Social support predicts reductions in PTSD symptoms when substances are not used to cope: A longitudinal study of sexual assault survivors

Background: After sexual assault, many college women develop symptoms of posttraumatic stress disorder (PTSD), and those who engage in substance use coping are at heightened risk for this outcome. Positively-perceived social support has been identified as an important protective factor against the development of PTSD, but received social support could involve problematic behaviors-like the encouragement of coping through use of alcohol and/ or drugs-that could worsen symptoms. Methods: In the current study, 147 undergraduate women with a lifetime history of sexual assault completed two waves of self-report measures assessing their symptoms. We test main and interaction effects for social support and substance use coping at baseline on PTSD symptoms one month later. Results: Results suggest that social support is longitudinally associated with decreases in PTSD. Although substance use coping did not evidence a direct association with PTSD, the relationship between social support and PTSD was significantly weaker as substance use coping increased. Only support from friends (but not family members or a special person) was associated with later PTSD, and this relationship was moderated by substance use coping. Limitations: Substance use coping was assessed via a brief measure, and peer encouragement of coping by using alcohol and/ or drugs was not directly assessed. Conclusions: Clinicians should consider ways to increase access to social support from friends in patients with PTSD and evaluate ways that substance use coping may interfere with social support's benefits.