(PS10-6) Cambodian Female Entertainment Workers: Investigating Social Support as a Moderator in the Relationship of Adverse Childhood Experiences and Adult Quality of Life

Childhood traumatic events (CTEs) are common worldwide, particularly in Low and Middle-Income Countries (LMICs). The impact of childhood trauma is consistently associated with vast negative outcomes that can persist well into adulthood. While research has found that social support may moderate the relationship between traumatic experiences and negative impacts, this relationship is less understood in LMICs like Cambodia. Thus, the present study aimed to determine if social support moderates the relationship between the additive effects of CTEs and quality of life (QOL) in an adult sample of 160 Cambodian female entertainment workers (FEWs).
Participants were at least 24 years old and worked in the sex industry for at least three months. Social support was measured with the Multidimensional Scale of Perceived Social Support (Zimet et al., 1998). Childhood Traumatic Experiences were extracted from the Adverse Childhood Experiences (Felitti et al., 1998) questionnaire. Specifically, adverse events that overlapped with posttraumatic stress disorder criterion A traumas were used for data analysis.
Results indicate that 70% (n=112) of participants endorsed at least one CTE. Most commonly, FEWs endorsed experiencing two or more forms of CTEs. For social support, the overall model of direct associations was significant (F(3, 108) = 6.2, ΔR2 = 0.15, p <= 0.001) and total support was a significant moderator (p <= 0.005) of the relationship between greater number of trauma types and QOL. This association was significant at moderate (p < 0.05) and high (p < 0.001) levels of total support. Further examination ofsupport types indicate that social support from friends was also a significant moderator (F(2, 106) = 4.84, ΔR2 = 0.08, p < 0.05) in the number of trauma types experienced and lower QOL at moderate (p < 0.05) and high levels (p < 0.05) of support. In contrast, support from family or significant others was not found to moderate the relationship between CTEs experienced and QOL.
The present findings support a moderating role of social support from friends in the relationship between the number of CTEs experiences and QOL, but not other types of social support. Thus, in Cambodian FEWs, treatment aimed at combating the negative additive impacts of childhood trauma in adulthood may benefit from incorporating non-romantic loved ones outside of one's family. The present study illustrates how the role of social support in mitigating the additive impacts of childhood trauma varies cross-culturally. These results also underscore the crucial need to examine potential confounds in examining the moderating role of social support in the relationship between adverse childhood experiences and social support in Cambodian FEWs. For example, given that many of the investigated traumas occurred in one’s home, examination of who the alleged perpetrator is, in cases of interpersonal trauma, should be considered before concluding that social support from family or a significant other does not buffer the additive negative impacts of childhood trauma and QOL. Additionally, the types and quality of social support that is typically provided by friends versus family and significant others should be investigated.