Contents lists available at ScienceDirect Child Abuse & Neglect journal homepage: www.elsevier.com/locate/chiabuneg Research article When social support is not enough: Trauma and PTSD symptoms in a risk-sample of adolescents Ricardo J. Pinto a, ⁎ , Diogo Morgado a , Sara Reis a , Rita Monteiro a , Alytia Levendosky b , Inês Jongenelen a a Faculty of Psychology, University of Lusófona, Oporto, Portugal 1 b Department of Psychology at Michigan State University, United States ARTICLE INFO Keywords: Posttraumatic stress disorder Traumatic events Social support Covariates ABSTRACT Social support can mitigate the severity of posttraumatic stress disorder (PTSD) in children and adults following traumatic events. However, little is known about the role of social support in high-risk samples of adolescents from the community. The present study examined the re- lationship between social support and PTSD symptoms in adolescents exposed to traumatic events and childhood adversity, after adjusting for the effects of potential covariates, including sociodemographic factors, previous childhood adversity, level of exposure, comorbid anxiety, depression symptoms, and substance abuse, and coping strategies. Method: The participants of the study were 183 adolescents, mean age of 16 years old (M = 15.71, SD = 1.31), ranged between 13 and 17 years old, 89 (48.6%) males and 94 (51.4%) females. Results: The results revealed that 26.2% of the sample met the criteria for probable PTSD. Our statistical model explained 64% of the variance in PTSD symptoms, but social support was not significant after adjusting for covariates. This study found that social support was not enough to reduce PTSD symptoms in adolescents exposed to trauma and adversity. Programs focused only on improving social support may not be effective in reducing mental health symptoms for ado- lescents, particularly when there has been severe and/or multiple forms of childhood adversity. 1. Introduction According to epidemiological surveys in numerous countries, 20–90% of the general population is exposed to traumatic events at least once in their lives (Perrin et al., 2014). Because of exposure to traumatic events, individuals may develop post-traumatic stress disorder (PTSD) (American Psychiatric Association, 2013). Research has shown disparate rates of PTSD ranging from 1.5% to 4.8% in community samples of adolescents (Garland, Hough, McCabe, Yeh, Wood, & Aarons, 2001; Kilpatrick et al., 2003; Merikangas et al., 2010), 14% to 23.6% in risk-samples of adolescents (Alisic et al., 2014; Dierkhising et al., 2013; Keller, Salazar, & Courtney, 2010; McMillen et al., 2005), and about 60% in war zones (Khamis, 2005; Neugebauer et al., 2009). The variability in estimates is due to the variability in the types of trauma. For example, interpersonal trauma may lead to higher rates of PTSD because, unlike a natural disaster, typically a one-time event, interpersonal traumas are often chronic, and corrode social support, especially in cases where the perpetrator is a family member. In addition, the nature of interpersonal traumas has been http://dx.doi.org/10.1016/j.chiabu.2017.07.017 Received 18 February 2017; Received in revised form 29 June 2017; Accepted 24 July 2017 ⁎ Corresponding author at: Faculdade de Psicologia, Universidade Lusófona do Porto, Rua Augusto Rosa, no 24, Porto 4000-098, Portugal. 1 COPElabs. E-mail address: ricardo.pinto@ulp.pt (R.J. Pinto). Child Abuse & Neglect 72 (2017) 110–119 0145-2134/ © 2017 Elsevier Ltd. All rights reserved. MARK