Impact Of Stressful Life Events Research Articles

How do stressful life events affect medical students’ academic adjustment? Parallel mediating mechanisms of anxiety and depression

BackgroundMedical students frequently face challenges in academic adjustment, necessitating effective support and intervention. This study aimed to investigate the impact of stressful life events on medical students’ academic adjustment, focusing on the mediating roles of depression and anxiety. It also differentiated the impacts between at-risk students (those with academic failures) and their peers respectively.MethodsThis case-control study involved 320 at-risk medical students and 800 other students from a university in western China. Participants anonymously completed the scales of stressful life events, depression, anxiety, and academic adjustment. T-tests, ANOVA, Pearson correlation, and structural equation modeling were employed for statistical analysis.ResultsDepression and anxiety were significantly more prevalent in at-risk students (46.8% and 46.1%, respectively) than in controls (34.0% and 40.3%, respectively). Notably, at-risk students had poorer academic adjustment (t = 5.43, p < 0.001). The structural equation modeling had good fit indices and the results indicated that depression and anxiety fully mediated the effects of stressful life events on academic adjustment. For at-risk students, stressful life events significantly decreased academic adjustment through increased depression and anxiety (p < 0.001). Conversely, anxiety had a positive effect on academic adjustment in other students.ConclusionTargeted interventions focusing on depression and anxiety could reduce the negative impact of stressful life events on medical students’ academic adjustment. However, educators have to distinguish the differences between at-risk students and others.

A cross-sectional study of stressful life events and quality of life among FGID and non-FGID patients

ABSTRACT Background: Gastrointestinal disorders, both non-functional and functional, are prevalent among the general population, and understanding these in relation to psychological factors is crucial for clinicians to design effective management strategies. Psycho-social factors, including stressful life events, significantly impact disease outcomes and quality of life (QOL). Limited research has explored these factors in the context of functional gastrointestinal disorders (FGIDs) and non-functional gastrointestinal disorders (non-FGIDs), especially in culturally diverse populations. Aim: To investigate the relationship between QOL and stressful life events in patients with FGID and non-FGID. Materials and Methods: This study involved 200 participants diagnosed with FGID using ROME IV criteria and non-FGID clinically. The research utilized a socio-demographic questionnaire, the Psychological General Well-Being Index (QOL), and the Presumptive Stressful Life Events Scale (PSLES). Results: Among FGID patients, functional dyspepsia was the common diagnosis, while erosive gastritis was more prevalent among non-FGID patients. A significant association in QOL was observed between FGID and non-FGID (P &lt; 0.001), with FGID patients exhibiting lower scores. Overall, a mild negative correlation was found between QOL and PSLES (r = -0.20, P = 0.003). Stressful life events contributed to 13% variance of QOL in non-FGID patients. Conclusion: This study highlights the impact of stressful life events on QOL in both FGID and non-FGID patients. While FGID patients experienced poorer QOL, non-FGID also showed QOL reductions with recent life events. Understanding these associations can aid clinicians in comprehensive patient care, emphasizing the importance of addressing psycho-social factors alongside clinical symptoms. Cultural nuances influencing stress perception and its relation to gastrointestinal disorders merit further investigation.

Resilience to Physical and Emotional Stress

Resilience is the ability of an individual to successfully adapt to stressful and challenging situations. However, resilience encompasses not only the way we react to a specific stressful situation but also how we cope with accompanying physical, psychological, and social challenges. A resilient person is not immune to failures, losses, and the effects of stress. It is the way a person responds after the initial shock that stands out and distinguishes resilient individuals from others. The aim of this study is to examine differences in resilience and quality of life among early and middle-aged participants, as well as the relationship between these variables. We aim to determine the importance of self-efficacy, perseverance, social support, internal locus of control, and coping and adaptation strategies for preserving the physical and mental health of individuals under the impact of stressful life events.

Stressful Life Events, Sleep Quality and Non-Suicidal Self-Injury in Chinese Adolescents: The Moderating Effect of Sensation Seeking.

Despite the growing evidence that stressful life events are associated with adolescent non-suicidal self-injury (NSSI), few studies have investigated the mediating and moderating mechanisms underlying this link. The current study examined whether sleep quality mediated the link between stressful life events and NSSI and whether this mediating process was moderated by adolescent sensation seeking. The participants were 1006 Chinese adolescents (48.21% boys; mean age = 13.16 years, SD = 0.67). They completed the Life Events Checklist, Pittsburgh Sleep Quality Index, UPPS-P Impulsive Behavior Scale, and NSSI Questionnaire. The PROCESS macro for SPSS was used to examine the hypothesized moderated mediation model. The results showed that sleep quality significantly mediated the positive association between stressful life events and adolescent NSSI. Moreover, this mediating pathway was moderated by sensation seeking. Specifically, the risk impact of stressful life events on NSSI through sleep quality was significant only among adolescents with high-level sensation seeking but not among those with low-level sensation seeking. These findings provide intervention insights to reduce the risk of adolescent NSSI.

Exploring the impact of stressful life events on quality of life: meaning making and narrative reconstruction

ABSTRACT Purpose Stressful life events have the capacity to disrupt an individual’s worldview and life goals, leading to existential questions and identity loss. The subjective perception of identity is intricately linked with quality of life (QoL), and how individuals derive meaning from these stressful life events significantly influences their well-being. This article explored the impact of stressful life events on individuals’ QoL, and examined the potential for enhancing QoL through meaning making and narrative reconstruction. Methods Qualitative interviews were conducted with 11 individuals reporting diminished QoL and analysed using thematic analysis. Results The study reveals that stressful life events confront interviewees with the vulnerability of their values in life and the limits of their control, leading them to question their own beliefs and purpose in life. Consequently, these events prompt individuals to reconstruction their narratives to adapt to new life circumstances. Conclusions The study suggests that “securing the base,” including strong social relations and security in economic and housing conditions, is a prerequisite for enhancing QoL. The insights on “the base” have profound implications for QoL. Recognizing their fundamental importance, policymakers, healthcare professionals, and social service providers can support mechanisms to enhance these foundations, improving overall well-being for individuals and communities.

An exploratory study of resilience to stressful life events in autistic children

BackgroundAutistic children experience more stressful life events (SLEs) than their neurotypical peers, which are related to poor mental health outcomes in both neurotypical and autistic individuals. However, there is a lack of longitudinal research assessing the perceived impact of stressful life events on autistic children’s mental health. MethodUtilizing a novel statistical technique (Ratcliff et al., 2019), called ‘area of resilience to stress events’ or ARSE in R, we aimed to quantify aspects of resilience, growth, and non-resilience for 67 autistic children (6–13 years old) enrolled in a larger longitudinal study who experienced a SLE. Parents reported demographic information (e.g., child age, biological sex, household income) as well as the child’s internalizing and externalizing symptoms and autism characteristics across multiple time points spaced one year apart (baseline, T2, T3, T4). ResultsThere was substantial variability in the resilience process within the sample. Older children exhibited a less adaptive resilience process (i.e., higher total scaled scores or arsets). Perceived stress of the disruptive event was not correlated with resilience; however, there was a significant child age x stress severity interaction, suggesting that younger children in households that perceived the disruptive event as highly stressful exhibited more efficient resilience, or lower arsets scores, compared to other children. ConclusionsThis study introduces an innovative methodological approach to understanding the effects of stressful life events on the mental health of autistic children. Results have implications for family-based policy and practice and highlight for whom services may be most beneficial.

Leveraging adversity during pandemics: the role of adaptive cognitive appraisals of self and others in mental health outcomes among students

Researchers have paid limited attention to the role of adaptive cognitive appraisals in conferring resilience. In this study, we demonstrate the influence of positive appraisals of problem-solving ability and social support on mental health outcomes. A random sample of students at a university in South Africa ( n = 322) participated in the study. They completed the Perceived Stress Scale, the Multidimensional Scale of Perceived Social Support, the Problem-Solving Inventory, the Beck Hopelessness Scale, and the Satisfaction with Life Scale. Mediation analysis found that problem-solving appraisal and social support jointly and separately mediated the effects of perceived stress on hopelessness. The combined effect of social support and problem-solving appraisal on life satisfaction was significant; however, only social support was found to mediate the relationship between perceived stress and life satisfaction. The findings indicate that adaptive appraisals of self and others are potential sources of resilience that can buffer individuals from the adverse impact of stressful life events.

P38: A qualitative study on the impacts of stressful life events on the mental health of older adults in Colombia

Background:Many older adults in Colombia have lived through violent and stressful life events, particularly in areas of poverty where the problem of mental ill-health is commonly tigmatized in lower- and middle-income countries. The aim of this qualitative study was to understand the impact of stressful life events on the mental health and wellbeing of older Colombians living in areas of relative poverty.Methods:Older adults (aged 60+) living in the Turbo region in Colombia were interviewed face-to-face between August and December 2021. Participants were recruited via snowball sampling based on criteria of ethnicity, gender, age, and place of residence. Transcripts were coded in Spanish and English by at least two research team members, using inductive thematic analysis.Results:Twenty-six older adults participated in the study. Four overarching themes were generated: Living in violent and dangerous communities; Disturbing gender violence and gender roles; Lack of mental health awareness; Coping mechanisms. Older adults experienced a long narrative of stressful life events, from their youth into old age. Younger generations appeared to disrespect older members of Society, and participants witnessed a constant availability of around them – both interpersonal and within their neighbourhoods. Without any mental health support or awareness, older adults coped by merely accepting the extreme situations or seeking solace in their faith.Conclusions:The health system and Government need to build up trust in its institutions and generate an awareness of mental health, as older Colombians will not approach psychological support otherwise. Intergenerational community-based interventions embedded within neighbourhoods may provide a first avenue of mental health support.

Coping in the Face of Violence – a Qualitative Study on the Impacts of Stressful Life Events on the Mental Health of Older Adults in Colombia

ABSTRACT Background Many older adults in Colombia have lived through violent and stressful life events, particularly in areas of poverty. The aim of this qualitative study was to understand the impact of stressful life events on the mental health and wellbeing of older Colombians living in areas of relative poverty. Methods Older adults (aged 60+) living in the Turbo region in Colombia were interviewed face-to-face between August and December 2021. Transcripts were coded in Spanish and English by at least two researchers, using inductive thematic analysis. Results Twenty-six older adults participated in the study. Four overarching themes were generated: Living in violent and dangerous communities; Disturbing gender violence and gender roles; Lack of mental health awareness; Coping mechanisms. Older adults experienced a long narrative of stressful life events. Younger generations appeared to disrespect older members of Society. Without any mental health support, older adults coped by accepting the extreme situations or seeking solace in their faith. Conclusions The health system and Government need to build up trust and generate an awareness of mental health, as older Colombians will not approach psychological support otherwise. Intergenerational community-based interventions may provide a first avenue of mental health support.

The Perceived Stress Scale is essentially unidimensional: Complementary evidence from ancillary bifactor indices and Mokken analysis

Stress is a significant contributor to physical and mental health. However, there is considerable variability in response to stress, underscoring the role of stress perception in health outcomes. Perceptions of stress are influenced by socio-demographic and cultural factors. The Perceived Stress Scale (PSS) has been used extensively to assess stress among different populations and for cross-cultural comparisons. Given its wide-ranging application, the rigorous assessment of its psychometric properties is necessary to solidify its standing as a dependable measure. The scale was originally conceptualized as unidimensional but there has been controversy regarding its factor structure, leading to various factor models. Conclusions about the structure of the PSS were largely based on fit indices in confirmatory factor analysis and often did not go beyond fit indices. In addition, classical test theory indices are sample dependent and it is not surprising that instruments can exhibit different properties in different samples. Over reliance on fit indices can lead to overly simplistic interpretations of underlying dimensionality. Hence, the current study extends this research by using item response theory and examining ancillary bifactor indices to determine the amount of variance explained by the total scale and subscales. Participants were students (n = 322) at a South African institution who completed the PSS and a demographic questionnaire. Fit indices in confirmatory factor analysis indicated that a one-factor model, a bifactor model and a correlated-two factor model fit the data to an acceptable degree (GFI > 0.95, CFI > 0.90, RMSEA <0.08). Ancillary bifactor indices supported the essential unidimensionality of the scale as the two subscales accounted for 18.9 % and 17.2 %, of the variance, respectively, while the total scale accounted for 63.9 % of the variance. This was confirmed by Mokken analysis, which indicated that all the items loaded on one scale. The unidimensionality of the PSS suggests that it can be an effective clinical screening tool and that it is easily adaptable across different populations and contexts, enabling standardized comparisons. However, it may lose sensitivity to cultural differences in how stress is perceived and experienced. Hence, integrating the PSS with tailored assessments would facilitate a more robust and inclusive approach to stress assessment in various settings and populations. The study did not take specific sources of stress into account and was conducted among a distinct population group. Future studies undertaken among diverse populations and linking global stress with the impact of stressful life events are needed to further confirm our results and understand the interconnection between these factors.

How much stressful life events really matter? Conceptual and methodological difficulties in assessing the impact of self-reported events on adolescents' subjective stress.

Numerous studies have pointed to the strong impact of stressful life events on subjective stress and indirectly on the adolescents' mental health. However, the results of many such studies contain bias caused by the choice of measurement method or an incomplete theoretical framework. To estimate the extent of possible bias when using self-reports, we conducted research on a representative sample of 2201 Croatian adolescents aged 14-18years. Using manipulation we examined the influence of measurement method and the number of constructs included in the model on the variance of subjective stress explained by stressful events. Structural equation modelling indicated that different measurement methods, occurrence-based and severity-based, provide a marked discrepancy in the impact size estimation. The occurrence-based method provided estimates of a much smaller proportion of the explained variance (6%-25%) compared to the severity-based approach, which estimated the explained variance in the range of 25%-55% depending on the model. The complexity of the tested models additionally contributed to the variation in the estimates. It is recommended that when using self-reports to measure stressful life events, occurrence-based and severity-based methods are used simultaneously and that impact estimates are expressed within intervals.

Do Stressful Events and Racial Discrimination Explain Racial Gaps in Exclusive Breastfeeding Duration? A Qualitative Interview Study with Black, Hispanic, and White Mothers Living in Ohio.

This study aimed to understand why breastfeeding and exclusive breastfeeding rates substantially decrease shortly after birth among mothers in the USA. Specifically, we aimed to illuminate the impact of stressful life events and racial discrimination on mothers' breastfeeding behaviors and duration. We conducted a qualitative analysis of semi-structured telephone interviews with women (N = 66; 47 White, 16 Black, and 3 Hispanic) who gave birth between 2019 and 2021 in Ohio. Interviews were conducted between March 2022 and May 2022. Interviews were digitally recorded, transcribed verbatim, analyzed, coded, and organized into themes. After thematic analysis of the data, five key themes were identified: (1) stress, (2) breastfeeding barriers, (3) policy and system change to support breastfeeding mothers, (4) racial discrimination, and (5) breastfeeding motivators. Our study found that the breastfeeding experience was both a positive bonding experience and a challenging practice, characterized by physical, mental, and sociocultural struggles. Addressing stress during pregnancy, equitable access to culturally sensitive lactation support, improved parental leave, and enhanced workplace breastfeeding regulations are essential to increasing breastfeeding duration among racially marginalized women.

The Effects of Self-Criticism and Self-Compassion on Adolescents' Depressive Symptoms and Nonsuicidal Self-Injury.

Symptoms of depression increase during adolescence as do nonsuicidal self-injurious behaviors (NSSI). The present study aimed to investigate how self-criticism interacted with the effects of stressful life events on depressive symptoms and NSSI and whether self-compassion would buffer these negative effects. A total of 908 Chinese adolescents (Mage = 13.46, SD = 0.57) completed a cross-sectional survey. The main and interacted effects of stressful life events, self-criticism, self-compassion on depressive symptoms and NSSI were examined respectively. The results showed that self-criticism significantly moderated the relationships between stressful events and depression and NSSI. Self-compassion could buffer the negative impacts of stressful events and self-criticism on NSSI but not on depression. High self-compassion significantly reduced the magnitude of the association between stressful life events and NSSI in adolescents with low self-criticism but not in those with high self-criticism. Self-criticism exacerbated the negative impacts of stressful life events on both depressive symptoms and NSSI, but self-compassion only buffered the impact of stressful life events on NSSI. Interventions designed to reduce NSSI risk of Chinese adolescents may benefit from training them to improve self-compassion abilities and to be less self-critical.

What makes left-behind children resilient? And how? The role of hope on the resilience of Chinese left-behind children

Left-behind children (LBC) in China, of which there are 40 million, are a significant concern due to reported mental health issues including depression. Recent research has shown the negative correlation between resilience and the poor mental health outcomes of LBC, but the underlying mechanisms of this resilience have remained unclear. This study utilized the Risk and Resilience framework and conceptualized that resilience is an outcome of the absence of depressive symptoms when protective factors mitigate the negative impact of risk factors. This study examined whether protective factors were correlated with a reduction in the association between risk factors and LBC’s depressive symptoms, thereby contributing to LBC’s resilience. Participants were recruited from first and second-year middle school students in Henan province, aged 11–15 years (N = 841). Researchers delivered the questionnaires to the classrooms. Logistic regression analyses were conducted to examine the association between hope and depressive symptoms as well as to examine the moderating role of hope on the correlations between risk factors and depressive symptoms. The same analyses were stratified by gender. Hope was negatively correlated with LBC’s depressive symptoms. For males, there was a significant interaction between hope and stressful life events, but the interaction was not significant for females. The results suggest that LBC boys’ resilience can improve if hope mitigates the negative impact of stressful life events on LBC’s depressive symptoms.

656-P: COVID-19 Exposure and Perceived Impact Associated with Poor Psychosocial, Behavioral, and Physical Health

Aim: To describe the exposure and impact of COVID-19 in teens with T1D and associations with health outcomes. Methods: In the first month of an intervention trial to reduce distress in teens with T1D, COVID-19 emerged. Thus, in addition to planned surveys (Table), participants reported on COVID-19 exposure and perceived impact of the pandemic. Subscales assessed: 1) COVID-19 exposure - a tally of whether teen/important contact was diagnosed, hospitalized, or died, 2) Pandemic-impact - overall worry/feelings about the pandemic (range: 2-10), and 3) T1D-impact - pandemic effect on diabetes care (range: 13-65). Higher scores indicated more exposure or perceived impact. Pearson correlations described all associations. Results: Of the 172 teens (A1C M=8.7%±2.0%, 56% female, 73% White, 19% Hispanic), 50% reported no exposures, 23% reported 1, 24% 2-3, and 2% 4-7 exposures. Mean pandemic-impact score was 5.6±1.6 (range=2-10), while mean T1D-impact was 36.8±6.9 (range=18-54). Table summarizes associations of subscales with A1C and behavioral markers. Conclusions: COVID-19 exposure and perceived impact were consistently linked with worse psychosocial and behavioral metrics and A1C for teens with T1D. In particular, associations with T1D-impact were strong. These findings suggest the impact of stressful life events should be monitored within the context of T1D management. Disclosure J.Yi-frazier: None. M.Bradford: None. C.Zhou: None. A.Rosenberg: None. M.E.Hilliard: None. M.B.O'donnell: None. B.M.Ellisor: None. S.Garcia perez: None. F.Malik: None. Y.Rojas: None. D.Desalvo: Consultant; Dexcom, Inc., Research Support; Insulet Corporation. C.Pihoker: None. S.R.Scott: None. Funding National Institutes of Health (R01DK121224)

The Impact of Stressful Life Events on Suicidal Ideation in Gender Dysphoria: A Moderator Effect of Perceived Social Support.

Factors associated with suicidal ideation in the gender dysphoria population are not completely understood. This high-risk population is more likely to suffer stressful events such as assault or employment discrimination. This study aimed to determine the association of stressful events and social support on suicidal ideation in gender dysphoria and to analyze the moderator effect of social support in relation to stressful events and suicidal ideation. A cross-sectional design was used in a clinical sample attending a public gender identity unit in Spain that consisted of 204 individuals (51.7% birth-assigned males and 48.3% birth-assigned females), aged between 13 and 59 (M = 27.95years, SD = 9.58). A Structured Clinical Interview, a list of 16 stressful events, and a functional social support questionnaire (Duke-UNC-11) were used during the initial visits to the unit. The data were collected between 2011 and 2012. A total of 50.1% of the sample have had suicidal ideation. The following stressful events were associated with suicidal ideation: homelessness, eviction from home, and having suffered from physical or verbal aggression. Also, there was an inverse relation between perceived social support and suicidal ideation. There was a statistically significant interaction between a specific stressful event (eviction) and perceived social support. The study suggests that the promotion of safer environments could be related to lower suicidal ideation and that networks that provide social support could buffer the association between specific stressful events and suicidal ideation.

The Impact of Stressful Life Events after Bereavement: A Nationwide Cross-sectional Survey.

Bereaved family members sometimes experience distress due to stressful life events. However, the effects of this distress on depression and grief remain unclear. To clarify the degree of distress due to postbereavement stressful life events, its associated factors, especially social isolation, and its effects on major depressive disorder (MDD) and complicated grief (CG) risks among bereaved family members of patients with cancer. This cross-sectional questionnaire survey was conducted in 2018 as part of the J-HOPE4 study. We recruited 1740 bereaved family members of patients with cancer who died from July to August of 2018. We assessed distress due to postbereavement stressful life events with the Bereavement Secondary Stressor Scale, social isolation with the Lubben Social Network Scale Short-Form, and the MDD and CG risk with the Patient Health Questionnaire-9 and Brief Grief Questionnaire, respectively. Among the 913 (52.5%) respondents, 88%, 57%, 46%, 28%, and 19% experienced distress due to incidental tasks, daily life difficulties, financial problems, problems with other people, and deterioration of family relationships, respectively. More distress was associated with higher risks of MDD (odds ratio [OR]=2.5, P < 0.01) and CG (OR=2.5, P < 0.01). Social isolation and specific backgrounds were associated with more distress in response to stressful life events. Most family members experienced distress due to stressful life events, which were risk factors for MDD and CG. Assessing risk factors for maladaptation to post-bereavement life changes and enhancing readiness to adapt to them is important.

Longitudinal impact of stressful life events on HIV-related risk and psychosocial problems among MSM in Chennai and Mumbai, India.

Studies show that stressful life events (SLE) (e.g., discrimination, financial problems) can lead to psychosocial problems and exacerbate condomless anal sex (CAS) without protection via pre-exposure prophylaxis (PrEP) among men who have sex with men. However, few studies have examined this relationship among men who have sex with men in India, and none have examined this longitudinally. As a part of an HIV-prevention intervention, 608 MSM from Chennai and Mumbai, India, completed behavioral surveys at baseline, 4, 8, and 12months. We used longitudinal generalized estimating equations (GEE) modeling to examine the relationship between SLE and its severity and subsequent psychosocial problems, CAS, and history of diagnosed sexually transmitted infection (STI). All models are adjusted for age, sexual identity, intervention arm, human immunodeficiency virus status, and recruitment city. The number of SLE and their corresponding perceived impact score remained consistent at each time point. In multivariable GEE models, the number of SLE was predictive of CAS, depression, and harmful drinking. Similarly, the ratio of the impact of SLE was predictive of CAS, depression, and diagnosed STI. However, harmful drinking was not predictive in this model. These findings provide evidence that can inform future interventions, which can be used to enhance self-acceptance, coping skills, and other forms of resiliency.

Influence of social support and stressful life events on adherence to colorectal cancer screening using faecal occult blood test in Spanish medium risk population

IntroductionColorectal cancer (CRC) is the second cause of cancer-related deaths worldwide. Five-year survival rate in Spain is 57%. The most important prognostic factor is the stage of the tumor at the diagnosis. CRC can be early diagnosed, but the adherence to screening programs is low (<50%). This study aims to ascertain the influence of social support and stressful life events on the adherence to the population screening of CRC with fecal occult blood test in Spanish average risk population. MethodsMulticenter case–control study. We conducted a simple random sampling among individuals invited to participate in the colorectal cancer screening program. We analyzed epidemiological and social variables associated with lifestyle and behavioral factors. We performed a descriptive and a bivariant analyses and a logistic regression analysis. ResultsFour hundred and eight patients (237 cases and 171 controls) were included. Multivariant analyses showed independent association between higher adherence to the screening program and older age (OR: 1.06; 95% CI: 1.01–1.10), stable partner (OR: 1.77, 95% CI: 1.08–2.89) and wide social network (OR: 1.68; 95% CI: 1.07–2.66). Otherwise, lower adherence was associated to perceiving barriers to participate in the program (OR: 0.92; 95% CI: 0.88–0.96). We find a statistically significant association between lower adherence and high impact stressful life events in the bivariant analyses, and the tendency was maintained (OR: 0.63, 95% CI: 0.37–1.08) in the multivariant. ConclusionSocial variables decisively influence the adherence to colorectal cancer screening. The implementation of social interventions that improve social support, reduce impact of stressful life events and the design of screening programs that decrease the perceived barriers, will contribute to increase the participation on these programs. Secondary, the colorectal cancer diagnosis will be made in early-stages with the consequent mortality reduction.

The mediating effect of distress tolerance on the relationship between stressful life events and suicide risk in patients with major depressive disorder

BackgroundDespite widespread acknowledgment of the impact of stressful life events on suicide risk, the understanding of the psychological mechanisms underlying the relationship between stressful life events and suicide risk in major depressive disorder (MDD) remain unclear. This study aim to examine whether the distress tolerance mediates the relationship between the stressful life events and suicide risk in patients with MDD.MethodsA cross-sectional study was carried out among 125 Chinese patients with MDD, mean age was 27.05 (SD=0.68) and 68.8% were females. The 17-item Hamilton Depression Rating scale (HAMD-17), the validated Chinese version of the Mini International Neuropsychiatric Interview (MINI) suicide module, Life Events Scale (LES) and Distress Tolerance Scale (DTS) were utilized to evaluate depressive symptoms, stressful life events, levels of distress tolerance, and suicide risk, respectively. Mediation analyses was used to test the mediation effect of distress tolerance on the relationship between stressful life events and suicide risk.ResultsThe ratio of suicide risk in patients with MDD was 75.2%. Pearson correlation analysis showed that stressful life events were positively correlated with suicide risk(r=0.182, p<0.05). Stressful life events(r=-0.323, p<0.01) and suicide risk(r=-0.354, p<0.01) were negatively correlated with distress tolerance. Mediation analyses showed that the direct path from stressful life events to suicide risk was not significant (B= 0.012, 95% confidence interval (CI) [-0.017, 0.042]). Stressful life events affected suicide risk indirectly through distress tolerance (B= 0.018, 95% CI [0.007, 0.031]), and the mediating effect accounted for 60.0% of the total effect.ConclusionDistress tolerance completely played a mediating role between stressful life events and suicide risk. Further suicide prevention and intervention strategies should focus on increasing levels of distress tolerance in patients with MDD.