Abstract
We examined the associations of different aspects of social support during emergency department (ED) evaluation for an acute cardiac event with perceptions of threat in the ED and subsequent posttraumatic stress symptoms (PSS) in 484 patients. Participants were enrolled in the ED where they reported on their perceptions of threat in the ED. Social support in the ED and PSS were assessed at inpatient bedside or by telephone a median of 3 days later. Positive aspects of social support were not associated with subsequent PSS. Anxiety-provoking social support was significantly associated with increased PSS at follow-up. Greater ED threat perception partially mediated that relationship.
Similar content being viewed by others
References
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, D.C.: American Psychiatric Association.
Andrews, B., Brewin, C. R., & Rose, S. (2003). Gender, social support and PTSD in victims of violent crime. Journal of Traumatic Stress, 16(4), 421–427.
Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173–1182.
Bennett, P., & Brooke, S. (1999). Intrusive memories, post-traumatic stress disorder and myocardial infarction. British Journal of Clinical Psychology, 38(4), 411–416.
Birmingham, W., Uchino, B. N., Smith, T. W., Light, K. C., & Sanbonmatsu, D. M. (2009). Social ties and cardiovascular function: An examination of relationship positivity and negativity during stress. International Journal of Psychophysiology, 74(2), 114–119. doi:10.1016/j.ijpsycho.2009.08.002.
Brewin, C. R., Dalgleish, T., & Joseph, S. (1996). A dual representation theory of posttraumatic stress disorder. Psychological Review, 103(4), 670–686.
Brummett, B. H., Barefoot, J. C., Siegler, I. C., Clapp-Channing, N. E., Lytle, B. L., Bosworth, H. B., et al. (2001). Characteristics of socially isolated patients with coronary artery disease who are at elevated risk for mortality. Psychosomatic Medicine, 63(2), 267–272.
Bryant, R. A., Moulds, M. L., & Guthrie, R. M. (2000). Acute stress disorder scale: A self-report measure of acute stress disorder. Psychological Assessment, 12(1), 61–68.
Buckley, T., & Kaloupek, D. G. (2001). A meta-analytic examination of basal cardiovascular activity in posttraumatic stress disorder. Psychosomatic Medicine, 63(4), 585–594.
Carlisle, M., Uchino, B. N., Sanbonmatsu, D. M., Smith, T. W., Cribbet, M. R., Birmingham, W., et al. (2012). Subliminal activation of social ties moderates cardiovascular reactivity during acute stress. Health Psychology, 31(2), 217–225.
Case, R. B., Moss, A. J., Case, N., McDermott, M., & Eberly, S. (1992). Living alone after myocardial infarction: Impact on prognosis. JAMA, 267(4), 515–519.
Chang, B. P., Carter, E. C., Suh, E. H., Kronish, I. M., & Edmondson, D. (2016a). Patient treatment in emergency department hallways and patient perception of clinician-patient communication. American Journal of Emergency Medicine. doi:10.1016/j.ajem.2016.02.074.
Chang, B. P., Sumner, J. A., Haerizadeh, M., Carter, E. C., & Edmondson, D. (2016b). Perceived clinician-patient communication in the emergency department and subsequent posttraumatic stress symptoms in patients evaluated for acute coronary syndrome. Emergency Medicine Journal. doi:10.1136/emermed-2015-205473.
Charlson, M., Szatrowski, T. P., Peterson, J., & Gold, J. (1994). Validation of a combined comorbidity index. Journal of Clinical Epidemiology, 47(11), 1245–1251.
Cohen, S., & McKay, G. (1984). Social support, stress and the buffering hypothesis: A theoretical analysis. In A. Baum, S. E. Taylor, & J. E. Singer (Eds.), Handbook of psychology and health (Vol. 4, pp. 253–267). Hillside, NJ: Lawrence Erlbaum.
Cohen, S., & Wills, T. A. (1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98(2), 310–357.
Doerfler, L. A., Paraskos, J. A., & Piniarski, L. (2005). Relationship of quality of life and perceived control with posttraumatic stress disorder symptoms 3 to 6 months after myocardial infarction. Journal of Cardiopulmonary Rehabilitation, 25(3), 166–172.
Edmondson, D., Richardson, S., Falzon, L., Davidson, K. W., Mills, M. A., & Neria, Y. (2012). Posttraumatic stress disorder prevalence and risk of recurrence in acute coronary syndrome patients: A meta-analytic review. PLoS ONE, 7(6), 1–10.
Edmondson, D., Shimbo, D., Ye, S., Wyer, P., & Davidson, K. W. (2013). The association of emergency department crowding during treatment for acute coronary syndrome with subsequent posttraumatic stress disorder symptoms. JAMA Internal Medicine, 173(6), 472–474.
Finch, J. F., Okun, M. A., Barrera, M., Jr., Zautra, A. J., & Reich, J. W. (1989). Positive and negative social ties among older adults: Measurement models and the prediction of psychological distress and well-being. American Journal of Community Psychology, 17(5), 585–605.
Fox, K. A. A., Dabbous, O. H., Goldberg, R. J., Pieper, K. S., Eagle, K. A., Van de Werf, F., et al. (2006). Prediction of risk of death and myocardial infarction in the six months after presentation with acute coronary syndrome: prospective multinational observational study (GRACE). British Medical Journal, 333, 1091–1094.
Frasure-Smith, N., Lespérance, F., Gravel, G., Masson, A., Juneau, M., Talajic, M., & Bourassa, M. G. (2000). Social support, depression, and mortality during the first year after myocardial infarction. Circulation, 101(16), 1919–1924.
Frasure-Smith, N., Lespérance, F., Juneau, M., Talajic, M., & Bourassa, M. G. (1999). Gender, depression, and one-year prognosis after myocardial infarction. Psychosomatic Medicine, 61(1), 26–37.
Gerin, W., Pieper, C., Levy, R., & Pickering, T. G. (1992). Social support in social interaction: A moderator of cardiovascular reactivity. Psychosomatic Medicine, 54, 324–336.
Guay, S., Billette, V., & Marchand, A. (2006). Exploring the links between posttraumatic stress disorder and social support: Processes and potential research avenues. Journal of Traumatic Stress, 19(3), 327–338.
Heller, K., Swindle, R. W., Jr., & Dusenbury, L. (1986). Component social support processes: Comments and integration. Journal of Consulting and Clinical Psychology, 54(4), 466–470.
Ho, V. T., Shimbo, D., Duer-Hefele, J., Whang, W., Chang, M., & Edmondson, D. (2016). Posttraumatic stress disorder symptoms and hypercoagulability during emergency department evaluation for acute coronary syndrome. International Journal of Cardiology: Metabolic and Endocrine, 11, 1–2.
Ingram, K. M., Jones, D. A., Fass, R., Neidig, J. L., & Song, Y. S. (1999). Social support and unsupportive social interactions: Their association with depression among people living with HIV. AIDS Care, 11(3), 313–329.
Joseph, S., & Williams, R. (2005). Understanding posttraumatic stress: Theory, reflections, context and future. Behavioural and Cognitive Psychotherapy, 33(4), 423–441. doi:10.1017/S1352465805002328.
Kaniasty, K., & Norris, F. H. (2008). Longitudinal linkages between perceived social support and posttraumatic stress symptoms: Sequential roles of social causation and social selection. Journal of Traumatic Stress, 21(3), 274–281.
Krause, N., Liang, J., & Yatomi, N. (1989). Satisfaction with social support and depressive symptoms: A panel analysis. Psychology and Aging, 4(1), 88–97.
Kronish, I. M., Edmondson, D., Goldfinger, J. Z., Fei, K., & Horowitz, C. R. (2012). Post-traumatic stress disorder and adherence to medications in survivors of strokes and transient ischemic attacks. Stroke, 43(8), 2192–2197.
Lepore, S. J. (1992). Social conflict, social support, and psychological distress: Evidence of cross-domain buffering effects. Journal of Personality and Social Psychology, 63(5), 857–867.
Lepore, S. J., Allen, K. A., & Evans, G. W. (1993). Social support lowers cardiovascular reactivity to an acute stressor. Psychosomatic Medicine, 55(6), 518–524.
Marke, V., & Bennett, P. (2013). Predicting post-traumatic stress disorder following first onset acute coronary syndrome: Testing a theoretical model. British Journal of Clinical Psychology, 52(1), 70–81.
Moos, R. H., Cronkite, R. C., & Moos, B. S. (1998). The long-term interplay between family and extrafamily resources and depression. Journal of Family Psychology, 12(3), 326–343.
Ozer, E. J., Best, S. R., Lipsey, T. L., & Weiss, D. S. (2003). Predictors of posttraumatic stress disorder and symptoms in adults: A meta-analysis. Psychological Bulletin, 129(1), 52–73.
Pederson, S. S., & Denollet, J. (2004). Validity of the type D personality construct in Danish post-MI patients and healthy controls. Psychosomatic Research, 57(3), 265–272.
Revenson, T. A., Schiaffino, K. M., Majerovitz, S. D., & Gibofsky, A. (1991). Social support as a double-edged sword: The relation of positive and problematic support to depression among rheumatoid arthritis patients. Social Science and Medicine, 33(7), 807–813.
Rook, K. S. (1984). The negative side of social interaction: Impact on psychological well-being. Journal of Personality and Social Psychology, 46(5), 1097–1108.
Rutledge, T., Reis, S. E., Olson, M., Owens, J., Kelsey, S. F., Pepine, C. J., et al. (2004). Social networks are associated with lower mortality rates among women with suspected coronary disease: the National Heart, Lung, and Blood Institute-Sponsored Women’s Ischemia Syndrome Evaluation study. Psychosomatic Medicine, 2004(66), 6.
Shemesh, E., Rudnick, A., Kaluski, E., Milovanov, O., Salah, A., Alon, D., et al. (2001). A prospective study of posttraumatic stress symptoms and nonadherence in survivors of a myocardial infarction (MI). General Hospital Psychiatry, 23(4), 215–222.
Smith, T. W., Ruiz, J. M., & Uchino, B. N. (2004). Mental activation of supportive ties, hostility, and cardiovascular reactivity to laboratory stress in young men and women. Health Psychology, 23(5), 476–485.
Sumner, J. A., Kronish, I. M., Pietrzak, R. H., Shimbo, D., Shaffer, J. A., Parsons, F. E., & Edmondson, D. (2015). Dimensional structure and correlates of posttraumatic stress symptoms following suspected acute coronary syndrome. Journal of Affective Disorders, 186, 178–185.
Sundquist, K., Chang, B. P., Parsons, F., Dalrymple, N., Edmondson, D., & Sumner, J. A. (2016). Treatment rates for PTSD and depression in recently hospitalized cardiac patients. Journal of Psychosomatic Research. doi:10.1016/j.jpsychores.2016.05.007.
Treiber, F. A., Kamarck, T., Schneiderman, N., Sheffield, D., Kapuku, G., & Taylor, T. (2003). Cardiovascular reactivity and development of preclinical and clinical disease states. Psychosomatic Medicine, 65, 46–62.
Uchino, B. N., Carlisle, M., Birmingham, W., & Vaughn, A. A. (2011). Social support and the reactivity hypothesis: Conceptual issues in examining the efficacy of received support during acute psychological stress. Biological Psychology, 86, 137–142. doi:10.1016/j.biopsycho.2010.04.003.
Uchino, B. N., & Garvey, T. S. (1997). The availability of social support reduces cardiovascular reactivity to acute psychological stress. Journal of Behavioral Medicine, 20(1), 15–27.
Uno, D., Uchino, B. N., & Smith, T. W. (2002). Relationship quality moderates the effect of social support given by close friends on cardiovascular reactivity in women. International Journal of Behavioral Medicine, 9(3), 243–262.
von Känel, R., Hari, R., Schmid, J. P., Wiedemar, L., Guler, E., & Barth, J. (2011). Non-fatal cardiovascular outcome in patients with posttraumatic stress symptoms caused by myocardial infarction. Journal of Cardiology, 58(1), 61–68.
Wiedemar, L., Schmid, J. P., Müller, J., Wittmann, L., Schnyder, U., Saner, H., & von Känel, R. (2008). Prevalence and predictors of posttraumatic stress disorder in patients with acute myocardial infarction. Heart and Lung, 37(2), 113–121.
Williams, R. B., Barefoot, J. C., Califf, R. M., Haney, T. L., Saunders, W. B., Pryor, D. B., et al. (1992). Prognostic importance of social and economic resources among medically treated patients with angiographically documented coronary artery disease. JAMA, 267(4), 520–524.
Zoellner, L. A., Foa, E. B., & Brigidi, B. D. (1999). Interpersonal friction and PTSD in female victims of sexual and nonsexual assault. Journal of Traumatic Stress, 12(4), 689–700.
Acknowledgments
This work was supported by Grants HL117832, HL123368, and HL128310 from NIH/NHLBI.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
Kirsten Homma, Bernard Chang, Jonathan Shaffer, Barvina Toledo, Brooke Hefele, Nathan Dalrymple and Donald Edmondson declare that they do not have any conflict of interest.
Human and animal rights and Informed consent
All procedures followed were in accordance with ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.
Rights and permissions
About this article
Cite this article
Homma, K., Chang, B., Shaffer, J. et al. Association of social support during emergency department evaluation for acute coronary syndrome with subsequent posttraumatic stress symptoms. J Behav Med 39, 823–831 (2016). https://doi.org/10.1007/s10865-016-9748-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10865-016-9748-4