Do Initial Mental Health, Somatic, and Social Problems Predict Postdisaster Lack of Social Support in the Medium Term? A Latent Profile Analysis

Clinical Impact Statement A perceived lack of social support after a disaster may hinder recovery from postdisaster problems in wellbeing. For victims' support services, it is therefore important to have insight in which groups are at risk for a perceived lack of social support. This study identified seven distinct subgroups that differed in mental health, somatic and social problems 2 to 3 weeks postevent. Subgroups considered (sub)clinical groups faced a lack of social support 1.5 years after the disaster more often than did other groups. Victims' services should therefore develop interventions to stimulate or secure social support for these clinical subgroups, specifically in the medium term (about 1.5 years post event). Objective: Findings on the relationship between social support and mental health problems after potentially traumatic events vary across studies. Aim of our longitudinal study is to assess to what extent initial postdisaster mental health, somatic, and social functioning problems affect social support 1.5 years later. This is relevant for the discussion about social causation versus social selection processes. Method: Data from Time 1 (T1; 2 to 3 weeks postevent) and Time 2 (T2; 1.5 years postevent) from the Dutch longitudinal Enschede Fireworks Disaster Study were extracted (N = 781). Latent profile analysis (LPA) was used to identify classes of (mental) health and social problems at T1 among disaster affected adult residents, using anxiety, depressive and PTSD symptoms, and somatic and social functioning problems as indicators. Relationships between classes at T1 and lack of social support at T2 were assessed using analyses of covariance (ANCOVAs). Results: LPA identified the following seven classes: very resilient (10.6%), resilient (7.2%), minor problems (16.1%), elevated problems (28.8%), subclinical problems (20.5%), clinical problems (13.9%), and severe clinical problems (2.9%). In general, classes with subclinical to severe clinical levels at T1 showed higher lack of everyday, emotional, esteem, instrumental, companionship, and informative support at T2 while controlling for demographics and disaster experiences. Conclusions: Affected adults who belong to the subclinical to severe clinical classes in the first weeks suffered more often from a lack of social support 1.5 years postevent than did others. Mental health policies should target the risk of lack of social support among these groups.