The effects of social support and negative appraisals on acute stress symptoms and depression in children and adolescents

Abstract

To investigate the impact of social support on both acute stress symptoms and depression in children and adolescents following a single-incident trauma as well as the potential mediating effects of negative appraisals. A cross-sectional concurrent design was used. Ninety-seven children (aged 7-17 years) and a parent of each were recruited through the emergency department or in-patient ward of two metropolitan hospitals. Negative appraisals, child perception of social support, parent availability to provide social support, prior trauma and psychological difficulties, depression and acute stress symptoms were measured within 4 weeks of trauma. Negative appraisals about the trauma were highly correlated with both acute stress and depression symptoms. Social support was negatively correlated with depression symptoms, but not acute stress symptoms. There was a trend for social support to be negatively correlated with negative appraisals. There was no evidence that negative appraisals mediated the social support-symptoms relationships. The findings lend support to recent cognitive and developmental models of the aetiology of post-traumatic stress disorder, and the possible shared cognitive vulnerability between trauma symptoms and depression. Clinically, the results indicate that, appraisals, social support, and depression symptoms should be assessed in addition to trauma symptoms following single-incident traumatic events. The findings also suggest that when depression symptoms are present following trauma exposure, it may be useful to ensure children have adequate social support. Future research should also develop trauma specific measures of social support.