The association between post-traumatic stress disorder symptoms and the quality of life among Wenchuan earthquake survivors: the role of social support as a moderator

OBJECTIVE: To examine the role of the three types of social support as possible moderating factors between post-traumatic stress disorder (PTSD) and its relationship to two domains of the quality of life (QOL).

METHODS: A cross-sectional survey was done in a local area near the epicenter of the severe earthquake in Wenchuan. The Diagnostic and statistical manual of mental disorders, fourth edition (DSM-IV), the standard Chinese 12-item Short Form (SF-12v2), and the Social Support Rating Scale (SSRS) were used to interview a total of 2,080 earthquake survivors in the one-year follow-up period. Multiple regressions were performed to evaluate the moderating role of social support on the relationship between PTSD and QOL.

RESULTS: Among survivors one-year after the Wenchuan earthquake, being a woman (p < 0.01), having a lower level of education (p < 0.01), having a lower level of income (p < 0.01), having a worse housing status (p < 0.05) and having a higher level of exposure (p < 0.05) were risk factors for a poorer QOL (∆R (2) = 0.063). PTSD symptoms negatively influenced the QOL (∆R (2) = 0.145), while social support positively influenced the QOL (∆R (2) = 0.016). However, the interaction between social support and PTSD weakened the negative effect of PTSD on the QOL (∆R (2) = 0.012). Subjective support and support availability moderated the association between PTSD and the QOL (∆R (2) = 0.010).

CONCLUSION: Subjective support and support availability are more useful strategies to improve the QOL of the earthquake survivors with PTSD symptoms.