Social support has received a lot of attention in research contexts due to the potential of this variable to act as a protective factor. Social support has, among other, been studied in the context of chronically ill children and their parents.
When social support acts as a mediating variable, it means that the association between illness and psychological burden may vary as a function of social support. In this way, social support is a protective factor for the illness-related stressors, and a lack of social support can work in the opposite direction.
Research findings in paediatric oncology have generally found that perceived social support has a stress-mediating role on parents. Similarly, in this context, it has been found that it is the perceived social support that matters most for the degree of PTSD symptoms in parents, compared to the size of the social network and social interactions.
The Danish Center for Psychotraumatology contributes research on the role of social support in a wide range of contexts. You can read about them on this page.
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.
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.
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.
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.
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
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: https://doi.org/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.
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
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