The Impact of Post-Traumatic Stress Disorder Symptoms on Depressive Symptoms and Health-Promoting Behaviors Among Korean Coast Guards: The Mediating Role of Social Support.

Background: Post-traumatic stress disorder (PTSD) can result in severe depression. Yet, it is not clear how to improve health-promoting behavior and reduce depressive symptoms. This study aimed to examine whether social support mediates the link between PTSD, depression, and health-promoting behaviors.

Methods: A cross-sectional study was conducted with 308 Korean Coast Guards in Gangwon-do, South Korea, in October and November 2020. The variables of PTSD and depressive symptoms were assessed using the Korean versions of the Impact of Event Scale-Revised and the Center for Epidemiologic Studies Depressive Scale-Revised. Health-promoting behaviors and social support were assessed using the Health-Promoting Lifestyle Profile-II and the Korean version of the Personal Resource Questionnaire 85-Part 2. Multiple regression analysis and Sobel tests were performed.

Findings: Higher levels of PTSD symptoms and lower levels of social support were significantly associated with higher levels of depressive symptoms. Social support had a significant partial mediating effect on the association between PTSD and depressive symptoms. In addition, lower levels of PTSD symptoms and higher levels of social support were significantly associated with higher levels of health-promoting behaviors. Social support has a full mediating effect on the association between PTSD symptoms and health-promoting behaviors.

Conclusions/application to practice: Our findings indicate that social support may mediate the association between PTSD symptoms and health outcomes. Occupational health nurses can use these findings to proactively develop interventions which improve social support for coast guard workers who are at risk of developing PTSD due to exposure to traumatic events on their job.