ABSTRACT

Background: Betrayal traumas have a particularly deleterious effect on mental health. Although social support is a robust predictor of posttraumatic stress disorder (PTSD) symptom severity, it is not clear what factors may impact this relationship among betrayal trauma survivors.

Objective: This study sought to describe the association between social support and PTSD symptom severity among survivors of betrayal trauma and examine whether methodological, sample, trauma, and social support characteristics moderated this association.

Method: A comprehensive search identified 29 studies that assessed the cross-sectional association between PTSD symptom severity and social support among 6,510 adult betrayal trauma survivors.

Results: The average effect size (r = −.25; 95% CI: −.30, −.20) was small to medium, with significant heterogeneity between studies (I² = 71.86). The association between PTSD and social support was stronger when the trauma was perpetrated by a romantic partner compared to mixed perpetrators, even after accounting for covariates. There was also a significant effect of support type depending on whether the support was provided in the context of trauma disclosure. Specifically, positive reactions to trauma disclosure were not associated with PTSD symptoms whereas general positive social support (not disclosure focused) was associated with fewer PTSD symptoms. Negative reactions to trauma disclosure were associated with more PTSD symptoms. None of the included studies measured general negative social support outside of trauma disclosure.

Conclusions: Our findings suggest that social support may be a particularly important buffer against PTSD symptoms when experiencing traumatic betrayal by an intimate partner. Additionally, our results suggest that social support interventions for those experiencing betrayal trauma should focus on reducing negative responses to disclosure and bolstering general satisfaction with social support.

摘要

背景：背叛创伤对心理健康有着特别有害的影响。尽管社会支持是创伤后应激障碍（PTSD）症状严重程度的有力预测因素，但尚不清楚哪些因素可能影响背叛创伤幸存者之间的这种关系。

目的：本研究试图描述背叛创伤幸存者的社会支持与 PTSD 症状严重程度之间的关联，并检验方法、样本、创伤和社会支持特征是否调节了这种关联。

方法：全面检索确定了 29 项研究，这些研究评估了 6,510 名成年背叛创伤幸存者的 PTSD 症状严重程度与社会支持之间的横断面关联。

结果：平均效应大小（r = -.25；95% CI：-.30，-.20）为小至中等，研究之间存在显着异质性（I ²  = 71.86）。与混合肇事者相比，当创伤由浪漫伴侣实施时，创伤后应激障碍与社会支持之间的关联更强，即使在考虑了协变量之后也是如此。支持类型也有显着影响，具体取决于是否在创伤披露的背景下提供支持。具体来说，对创伤披露的积极反应与 PTSD 症状无关，而一般积极的社会支持（不以披露为重点）与较少的 PTSD 症状相关。对创伤披露的负面反应与更多的创伤后应激障碍症状相关。纳入的研究均未测量创伤披露之外的一般负面社会支持。

结论：我们的研究结果表明，当经历亲密伴侣的创伤性背叛时，社会支持可能是对抗 PTSD 症状的特别重要的缓冲剂。此外，我们的结果表明，对经历背叛创伤的人的社会支持干预措施应侧重于减少对披露的负面反应，并提高对社会支持的总体满意度。