Exploring How Positive and Negative Social Exchanges Relate to Posttraumatic Stress Disorder Severity Among Previously Deployed Men Service Members/Veterans

Clinical Impact Statement Our study showed that for previously deployed male service members/veterans (SM/Vs), negative social support had a stronger relationship with posttraumatic stress disorder (PTSD) symptoms than positive social support. Moreover, positive social support was only related to PTSD symptoms when SM/Vs had positive appraisals of the support whereas negative social support had a direct relationship with PTSD symptoms that was not mediated by appraisals. Though we cannot determine causality, our findings suggest that positive support interventions should focus on individual perceptions whereas negative support interventions should focus on decreasing how often these interactions occur. Objective: Research in civilians and women shows negative social support is more deleterious for posttraumatic stress disorder (PTSD) symptoms than are the buffering effects of positive social support. However, this is understudied in male military samples. Moreover, appraisals of social support appear to be the mechanism of the association of social support type and PTSD severity, but appraisals as mediators have not been explored in military samples. Method: Previously deployed male service members/veterans (SM/Vs; n = 333) completed a demographic inventory, the Positive and Negative Social Exchange Scale, which assesses positive and negative social support and their appraisals, and the PTSD Checklist-5. Path analyses examined associations of positive and negative social support with PTSD severity and whether appraisals mediated these associations. Results: The magnitude of the association of negative social support and PTSD symptom severity (standardized estimate = .33; SE = .06, p < .001) was statistically greater than the association of positive social support and PTSD symptom severity (standardized estimate = -.26; SE = .06, p < .001). Higher positive support was associated with higher appraisals, and in turn, higher appraisals were associated with lower PTSD severity, suggesting mediation. In contrast, the association of negative social support with PTSD was direct. Conclusion: Causality cannot be inferred. Positive support exhibits a weaker relationship with PTSD because its effect is dependent on how an individual appraises the support whereas negative support has a direct relationship with PTSD regardless of appraisals. Findings suggest positive support interventions should focus on individual perceptions whereas negative support interventions should focus on decreasing how often these interactions occur.