From Gaslighting to Mistrust in Others: A Serial Mediation Model of Social Support and Self-Care.

This study aims to explore the serial mediating effect of stigma and depression on the association between social support and medication adherence. A cross-sectional survey was undertaken in the Changning District of Shanghai using a five-part questionnaire from August to December 2023. A convenient sampling method was employed, and 35 patients with schizophrenia were invited from each of the 9 streets in Changning District to participate in the survey, resulting in a total of 305 valid questionnaires collected. The questionnaire measured social support, stigma, depression, medication adherence, and demographic characteristics. Data analysis involved descriptive statistics, independent samples t-tests, ANOVA, Pearson correlation analysis, and the bootstrap method. There was a direct and significantly positive association between social support and medication adherence (β = 0.69, p < 0.001). Moreover, increased levels of stigma (β = - 0.45, p = 0.013) and depression (β = - 0.09, p = 0.017) were both associated with a decline in medication adherence. Bootstrapping analysis revealed that the association between social support and medication adherence operated indirectly through stigma (β = 0.11, 95% CI: 0.03, 0.18). Additionally, social support was indirectly associated with medication adherence through depression (β = 0.15, 95% CI: 0.04, 0.30). Further analysis indicated that social support had an indirect association with medication adherence through both stigma and depression (β = 0.04, 95% CI: 0.01, 0.07). Stigma and depression serially mediate the association between social support and medication adherence among patients with schizophrenia. This serial multiple mediation model underscores the importance of integrating social support interventions with psychological interventions aimed at reducing stigma and depression, thereby effectively enhancing medication adherence in patients with schizophrenia.

This study aimed to explore the relationship between the experience of abuse and depressive symptoms among children and adolescents in a post-conflict setting while controlling for perceived support and individual background factors. This cross-sectional study was conducted in the post-conflict setting of Borama, Somaliland. A total of 645 adolescents that attended upper primary and lower secondary schools were included. The exposure variables were (a) experience of physical abuse, (b) experience of psychological abuse, and (c) experience of either or both forms of abuse. The outcome was depressive symptoms as measured by the Patient Health Questionnaire-9. Physical and psychological abuse were associated with higher levels of depressive symptoms (B = 2.74, p &lt; 0.001 and B = 1.62, p &lt; 0.001, respectively). The girls had higher levels of depressive symptoms than the boys (B = 0.71, p = 0.004). Moreover, a greater age was associated with higher levels of symptoms (B = 0.17, p = 0.033). Higher social support levels were associated with lower levels of depressive symptoms (B = −0.08, p = 0.001). Our findings suggest that interventions providing social support to adolescents who experience abuse may be beneficial in reducing depressive symptoms.

Square dance is gaining increasing popularity among middle-aged and older Chinese women who are also at high risk of sleep disturbance. Although previous studies have shown exercise could improve sleep quality, the association between square dance and sleep quality remains to be discussed, and even less is known about the potential mechanism underlying this association. This study aims to investigate the relationship between square dance and sleep quality and test if social support and depressive symptoms together play a serial mediating role in the influence of square dance on sleep quality. A cross-sectional study was conducted among 549 middle-aged and older Chinese females from September to December 2020 in Shao Yang City, Hunan Province of China, with ethics approval granted (SYU [2020]002). Square dance involvement was assessed by three questions about the time participants spent in square dance. Social support, depressive symptoms, and sleep quality were measured using the Pittsburgh Sleep Quality Index (PSQI), Social Support Self-Rating Scale (SSRS), and 9-item Patient Health Questionnaire (PHQ-9), respectively. The serial mediation model was analyzed by the bootstrapping method to assess whether social support and depressive symptoms mediate the relationship between square dance and sleep quality. Two-thirds of the participants had high involvement in square dance and most reported a moderate and high level of social support (98.54%). The prevalence of depressive symptoms and sleep disturbance was 19.49 and 26.78%, respectively. The serial mediation model showed a significant association between square dance and sleep quality, which was fully mediated by social support and depressive symptoms in a serial model (total effect c = -0.114, 95%CI = -0.227 to -0.001; direct effect c' = -0.036, 95% CI = -0.138 to 0.065; total indirect effect ab = -0.077, 95% CI = -0.139 to-0.016). Our study extends the understanding of how square dance is associated with sleep quality through the serial mediating roles of social support and depressive symptoms. It provides crucial implications for developing square dance interventions to improve sleep quality among middle-aged and older Chinese females.

Can Focusing on Self-Care Reduce Disparities in Kidney Transplantation Outcomes?

The Chinese population is aging, and chronic non-communicable diseases (NCDs) prevalence is correspondingly increasing, along with associated disability and healthcare costs. Although self-management has been associated with social support and is a recognized priority, its mediating variables have not been studied in detail, particularly among old people with chronic diseases. To examine the mediating role of e-health literacy and general self-efficacy in the relationship between social support and self-management of chronic NCDs in Chinese community home-based aging institution residents. A random sample of 289 community home-based aging institution elders (≥60 years) with chronic NCDs in China was recruited. Questionnaire data were recorded on self-reported socio-demographics, self-management, social support, e-health literacy, and general self-efficacy. Pearson's correlation analysis identified the relationship between these factors and self-management. Serial multiple mediation model was used to test the hypothesized relationships. The self-management mean (±SD) score was 29.39 ± 9.60, and the level of self-management was medium. Social support (r = 0.283; P < 0.001), e-health literacy (r = 0.566; P < 0.001), and general self-efficacy (r = 0.477; P < 0.001) were positively associated with self-management. Furthermore, social support indirectly influenced self-management through three pathways: independent mediation of e-health literacy (effect = 0.234, P < 0.001), independent mediation of general self-efficacy (effect = 0.515, P < 0.001), and chain mediation of e-health literacy and general self-efficacy (effect = 0.075, P < 0.001). In Chinese community home-based aging institution elders, the relationship between self-reported self-management and social support is positively affected by the independent mediating effect of e-health literacy and general self-efficacy and the serial mediating effect of e-health literacy and general self-efficacy. Targeted self-management programs for elders with chronic NCDs have theoretical support, which could improve the health status and quality of life in this population.

Role of self-esteem and personal mastery on the association between social support and resilience among COVID-19 long haulers

BackgroundJob search anxiety among university students has intensified due to increased uncertainty in youth employment within global labor markets. This study aimed to examine the serial mediating roles of social support and strengths use in the relationship between job search anxiety and flourishing.MethodsThis study was conducted online during the pandemic and included 228 Korean university students aged 21–29 years. Data were analyzed using independent t-tests, ANOVA (analysis of variance), Welch’s ANOVA, Pearson’s correlation, and serial multiple mediation analyses with the bootstrapping method.ResultsAfter controlling for covariates, job search anxiety was directly related to flourishing (B = − 0.477, 95% confidence interval (CI) [− 0.649, − 0.304]). Furthermore, the indirect effects of job search anxiety on flourishing via social support and strengths use were statistically significant (BSocial support = − 0.192, 95% CI [− 0.316, − 0.083]; BStrengths use = − 0.134, 95% CI [− 0.234, − 0.055]). Additionally, a serial mediation effect of social support and strengths use on the path from job search anxiety to flourishing was statistically significant (B = − 0.046, 95% CI [− 0.084, − 0.018]). This result indicated that the serial mediation by first social support and then strengths use demonstrated a stronger effect than mediation by either variable alone.ConclusionsThis study provides novel insights for mental health professionals, policymakers, and educators concerning the serial mediating mechanism linking job search anxiety and flourishing. These findings underscore the importance of assessing job search anxiety among university students and providing psychological interventions that promote flourishing, particularly through enhancing social support and encouraging strengths use.

Hopelessness and insomnia remain growing mental health issues worldwide, their relationship has been neglected by international development policies, especially in the countries with rapidly aging population like China. However, there is little conclusive evidence on the mechanisms through which insomnia severity influences hopelessness. Based on previous research regarding the significant associations among fatigue, social support, insomnia and hopelessness, this study aims to investigate the relationship between insomnia and hopelessness as well as how insomnia affects hopelessness through fatigue and social support. A population-based data including 946 community-dwelling older adults extracted from "Elderly Care Household Survey in 2019" in Beijing were used. The age of the participants ranged from 66 to 97years old, and 53.3% of the respondents were female. Intercorrelations among insomnia, fatigue, social support and hopelessness were examined. Serial multiple mediation models were analyzed by the bootstrapping method to assess whether fatigue and social support serially mediate the relationship between insomnia and hopelessness. Higher level of insomnia severity (coefficient=0.0421, p<0.001), higher level of fatigue (coefficient=0.0171, p < 0.001), and lower level of social support (coefficient=-0.0320, p<0.001) were significantly associated with higher level of hopelessness. Fatigue and social support in serial, mediated the relationship between insomnia and hopelessness (total effect: coefficient=0.0623, 95% CI [0.0466, 0.0780]; total direct effect: coefficient=0.0421, 95% CI [0.0262, 0.0581]; total indirect effect: coefficient=0.0202, 95% CI [0.0147, 0.0272]). Improving sleep quality and eliminating fatigue could effectively alleviate the sense of hopelessness among Chinese older adults. In addition, establishing stronger social support brought by social network from family and friends could confer resilience against the negative effects of despair brought by insomnia. Our findings highlighted the mechanism connecting insomnia to hopelessness, which would inspire the future practice.

This study aimed to examine the relationship between perceived social support and life satisfaction among adolescents who experienced the 6 February 2023 Kahramanmaraş-centered earthquakes, in the context of the serial mediation roles of psychological resilience and post-traumatic stress disorder (PTSD) symptoms. The study included a total of 692 high school students (mean age = 15.62, SD = 1.29) enrolled in schools in Malatya, one of the provinces most affected by the earthquakes. The data were collected using the Student's Life Satisfaction Scale, the Brief Resilience Scale, the Perceived Social Support Scale, and the Posttraumatic Stress Disorder (PTSD) Scale. In the preliminary analyses, independent samples t-tests, one-way ANOVAs, and Pearson correlation analyses were used. The serial mediation model, in which social support was the independent variable, life satisfaction was the dependent variable, and psychological resilience and PTSD were the mediating variables, respectively, was tested using Model 6 of the PROCESS macro. The findings revealed that perceived social support in adolescents significantly predicts life satisfaction in a positive direction, and that psychological resilience and PTSD play a mediating role in the relationship between social support and life satisfaction. Our results suggest that, in the context of serial mediation, increased social support following the earthquake is associated with enhanced psychological resilience. Increased psychological resilience, in turn, predicts a decrease in PTSD levels, which is linked to higher life satisfaction. These findings suggest that post-disaster mental health interventions should prioritize strengthening adolescents' social support networks and resilience capacities to reduce PTSD and promote long-term psychological well-being.

BackgroundParenting today is characterized by numerous challenges and stressors. As a well-researched contextual factor for parenting, social support may help parents reduce parenting stress and adopt more positive parenting practices. However, the direct and indirect pathways linking social support to parenting outcomes remain largely unexplored. This study aimed to investigate whether and how the association between social support and parent-child relationships was mediated by the presence of meaning in parenthood and parental self-efficacy.MethodsAs part of a parent education project, a total of 1,242 Chinese parents (87.2% female) participated in questionnaire surveys conducted by this cross-sectional study in Hong Kong. Data were analyzed using SPSS Statistics 26.0 and PROCESS Macro v4.1 for correlation analysis and serial mediation analysis.ResultsThe results indicated that the presence of meaning in parenthood and parental self-efficacy mediated the association between social support and parent-child relationships, both individually and serially. Furthermore, the mediating effect of the presence of meaning in parenthood was significantly greater than that of parental self-efficacy, as well as the serial mediating effect of the presence of meaning in parenthood and parental self-efficacy.ConclusionsSocial support is positively associated with parent-child relationships, both directly and indirectly, via the presence of meaning in parenthood and parental self-efficacy. Future research could employ the serial mediation model to explore the effects of social support on the well-being of parents and children. Additionally, future practice may prioritize the presence of meaning in parenthood as a crucial outcome indicator for parenting interventions.

Life course perspectives on economic stress and generalized trust in other people

BackgroundDespite a flood of research on job satisfaction, few studies have examined how and why social support influences job satisfaction. This study aimed to explore how social support has an indirect effect on job satisfaction by examining its impact on emotional exhaustion and anxiety symptoms among residents of the physicians standardized residency training program in China.MethodsThis cross-sectional study adopted questionnaires to collect data from residents in the standardized residency training program in China. The PROCESS macro for SPSS based on ordinary least-squares regression and the bootstrap method was used. The indirect effect of social support was examined using bootstrapping procedures. A serial multiple mediation model was examined in which social support was associated with job satisfaction via emotional exhaustion and anxiety symptoms.ResultsThere were 269 residents who provided usable data for the analysis. The mean age of residents was 25.98 years old. Close to half (52%) of the participants were female. The total indirect effect of social support on job satisfaction was significant (ab=0.21, SE=0.05, CI=0.12 to 0.32). The specific indirect effect 1 (social support→emotional exhaustion→job satisfaction) was significant (a1b1=0.12, SE=0.04, CI=0.05 to 0.19). The specific indirect effect 2 (social support→anxiety symptoms→job satisfaction) was significant (a2b2=0.07, SE=0.03, CI=0.02 to 0.13).The specific indirect effect 3 (social support→emotional exhaustion→anxiety symptoms→job satisfaction) was also found to be significant through both optimism and work engagement (a1a3b2=0.03, SE=0.01, CI=0.01 to 0.05).ConclusionIt seems critical for hospital management to develop a supportive work environment to improve the effects of emotional exhaustion and anxiety symptoms and to provide sufficient support to improve job satisfaction among residents in standardized residency training programs.

Social support plays an important role in helping female college students in particular to achieve and feel well in the face of changing social circumstances. The present study aims to delve into the specific mechanisms through which social support contributes to enhancing life satisfaction among female college students. Therefore, a serial mediation model was tested to examine the relationship between social support, grit, basic psychological needs satisfaction, and life satisfaction among female college students. 588 female college students residing in China, with an average age of 19 years (SD = 1.29), participated in this study. The instruments used included the Social Support Scale, the Grit Scale, the Basic Psychological Needs Satisfaction Scale, and the Life Satisfaction Scale. Correlation analysis, confirmatory factor analysis (CFA), and structural equation modeling (SEM) were employed to examine the relationships among the variables. The study findings reveal a positive association between higher levels of social support and increased grit, as well as satisfaction of basic psychological needs among female college students. The structural equation modeling confirms the validity of the serial mediation model. This model suggests that social support is a significant predictor of holistic well-being, with its influence on life satisfaction being partially mediated by grit and basic psychological needs satisfaction. The findings underscore the importance of social support as a potential pathway to enhancing life satisfaction through the cultivation of grit and the satisfaction of psychological needs.

Previous studies have consistently found a robust relationship between childhood maltreatment and psychological distress. Despite the increasing number of studies in recent years that have identified social support or self-compassion as potential mechanisms in this relationship, no study examines the mediating role of both social support and self-compassion in adults. This study aimed to investigate social support and self-compassion as potential mediators in the relationship between childhood maltreatment and psychological distress using a serial mediation model. Using online surveys, a total of 310 participants (Mage = 28.83, SD = 6.07) were included in this study. The data was collected using the Childhood Trauma Questionnaire, Self-Compassion Scale-Short Form, Multidimensional Scale of Perceived Social Support, and Depression Anxiety Stress Scales - Short Form. The proposed serial mediation model was conducted using PROCESS macro for SPSS. After controlling age and gender, the results showed that: (a) there was a direct effect of childhood maltreatment on psychological distress (B = 0.192, p < .001); (b) self-compassion mediated the relationship between childhood maltreatment and psychological distress (effect = 0.107, SE = 0.03, 95% CI [0.051, 0.170]) whereas social support did not mediate this relationship (effect = 0.026, SE = 0.01, 95% CI [-0.009, 0.065]); and (c) social support and self-compassion mediated the relationship between childhood maltreatment and psychological distress in a sequential way (effect = 0.053, SE = 0.01, 95% CI [0.031, 0.083]). This study demonstrated that increasing social support resources and particularly addressing self-compassion in therapy may help individuals exposed to childhood maltreatment.

Caregiving burden and positive aspects of caregiving in schizophrenia: Mediating roles of hope and social support