Social support and treatment utilization for posttraumatic stress disorder: Examining reciprocal relations among active duty service members

Abstract

Evidence‐based treatments for posttraumatic stress disorder (PTSD) are underutilized by active duty service members in the United States. Social support may help service members overcome avoidance and facilitate treatment utilization. In turn, treatment utilization may improve social support. To evaluate these possibilities, the aim of the current study was to examine potential reciprocal associations between social support and treatment utilization among service members. Secondary analyses were conducted on a randomized controlled trial of 161 U.S. military service members with PTSD. Participants completed assessments of perceived social support and attendance at individual therapy sessions at baseline and 3‐ and 6‐month follow‐ups. To determine reciprocal relations between social support and treatment utilization, a Bayesian approach was used to estimate a random‐intercept cross‐lagged panel model with a two‐part variable for treatment utilization (i.e., any therapy, and if so, dose). There were no between‐person associations between average social support and treatment utilization. One prospective cross‐lagged within‐person association emerged as significant: social support at 3 months was negatively associated with any therapy use at 6 months; the model explained 26.1% of the variance in this observed variable. The findings revealed that low social support promoted subsequent treatment utilization, but such treatment did not lead to changes in social support. This suggests service members with PTSD may have been motivated to attend individual therapy in pursuit of social connection and support. Future research is needed to determine if reciprocal associations between various forms of social support and therapy utilization differ by treatment modality.

Introduction to the special section on social relationships and posttraumatic stress disorder treatment: Harnessing the power of significant relationships

“…The fact that Jaffe et al. (2023) only found this association in the within‐person analyses and not the between‐person analyses speaks to the importance of measuring these variables at multiple time points when possible and disaggregating within‐ versus between‐person effects. At the between‐person level, individuals with more robust social networks may turn to people within these networks for support when they are struggling rather than seeking formal therapy.…”

“…First, Jaffe et al. (2023) examined whether perceived social support reported by SMs with PTSD ( N = 161) predicted the subsequent use of individual PTSD therapy. SMs are particularly unlikely to seek treatment for mental health difficulties (e.g., Hoge et al., 2004); therefore, it is especially important to identify any factors that might promote higher levels of treatment utilization in this population.…”