The indirect effect of perceived social support on the relationship between psychological inflexibility and PTSD/depression symptoms in college students.

OBJECTIVE

Posttraumatic stress disorder and depression occur at high rates among college students, making it critical to identify modifiable factors that confer risk or protective effects. Psychological inflexibility (PI; a rigid pattern of thinking and behavior) predicts worse posttraumatic stress and depression (PTS-D) symptoms, whereas perceived social support (PSS) is a robust protective factor. No studies have examined interrelationships among PI, PSS, and PTS-D, which was the aim of this study.

METHOD: College students (n = 1,184) who endorsed experiencing a potentially traumatic event completed an online survey assessing trauma exposure, posttraumatic stress disorder symptoms, depression symptoms, PI, and PSS. Due to the high correlation between measures, a PTS-D symptoms factor was created using principal components analysis.

RESULTS

An indirect effects model using Hayes PROCESS Model 4 (mediation; 5,000 bootstrapped samples) was conducted, controlling for sex, to evaluate both the direct effects of PI on PTS-D and the indirect effect of PI on PTS-D through its influence on worse PSS. A significant direct effect was observed between PI and PTS-D (b = 0.055, SE = .002, p < .001). There was a significant indirect effect, demonstrating higher PI was associated with lower PSS, which was associated with higher PTS-D (b = 0.003, SE = 0.001, 95% CI [0.002, 0.004]). Thus, the potential positive effects of PSS on PTS-D were diminished by the negative influence of PI on lowering PSS.

CONCLUSIONS

Future longitudinal studies are needed to prospectively test mediation and whether PI and PSS should be addressed as concurrent treatment targets to positively impact PTS-D symptoms. (PsycInfo Database Record (c) 2026 APA, all rights reserved).