(PS11-C71) Quality of Life: Testing the Stress-buffering Model of Social Support in a Sample of Cambodian Female Entertainment Workers

Cambodia is an underdeveloped country in Asia with significant mental health concerns (e.g., high rates of anxiety and PTSD). Childhood trauma and ongoing adult stressors, such as poverty and violence are particularly common in Cambodian women, specifically in Female Entertainment Workers (FEWs). Research examining this population is underrepresented in current literature, including the possible positive impacts of social support. The stress-buffering model of social support posits that social support will minimize the deleterious impacts of stress. Exposure to adverse childhood experiences are associated with various adverse physical, behavioral, and mental health outcomes. An additive effect of adverse childhood experiences that overlap with posttraumatic stress disorder criterion A traumatic events has been observed. The current study sought to examine the relevance of the stress-buffering model in 160 Cambodian FEWs. Potential childhood traumatic experiences were derived from the Adverse Childhood Experiences list. 70% of the FEWs in the current sample identified experiencing one or more of the following: psychological abuse and/or fearing that adult household members may physically harm them (n = 98), physical abuse (n = 63), living with someone with a mental illness or who  attempted suicide (n = 46), domestic violence (n = 41), and sexual abuse (n = 40). Of the FEWs with a trauma history, experiencing two unique trauma types was most common (n = 35), followed by one (n = 30), and four (n = 21). Experiencing three or five traumas were each reported by 13 FEWs.

Analyses examining the buffering effect of social support on the relationship between number of unique childhood trauma types and outcomes were conducted with data from FEWs who endorsed childhood trauma. The overall model of the effects of trauma types and total social support on quality of life (QOL) was significant (F(3, 108) = 6.2, ΔR2 = 0.15, p < = 0.001). Total social support was a significant moderator (p < = 0.005). More unique trauma types were significantly associated with poorer QOL at moderate (p < 0.05) and high (p < 0.001) levels of support. Likewise, the overall model including number of unique trauma types, QOL, and support from      friends was significant (F(5, 106) = 3.69, ΔR2 = 0.38, p < 0.005).  Support from friends was a significant moderator (F(2, 106) = 4.84, ΔR2 = 0.08, p < 0.05) such that moderate (p < 0.05) and high levels (p < 0.05) of friend support were associated with lower QOL. This relationship was reversed, but insignificant at low levels of support. Support from family, significant others, and total social support did not moderate this relationship. Thus, in a Cambodian sample of FEWs, the stress-buffering model of social support is unsupported with regard to QOL.  Surprisingly, findings suggest that greater total social support and support from friends may have negative effects on QOL in Cambodian FEWs. Perhaps a greater sense of social support, particularly from friends, increases upward social comparisons, and thus, lower perceptions of QOL, therefore making social support an ineffective intervention for related concerns. Implications, including possible cultural explanations, will be discussed.