Proximal relationships between social support and PTSD symptom severity: A daily diary study of sexual assault survivors

Abstract

Background In cross‐sectional studies, social support and posttraumatic stress disorder (PTSD) symptoms appear related, in that higher severity of PTSD is associated with lower social support and vice versa. Theoretical models of the causal direction of this relationship differ. Most longitudinal studies suggest that PTSD symptoms erode social support over time, although some suggest that higher social support is prospectively associated with decrease in PTSD symptom severity. It is unclear, though, how social support and PTSD affect each other in the short term. The purpose of this study was to test day‐to‐day relationships between PTSD and social support to elucidate how PTSD and social support influence each other. Methods Using 1173 daily observations from 75 college women who met screening criteria for lifetime sexual assault and past‐month PTSD, this study tested same‐day and next‐day relationships between PTSD and social support using mixed models. Results Within‐person analyses indicated that, when PTSD was higher than usual on a given day, social support was higher the next day. Between‐person analyses suggested that people with generally higher social support tended to have lower PTSD symptoms on a given day, but average PTSD symptom severity was not associated with day‐to‐day fluctuations in social support. Conclusions Rather than eroding in response to daily symptoms, social support might be sought out following increases in PTSD, and when received consistently, might reduce symptoms of PTSD in the short term. Interventions that increase college women's access to social support after sexual assault may thus be helpful in addressing PTSD.

Sexual victimization, PTSD, depression, and social support among women survivors of the 2010 earthquake in Haiti: a moderated moderation model

“…The moderated moderation model shows that, separately, sexual assault and exposure to the earthquake positively predict traumatic consequences, while social support predicts them negatively. Research has previously shown the efficacy of social support in dealing with traumatic consequences experienced by women (Bryant-Davis et al ., 2015; Ullman and Peter-Hagene, 2016; Dworkin et al ., 2018). Our results corroborate that social support plays a protective role in women, but go beyond that by also showing that it plays a protective role in cumulative trauma.…”

“…Studies showed that sexual assault is associated with multiple lifetime psychiatric disorders including PTSD, depression, anxiety, and others (Chen et al ., 2010). Studies conducted among sexually assaulted people in general, and among women particularly, have shown that they are more likely to present significant symptoms of PTSD, depression, anxiety, and substance use problems, among others (Ullman, 2016; Dworkin et al ., 2018; Scott et al ., 2018). These studies and others have also shown that social support is an important protective factor in helping women survivors of sexual assault cope with traumatic consequences (Bryant-Davis et al ., 2015; Ullman and Peter-Hagene, 2016; Dworkin et al ., 2018).…”

Heterogeneity of posttraumatic stress symptomatology and social connectedness in treatment-seeking military veterans: a longitudinal examination

“…Studies in military samples that tested both models support the social erosion model (King, Taft, King, Hammond, & Stone, 2006) or both models (Ren, Skinner, Lee, & Kazis, 1999;Shallcross, Arbisi, Polusny, Kramer, & Erbes, 2016;Woodward et al, 2018). Data from nonmilitary samples support social causation (Dworkin, Ullman, Stappenbeck, Brill, & Kaysen, 2018), social erosion (Nickerson et al, 2017), or both models (Platt, Lowe, Galea, Norris, & Koenen, 2016). Inconsistent findings may be due to heterogeneities in study design, such as duration of time since participants' trauma exposure, prevalence of PTSD in a given sample, and variability in assessment methods (Woodward et al, 2018).…”

Keep Calm and Carry On: The Relations Between Narrative Coherence, Trauma, Social Support, Psychological Well-Being, and Cortisol Responses

“…For instance, comparing a condition in which participants can have a phone call to a (supportive) loved one after a traumatic event, to a condition in which they are only allowed to talk to an (unsupportive) experimenter, and to a control condition in which they could not talk to any other person, could help to disentangle this effect. In addition, while people who generally have high social support tend to have lower PTSD symptoms on any given day, average PTSD symptom severity does not seem to be associated with day-to-day fluctuations in the availability of social support (Dworkin et al, 2018 ). For the present study, this would imply that the social support right after the MAST task may have not been enough to buffer memory coherence or state anxiety, and rather that we would need a follow-up design to create a larger difference between conditions (more social support over time in supportive group, less social support over time in unsupportive group), in order to be able to pick up differences in posttraumatic responses, like state anxiety or memory coherence.…”