title: The relationships of posttraumatic stress disorder and depression symptoms with health-related quality of life and the role of social support among Veterans.
abstract: 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.
authors.affiliation: Seattle Division, Mental Health Service, VA Puget Sound Health Care System, 1660 S. Columbian Way (S-116), Seattle, WA, 98108, USA. janelle.painter@va.gov.|Department of Psychology, University of California, Berkeley, Berkeley, CA, USA. janelle.painter@va.gov.
authors.forename: Janelle M
authors.initials: JM
authors.lastname: Painter
authors.affiliation: Seattle Division, Health Services Research and Development Service, VA Puget Sound Health Care System, Seattle, WA, USA.|Department of Health Services, University of Washington, Seattle, WA, USA.
authors.forename: Kristen
authors.initials: K
authors.lastname: Gray
authors.affiliation: Seattle Division, Mental Health Service, VA Puget Sound Health Care System, 1660 S. Columbian Way (S-116), Seattle, WA, 98108, USA.|Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
authors.forename: Meghan M
authors.initials: MM
authors.lastname: McGinn
authors.affiliation: Seattle Division, Mental Health Service, VA Puget Sound Health Care System, 1660 S. Columbian Way (S-116), Seattle, WA, 98108, USA.
authors.forename: Sheeva
authors.initials: S
authors.lastname: Mostoufi
authors.affiliation: Seattle Division, Health Services Research and Development Service, VA Puget Sound Health Care System, Seattle, WA, USA.|Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
authors.forename: Katherine D
authors.initials: KD
authors.lastname: Hoerster
mesh_terms: D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018434:Sickness Impact Profile; D012944:Social Support; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology*; D016896:Treatment Outcome; D014728:Veterans / Q000523:psychology*
keywords: Depression; Health-related quality of life; Mental health; PTSD; Physical health; Social support