Apoyo Social Percibido como Moderador de Síntomas de Depresión y Ansiedad en Adolescentes con Trauma Psicológico


  • Natalie García-Justiniano Universidad Albizu, Recinto de San Juan
  • Coralee Pérez-Pedrogo Universidad Albizu, Recinto de San Juan; Universidad de Puerto Rico, Recinto de Ciencias Médicas

Palabras clave:

apoyo social percibido, trauma, depresión, ansiedad, Puerto Rico


El apoyo social percibido (ASP) se ha identificado como un factor protector para mitigar síntomas de condiciones de salud mental comúnmente asociados con experiencias traumáticas. Este estudio examina el ASP como moderador en la relación entre los síntomas de trauma y los síntomas de depresión y ansiedad en niños y jóvenes (N = 646). Los resultados del análisis de moderación con regresión reflejan que el ASP modera la relación entre el trauma y los síntomas de depresión (b = -.03, p < .001, IC 95% [-.05, -.02]) y ansiedad (b = -.02, p < .001, IC 95% [-.03, -.01]). Los análisis de pendiente simple resaltan que cuando el ASP es alto, existe una relación menor entre los síntomas de trauma y los de depresión, b = .83, p < .001, IC 95% [.70, .96] y ansiedad, b = .70, p < .001, IC 95% [.60, .80]. Estos resultados muestran que el ASP puede reducir el efecto del trauma en la presencia de síntomas de depresión y ansiedad.


Aiken, L. S., & West, S. G. (1991). Multiple regression: Testing and interpreting interactions. SAGE Publications.

Alisic, E., Zalta, A., Wesel Van, F., Larsen, S., Hafstad, G., Hassanpour, K., & Smid, G. (2018). Rates of posttraumatic stress disorder in trauma-exposed children and adolescents: Meta-analysis. British Journal of Psychiatry, 204(5), 335–340. https://doi.org/10.1192/bjp.bp.113.131227

Brewin, C. R., Rose, S., Andrews, B., Green, J., Tata, P., McEvedy, C., Turner, S., & Foa, E. B. (2002). Brief screening instrument for posttraumatic stress disorder. British Journal of Psychiatry, 181(2), 158–162. https://doi.org/10.1192/bjp.181.2.158

Briggs-Gowan, M. J., Carter, A. S., Clark, R., Augustyn, M., McCarthy, K. J., & Ford, J. D. (2010). Exposure to potentially traumatic events in early childhood: Differential links to emergent psychopathology. J Child Psychol Psychiatry, 51(10), 1132–1140. https://doi.org/10.1111/j.1469-7610.2010.02256.x

Centers for Disease Control and Prevention. (2022). Fast Facts: Preventing Adverse Childhood Experiences. https://www.cdc.gov/violenceprevention/aces/fastfact.html#:~:text=Adverse%20childhood%20experiences%2C%20or%20ACEs,in%20the%20home%20or%20community

Chapman, D. P., Whitfield, C. L., Felitti, V. J., Dube, S. R., Edwards, V. J., & Anda, R. F. (2004). Adverse childhood experiences and the risk of depressive disorders in adulthood. Journal of Affective Disorders, 82(2), 217–225. https://doi.org/10.1016/j.jad.2003.12.013

Cohen, S., & Wills, T. A. (1985). Stress, Social Support, and the Buffering Hypothesis. Psychological Bulletin, 98(2), 310–357. https://doi.org/10.1037/0033-2909.98.2.310

Duru, E., & Balkis, M. (2018). Exposure to school violence at school and mental health of victimized adolescents: The mediation role of social support. Child Abuse & Neglect, 76, 342–352. https://psycnet.apa.org/doi/10.1016/j.chiabu.2017.11.016

Elkins, J., Miller, K. M., Briggs, H. E., Kim, I., Mowbray, O., & Orellana, R. E. (2019). Associations between Adverse Childhood Experiences, Major Depressive Episode and Chronic Physical Health in Adolescents: Moderation of Race/Ethnicity. Social Work in Public Health, 34(5), 444–456. https://doi.org/10.1080/19371918.2019.1617216

Evans, S. E., Steel, A. L., & DiLillo, D. (2013). Child maltreatment severity and adult trauma symptoms: Does perceived social support play a buffering role? Child Abuse and Neglect, 37(11), 934–943. https://doi.org/10.1016/j.chiabu.2013.03.005

Fredman, S. J., Beck, J. G., Shnaider, P., Le, Y., Pukay-Martin, N. D., Pentel, K. Z., Monson, C. M., Simon, N. M., & Marques, L. (2017). Longitudinal Associations Between PTSD Symptoms and Dyadic Conflict Communication Following a Severe Motor Vehicle Accident. Behavior Therapy, 48(2), 235–246. https://doi.org/10.1016/j.beth.2016.05.001

García-Justiniano, N., Pérez-Pedrogo, C., Sánchez-Cardona, I., & Padilla-Cotto, L. (in press). Psychometric Properties of the Medical Outcomes Study- Social Support Survey (MOS-SSS-A) among Adolescents in Puerto Rico. Behavioral Psychology.

Hodgkinson, S., Godoy, L., Beers, L. S., & Lewin, A. (2017). Improving Mental Health Access for Low-Income Children and Families in the Primary Care Setting. Pediatrics, 139(1), e20151175. https://doi.org/10.1542/peds.2015-1175

Hughes, K., Bellis, M. A., Hardcastle, K. A., Sethi, D., Butchart, A., Mikton, C., Jones, L., & Dunne, M. P. (2017). The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis. The Lancet Public Health, 2(8), e356–e366. https://doi.org/10.1016/S2468-2667(17)30118-4

Kim, P., Evans, G. W., Angstadt, M., Ho, S. S., Sripada, C. S., Swain, J. E., Liberzon, I., & Phan, K. L. (2013). Effects of childhood poverty and chronic stress on emotion regulatory brain function in adulthood. Proceedings of the National Academy of Sciences of the United States of America, 110(46), 18442–18447. https://doi.org/10.1073/pnas.1308240110

Kroenke, K., & Spitzer, R. L. (2002). The PHQ-9: A new depression diagnostic and severity measure. Psychiatric Annals, 32(9), 509–515. https://doi.org/10.3928/0048-5713-20020901-06

LaBrenz, C. A., Panisch, L. S., Lawson, J., Borcyk, A. L., Gerlach, B., Tennant, P. S., Nulu, S., & Faulkner, M. (2020). Adverse Childhood Experiences and Outcomes among At-Risk Spanish-Speaking Latino Families. Journal of Child and Family Studies, 29(5), 1221–1235. https://doi.org/10.1007/s10826-019-01589-0

Lagdon, S., Ross, J., Robinson, M., Contractor, A. A., Charak, R., & Armour, C. (2021). Assessing the Mediating Role of Social Support in Childhood Maltreatment and Psychopathology Among College Students in Northern Ireland. Journal of Interpersonal Violence, 36(3–4), 2112–2136. https://doi.org/10.1177/0886260518755489

López-Torres, S., Pérez-Pedrogo, C., Sánchez-Cardona, I., & Sánchez-Cesareo, M. (2019). Psychometric Properties of the PHQ-A among a Sample of Children and Adolescents in Puerto Rico. Current Psychology, 41, 90–98. https://doi.org/10.1007/s12144-019-00468-7

Maheux, A., & Price, M. (2016). The indirect effect of social support on post-trauma psychopathology via self-compassion. Personality and Individual Differences, 88, 102–107. https://doi.org/10.1016/j.paid.2015.08.051

Mersky, J. P., Topitzes, J., & Reynolds, A. J. (2013). Impacts of adverse childhood experiences on health, mental health, and substance use in early adulthood: A cohort study of an urban, minority sample in the U.S. Child Abuse and Neglect, 37(11), 917–925. https://doi.org/10.1016/j.chiabu.2013.07.011

Orengo-Aguayo, R., Stewart, R. W., de Arellano, M. A., Suárez-Kindy, J. L., & Young, J. (2019). Disaster Exposure and Mental Health Among Puerto Rican Youths After Hurricane Maria. JAMA Network Open, 2(4), e192619. https://doi.org/10.1001/jamanetworkopen.2019.2619

Pérez-Morales, Á., Pérez-Pedrogo, C., López-Torres, S., & Sánchez-Cardona, I. (2019). Validación de Traducción al Español del TSQ con Participantes entre 8 a 17 Años Residentes de Puerto Rico. Revista Puertorriqueña de Psicología Psicología, 30(2), 242–252.

Pérez-Pedrogo, C., Sánchez-Cardona, I., Castro-Díaz, B., & López-Torres, S. (in press). Psychometric properties of the Generalized Anxiety Disorder 7-item scale in adolescents: An effective screening tool for school and community settings. Puerto Rico Health Sciences Journal.

Peter, P. J., de Mola, C. L., de Matos, M. B., Coelho, F. M., Pinheiro, K., da Silva, R. A., Castelli, R. D., Pinheiro, R. T., & Quevedo, L. A. (2017). Association between perceived social support and anxiety in pregnant adolescents. Braz J Psychiatry, 39(1), 21–27. https://doi.org/10.1590/1516-4446-2015-1806

Podsakoff, P. M., Mackenzie, S. B., & Podsakoff, N. P. (2012). Sources of Method Bias in Social Science Research and Recommendations on How to Control It. Annual Review of Psychology, 63, 539–569. https://doi.org/10.1146/annurev-psych-120710-100452

Poole, J. C., Dobson, K. S., & Pusch, D. (2017). Childhood adversity and adult depression: The protective role of psychological resilience. Child Abuse and Neglect, 64, 89–100. https://doi.org/10.1016/j.chiabu.2016.12.012

Rao, U., & Chen, L. A. (2009). Characteristics, correlates, and outcomes of childhood and adolescent depressive disorders. Dialogues in Clinical Neuroscience, 11(1), 45–62. https://doi.org/10.31887/dcns.2009.11.1/urao

Reiss, F., Meyrose, A. K., Otto, C., Lampert, T., Klasen, F., & Ravens-Sieberer, U. (2019). Socioeconomic status, stressful life situations and mental health problems in children and adolescents: Results of the German BELLA cohort-study. PLoS ONE, 14(3), e0213700. https://doi.org/10.1371/journal.pone.0213700

Rodríguez-Espínola, S. (2011). Adaptación a niños del cuestionario MOS de Apoyo Social Percibido. LIBERABIT, 17(2), 117–128. http://www.scielo.org.pe/pdf/liber/v17n2/a02v17n2.pdf

Rolstad, S., Adler, J., & Rydén, A. (2011). Response burden and questionnaire length: Is shorter better? A review and meta-analysis. Value in Health, 14(8), 1101–1108. https://doi.org/10.1016/j.jval.2011.06.003

Rosa-Rodríguez, B. L. (2019, November). State of mental health services for children in Puerto Rico. American Psychological Association. https://www.apa.org/pi/families/resources/newsletter/2019/11/mental-health-puerto-rico-children

Schauss, E., Hawes, K., Roberts, S., Clayton, J. M., Li, C., Littlejohn, A., Bartelli, D., Williams, R., & The BRAIN Center at the University of Memphis. (2022). Examining the incidence of acute stress in pediatric trauma patients. Trauma Surgery & Acute Care Open, 7(1), e000946. https://doi.org/10.1136/tsaco-2022-000946

Sherbourne, C. D., & Stewart, A. L. (1991). The MOS Social Support Survey. Social Science & Medicine, 32(6), 705–714. https://doi.org/10.1016/0277-9536(91)90150-B

Spitzer, R., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). A Brief Measure for Assessing Generalized Anxiety DisorderThe GAD-7. Archives of Internal Medicine, 166(10), 1092–1097. https://doi.org/10.1001/archinte.166.10.1092

The Annie E. Casey Foundation. (2021). Kids Count Data Book 2021 - State Trends in Child Well-Being. https://assets-global.website-files.com/60f311e9e2e57d523d28bba2/6160ce4b6d5dbb275a863f49_071f86d34d3f5a1cbc8d9c0a0aeb1050_aecf-2021kidscountdatabook-2021%20(1).pdf

Thompson, E. A., Mazza, J. J., Herting, J. R., Randell, B. P., & Eggert, L. L. (2005). The Mediating Roles of Anxiety, Depression, and Hopelessness on Adolescent Suicidal Behaviors. Suicide and Life-Threatening Behavior, 35(1), 14–34. https://doi.org/10.1521/suli.

Thompson, M. P., Kingree, J. B., & Lamis, D. (2018). Associations of adverse childhood experiences and suicidal behaviors in adulthood in a U.S. nationally representative sample. Child: Care, Health and Development, 45(1), 121–128. https://doi.org/10.1111/cch.12617

Wethington, E., & Kessler, R. C. (1986). Perceived support, received support, and adjustment to stressful life events. Journal of Health and Social Behavior, 27(1), 78–89. https://doi.org/10.2307/2136504