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Social relationship satisfaction and PTSD: which is the chicken and which is the egg?

ABSTRACT: Impaired social relationships are linked with higher levels of posttraumatic stress disorder (PTSD), but the association's underlying dynamics are unknown. PTSD may impair social relationships, and, vice versa, poorer relationship quality may interfere with the recovery from PTSD.This work longitudinally evaluates the simultaneous progression of PTSD symptoms and social relationship satisfaction (SRS) in a large cohort of recent trauma survivors. It also explores the effect of cognitive behavior therapy (CBT) on the association between the two.Consecutive emergency department trauma admissions with qualifying PTSD symptoms (n=501) were assessed 3 weeks and 5 months after trauma admission. The World Health Organization Quality of Life evaluated SRS and the Clinician Administered PTSD Scale evaluated PTSD symptom severity. Ninety-eight survivors received CBT between measurement sessions. We used Structural Equation Modeling to evaluate cross-lagged effects between the SRS and PTSD symptoms.The cross-lagged effect of SRS on PTSD was statistically significant (?=-0.12, p=0.01) among survivors who did not receive treatment whilst the effect of PTDS on SRS was nil (?=-0.02, p=0.67). Both relationships were non-significant among survivors who received CBT.SRS and PTSD are highly associated, and this study shows that changes in SRS in the early aftermath of traumatic events contribute to changes in PTSD, rather than vice versa. SRS impacts natural recovery, but not effective treatment. This study suggests that being satisfied with one's relationships might be considered as an important factor in natural recovery from trauma, as well as in intervention.

SUBMITTER: Freedman SA

PROVIDER: S-EPMC4696463 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

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Social relationship satisfaction and PTSD: which is the chicken and which is the egg?

Freedman Sara A SA Gilad Moran M Ankri Yael Y Roziner Ilan I Shalev Arieh Y AY

European journal of psychotraumatology 20151216

<h4>Background</h4>Impaired social relationships are linked with higher levels of posttraumatic stress disorder (PTSD), but the association's underlying dynamics are unknown. PTSD may impair social relationships, and, vice versa, poorer relationship quality may interfere with the recovery from PTSD.<h4>Objective</h4>This work longitudinally evaluates the simultaneous progression of PTSD symptoms and social relationship satisfaction (SRS) in a large cohort of recent trauma survivors. It also expl ...[more]

PMID: 26684986

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Project description:Background Ensuring safety and wellbeing of all the minority populations of Pakistan is essential for collective national growth. The Pakistani Hazara Shias are a marginalized non-combative migrant population who face targeted violence in Pakistan, and suffer from great challenges which compromise their life satisfaction and mental health. In this study, we aim to identify the determinants of life satisfaction and mental health disorders in Hazara Shias and ascertain which socio-demographic characteristics are associated with post-traumatic stress disorder (PTSD). Methods We used a cross-sectional quantitative survey, utilizing internationally standardized instruments; with an additional qualitative item. Seven constructs were measured, including household stability; job satisfaction; financial security; community support; life satisfaction; PTSD; and mental health. Factor analysis was performed showing satisfactory Cronbach alpha results. A total of 251 Hazara Shias from Quetta were sampled at community centers through convenience method based on their willingness to participate. Results Comparison of mean scores shows significantly higher PTSD in women and unemployed participants. Regression results reveal that people who have low community support, especially from national and ethnic community, religious community, and other community groups, had higher risk of mental health disorders. Structural equation modeling identified that four study variables contribute to greater life satisfaction, including: household satisfaction (β = 0.25, p < 0.001); community satisfaction (β = 0.26, p < 0.001); financial security (β = 0.11, p < 0.05); and job satisfaction (β = 0.13, p < 0.05). Qualitative findings revealed three broad areas which create barriers to life satisfaction, including: fears of assault and discrimination; employment and education problems; and financial and food security issues. Conclusions The Hazara Shias need immediate assistance from state and society to improve safety, life opportunities, and mental health. Interventions for poverty alleviation, mental health, and fair education and employment opportunities need to be planned in partnership with the primary security issue.

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Social relationship satisfaction and PTSD: which is the chicken and which is the egg?

Publications

Social relationship satisfaction and PTSD: which is the chicken and which is the egg?

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