The Effect of Posttraumatic Stress on Depressive Symptoms Among Bereaved Parents in South Korea: The Role of Social Support

Background and Purpose: Bereaved parents who have lost a child to cancer often endure negative mental health outcomes such as depression following the traumatic loss. However, the burden of this depression can be mitigated through adequate social support. In South Korea, parents grieving the loss of a young child often confront significant challenges in openly sharing their sorrow, largely due to societal attitudes that frame such loss in terms of pity and shame. This cultural backdrop stifles open dialogue about their grief, resulting in a pronounced scarcity of support for bereaved people. This study examined bereaved parents’ depression levels, focusing on the effects of posttraumatic stress. Additionally, it examined the potential moderating effects of social support among bereaved parents whose child died of cancer in South Korea.

Methods: The study involved 58 bereaved parents who completed a self-administered questionnaire (44.8% fathers, 55.2% mothers). Many participants experienced the loss of their child before age 7 (41.4%), and the time since the child’s death ranged from 1 to 5 years (55.2%). The questionnaire featured 17 items from the Posttraumatic Diagnostic Scale, 20 items from the Korean version of CES-D scale, and five subscales of the MOS Social Support Survey, assessing emotional, informational, tangible, affectionate, and positive social interactions. In the preliminary analysis, t-tests were conducted to identify differences in the levels of depressive symptoms based on sociodemographic and child characteristics. To test the main hypothesis, multiple regression analyses were conducted to investigate the associations between posttraumatic stress and depressive symptoms, with each subscale of social support examined as a moderator.

Results: More than a third of participants (35.7%) exhibited significant levels of depressive symptoms, surpassing the cutoff (21 or greater) on the CES-D. Depressive symptoms varied among participants based on gender, religious affiliation, and time since their child’s death. Female gender, having a religious affiliation, and less than 5 years since the child’s death were associated with higher levels of depressive symptoms. Regression analysis revealed a significant association between posttraumatic stress and depression (β = .34; SE = .31, t = 1.620), accounting for 75.5% of the variance. Notably, emotional support moderated the relationship between posttraumatic stress and depressive symptoms (β = .41, p = .04), whereas other subscales of social support did not exhibit moderation effects.

Conclusions and implications: Understanding the impact of posttraumatic stress on depression among bereaved parents can provide valuable insights for social work professionals in developing psychosocial interventions to address the traumatic loss of a child and resulting depressive symptoms. Recognizing the significant role of emotional support in mitigating the adverse effects of traumatic loss, interventions should prioritize the enhancement of support networks that offer open exchanges of emotions for bereaved parents that can validate their loss and grief.