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Social defeat and PTSD symptoms following trauma

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Abstract

Objectives

Research indicates that constructs relevant to social rank predict a diagnosis of post-traumatic stress disorder (PTSD), including mental defeat, alienation, and shame. However, no studies have yet explored a social rank view explicitly.

Design

This was a community-based study carried out online. Analyses were both cross-sectional and longitudinal over 6 months.

Methods

Participants were recruited online for a cross-sectional study (Study 1, n = 194) and a 6-month longitudinal study (Study 2, n = 81). Measures included self-report measures of PTSD symptoms (the Post-Traumatic Diagnostic Scale) and social rank (including measures of unfavourable social comparison, social defeat, and internal/external entrapment).

Results

Cross-sectional analysis showed that social defeat, but not other aspects of social rank, was independently predictive of a diagnosis of PTSD. Longitudinal analysis showed that greater social defeat at baseline predicted less improvement in PTSD symptoms, whereas greater reduction in social defeat over the 6-month follow-up predicted greater improvement in PTSD symptoms.

Conclusions

In addition to the implications for understanding the role of social (rather than individual mental) defeat in the aetiology of PTSD, interventions could usefully incorporate methods that either increase social status or else minimize the impact of low status (e.g., through the use of compassion-focused approaches).

Practitioner points

Clinical implications

  • Post-traumatic stress disorder (PTSD) status is related to social defeat independently of demographic characteristics and features of the trauma.
  • Reduction in PTSD symptoms over 6 months is predicted by reduction in social defeat.
  • The evidence supports the use of interventions that increase self-perceived status or minimize the impact of low status (such as compassion-focused approaches).

Cautions or limitations

  • Participants were recruited online and may not be representative of clinical samples.
  • Measures, including diagnostic tools, were self-report rather than interview- or observation based.
  • With only two time points in the longitudinal study, direction of causality cannot be determined.

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