Yonsei Med J.  2017 Nov;58(6):1211-1215. 10.3349/ymj.2017.58.6.1211.

Social Support as a Mediator of Posttraumatic Embitterment and Perceptions of Meaning in Life among Danwon Survivors of the Sewol Ferry Disaster

• Lee SH
• Nam HS
• Kim HB
• Kim EJ
• Won SD
• Chae JH

• KMID: 2418904
• DOI: http://doi.org/10.3349/ymj.2017.58.6.1211

Abstract

PURPOSE
Our research was designed to test and explore the relationships among embitterment, social support, and perceptions of meaning in life in the Danwon High School survivors of the Sewol ferry disaster.
MATERIALS AND METHODS
Seventy-five Sewol ferry disaster survivors were eligible for participation, and were invited to participate in the study 28 months after the disaster. Forty-eight (64%) survivors (24 males, 24 females) completed questionnaires; the Posttraumatic Embitterment Disorder (PTED) scale, the Functional Social Support Questionnaire (FSSQ), and the Meaning in Life Questionnaire (MLQ).
RESULTS
PTED scores were negatively correlated with scores on the FSSQ and the Presence of Meaning (MLQ-P) (r=-0.43 and -0.40, respectively). The hierarchical regression analysis showed that FSSQ scores may fully mediate the effects of PTED scores on MLQ-P scores, given that the indirect effect was significant whereas the direct effect was not (95% confidence interval=-0.5912 to -0.0365).
CONCLUSION
These findings imply that therapies targeting embitterment may play a vital role in increasing positive cognitions, such as those related to perceived social support and the meaningfulness of life.

Keyword

Sewol ferry disaster; Danwon High School survivors; posttraumatic embitterment; meaning in life; social support

MeSH Terms

Adaptation, Psychological
Adjustment Disorders/*diagnosis
Cross-Sectional Studies
*Disasters
Female
Humans
*Life Change Events
Male
Perception
*Social Support
Stress Disorders, Post-Traumatic/*psychology
Stress Disorders, Traumatic/diagnosis/psychology
*Surveys and Questionnaires
Survivors/*psychology

Figure

• 

  Fig. 1 Social support mediates the relationship between posttraumatic embitterment and presence of meaning in life. *p<0.050, †p<0.01. PTED, Posttraumatic Embitterment Disorder; FSSQ, Functional Social Support Questionnaire; MLQ, Meaning in Life Questionnaire; MLQ-P, Presence of Meaning; MLQ-S, Search for Meaning; c, total effect ; c', direct effect; ns, not significant.

Reference

1. theguardian. South Korea ferry disaster: rescued teacher found dead - video. accessed on 2014 April 25. Available at: https://www.theguardian.com/world/video/2014/apr/18/south-koreaferry-rescued-teacher-dead-video.

2. The Korean Times. Sewol survivor attempts suicide. accessed on 2014 December 30. Available at: https://www.koreatimes.co.kr/www/news/nation/2016/10/511_170447.html.

3. Blackburn L, Owens GP. The effect of self efficacy and meaning in life on posttraumatic stress disorder and depression severity among veterans. J Clin Psychol. 2015; 71:219–228. PMID: 25270887.

4. Dursun P, Steger MF, Bentele C, Schulenberg SE. Meaning and posttraumatic growth among survivors of the september 2013 colorado floods. J Clin Psychol. 2016; 72:1247–1263. PMID: 27459242.

5. Marco JH, Pérez S, García-Alandete J, Moliner R. Meaning in life in people with borderline personality disorder. Clin Psychol Psychother. 2017; 24:162–170. PMID: 26639791.

6. Kim SS. Results of the studies on supports for the victims of the Sewol ferry disaster. Presentation on the results of the studies on supports for the victims of the Sewol ferry disaster. Seoul: Kim Koo Museum & Library;2016. 7. 20.

7. Linden M. Posttraumatic embitterment disorder. Psychother Psychosom. 2003; 72:195–202. PMID: 12792124.

8. Shin C, Han C, Linden M, Chae JH, Ko YH, Kim YK, et al. Standardization of the Korean version of the posttraumatic embitterment disorder self-rating scale. Psychiatry Investig. 2012; 9:368–372.

9. Kleim B, Griffith JW, Gäbler I, Schützwohl M, Maercker A. The impact of imprisonment on overgeneral autobiographical memory in former political prisoners. J Trauma Stress. 2013; 26:626–630. PMID: 24114806.

10. Linden M, Baumann K, Lieberei B, Rotter M. The Post-Traumatic Embitterment Disorder Self-Rating Scale (PTED Scale). Clin Psychol Psychother. 2009; 16:139–147. PMID: 19229838.

11. Broadhead WE, Gehlbach SH, de Gruy FV, Kaplan BH. The Duke-UNC Functional Social Support Questionnaire. Measurement of social support in family medicine patients. Med Care. 1988; 26:709–723. PMID: 3393031.

12. Suh SY, Im YS, Lee SH, Park MS, Yoo T. A study for the development of Korean version of the Duke-UNC functional social support questionnaire. J Korean Acad Fam Med. 1997; 18:250–260.

13. Steger MF, Frazier P, Oishi S, Kaler M. The Meaning in Life Questionnaire: assessing the presence of and search for meaning in life. J Couns Psychol. 2006; 53:80–93.

14. Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol. 1986; 51:1173–1182. PMID: 3806354.

15. Hayes AF. PROCESS: a versatile computational tool for observed variable mediation, moderation, and conditional process modeling. 2012. accessed on 2017 March 17. Available at: http://www.afhayes.com/public/process2012.pdf.

16. Shrout PE, Bolger N. Mediation in experimental and nonexperimental studies: new procedures and recommendations. Psychol Methods. 2002; 7:422–445. PMID: 12530702.

17. Sensky T, Salimu R, Ballard J, Pereira D. Associations of chronic embitterment among NHS staff. Occup Med (Lond). 2015; 65:431–436. PMID: 26136596.

18. Blom D, Thomaes S, Bijlsma JW, Geenen R. Embitterment in patients with a rheumatic disease after a disability pension examination: occurrence and potential determinants. Clin Exp Rheumatol. 2014; 32:308–314. PMID: 24708914.