Intimate Partner Support as a Critical Source of Social Support on Women’s Post-Trauma Mental Recovery: A Cross-Sectional Study

Abstract

Exposure to traumatic events such as natural disasters and child loss is strongly linked to trauma- and stressor-related disorders. This study examined how different sources of social support relate to PTSD and prolonged grief disorder (PGD) symptoms among women who lost a child in an earthquake. A cross-sectional survey with structured interviews and standardized instruments was conducted among 226 participants. Clinically significant PGD symptoms were reported by 89%, and PTSD symptoms by 54%, with 80% experiencing comorbidity. Having a supportive, affectionate, and confiding relationship with an intimate partner and having a subsequent child were each associated with fewer symptoms of both disorders. Intimate partner support had the greatest impact on recovery. Women who had a subsequent child reported more positive partner relationships and better mental health outcomes. These findings underscore the critical role of intimate partner support in post-trauma recovery and highlight the importance of enhancing emotional and relational support.

Keywords

mental recovery social support intimate partner post-traumatic stress disorder prolonged grief disorder

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References

American Psychiatric Association . (2013a). Diagnostic and statistical manual of mental disorders : DSM-V (5th ed.) American Psychiatric Association.

American Psychiatric Association . (2022). Diagnostic and statistical manual of mental disorders (5th ed., Text Revision ed.) American Psychiatric Association.

Arnberg

F. K.

Melin

(2013). Can demographic and exposure characteristics predict levels of social support in survivors from a natural disaster? PLoS One, 8(6), 1–7. https://doi.org/10.1371/journal.pone.0065709

Barrera

D'Agostino

N. M.

Schneiderman

Tallett

Spencer

Jovcevska

(2007). Patterns of parental bereavement following the loss of a child and related factors [; Research Support, Non-U.S. Gov’t]. Omega, 55(2), 145–167. https://doi.org/10.2190/OM.55.2.d

Blanchard

E. B.

Jones-Alexander

Buckley

T. C.

Forneris

C. A.

(1996). Psychometric properties of the PTSD checklist (PCL). Behaviour Research and Therapy, 34(8), 669–673. https://doi.org/10.1016/0005-7967(96)00033-2

Carr

V. J.

Lewin

T. J.

Webster

R. A.

Kenardy

J. A.

Hazell

P. L.

Carter

G. L.

(1997). Psychosocial sequelae of the 1989 Newcastle earthquake: II. Exposure and morbidity profiles during the first 2 years post-disaster. Psychological Medicine, 27(1), 167–178. https://doi.org/10.1017/s0033291796004278

Chan

C. L. W.

Wang

C. W.

A. H. Y.

Z. Y.

Wang

X. Y.

Ran

M. S.

Mao

W. J.

B. Q. B.

Zhang

B. Q.

Zhang

X. L.

(2012). Symptoms of posttraumatic stress disorder and depression among bereaved and non-bereaved survivors following the 2008 Sichuan earthquake. Journal of Anxiety Disorders, 26(6), 673–679. https://doi.org/10.1016/j.janxdis.2012.05.002

Chiu

Y. W.

Huang

C. T.

Yin

S. M.

Huang

Y. C.

Chien

C. H.

Chuang

H. Y.

(2010). Determinants of complicated grief in caregivers who cared for terminal cancer patients. Supportive Care in Cancer, 18(10), 1321–1327. https://doi.org/10.1007/s00520-009-0756-6

Chou

K. L.

(2000). Assessing Chinese adolescents’ social support: The multidimensional scale of perceived social support. Personality and Individual Differences, 28(2), 299–307. https://doi.org/10.1016/s0191-8869(99)00098-7

10.

Cohen

R. E.

(1998). Disaster mental health services: Manual for workers. US Library of Congress.

11.

Fisher

J. R. W.

Tran

T. D.

Biggs

Tran

(2014). Validation of the intimate bonds measure for women who are pregnant or have recently given birth in Vietnam. Asia-Pacific Psychiatry, 6(1), 28–37. https://doi.org/10.1111/appy.12011

12.

Ghaffari-Nejad

Ahmadi-Mousavi

Gandomkar

Reihani-Kermani

(2007). The prevalence of complicated grief among bam earthquake survivors in Iran. Archives of Iranian Medicine, 10(4), 525–528.

13.

Hays

(2008a, 29 June). Sichuan earthquake in 2008: Geology, damage, and possible causes. Facts and Details-China. https://factsanddetails.com/china/cat10/sub65/item407.html

14.

Katz

C. L.

Pellegrino

Pandya

DeLisi

L. E.

(2002). Research on psychiatric outcomes and interventions subsequent to disasters: A review of the literature. Psychiatry Research, 110(3), 201-217. https://doi.org/10.1016/s0165-1781(02)00110-5

15.

Kessler

R. C.

Ustun

T. B.

(2008). In Ronald

Kessler

Ustun

(Eds.), The WHO world mental health surveys : Global perspectives on the epidemiology of mental disorders [bibliographies Non-fiction]. Cambridge University Press. https://www.loc.gov/catdir/toc/ecip0811/2008007732.html

16.

Kimerling

Mack

K. P.

Alvarez

(2009). Women and disasters. In Neria

Galea

Norris

F. H.

(Eds.), Mental health and disasters (pp. 203–217). Cambridge University Press. https://doi.org/10.1017/cbo9780511730030.012

17.

Kline

R. B.

(2011). Principles and practice of structural equation modeling (3rd ed.) [Bibliographies Non-fiction]. Guilford Press.

18.

Kristensen

Weisæth

Heir

(2009). Psychiatric disorders among disaster bereaved: An interview study of individuals directly or not directly exposed to the 2004 tsunami. Depression and Anxiety, 26(12), 1127–1133. https://doi.org/10.1002/da.20625

19.

Laakso

Paunonen-Ilmonen

(2002). Mothers’ experience of social support following the death of a child. Journal of Clinical Nursing, 11(2), 176–185. https://doi.org/10.1046/j.1365-2702.2002.00611.x

20.

Levin

B. G.

(2004). Coping with traumatic loss: An interview with the parents of TWA 800 crash victims and implications for disaster mental health professionals. International Journal of Emergency Mental Health, 6(1), 25–31.

21.

Laursen

T. M.

Precht

D. H.

Olsen

Mortensen

P. B.

(2005). Hospitalization for mental illness among parents after the death of a child [Comparative Study; Research Support, Non-U.S. Gov’t]. New England Journal of Medicine, 352(12), 1190–1196. https://doi.org/10.1056/NEJMoa033160

22.

Precht

D. H.

Mortensen

P. B.

Olsen

(2003). Mortality in parents after death of a child in Denmark: A nationwide follow-up study [; Research Support, Non-U.S. Gov't]. Lancet, 361(9355), 363–367. https://doi.org/10.1016/S0140-6736(03)12387-2

23.

Lopes Cardozo

Bilukha

O. O.

Gotway

C. A.

Wolfe

M. I.

Gerber

M. L.

Anderson

(2005). Mental health of women in postwar Afghanistan. Journal of Women's Health, 14(4), 285–293. https://doi.org/10.1089/jwh.2005.14.285

24.

Middleton

Raphael

Burnett

Martinek

(1998). A longitudinal study comparing bereavement phenomena in recently bereaved spouses, adult children and parents. Australian and New Zealand Journal of Psychiatry, 32(2), 235–241. https://doi.org/10.3109/00048679809062734

25.

Mukherjee

P. P.

Alpert

J. L.

(2006). Overview of psychological interventions in the acute aftermath of disaster. In Barbanel

Sternberg

R. J.

(Eds.), Psychological interventions in times of crisis (pp. 3–36). Springer Publishing Company.

26.

Norris

F. H.

Elrod

C. L.

(2006). Psychosocial consequences of disaster: A review of past research. In Norris

F. H.

Galea

Friedman

M. J.

Watson

P. J.

(Eds.), Methods for disaster mental health research (pp. 20–42). The Guilford Press.

27.

Nour

N. N.

(2011). Maternal health considerations during disaster relief. Reviews In Obstetrics And Gynecology, 4(1), 22–27.

28.

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. https://doi.org/10.1037/0033-2909.129.1.52

29.

Piccinelli

Wilkinson

(2000). Gender differences in depression. Critical review [; Review]. British Journal of Psychiatry, 177(6), 486–492. https://doi.org/10.1192/bjp.177.6.486

30.

Prigerson

H. G.

Maciejewski

P. K.

Reynolds

C. F.

Bierhals

A. J.

Newsom

J. T.

Fasiczka

Frank

Doman

Miller

(1995). Inventory of complicated grief: A scale to measure maladaptive symptoms of loss. Psychiatry Research, 59(1-2), 65–79. https://doi.org/10.1016/0165-1781(95)02757-2

31.

Ranasinghe

P. D.

Levy

B. R.

(2007). Prevalence of and sex disparities in posttraumatic stress disorder in an internally displaced Sri Lankan population 6 months after the 2004 Tsunami. Disaster Medicine and Public Health Preparedness, 1(1), 34–41. https://doi.org/10.1097/DMP.0b013e318068fbb7

32.

Raphael

(2000). Disaster mental health response handbook. In Disaster mental health response handbook B2 - Disaster mental health response handbook: New South Wales Health.

33.

Salcioglu

Basoglu

Livanou

(2007). Post-traumatic stress disorder and comorbid depression among survivors of the 1999 earthquake in Turkey. Disasters, 31(2), 115–129. https://doi.org/10.1111/j.1467-7717.2007.01000.x

34.

Shultz

J. M.

Espinel

Galea

Reissman

D. B.

(2007). Disaster ecology: Implication for disaster psychiatry. In Ursano

R. J.

Fullerton

C. S.

Weisaeth

Raphael

(Eds.), Textbook of disaster psychiatry. Cambridge University Press.

35.

Singh

Raphael

(1981). Postdisaster morbidity of the bereaved. A possible role for preventive psychiatry? Journal of Nervous and Mental Disease, 169(4), 203–212. https://doi.org/10.1097/00005053-198104000-00001

36.

Solomon

S. D.

Davidson

J. R.

(1997). Trauma: prevalence, impairment, service use, and cost [; Review]. The Journal of Clinical Psychiatry, 58(Suppl 9), 5–11.

37.

Somers

J. M.

Goldner

E. M.

Waraich

Hsu

(2006). Prevalence and incidence studies of anxiety disorders: A systematic review of the literature. Canadian journal of psychiatry. Revue canadienne de psychiatrie, 51(2), 100–113. https://doi.org/10.1177/070674370605100206

38.

Stroebe

Schut

(2010). The dual process model of coping with bereavement. Omega, 61(4), 273–289. https://doi.org/10.2190/OM.61.4.b

39.

Stroebe

Schut

Stroebe

(2005a). Grief work, disclosure and counseling: Do they help the bereaved? Clinical Psychology Review, 25(4), 395–414. https://doi.org/10.1016/j.cpr.2005.01.004

40.

Stroebe

Zech

Stroebe

M. S.

Abakoumkin

(2005b). Does social support help in bereavement? Journal of Social and Clinical Psychology, 24(7), 1030–1050. https://doi.org/10.1521/jscp.2005.24.7.1030

41.

Ursano

R. J.

Fullerton

C. S.

Weisaeth

Raphael

(Eds.), (2007c). Textbook of disaster psychiatry. Cambridge University Press.

42.

Ursano

R. J.

Fullerton

C. S.

Weisaeth

Raphael

(2007a). Individual and community responses to disasters. In Ursano

R. J.

Fullerton

C. S.

Weisaeth

Raphael

(Eds.), Textbook of disaster psychiatry. Cambridge University Press. https://doi.org/10.1017/cbo9780511544415.002

43.

Ursano

R. J.

Fullerton

C. S.

Weisaeth

Raphael

(2007b). Individual and community responses to disastes. In Ursano

R. J.

Fullerton

C. S.

Weisaeth

Raphael

(Eds.), Textbook of disaster psychiatry. Cambridge University Press.

44.

Wahlström

Michélsen

Schulman

Backheden

(2013). Support, opinion of support and psychological health among survivors of a natural disaster. International Journal of Social Psychiatry, 59(1), 40–47. https://doi.org/10.1177/0020764011423174

45.

Wilhelm

Parker

(1988). The development of a measure of intimate bonds. Psychological Medicine, 18(1), 225–234. https://doi.org/10.1017/s0033291700002051

46.

Wongpakaran

Ruktrakul

(2011). Reliability and validity of the multidimensional Scale of perceived social support (MSPSS): Thai version. Clinical Practice and Epidemiology in Mental Health: CP & EMH, 7(1), 161–166. https://doi.org/10.2174/1745017901107010161

47.

Woodgate

R. L.

(2006). Living in a world without closure: Reality for parents who have experienced the death of a child [; Research Support, Non-U.S. Gov’t]. Journal of Palliative Care, 22(2), 75–82. https://doi.org/10.1177/082585970602200203

48.

Xinhua Net . (2008b). Three more people died in the Wenchuan earthquake, a million units of temporary housing installed (四川汶川地震遇难人数增加3名灾区过渡安置房安装过万套). New China News Angency (NCNA). https://news.xinhuanet.com/newscenter/2008-06/02/content_8301468.htm

49.

Herrman

Bentley

Tsutsumi

Fisher

(2014). Effect of having a subsequent child on the mental health of women who lost a child in the 2008 Sichuan earthquake: A cross-sectional study. Bulletin of the World Health Organization, 92(5), 348–355. https://doi.org/10.2471/BLT.13.124677

50.

Yang

X. Y.

Yang

H. A.

Liu

Q. G.

Yang

L. Z.

(2007). The research on the reliability and validity of PCL-C and influence factors. China Journal of Health Psychology, 15(1), 6–9. https://doi.org/10.3969/j.issn.1005-1252.2007.01.36

51.

Yuan

Mao

W. J.

Yang

D. H.

Ran

M. S.

Kong

Zhang

Lou

W. Q.

Wang

X. L.

X. E.

Chen

L. Y.

J. J.

(2009). Comparison of PTSD symptoms, depression and anxiety between bereaved and non-bereaved survivors after the Wenchuan earthquake (汶川地震丧亲与非丧亲者PTSD、焦虑和抑郁的对比研究). Chinese Journal of Behavioral Medicine and Brain Science, 18(12), 1109–1111. https://doi.org/10.3760/cma.j.issn.1674-6554.2009.12.018