Targeting social connection in the context of Trauma: Functional outcomes and mechanisms of change

Abstract

The current study presents and preliminarily tests a brief, theory driven intervention designed to target social connectivity as a transdiagnostic mechanism of health. We tested four hypotheses to examine whether and how explicitly targeting social behavior engagement (activating values-led behaviors towards specific network members) may improve other downstream aspects of social connectivity (i.e., social cognitions measured as loneliness, interpersonal closeness, perceived social support) and functioning (quality of life [QOL] and posttraumatic stress symptoms [PTS]). Methods. Participants included 15 patients (10 veterans, 5 firefighters) who completed the six-session intervention. Demographics: age (M = 46, SD = 17), 87% male, race (80% Caucasian, 20% Hispanic), 60% married/partnered, 47% living alone. Our multi-analytic approach included parametric and non-parametric tests: (a) significance testing and effect sizes to examine whether variables of interest changed, and (b) Granger causality analysis of repeated measures to examine the mechanistic theory of change (does social behavior engagement lead to improved social cognition and functioning?). Results. Statistically significant, medium-large effect size improvements were shown for QOL (Cohens d = 1.05), PTS (d = 1.05), social behavior engagement (d = 0.78), and several social cognitions (loneliness, d = 0.80, interpersonal closeness, d = 0.53). Models accounted for medium-large variance explained in improved QOL (R2 = 0.47, 95% CI [0.00,0.66]) and PTS (R2 = 0.56, 95% CI[0.07,0.72]). The theory of change was supported, with increase in social behaviors preceding improvement in social cognitions (not vice-versa). Conclusions. Improving social connectivity is a mechanism for improving QOL and mental health. Focus on initiating values-driven social behaviors may be an efficient and effective entry point to stimulate change.