Self-reported PTSD symptoms and social support in U.S. military service members and veterans: a meta-analysis

Rebecca K. Blais, Vanessa Tirone, Daria Orlowska, Ashton Lofgreen, Brian Klassen, Philip Held, Natalie Stevens, Alyson K. Zalta

Research output: Contribution to journalReview articlepeer-review

30 Scopus citations


Background: The mental health burden of posttraumatic stress disorder (PTSD) is high in U.S. military samples. Social support is one of the most robust protective factors against PTSD and a recent meta-analysis indicates that this relationship is even stronger in military samples compared to civilian samples. Yet no meta-analyses have explored factors impacting this association in veterans and military service members (VSMs). Objective: The current meta-analysis examined demographic, social support, and military characteristics that may moderate the relationship of PTSD severity and social support among U.S. VSMs. Method: A search identified 37 cross-sectional studies, representing 38 unique samples with a total of 18,766 individuals. Results: The overall random effects estimate was −.33 (95% CI: −.38, −.27, Z = −10.19, p <.001), indicating that lower levels of social support were associated with more severe PTSD symptoms. PTSD measures based on the Diagnostic and Statistical Manual (DSM)-III had a larger effect size than measures based on DSM-IV or DSM-5. The social support source was a significant moderator such that support perceived from non-military sources was associated with a larger effect size than support perceived from military sources. This finding held after accounting for covariates. Deployment-era, timing of social support, and age were also significant moderators, but were no longer significantly associated with effect size after adjusting for covariates. Although previous meta-analyses have shown social negativity to be more impactful than positive forms of social support, there were too few studies conducted to evaluate social negativity in moderator analyses. Conclusion: Results suggest that social support received from civilians and in the home environment may play a greater protective role than social support received from military sources on long-term PTSD symptom severity. The literature on social support and PTSD in U.S. VSMs would be strengthened by studies examining the association of social negativity and PTSD symptoms.

Original languageEnglish (US)
Article number1851078
JournalEuropean Journal of Psychotraumatology
Issue number1
StatePublished - 2021
Externally publishedYes


  • Posttraumatic stress disorder
  • active duty
  • military
  • social support
  • veterans

ASJC Scopus subject areas

  • Psychiatry and Mental health


Dive into the research topics of 'Self-reported PTSD symptoms and social support in U.S. military service members and veterans: a meta-analysis'. Together they form a unique fingerprint.

Cite this