The relationships of posttraumatic stress disorder and depression symptoms with health-related quality of life and the role of social support among Veterans
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The presence of posttraumatic stress disorder (PTSD) or depression symptoms is associated with poor quality of life. Social support buffers against developing symptoms of PTSD and depression and is associated with greater quality of life. We examined the relationships between PTSD and depression symptom severity with physical (PCS) and mental (MCS) health-related quality of life (HRQoL), and whether social support moderated these relationships.
Randomly selected Veterans with at least one Primary Care or PTSD Clinical Team visit received a mailed survey including self-report measures of health and wellness. Among the 717 respondents, we examined the association between symptom severity and HRQoL using linear regression. We included interaction terms between symptom severity and social support to examine whether social support moderated these associations.
Social support did not moderate the association between symptom severity and mental HRQoL. Higher PTSD and depression symptom severity were associated with lower MCS scores, whereas higher social support was associated with higher MCS scores. When examining physical HRQoL, social support moderated the association with PTSD and depression symptom severity. Among individuals with high social support, there was a negative association between symptom severity and PCS scores, whereas there was no association among those with low social support.
Although there are contexts in which social support is helpful, in some cases it may interfere with HRQoL among those with mental health conditions. Thus, it is important to educate support providers about behaviors that enhance the benefits and minimize the costs of social support.
KeywordsPTSD Depression Health-related quality of life Physical health Mental health Social support
The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs. The authors would like to acknowledge Carol Malte, Linda Guerrero, David Tice, Marie Lutton, and Jeff Rodenbaugh, all from VA Puget Sound Healthcare System, Seattle Division, for their important contributions to this study. Ms. Malte identified the survey sample using VA administrative data. Ms. Guerrero, Mr. Tice, and Ms. Lutton helped to coordinate the survey mailing. Ms. Lutton performed data entry, and Mr. Rodenbaugh performed data management tasks.
This material is the result of work supported by resources from VA Puget Sound Healthcare System. Funding for the study was provided by the VA Puget Sound, Seattle Division Mental Illness Research Education and Clinical Center and the VA Puget Sound, Seattle Division Health Services Research and Development Center of Excellence. Dr. Hoerster is supported by a VA Career Development Award (HSR&D CDA 12-263).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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