Social Support May Protect Against Development of Posttraumatic Stress Disorder: Findings From the Heart and Soul Study

Purpose. No prospective studies have examined the association of poor social support and development of posttraumatic stress disorder (PTSD) in patients with chronic illness. This study addresses this knowledge gap. Design. This prospective study examines the relationship of social support to the subsequent development of PTSD during a 5-year period. Setting. San Francisco Veterans Affairs Medical Center. Subjects. A total of 579 participants with cardiovascular disease did not have PTSD at baseline and returned for the 5-year follow-up examination. Measures. PTSD measured by Computerized Diagnostic Interview Schedule for DSM-IV Social support measured by Interpersonal Support Evaluation List (ISEL). Analysis. Unconditional ordered logistic regression analyses were performed to yield the odds ratio of developing PTSD for a one-standard-deviation change in ISEL score. Results. Of 579 participants who did not have PTSD at baseline, approximately 6.4% (n = 37) developed PTSD. Higher baseline perceived social support was strongly protective against development of PTSD (OR = .60, p = .001). Results remained significant after adjustment for age, sex, race, income, and depression (OR = .69, p = .04). Of social support types examined, the tangible and belonging domains were most strongly associated with future PTSD status. Conclusion. Social support may impact development of PTSD. Interventions that optimize social support may be part of a PTSD prevention program designed to help individuals at risk of developing PTSD.