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.