Longitudinal Mediation Analysis Research Articles

Pathways from adolescent screen time to eating related symptoms: a multilevel longitudinal mediation analysis through self-esteem

Objective Screen time and self-esteem have been shown to be important correlates of eating disorders in adolescence. However, there is an absence of longitudinal studies that distinguish between time-varying factors, accounting for parallel developmental changes and common underlying vulnerability. Design A total of 3,801 adolescents were administered self-report measures, annually, over the course of 5 years. The association of screen time (social media use, television watching, video gaming) on eating related symptoms was analyzed using a longitudinal Bayesian multilevel path analysis framework. Self-esteem was examined as a mediating factor in this model. This study investigated direct and indirect associations at between-person, concurrent within-person, and lagged-within-person levels, while controlling for gender. Results The findings revealed that all types of screen time exposure were significantly associated with eating related symptoms at between and within-person levels. A significant association at the lagged-within person level was only revealed for social media use. Self-esteem was found to be a significant mediating factor between screen time and eating related symptoms. Conclusion An increase in social media use one year was associated with increased of eating related symptoms two years later through lower self-esteem. Implications for prevention are discussed.

Keeping up with this workload is difficult: the ramifications of work overload on career resilience

PurposeA paradigm shift toward a corporate model of higher educational settings has led to complex and excess work demands, yet the potential long-run ramifications of work overload are still under-examined. Building the arguments on the “spiral of resource loss” corollary of the conservation of resources (COR) theory, the authors have bridged this gap by testing how work overload spills over into career resilience via reduced harmonious passion. In addition, the authors compare how the employees having standardized workloads differ in their harmonious passion and career resilience from those having excessive (non-standardized) workloads.Design/methodology/approachThrough a longitudinal natural field experiment of 402 faculty members [N = 198 in the standardized group (optimal load) and N = 204 in the non-standardized group (overload)] working in higher educational institutions of Pakistan, data were collected in three waves (each six months apart). The group comparison, trend analysis and longitudinal mediation analysis done through SPSS and MPlus affirmed the hypothesized associations.FindingsThe results have shown that work overload impacts career resilience through the mediating role of harmonious passion. The faculty members in the standardized workload had more passion and career resilience as compared to the non-standardized workload group. In addition, these impacts intensified overtime for the overloaded faculty members while faculty members with optimal workload sustained their passion and resilience for the teaching profession.Originality/valueTaking the COR perspective, this study sheds light on how faculty members' work overloads reduce their capability to retain their passion and resilience for teaching from a longitudinal and experimental perspective.

Wellness of patients with chronic pain is not only about pain intensity.

Attaining good outcomes in the management of chronic pain remains a clinical challenge. This study aimed to investigate the relationships between - and the contribution of - pain and related conditions to the wellness of these patients. A secondary analysis of database of patients with chronic pain treated with medical cannabis (MC) to carry out a one-year prospective follow-up study was conducted. Questionnaires were completed before (T0 ), six (T6 ), and twelve (T12 ) months after MC initiation. Data included patients' demographics and questionnaires related to three latent factors: pain intensity measures, related conditions (catastrophizing, sleep disturbance, anxiety, and depression), and wellness parameters (quality-of-life, disability, subjective-health-state). Weighted average of the observed variables (WOBs) were calculated for each latent factor. Longitudinal structural equation modeling (SEM) and mediation analyses were performed to identify predictors and interrelations between the WOBs, respectively. Participants included 510 patients. All variables were significantly improved from T0 to T6 and T12 . SEM revealed that related conditions, and to a lesser extent pain, predicted wellness at T0 , T6 , and T12 (related conditions: β0 =0.55, p < 0.001; β6 =0.54, p < 0.001; and β12 =0.51, p < 0.001; pain: β0 =0.42, p < 0.001; β6 =0.18, p < 0.001; and β12 =0.25, p < 0.001). Mediation analyses demonstrated that the effect of WOB-related conditions was greater than WOB-pain on wellness. Wellness of patients with chronic pain can be determined not only by pain itself but even more so by the severity of related conditions. Thus, considering a broad spectrum of pain measures and related conditions seems relevant for improving the wellness of patients with chronic pain.

Physical activity partly mediates the association between cognitive function and depressive symptoms

Cognitive function, physical activity, and depressive symptoms are intertwined in later life. Yet, the nature of the relationship between these three variables is unclear. Here, we aimed to determine which of physical activity or cognitive function mediated this relationship. We used large-scale longitudinal data from 51,191 adults 50 years of age or older (mean: 64.8 years, 54.7% women) from the Survey of Health, Ageing and Retirement in Europe (SHARE). Results of the longitudinal mediation analyses combined with autoregressive cross-lagged panel models showed that the model with physical activity as a mediator better fitted the data than the model with cognitive function as a mediator. Moreover, the mediating effect of physical activity was 8–9% of the total effect of cognitive function on depressive symptoms. Our findings suggest that higher cognitive resources favor the engagement in physical activity, which contributes to reduced depressive symptoms.

Family Structure and Family Climate in Relation to Health and Socioeconomic Status for Older Adults: A Longitudinal Moderated Mediation Analysis.

Family characteristics are associated with individuals’ health and wellbeing. However, the link between family structure (e.g., operationalized via marital status) and health outcomes is ambiguous, and whether family climate mediates the relationship is unclear. This study uses the Biobehavioral Family Model (BBFM) to investigate the association of older adults’ family structure with later health, the mediating role of family climate and mental health and how these links vary by socioeconomic status (SES). Using data from n = 29,457 respondents aged over 50 in Waves 4, 5 and 6 (2011, 2013 and 2015) of the Survey of Health, Retirement and Ageing in Europe (SHARE), the BBFM was applied in a longitudinal mediation analysis of family structure and health, including both indicators of mental and physical health. Structural equation modeling was applied, and a multigroup analysis was performed to test the role of SES in a moderated mediation. Family climate and mental health mediated the relationship between family structure and subsequent physical health. Good levels of family climate were found to be consistently associated with improved mental and physical health. These relationships were significantly moderated by SES, showing that the association of family climate and health was weaker for those in low SES positions. Family climate and mental health should be considered as potential mechanisms linking family structure to later physical health outcomes across time; however, these associations are diminished for those with low SES.

Does body appreciation predict decreases in eating pathology via intuitive eating? A longitudinal mediation analysis

Evidence suggests that body appreciation may be a protective factor for eating pathology. However, potential explanatory mechanisms for this association are unclear, as longitudinal studies testing mediational pathways are missing. This longitudinal study tested whether intuitive eating mediates the association between body appreciation and eating pathology. Data were analyzed from 3039 women recruited from an educational platform about disordered eating, many of whom exhibited elevated symptomatology. Measures were administered at baseline (T1), four-month (T2) and eight-month (T3) follow-up. Path analyses were computed to test hypothesized indirect effects. Direct paths from T1 body appreciation to T2 intuitive eating (total and subscale scores) and T3 eating pathology/binge eating were observed. However, only one significant indirect effect emerged: higher T1 body appreciation scores predicted greater decreases in T3 eating pathology and binge eating via its effect on increasing T2 Unconditional Permission to Eat (UPE) subscale scores. Findings suggest that the features of the UPE construct (e.g., eating foods that are desired in a given moment, refusal to dichotomize foods as “good” or “bad,” etc.) may be important mechanisms explaining how and why body appreciation protects against eating pathology. Efforts should be made to enhance body appreciation and intuitive eating in eating disorder prevention programs.

Time lags and time interactions in mixed effects models impacted longitudinal mediation effect estimates

ObjectivesLongitudinal mediation effects can be estimated with mixed effects models. Mixed effects models are versatile, as they accommodate the estimation of contemporaneous, lagged, time-independent, and time-dependent effects. However, the inclusion of time lags and time interactions in mixed effects models for longitudinal mediation analysis has received little attention. This article demonstrates how time lags and time interactions in mixed effects models affect the interpretation of longitudinal mediation effect estimates. Study Design and SettingWe used a data example from the Amsterdam Growth and Health Longitudinal Study to illustrate how the inclusion of time lags and time interactions in mixed effects models may affect the size and interpretation of longitudinal mediation effect estimates. ResultsThe chosen time lags between the determinant, mediator, and outcome influenced the size and interpretation of the mediation effect estimates. Furthermore, time interactions can be used to model linear or nonlinear development of the mediation effects over time. ConclusionThe inclusion of time lags and time interactions should be considered when estimating longitudinal mediation effects based on mixed effects models, as this enables the estimation of lagged and time-dependent effects.

The Mediating Effect of Maternal Wellbeing on the Association between Neighborhood Perception and Child Wellbeing: A Longitudinal Investigation.

Negative perceptions of one's neighborhood are linked to poor mental and physical health. However, it is unclear how caregiver's neighborhood perception affects health outcomes in children. This study assessed the mediating effect of maternal wellbeing on the association between neighborhood perception and child wellbeing at different time points and overall. A structural equation model (SEM) was used to evaluate whether maternal wellbeing mediates the influence of neighborhood perception on child wellbeing at different ages. The Fragile Families and Child Wellbeing Study data from years 3, 5, and 9 was analyzed. The delta method evaluated the mediation effect of maternal wellbeing, controlling for mothers' age. Direct and indirect effects of neighborhood perception at year 3 on child wellbeing at year 9 via maternal wellbeing at year 5 were analyzed via a longitudinal mediation with a two time points lag. Maternal wellbeing partially mediated the effect of neighborhood perception on child wellbeing at different ages. Longitudinal mediation analyses revealed that better neighborhood perception at year 3 improved maternal wellbeing at year 5 and child wellbeing at year 9; maternal wellbeing at year 5 partially mediated the effect of neighborhood perception at year 3 on child wellbeing at year 5. Our findings suggest that it may be beneficial for mental health practitioners to discuss relationships between neighborhood environment and wellbeing with caregivers, with a focus on reframing negative self-perceptions. Future research should evaluate longitudinal relationships between changes in neighborhood infrastructure and corresponding wellbeing in caregivers and children.

No more career resilient and passionate! A longitudinal experimental insight into work overload

Complex and excess work demands are a byproduct of corporate model in higher educational settings, however, how work overload manifests in long-run career outcomes is yet to be examined. We therefore built on the ‘primacy of resource loss’ corollary of the Conservation of Resources theory to find out the repercussions of work overload on career resilience via reduced harmonious passion. We conducted a longitudinal natural field experiment of 402 faculty members (N=198 in the standardized group (optimal load) and N= 204 in the non-standardized (overload) group working in Higher Educational Institutions in Pakistan. Data were collected in three waves (six months apart). The analysis was performed through group comparisons, trend analysis, and longitudinal mediation analysis, using SPSS and MPlus. Our findings suggest that, as opposed to the much-held conception of harmonious passion and career resilience as buffering resources to sustain work overload, these rescores are also depleted by the same phenomenon. Based on these results, we suggest that faculty members should be given optimal workload to retain their passion and resilience for teaching.

A tool or a social being? A dynamic longitudinal investigation of functional use and relational use of AI voice assistants

This study integrates two lines of research: technologies as tools and technologies as social beings, under the theoretical framework of dynamic systems, to investigate the reciprocal dynamics between functional use and relational use of artificial intelligence (AI) voice assistants, and the mediating roles of self-disclosure and privacy concerns. A two-wave longitudinal survey was conducted among 354 AI voice assistant users across 2 months. Factor analysis results supported the conceptualization and operationalization of functional use and relational use of voice assistants. Results from the cross-lagged panel model confirmed that functional use and relational use reinforced themselves over time, respectively. Relational use increased subsequent functional use, and relational use reinforced itself through self-disclosure. Surprisingly, functional use did not increase subsequent relational use; instead, longitudinal mediation analysis showed that functional use reduced subsequent relational use due to the lack of self-disclosure. Furthermore, while self-disclosure increased subsequent privacy concerns, privacy concerns did not reduce subsequent self-disclosure.

Why Sleep is Key: Poor Sleep Quality is a Mechanism for the Bidirectional Relationship between Major Depressive Disorder and Generalized Anxiety Disorder Across 18 Years

BackgroundGeneralized anxiety disorder (GAD) and major depressive disorder (MDD) reliably precede and predict one another. However, there is insufficient data on mediators through which the longitudinal GAD-MDD association unfold. Based on insomnia theories, such as the hyperarousal model of sleep, we tested the degree to which poor global sleep quality functioned as a mediator of the prospective bidirectional anxiety-depression relationship. MethodParticipants were 3,294 community-dwelling adults who partook in three measurement waves nine years apart. The Composite International Diagnostic Interview-Short Form assessed GAD and MDD in-person at baseline (Time 1 [T1]), Time 2 (T2; nine years after T1), and 18 years later (T3). T2 global sleep quality was measured using the multiple-domain Pittsburgh Sleep Quality Index self-report at T2. We used longitudinal structural equation modeling mediation analyses. ResultsAnalyses showed that higher T1 MDD and GAD severity individually predicted lower T2 global sleep quality (Cohen’s d = −0.561 to −0.480) and less T2 global sleep quality, thereby forecasted both higher T3 MDD and GAD (d = −0.275 to −0.190). Poorer T2 global sleep quality significantly mediated the T1 GAD–T3 MDD relation, explaining 41% of the association. Worse global sleep quality at T2 also significantly mediated the T1 MDD–T3 GAD association, mediating 11% of the T1 MDD–T3 GAD pathway. The results remained similar after controlling for multiple sociodemographic and clinical variables. Conclusions: Findings offer evidence for transdiagnostic theories of sleep and insomnia. Theoretical and clinical implications, such as prioritizing sleep improvement in cognitive-behavioral therapies, are also discussed.

Associations of DNA Methylation With Behavioral Problems, Gray Matter Volumes, and Negative Life Events Across Adolescence: Evidence From the Longitudinal IMAGEN Study

BackgroundNegative life events (NLEs) increase the risk for externalizing behaviors (EBs) and internalizing behaviors (IBs) in adolescence and adult psychopathology. DNA methylation associated with behavioral problems may reflect this risk and long-lasting effects of NLEs. MethodsTo identify consistent associations between blood DNA methylation and EBs or IBs across adolescence, we conducted longitudinal epigenome-wide association studies (EWASs) using data from the IMAGEN cohort, collected at ages 14 and 19 years (n = 506). Significant findings were validated in a separate subsample (n = 823). Methylation risk scores were generated by 10-fold cross-validation and further tested for their associations with gray matter volumes and NLEs. ResultsNo significant findings were obtained for the IB-EWAS. The EB-EWAS identified a genome-wide significant locus in a gene linked to attention-deficit/hyperactivity disorder (ADHD) (IQSEC1, cg01460382; p = 1.26 × 10−8). Other most significant CpG sites were near ADHD-related genes and enriched for genes regulating tumor necrosis factor and interferon-γ signaling, highlighting the relevance of EB-EWAS findings for ADHD. Analyses with the EB methylation risk scores suggested that it partly reflected comorbidity with IBs in late adolescence. Specific to EBs, EB methylation risk scores correlated with smaller gray matter volumes in medial orbitofrontal and anterior/middle cingulate cortices, brain regions known to associate with ADHD and conduct problems. Longitudinal mediation analyses indicated that EB-related DNA methylation were more likely the outcomes of problematic behaviors accentuated by NLEs, and less likely the epigenetic bases of such behaviors. ConclusionsOur findings suggest that novel epigenetic mechanisms through which NLEs exert short and longer-term effects on behavior may contribute to ADHD.

Salivary Biomarkers as Predictors of Obesity and Intermediate Hyperglycemia in Adolescents.

IntroductionChildhood obesity presents a major risk for metabolic diseases in adulthood. Noninvasive methods are needed for predicting the course of obesity in children and its complications. Using blood for longitudinal analyses of biomarkers to predict disease in children is not a convenient method. Saliva presents a noninvasive platform to detect inflammatory changes in biomarkers as possible predictive measures of future pathological events.ObjectivesThe aim of this study was to evaluate the relationship between specific salivary biomarkers, obesity, and intermediate hyperglycemia in children. We also investigated the longitudinal association between the salivary biomarkers and change in Body Mass Index-for-age percentile scores (BMIz).MethodsData on 353 adolescents were collected from the individuals recruited for seven years in an ongoing Kuwait Healthy Life Study cohort. BMIz was measured at 10, 12, and 17 years of age. Interleukin (IL)-6, IL-8, IL-10, Leptin, C-Reactive Protein (CRP), Insulin, Vascular Endothelial Growth Factor (VEGF), and Monocyte Chemoattractant Protein-1 (MCP-1) were measured in saliva and serum. Additionally, fasting blood plasma glucose levels were recorded. Multilevel longitudinal regression modeling, mediation analyses, and logistic regression were used to determine the predictive value of salivary biomarkers in obesity and hyperglycemia.ResultsLongitudinal analyses showed that with each one-unit increase of salivary CRP and insulin, there was a 3.5 kg/m2 and 3.2 kg/m2 increase in BMIz, respectively. Comparable to serum CRP and insulin, higher salivary CRP and insulin OR 4.94 [95%CI: 1.66,14., OR 2.64 [95%CI: 1.09, 6.38], respectively) were predictive of hyperglycemia and obesity (OR 4.53 [95%CI: 2.40,8.50], OR 3.29 [95%CI: 1.82,5.97], respectively). Insulin was a strong mediator in the relationship between obesity and hyperglycemia.ConclusionOur findings demonstrated that salivary CRP and insulin were associated with hyperglycemia, obesity, and possibly diabetes in adolescents. Salivary biomarkers are a noninvasive approach with significant value for disease risk assessment and prevention.

Adverse childhood experiences, sleep problems, low self-control, and adolescent delinquency: A longitudinal serial mediation analysis.

Several studies link adverse childhood experiences (ACEs) to delinquency. Yet, developmental sequalae accounting for this association remain unclear, with previous research limited by cross-sectional research designs and investigations of singular mediating processes. To redress these shortcomings, this study examines the longitudinal association between ACEs and delinquency as mediated by both sleep problems and low self-control, two factors which past research implicates as potentially important for understanding how ACEs contribute to antisocial behavior. Data collected from 480 adolescents (71.3% boys; 86.3% White) and their parents participating in the Michigan Longitudinal Study was used to conduct a serial mediation analysis. The association between ACEs (prior to age 11) and delinquency in late adolescence was found to operate indirectly via sleep problems in early adolescence and low self-control in middle adolescence. Nonetheless, a direct association between ACEs and later delinquency remained. Pathways through which ACEs contribute to later delinquency are complex and multiply determined. Findings indicate that early behavioral interventions, including improving sleep and self-control, could reduce later delinquency. Still, more research is needed to identify additional avenues through which the ACEs-delinquency association unfolds across development.

Longitudinal mediation analysis of time-to-event endpoints in the presence of competing risks.

This proposal is motivated by an analysis of the English Longitudinal Study of Ageing (ELSA), which aims to investigate the role of loneliness in explaining the negative impact of hearing loss on dementia. The methodological challenges that complicate this mediation analysis include the use of a time-to-event endpoint subject to competing risks, as well as the presence of feedback relationships between the mediator and confounders that are both repeatedly measured over time. To account for these challenges, we introduce path-specific effect proportional (cause-specific) hazard models. These extend marginal structural proportional (cause-specific) hazard models to enable effect decomposition on either the cause-specific hazard ratio scale or the cumulative incidence function scale. We show that under certain ignorability assumptions, the path-specific direct and indirect effects indexing this model are identifiable from the observed data. We next propose an inverse probability weighting approach to estimate these effects. On the ELSA data, this approach reveals little evidence that the total effect of hearing loss on dementia is mediated through the feeling of loneliness, with a non-statistically significant indirect effect equal to 1.01 (hazard ratio (HR) scale; 95% confidence interval (CI) 0.99 to 1.05).

Reexamining Causal Order between Job satisfaction and Performance: Longitudinal Mediation Analyses with Latent Growth Modeling

조직 학자들 사이에서 직무 만족이 조직 성과를 예측한다는 암묵적인 믿음이 존재해 왔다. 하지만 과연 그 믿음이 사실인지, 그 반대의 인과 관계가 존재하는 것은 아닌지에 대한 의문이 제기되어 왔다. 본 연구에서는 이 의문을 해결해 보기 위하여 192개 기업을 대상으로 세 시점의 종단 자료를 가지고 조직 수준에서 검증하였다. 특히, 본 연구에서는 조직 성과가 직무 만족을 예측한다는 가설을 설정하였다. 이를 검증하고자 구조 방정식 모형을 통해 직무 만족과 조직 성과 사이에 가능한 세 가지 인과 관계 모형(기본 인과 모형, 역 인과 모형, 상호 인과 모형)을 비교 검증한 결과, 역 인과 모형의 적합도가 가장 높았다. 또한 오직 조직 성과에서 직무 만족으로 연결되는 경로의 계수들만이 통계적으로 유의하였다. 이에 더해서, 조직 성과가 직무 만족을 향상시키는 구체적인 작동 기제(매개 변인)을 파악하고자 했다. 이를 위해 조직 성과가 인적 자원 관리 시스템 수준을 향상시켜서(매개로 하여) 직무 만족을 증가시킨다는 잠재 성장 모형을 검증하였고, 유의한 결과를 도출하였다. 위의 결과에 대해 그 함의와 한계점에 대해 논의하였다.

The effect of self-management online modules plus nurse-led support on pain and quality of life among young adults with irritable bowel syndrome: A randomized controlled trial

BackgroundIrritable bowel syndrome is a chronic pain condition that needs life-long self-management. However, the effect of self-management among young adults with irritable bowel syndrome is limited. ObjectivesThis study aimed to examine the effect of a nurse-led self-management program on pain, symptoms, and quality of life among young adults with irritable bowel syndrome. DesignA randomized controlled trial. Settings and participantsEighty young adults with irritable bowel syndrome recruited from two campuses of a public university and two gastrointestinal clinics were randomly assigned into a self-management online education and learning modules alone group (Online Modules, n = 41) or a nurse-led one-to-one consultation plus self-management online education and learning modules group (Nurse-Led Online Modules, n = 39). Twenty-one healthy controls were also recruited from these two campuses. MethodsBoth the intervention groups received ten online modules after baseline data collection. Participants in the Nurse-Led Online Modules group received additional three nurse-led one-to-one consultations at baseline, 6- and 12-week follow-ups. Self-reported pain, symptoms, quality of life, self-efficacy for managing chronic disease, and coping were measured at baseline, and 6- and 12-week follow-ups among the participants with irritable bowel syndrome. The healthy controls completed data collection of pain and symptoms at baseline and the 12-week follow-up. The intervention effects across study time points and the comparisons between the two interventional groups were analyzed using linear mixed models. A longitudinal mediation analysis was also conducted to explore the mediation effects of self-management mechanisms of the interventions. ResultsBoth the intervention groups showed significant interventional effects on decreasing pain intensity and pain interference and increasing quality of life at the 12-week follow-up (all p < 0.05). At the 12-week follow-up, the Nurse-Led Online Modules significantly reduced anxiety (p = 0.016) and had a significant greater improvement in quality of life than the Online Modules (p = 0.040). Increased self-efficacy mediated the intervention effect of the Nurse-Led Online Modules group on reducing pain interference and improving quality of life, while the effect of the Online Modules was mediated through decreasing inefficient coping strategy-catastrophizing. ConclusionsThis study showed that both the pain self-management online education and nurse-led intervention were effective for alleviating pain and improving quality of life among young adults with irritable bowel syndrome by targeting the self-management process. The nurse-led intervention had a better outcome than the online education alone in improving quality of life. Registration numberNCT03332537.

Prospective examination of adolescent emotional intelligence and post-traumatic growth during and after COVID-19 lockdown

ObjectivesWhile there have been some studies examining the post-traumatic growth (PTG) responses to the COVID-19 pandemic, few have been longitudinal studies exploring the changes over time or examining the underlying psychological PTG mechanisms. This study examined whether baseline perceived emotional intelligence (EI) predicted PTG through self-esteem and emotional regulation (ER) in a five-month follow-up study conducted on Chinese adolescents during the COVID-19 pandemic. MethodsValidated measures were completed by 2090 participants, which assessed both the perceived EI and the PTG 1 month after a nationwide lockdown in China, with 1609 of these participating in the follow-up five months later. Structural equation models (SEM) were then used to explore the paths between the variables. ResultsAs hypothesized, the follow-up survey found that the baseline perceived EI predicted PTG, ER, and self-esteem outcomes. The SEM analyses also revealed that self-esteem and ER significantly mediated the association between EI and PTG. LimitationsStudies of three or more waves may be more suitable for longitudinal mediation analyses. Self-assessment reports may have subjective effects. ConclusionsIt was concluded that perceived EI might improve PTG in adolescents following the COVID-19 pandemic, and self-esteem and ER program training could be helpful in promoting PTG.

Integrating the Interpersonal Theory of Suicide Into the Relations Between Cyber-Victimization and Suicidality Among Adolescents: A Short-Term Prospective Study

The relation between cyber-victimization and suicidality among adolescents has been well documented; however, the mechanisms underlying this association have not been well investigated. Drawing upon the interpersonal theory of suicide, this study aimed to examine the mediating mechanisms (i.e., thwarted belongingness and perceived burdensomeness) underlying longitudinal, bidirectional relations between cyber-victimization and suicidal ideation/attempts among adolescents and explore gender differences in the mechanisms. Participants were 497 Chinese adolescents (46.1% male; Mage = 13.28, SD = .66), who completed the assessment of cyber-victimization, thwarted belongingness, and perceived burdensomeness, suicidal ideation/attempts at three-time points. The time interval between each two assessments is two weeks. Results showed the reciprocal relations between cyber-victimization and thwarted belongingness/perceived burdensomeness, between thwarted belongingness and suicidal ideation/suicide attempts, and between perceived burdensomeness and suicide attempts. Longitudinal mediation analyses indicated that Time 2 thwarted belongingness mediated the relation between Time 1 cyber-victimization and Time 3 suicidal ideation/suicide attempts. Besides, the reverse pathway from Time 1 suicidal ideation to Time 3 cyber-victimization was also mediated by Time 2 thwarted belongingness, but it was only significant in females, as suggested by multiple-group analyses. According to the aforementioned results, the interpersonal theory of suicide provides a useful framework for understanding relations between cyber-victimization and suicidality. Findings suggest that intervention targeted at improving the need to belong may help reduce suicide risk and lower cyber-victimization. Anti-cyber-victimization should be integrated into suicide intervention and prevention programs, and gender differences should be taken into account in order to enhance the program's effectiveness.

Integrating the Interpersonal Theory of Suicide Into the Relations Between Cyber-Victimization and Suicidality Among Adolescents: A Short-Term Prospective Study.

The relation between cyber-victimization and suicidality among adolescents has been well documented; however, the mechanisms underlying this association have not been well investigated. Drawing upon the interpersonal theory of suicide, this study aimed to examine the mediating mechanisms (i.e., thwarted belongingness and perceived burdensomeness) underlying longitudinal, bidirectional relations between cyber-victimization and suicidal ideation/attempts among adolescents and explore gender differences in the mechanisms. Participants were 497 Chinese adolescents (46.1% male; Mage = 13.28, SD = .66), who completed the assessment of cyber-victimization, thwarted belongingness, and perceived burdensomeness, suicidal ideation/attempts at three-time points. The time interval between each two assessments is two weeks. Results showed the reciprocal relations between cyber-victimization and thwarted belongingness/perceived burdensomeness, between thwarted belongingness and suicidal ideation/suicide attempts, and between perceived burdensomeness and suicide attempts. Longitudinal mediation analyses indicated that Time 2 thwarted belongingness mediated the relation between Time 1 cyber-victimization and Time 3 suicidal ideation/suicide attempts. Besides, the reverse pathway from Time 1 suicidal ideation to Time 3 cyber-victimization was also mediated by Time 2 thwarted belongingness, but it was only significant in females, as suggested by multiple-group analyses. According to the aforementioned results, the interpersonal theory of suicide provides a useful framework for understanding relations between cyber-victimization and suicidality. Findings suggest that intervention targeted at improving the need to belong may help reduce suicide risk and lower cyber-victimization. Anti-cyber-victimization should be integrated into suicide intervention and prevention programs, and gender differences should be taken into account in order to enhance the program's effectiveness.