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The Bidirectional Relationship between Posttraumatic Stress Symptoms and Social Support in a 9/11-Exposed Cohort: A Longitudinal Cross-Lagged Analysis

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  • Sze Yan Liu

    (New York City Department of Health and Mental Hygiene, World Trade Center Health Registry, New York, NY 10279, USA)

  • Jiehui Li

    (New York City Department of Health and Mental Hygiene, World Trade Center Health Registry, New York, NY 10279, USA)

  • Lydia F. Leon

    (New York City Department of Health and Mental Hygiene, World Trade Center Health Registry, New York, NY 10279, USA)

  • Ralf Schwarzer

    (Department of Psychology, Freie University of Berlin, 14195 Berlin, Germany
    Department of Psychology, SWPS University of Social Sciences and Humanities, 03-815 Warsaw, Poland)

  • James E. Cone

    (New York City Department of Health and Mental Hygiene, World Trade Center Health Registry, New York, NY 10279, USA)

Abstract

Research on the longitudinal relationship between posttraumatic stress disorder (PTSD) and social support among survivors of large-scale trauma is limited. This study assessed bidirectional relationships between PTSD and perceived social support in a large sample of the 9/11-exposed cohort over a 14-year follow-up. We used data from 23,165 World Trade Center Health Registry (WTCHR) enrollees who were exposed to the 9/11 attacks and participated in the first four WTCHR surveys (Wave 1 (2003–2004) to Wave 4 (2015–2016)). PTSD symptoms were measured using the 17-item PTSD Checklist. Perceived social support was measured using the five-item version of the Modified Social Support Survey. We used a cross-lagged panel analysis and found an inverse relationship between PTSD symptoms and social support. PTSD at Wave 2 (W2) predicted less social support at Wave 3 (W3) (β = −0.10, p < 0.01), and PTSD at W3 predicted less social support at W4 (β = −0.05, p < 0.01). Conversely, social support at W3 buffered PTSD symptoms at W4 (β = −0.03, p < 0.05). Sub-analyses by types of perceived social support suggest greater effects of PTSD on emotional support than tangible support and in community members than rescue/recovery workers. Our findings suggest a bidirectional effect between PTSD symptoms and social support in a longitudinal study of 9/11-exposed populations.

Suggested Citation

  • Sze Yan Liu & Jiehui Li & Lydia F. Leon & Ralf Schwarzer & James E. Cone, 2022. "The Bidirectional Relationship between Posttraumatic Stress Symptoms and Social Support in a 9/11-Exposed Cohort: A Longitudinal Cross-Lagged Analysis," IJERPH, MDPI, vol. 19(5), pages 1-10, February.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:5:p:2604-:d:757213
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    References listed on IDEAS

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    1. Manfred E Beutel & Elmar Brähler & Jörg Wiltink & Matthias Michal & Eva M Klein & Claus Jünger & Philipp S Wild & Thomas Münzel & Maria Blettner & Karl Lackner & Stefan Nickels & Ana N Tibubos, 2017. "Emotional and tangible social support in a German population-based sample: Development and validation of the Brief Social Support Scale (BS6)," PLOS ONE, Public Library of Science, vol. 12(10), pages 1-12, October.
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