title: The impact of social support on psychological distress for U.S. Afghanistan/Iraq era veterans with PTSD and other psychiatric diagnoses.
abstract: This study aimed to examine the degree to which posttraumatic stress disorder (PTSD) affects the relationship between social support and psychological distress for U.S. Afghanistan/Iraq era veterans with and without co-occurring psychiatric disorders. Veterans (N=1825) were administered self-report questionnaires and a structured diagnostic interview as part of a multi-site study of post-deployment mental health through the Department of Veterans Affairs (VA) Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC). Main and interaction effects models assessed the association between psychological distress and social support for three comparisons conditions (Controls vs. PTSD-only, non-PTSD, and PTSD plus co-morbid diagnoses). Having PTSD was a critical factor in attenuating the strength of this association, more so than other diagnoses. Furthermore, those with PTSD plus co-morbid diagnoses did not demonstrate significantly larger attenuation in that association compared to the PTSD-only group, indicating that psychiatric comorbidity may be less important in considering the role of social support in PTSD. By understanding this relationship, new avenues for engaging and enhancing treatment outcomes related to social support for veterans of this cohort may be identified. Additional longitudinal research could help evaluate the effect of PTSD symptom clusters, social support type, and trauma exposure type on these relationships.
authors.affiliation: Mid-Atlantic VA Mental Illness Research, Education and Clinical Center (VISN 6 MIRECC), Durham, NC 27705, United States; Durham VA Medical Center, Durham, NC 27705, United States; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, United States. Electronic address: Mira.Brancu@va.gov.
authors.forename: Mira
authors.initials: M
authors.lastname: Brancu
authors.affiliation: Hunter Holmes McGuire VA Medical Center, Richmond, VA 23224, United States; Virginia Commonwealth University, Department of Psychology, Richmond, VA 23284, United States.
authors.forename: Nivonne L
authors.initials: NL
authors.lastname: Thompson
authors.affiliation: Mid-Atlantic VA Mental Illness Research, Education and Clinical Center (VISN 6 MIRECC), Durham, NC 27705, United States; Durham VA Medical Center, Durham, NC 27705, United States; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, United States.
authors.forename: Jean C
authors.initials: JC
authors.lastname: Beckham
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, United States.
authors.forename: Kimberly T
authors.initials: KT
authors.lastname: Green
authors.affiliation: Mid-Atlantic VA Mental Illness Research, Education and Clinical Center (VISN 6 MIRECC), Durham, NC 27705, United States; Durham VA Medical Center, Durham, NC 27705, United States; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, United States.
authors.forename: Patrick S
authors.initials: PS
authors.lastname: Calhoun
authors.affiliation: Mid-Atlantic VA Mental Illness Research, Education and Clinical Center (VISN 6 MIRECC), Durham, NC 27705, United States; Durham VA Medical Center, Durham, NC 27705, United States; Department of Psychiatry, University of North Carolina, Chapel Hill, NC 27514, United States.
authors.forename: Eric B
authors.initials: EB
authors.lastname: Elbogen
authors.affiliation: Mid-Atlantic VA Mental Illness Research, Education and Clinical Center (VISN 6 MIRECC), Durham, NC 27705, United States; Durham VA Medical Center, Durham, NC 27705, United States.
authors.forename: Allison T
authors.initials: AT
authors.lastname: Robbins
authors.affiliation: Mid-Atlantic VA Mental Illness Research, Education and Clinical Center (VISN 6 MIRECC), Durham, NC 27705, United States; Durham VA Medical Center, Durham, NC 27705, United States; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, United States.
authors.forename: John A
authors.initials: JA
authors.lastname: Fairbank
authors.affiliation: Mid-Atlantic VA Mental Illness Research, Education and Clinical Center (VISN 6 MIRECC), Durham, NC 27705, United States; Durham VA Medical Center, Durham, NC 27705, United States; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, United States.
authors.forename: H Ryan
authors.initials: HR
authors.lastname: Wagner
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D000346:Afghanistan; D015897:Comorbidity; D005260:Female; D006801:Humans; D007493:Iraq; D054542:Iraq War, 2003-2011; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology*; D057566:Self Report; D012944:Social Support; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000523:psychology*; D011795:Surveys and Questionnaires; D014481:United States; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data
keywords: Interview; Mental disorders; Posttraumatic; Psychological; Psychosocial support systems; Resilience; Veterans health