Using selfreport scales the present study investigated the prevalence of PTSD as well as factors associated with PTSD in a group of 119 Bosnian refugee youths (mean age 18.5). The group was special in that they had no right to seek asylum in the host country for the first couple of years of their stay. It is suspected that this circumstance had an effect on their wellbeing. Between 35-43% of the youth were found to be in the clinical range for a PTSD diagnosis. Female gender, problem-focused, and avoidant coping strategies, were significant predictors of PTSD. The protective effects of social support were, however, not observed for this group. There is a need for more studies, which address the factors that mediate and moderate effects of social support and effectiveness of different coping strategies in refugee youth dealing with different circumstances of the refugee experience.

Relevante publikationer:
Elklit. A., Palic, S., Lasgaard, M. & Kjær, K. (2012). Social Support, Coping and Posttraumatic Stress Symptoms in Young Refugees. Torture, 22(1), 11-23.

This study aimed to (a) identify posttraumatic stress disorder (PTSD) trajectories in a sample of Danish treatment-seeking childhood sexual abuse (CSA) survivors and (b) examine the roles of social support, coping style, and individual PTSD symptom clusters (avoidance, reexperiencing, and hyperarousal) as predictors of the identified trajectories. We utilized a convenience sample of 439 CSA survivors attending personalized psychotherapy treatment in Denmark. Four assessments were conducted on a six monthly basis over a period of 18 months. We used latent class growth analysis (LCGA) to test solutions with one to six classes. Following this, a logistic regression was conducted to examine predictors of the identified trajectories. Results revealed four distinct trajectories which were labeled high PTSD gradual response, high PTSD treatment resistant, moderate PTSD rapid response, and moderate PTSD gradual response. Emotional and detached coping and more severe pretreatment avoidance and reexperiencing symptoms were associated with more severe and treatment resistant PTSD. High social support and a longer length of time since the abuse were associated with less severe PTSD which improved over time. The findings suggested that treatment response of PTSD in CSA survivors is characterized by distinct patterns with varying levels and rates of PTSD symptom improvement. Results revealed that social support is protective and that emotional and detached coping and high pretreatment levels of avoidance and reexperiencing symptoms are risk factors in relation to PTSD severity and course. These factors could potentially identify patients who are at risk of not responding to treatment. Furthermore, these factors could be specifically addressed to increase positive outcomes for treatment-seeking CSA survivors.

Relevante publikationer:
Fletcher, S., Elklit, A., Shevlin, M. & Armour, C. (2017): Predictors of PTSD treatment response trajectories in a sample of childhood sexual abuse survivors: the roles of social support, coping and PTSD symptom clusters. Journal of Interpersonal Violence, 1-25. Doi: 10.1177/0886260517741212

This paper examines degree of traumatisation, defence styles, coping strategies, symptomatology, and social support in a small sample of HIV‐positive men and women in an effort to ascertain the psychological implications of living with Human Immunodeficiency Virus (HIV). Traumatisation and the potentially mediating effects of defence styles have only been the subject of a few studies of HIV positives. The study is based on a socio‐demographic questionnaire, the Impact of Event Scale, the Defence Style Questionnaire, the Coping Styles Questionnaire, the Trauma Symptom Checklist, and the Crisis Support Scale. A degree of traumatisation that warrants treatment was found together with an association between particular coping strategies and symptomatology, and particular defence styles and symptomatology, respectively. Social support had increased over time, which is contrary to other research findings on social support.

Relevante publikationer:
Pedersen, S.S. & Elklit, A. (1998). Traumatisation, Psychological Defense Style, Coping, Symptomatology, and Social Support in HIV-positive: A Pilot Study. Scandinavian Journal of Psychology, 39 (2), 55-60. Doi: 10.1111/1467-9450.00056

The current study assesses associations between multiple experience of traumatic events (polyvictimization), PTSD symptoms (PTSS) and psychiatric symptoms in early adolescence, and explores the mediating roles of attachment orientations and perceived social support in the associations between polyvictimization, PTSS and psychiatric symptoms. In 2001, a representative national sample of 390 Danish eighth-graders (M = 13.95, SD = .37) completed validated self-report questionnaires. Polyvictimization was related to higher PTSS and psychiatric symptoms. Importantly, polyvictimization was significantly linked to high attachment anxiety, which was linked with low perceived social support, which in turn was linked with high PTSS levels and psychiatric symptoms. Polyvictimization might have dire consequences in early adolescence. An individual's high attachment anxiety might be connected with lack of perceived social support, which should be seen as a possible psychological distress mechanism subsequent to exposure to a number of potentially traumatic events.

Relevante publikationer:

Zerach, G., & Elklit, A. (2019). Attachment and social support mediate associations between Polyvictimization and psychological distress in early adolescence. International Journal of Psychology. Doi: 10.1002/ijop.12590

The objective of the present study was to provide a further validation of the Crisis Support Scale, which is a short scale for measuring social support after a crisis has occurred. The data from eleven trauma studies of 4213 subjects were used to investigate the psychometric properties of the scale and the differences that emerge due to age, gender, and type of trauma. The scale appears to be very robust. Some aspects of crisis support seem to decrease as time goes by while others increase. Women survivors report less support than men both right after the trauma and later on. The younger survivors tend to report the least support in the acute phase although this picture is reversed later on. The various types of trauma have different item profiles, which supports the concurrent validity of the scale.

Relevante publikationer:
Elklit, A., Pedersen, S.S. & Jind, L. (2001). The Crisis Support Scale: Psychometric qualities and further validation. Personality and Individual Differences, 31, (8), 1291-1302. Doi: 10.1016/S0191-8869(00)00220-8