Table 3 Findings grouped by outcome
Outcome | Study | Exploratory or specific hypothesis | Analysis method | Covariates included in models | Sample size (n) | Findings |
|---|---|---|---|---|---|---|
Psychiatric outcomes | ||||||
 PTSD | Bottomley 2017 [31] | Exploratory | Regression model with social support as a predictor. | T1 PTSD (at a mean of 1.66 years since loss) | 47 | Of 12 social support variables, need for advice, need for physical assistance and satisfaction with physical assistance were included in the model. Satisfaction with physical assistance was the only significant predictor, negatively predicting PTSD severity at T2 (6 month follow-up) (p<.03, b=-.18). |
Burke 2010 [33] | Exploratory | Correlations | n/a | 54 | Of 6 variables measured, percentage of actual negative relationships significantly correlated with PTSD severity (.28, p<.05). | |
Heeke 2017 [38] | Specific hypothesis | Latent class analysis | Gender, years of education, number of assaultive/accidental traumatic events, relationship to person lost, how loss happened and time since loss. | 308 | Social support was the only factor associated with PTSD symptoms compared to the resilient class (OR= .95, p=.005). | |
Rheingold 2015 [47] | Exploratory | Generalised estimating equations | Variables found to significantly differ by diagnostic status: employment status, deceased contributing to household income. | 47 | Lack of social support was independently associated with increased risk of meeting criteria for PTSD (beta =.19, Wald x2 = 4.64, p<.05). | |
Sprang 1998 [50] | Exploratory | Regression model with social support as a predictor. | Gender, age, race, subjective health status, income, marital status, past experience with death, time since death and religious beliefs. | 171 | Greater social support was associated with lower rates of PTSD symptoms (beta=.415, p<.005; 43.2% of variance). | |
Xu 2017 [52] | Exploratory | Regression model with social support as a predictor. | Ethnicity, residence location, gender, age, monthly income, education level, age of child and gender of child. | 176 | Low social support was a significant risk factor for meeting criteria for PTSD (OR= .244, beta=-1.41, p=.002, 95% CI). | |
 Depression | Bottomley 2017 [31] | Exploratory | Regression model with social support as a predictor. | T1 depression (at a mean of 1.66 years since loss) | 47 | Of twelve social support variables, need for advice, need for physical assistance and satisfaction with physical assistance were included in the model but none were significant predictors. |
Burke 2010 [33] | Exploratory | Correlations | n/a | 54 | Of six social support measures, two were significantly correlated with depression severity: grief support (-.27, p<.05) and percentage of anticipated negative relationships (.28, p<.05). | |
Cowan 1985 [27] | Exploratory | Regression model with social support as a predictor. | Stress, age, gender, importance of deceased and perceived preventability of death. | 69 | Perceived social support was associated with greater depression severity (p<.05, b=-.14), accounting for 38% of variance in the model. | |
Fullerton 1999 [36] | Exploratory | Regression model with social support as a predictor. | Age, marital status, social network index, disaster specific social support, family distress, maximum closeness to deceased crew, transience, hardiness, social desirability and initial impact of event (IES). | 71 | Support from friends and support from family were entered as separate predictors in each model. In models controlling for total IES and IES intrusion scores, neither perceived social support variable was associated with depression severity. Controlling for IES avoidance (10%), perceived social support from friends was negatively associated with depression severity (5% of variance; beta=-.03, p=.027). | |
Oexle 2019 [45] | Specific hypothesis | Regression model with social support as a predictor. | Age, gender, pre-loss mental illness, time since loss, relationship to deceased and perceived closeness to deceased. | 195 | Greater perceived social support was significantly associated with a lower level of depressive symptoms (beta=-.53, p<.001). | |
Rheingold 2015 [47] | Exploratory | Generalised estimating equations with social support as a predictor. | Variables found to significantly differ by diagnostic status: age, employment status, deceased contributing to household income. | 47 | Lack of social support was independently associated with increased risk of meeting criteria for MDD (beta =.40, Wald x2 = 14.37, p<.005). | |
Spino 2016 [48] | Specific hypothesis | Regression model with social support as a predictor. | Physical health encumbrance. | 44 | Three social support variables were used as predictors. In a linear regression model, higher network score was associated with a significant decrease depression severity (beta= -0.53, p=.011). In a linear regression model, higher relationship score was associated with a significant decrease depression severity (beta= -0.18, p=.011). In the multiple regression model, higher total support score (beta= -0.02, p=.001) was associated with a significant decrease in depression severity. | |
 Complicated grief | Bottomley 2017 [31] | Exploratory | Regression model with social support as a predictor. | T1 complicated grief (at a mean of 1.66 years since loss) | 47 | Of twelve social support variables, satisfaction with physical assistance was the only significant predictor out of the three social support variables included in the model, positively predicting complicated grief severity at T2 (6 month follow-up) (beta=.20, p<.05). |
Burke 2010 [33] | Exploratory | Correlations | n/a | 54 | Of six social support measures, two were significantly correlated with complicated grief severity: percentage of actual negative relationships (.28, p<.05) and available support system (-.28, p<.05). | |
Kristensen 2010 [40] | Exploratory | Regression model with social support as a predictor. | Gender, pre-disaster employment, relationship to deceased, previous experience of loss, time elapsed before death confirmed. | 130 | Two social support variables were included in analysis: low positive social support (OR=.24, p=.012) and high negative social support (OR=3.81, p=.012) were significantly associated with meeting criteria for complicated grief. | |
Levi-Belz 2019 [43] | Specific hypothesis | Regression model with social support as a predictor. | Time since loss, attachment style, self-disclosure and interaction between secure attachment, social support and self-disclosure. | 156 | Greater perceived social support was significantly associated with lower severity of complicated grief (beta=-.30, p<.01). | |
Li 2015 [44] | Exploratory | Regression model with social support as a predictor. | n/a | 803 | Social support was not significantly associated with meeting criteria for complicated grief. | |
Rheingold 2015 [47] | Exploratory | Generalised estimating equations with social support as a predictor. | Variables found to significantly differ by diagnostic status: age, deceased contributing to household income. | 47 | Lack of social support was not significantly associated with increased risk of meeting criteria for complicated grief. | |
 Anxiety | Bottomley 2017 [31] | Exploratory | Regression model with social support as a predictor. | T1 anxiety (at a mean of 1.66 years since loss) | 47 | Need for advice, need for physical assistance and satisfaction with physical assistance were included in the model. Satisfaction with physical assistance was the only significant predictor, negatively predicting anxiety severity at T2 (6 month follow-up) (p<.001, b=-.30). |
 Prolonged grief | Heeke 2017 [38] | Specific hypothesis | Latent class analysis with social support as a predictor. | Gender, years of education, number of assaultive/accidental traumatic events, relationship to person lost, how loss happened and time since loss. | 308 | The amount of perceived social support did not predict membership of the PGD class. |
 Suicidal ideation | Oexle 2019 [45] | Specific hypothesis | Regression model with social support as a predictor. | Age, gender, pre-loss mental illness, time since loss, relationship to deceased and perceived closeness to deceased. | 195 | Greater perceived social support was significantly associated with lower severity of suicidal ideation (beta=-2.87, p<.001). |
Psychological wellbeing outcomes | ||||||
 Emotional distress | Heeke 2017 [38] | Specific hypothesis | Latent class analysis with social support as a predictor. | Gender, years of education, number of assaultive/accidental traumatic events, relationship to person lost, how loss happened and time since loss. | 308 | Less social support was a predictor of the emotional distress class (OR= .92, p<.001). |
 Grief | Sprang 1998 [50] | Exploratory | Regression model with social support as a predictor. | Gender, age, race, subjective health status, income, marital status, past experience with death, time since death and religious beliefs. | 171 | Greater social support predicted lower extent of grief (beta=-.479, p<.005). |
 Grief difficulties | Oexle 2019 [45] | Specific hypothesis | Regression model with social support as a predictor. | Age, gender, pre-loss mental illness, time since loss, relationship to deceased and perceived closeness to deceased. | 195 | Greater perceived social support was significantly associated with decreased grief difficulties (beta=-.47, p<.001). |
 Initial impact of event | Fullerton 1999 [36] | Exploratory | Regression model with social support as a predictor. | Age, marital status, social network index, disaster specific social support, family distress, maximum closeness to deceased crew, transience, hardiness and social desirability. | 71 | Neither perceived social support measure (support from friends/ support from family) was a good predictor of total or avoidance IES. Low perceived social support from friends predicted a higher intrusive initial IES score (beta=-.44, p=.044). |
 Loneliness | Spino 2016 [48] |  | n/a | n/a | n/a | Statistical analyses not reported. |
 Mental distress | Murphy 1988 [28] | Exploratory | Regression model with social support as a predictor. | T1 mental distress, age, sex, education, stress, self-efficacy and social support | 49 | Social support did not significantly predict severity of mental distress |
 Mourning | Sprang 1998 [50] | Exploratory | Regression model with social support as a predictor. | Gender, age, race, subjective health status, income, marital status, past experience with death, time since death and religious beliefs. | 171 | Greater social support significantly predicted lower extent of mourning (beta=.350, p<.005). |
 Personal growth | Oexle 2019 [45] |  | Regression model with social support as a predictor. | Age, gender, pre-loss mental illness, time since loss, relationship to deceased and perceived closeness to deceased. | 195 | Greater perceived social support was significantly associated with increased personal growth (beta=-44, p<.05). |
 Recovery | Murphy 1988 [28] | Exploratory | n/a | n/a | n/a | Social support was not included in the regression model predicting recovery. |
 Resiliencea | Bailey 2013 [29] | Exploratory | Regression model with social support as a predictor. | n/a | 48 | Unadjusted model where traumatic stress predicted greater levels of resilience was significant (b = -.241, p<.049). The adjusted model with social support as a mediator was also significant (b=.297, p=.032). |
  Stress-related growth | Levi-Belz 2015 [42] | Specific hypothesis | Regression model with social support as a predictor. | Time since loss, adaptive coping, maladaptive coping, self-disclosure, interaction between time and interpersonal variables. | 135 | Combined with self-disclosure as a predictive interpersonal variable, social support predicted levels stress-related growth (beta=.11, p=.027). |