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Social support and treatment utilization for posttraumatic stress disorder: Examining reciprocal relations among active duty service members

APA Citation:

Jaffe, A. E., Walton, T. O., Walker, D. D., & Kaysen, D. L. (2023). Social support and treatment utilization for posttraumatic stress disorder: Examining reciprocal relations among active duty service members. Journal of Traumatic Stress, 36(3), 537-548. https://doi.org/10.1002/jts.22908

Abstract Created by REACH:

This study examined the bidirectional relationship between social support and treatment use among 161 Service members with untreated posttraumatic stress disorder (PTSD) over time. The study’s goal was to understand how social support affects the use of treatment (i.e., attending therapy in the past 3 months, number of sessions attended), as well as how treatment use affects social support. Service members reported their PTSD symptom severity (at baseline) and their perceived social support and treatment use across time (baseline and 3- and 6-month follow-ups). Service members who reported less social support at the 3-month follow-up were more likely to engage in therapy at the 6-month follow-up. Treatment utilization was not related to changes in social support.


Mental health
Physical health

Branch of Service:

Multiple branches
Air Force

Military Affiliation:

Active Duty

Subject Affiliation:

Active duty service member
Guard/Reserve member


Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)


Longitudinal Study
Quantitative Study
Secondary Analysis


Jaffe, Anna E., Walton, Thomas O., Walker, Denise D., Kaysen, Debra L.


Evidence-based treatments for posttraumatic stress disorder (PTSD) are underutilized by active duty service members in the United States. Social support may help service members overcome avoidance and facilitate treatment utilization. In turn, treatment utilization may improve social support. To evaluate these possibilities, the aim of the current study was to examine potential reciprocal associations between social support and treatment utilization among service members. Secondary analyses were conducted on a randomized controlled trial of 161 U.S. military service members with PTSD. Participants completed assessments of perceived social support and attendance at individual therapy sessions at baseline and 3- and 6-month follow-ups. To determine reciprocal relations between social support and treatment utilization, a Bayesian approach was used to estimate a random-intercept cross-lagged panel model with a two-part variable for treatment utilization (i.e., any therapy, and if so, dose). There were no between-person associations between average social support and treatment utilization. One prospective cross-lagged within-person association emerged as significant: social support at 3 months was negatively associated with any therapy use at 6 months; the model explained 26.1% of the variance in this observed variable. The findings revealed that low social support promoted subsequent treatment utilization, but such treatment did not lead to changes in social support. This suggests service members with PTSD may have been motivated to attend individual therapy in pursuit of social connection and support. Future research is needed to determine if reciprocal associations between various forms of social support and therapy utilization differ by treatment modality.

Publication Type:

REACH Publication


social support, treatment utilization, posttraumatic stress disorder, PTSD

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REACH Publication Type:

Research Summary

REACH Newsletter:

  June 2023

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