Mediating Effect Of Depression Research Articles

Pain and Cognition of Breast Cancer Survivors Treated with Chemotherapy: The Mediating Role of Depression

ObjectivesWhile chemotherapy is the primary contributor to cancer-related cognitive impairment (CRCI), interindividual differences in CRCI are not well-understood. Studies suggest that breast cancer (BC) survivors who are in pain are more likely to experience depression, which in turn contributes to CRCI, although this hypothesis is not yet tested. Therefore, this study aimed to investigate the relationship between pain and CRCI among BC survivors and the mediation effect of depression on this relationship. MethodsAs a secondary analysis of a descriptive cross-sectional study investigating fatigue and preferred types of fatigue self-management in BC survivors recruited from five tertiary hospitals in South Korea; of the 229 participants, data on 186 who received chemotherapy were analyzed. Study participants were aged between 20 and 69 years, diagnosed with stage I to III, and treated with chemotherapy and/or radiation therapy. Measurement was done with Korean versions of the Cognitive Failure Questionnaire (to assess CRCI), Brief Pain Inventory (for pain severity and interference on daily functioning), and C-ESD (for depression). To assess bivariate relationships between pain, depression, and CRCI, Pearson correlation was used. A mediation analysis was used to examine the effect of depression on CRCI. ResultsSignificant associations were found among pain, depression, and CRCI (all P < 0.01). Furthermore, a mediation effect of depression was found on the association between pain and CRCI (severity, β = 1.26, SE = 0.38, 95% confidence intervals [0.60, 2.08]; interference, β = 1.53, SE = 0.32, 95% confidence intervals [0.95, 2.20]). ConclusionFindings indicate that among BC survivors, those with higher pain tend to show higher depression and consequently had lower cognitive function. Implication for Nursing PracticeOncology nurses may need to identify BC survivors with higher pain, and screening those survivors could be a strategy to identify those at higher risk for CRCI. Also, nurses should focus on managing depression to prevent and/or treat CRCI in BC survivors.

The Relationship between Discrimination Victim Experience and Discriminatory Behavior among Elementary School Students: The Mediation Effect of Depression and the Moderated Mediation Effect of Perceived Respect for Human Rights

The Relationship between Discrimination Victim Experience and Discriminatory Behavior among Elementary School Students: The Mediation Effect of Depression and the Moderated Mediation Effect of Perceived Respect for Human Rights

다문화 청소년의 역경경험과 사회적 역량과의 관계: 우울의 매개효과와 지역사회 지지원의 조절된 매개효과

다문화 청소년의 역경경험과 사회적 역량과의 관계: 우울의 매개효과와 지역사회 지지원의 조절된 매개효과

Mediation Effect of Depression, Alcohol Consumption, and Household Food Insecurity to Intimate Partner Violence in Rural Counterparts of Dakshin Dinajpur District, West Bengal

Mediation Effect of Depression, Alcohol Consumption, and Household Food Insecurity to Intimate Partner Violence in Rural Counterparts of Dakshin Dinajpur District, West Bengal

The association between dual sensory loss and healthcare expenditure: Mediating effect of depression

BackgroundPrevious studies have suggested the dual sensory loss (DSL) is linked to depression, and that they are associated with higher healthcare expenditures, respectively. However, the association between DSL, depression and healthcare expenditures remains ambiguous. ObjectivesThe current study aims to examine the association between DSL, depression and healthcare expenditures as well as catastrophic health expenditures (CHE) among Chinese people aged 45 and above. MethodsWe first utilized the China Health and Retirement Longitudinal Survey (CHARLS) 2018 to obtain data from a total of 13,412 Chinese individuals aged 45 and above to conduct a cross-sectional study. DSL was defined as a combined variable of self-reported vision loss and hearing loss. Depression was measured using The Center for Epidemiologic Studies Depression Scale (CESD-10). The healthcare expenditures, including outpatient out-of-pocket cost and inpatient out-of-pocket cost, were obtained from the Harmonized CHARLS section. CHE were defined as out-of-pocket (OOP) health spending equal to or higher than 40 % of a household's capacity to pay. A Tobit linear regression with three models and a path analysis were conducted to estimate the association between DSL, depression and healthcare expenditures and CHE. Then we utilized 2011CHARLS and 2018CHARLS to present a longitudinal analysis. A path analysis was conducted to estimate the association between 2011DSL, 2018depression and 2018healthcare expenditures and CHE. ResultsDepression has a significant mediating effect between DSL and healthcare expenditures. (For outpatient OOP cost: a = 0.453, b = 23.559, c = 25.257, the proportion of mediating effect in total effect = 29.71 %; for inpatient OOP cost: a = 0.453, b = 13.606, c = 15.463, the proportion of mediating effect in total effect = 28.50 %; all P < 0.05). The mediating effect of depression also exists in the association between DSL and CHE (a = 0.453, b = 0.018, c = 0.043, the proportion of mediating effect in total effect = 15.90 %; P < 0.05). The mediation effect of depression on healthcare expenditures and CHE also exists in the longitudinal analysis using CHARLS 2011 and CHARLS 2018 (all P < 0.05). LimitationsThe DSL status were based on self-report and we used 2018CHARLS to conduct the study, which may cause some bias. ConclusionSignificant mediating effect of depression exists between DSL and higher healthcare expenditures and CHE. The mental health of elder people with DSL should be focused on, and we should have an overall viewpoint on the topic of healthcare expenditures and CHE.

Association between vitamin D, depression, and sleep health in the National Health and Nutrition Examination Surveys: a mediation analysis

ABSTRACT Objective: This study aimed to assess the association between vitamin D and sleep health and to investigate whether depression could mediate this relationship. Methods: A cross-sectional analysis was performed using the 2005–2014 US National Health and Nutrition Examination Survey (NHANES) data. The logistic regression models were conducted to evaluate association of serum vitamin D concentrations with sleep health and depression. Mediation analyses were conducted to investigate the mediated effects of depression on the association of vitamin D with sleep health. Results: In multivariate logistic models, vitamin D was found to be negatively associated with an increased risk of poor sleep health, with an odds ratio (OR) of vitamin D deficiency versus sufficiency was 1.256 (95% CI = 1.084–1.455). Additionally, univariate logistic models showed that vitamin D was also negatively associated with depression risk (vitamin D deficiency vs. sufficiency: OR = 1.699, 95% CI = (1.373–2.103). Further mediation analyses showed that the association of vitamin D with sleep health was mediated by depression, with the mediating effects of depression accounted for 44.56% of the total effects. Conclusion: Vitamin D affects sleep health directly and indirectly through depression. The results suggest that interventions increasing intake of vitamin D should be prioritized to promote sleep health of persons with or at risk of depression.

Serial mediation of the relationship between impulsivity and suicidal ideation by depression and hopelessness in depressed patients

BackgroundClose relationships have been observed among impulsivity, depression, hopelessness, and suicidal ideation in depressed patients. However, the precise mechanism that connects these psychological symptoms remains unclear. This study aims to explore the mediation effect of depression and hopelessness on the relationship between impulsivity and suicidal ideation in depressed patients.MethodsA total of 258 depressed patients were evaluated using the Hamilton Depression Scale, the Beck Hopelessness Scale, the Scale for Suicide Ideation, and the Barratt Impulsiveness Scale. A path analysis was afterwards performed to determine the specified relationships in the proposed model.ResultsThe relationship between impulsivity and suicidal ideation was found to be serially mediated by depression and hopelessness. The mediating effect of depression and hopelessness accounted for 26.59% of the total effect. Specifically, in the pathway from impulsivity to hopelessness, the mediating effect of depression accounted for 40.26%. Moreover, the relationship between impulsivity and suicidal ideation was mediated by hopelessness, with the mediating effect accounting for 12.41%. It is important to note that these relationships were observed to be independent of age and marital status. Furthermore, the proposed model demonstrated a good fit with the data.ConclusionsThis study identified a serial mediation pathway between impulsivity and suicidal ideation, mediated by depression and hopelessness. Our findings indicate that impulsivity indirectly influences suicidal ideation through its association with depression, which subsequently contributes to feelings of hopelessness. These results emphasize the importance of addressing symptoms of depression and hopelessness in the prevention and intervention efforts targeting individuals with depression. Additionally, monitoring and addressing impulsivity levels may also be crucial in reducing the risk of suicidal ideation among this population. These findings provide valuable insights for future preventive programs and interventions aimed at mitigating suicidal ideation in individuals with depression.

Effects of adverse childhood health experiences on cognitive function in Chinese middle-aged and older adults: mediating role of depression

BackgroundAdverse childhood experiences are critical factors in depression and cognitive decrease, but the effect of adverse childhood health experiences (ACHEs) on cognitive function and the role of depression have not been fully studied.MethodsData were taken from the China Health and Retirement Longitudinal Study (CHARLS) of 2014 and 2018. This study used indicators of situational memory ability and mental status to measure cognitive capacity. Besides analyzing the different types of ACHEs, scores for ACHEs were calculated to represent the severity of ACHEs. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to assess depression. The analysis of this study employed two different analytical strategies in order to examine the mediated effects of depression. We used Sobel’s test and Baron and Kenny’s causal step approach, which utilized a generalized least squares regression model. Furthermore, a logistic regression model was used to evaluate the robustness of the Karlson-Holm-Breen (KHB) approach.ResultsIn this study, 6301 individuals who met the requirements of the study were included. We found that being confined to bed (ACHE3) (β=-0.3846, p = 0.022) in childhood had a negative impact on cognitive function. Similarly, ACHEs had a negative effect on cognitive function (β=-0.0819, p = 0.090). And after the depression had been introduced into the model, the regression coefficient of ACHEs on cognitive function was no longer significant (β=-0.0170, p = 0.727). The Sobel test showed that for ACHE3, the mediated proportion of the total effect of depression was 36.92%. While for ACHEs, the proportion of the mediated effect of depression was 70.11%. Finally, a robustness test of the mediating effect using the KHB method revealed that the mediating effect still existed. Further, based on different gender, age, and educational levels, the heterogeneity test indicated that the relationship between ACHEs and cognitive function and mediating effects of the depression were different as well as passing the robustness test of the interaction.ConclusionThe decline in cognition had been shown to be correlated with ACHEs and depression mediated this relationship. Positive interventions might help to improve cognitive performance in individuals suffering from ACHEs and depression.

일개 대학 의학전문대학원생의 사회부과 완벽주의가 우울을 매개하여 학업소진에 미치는 영향

이 연구의 목적은 의학전문대학원생의 사회부과 완벽주의와 우울, 학업소진 간의 구조적 관계를 확인하고, 사회부과 완벽주의와 학업소진의 관계에서 우울의 매개효과를 검증하는 것이다. 이를 위해, K의학전문대학원/의과대학에 재학 중인 의학전문대학원생 159명을 대상으로 2022년 12월부터 2023년 1월까지 설문조사를 실시하였으며, 최종 분석 대상은 116명이었다. 주요 연구 결과는 다음과 같다. 첫째, 의학전문대학원생의 사회부과 완벽주의는 우울에 유의한 영향을 미치는 것으로 나타났다. 둘째, 의학전문대학원생의 사회부과 완벽주의는 학업소진에 유의한 영향을 미치는 것으로 나타났다. 셋째, 의학전문대학원생의 우울은 학업소진에 유의한 영향을 미치는 것으로 나타났다. 넷째, 의학전문대학원생의 사회부과 완벽주의와 학업소진의 관계에서 우울이 완전매개하는 것으로 나타났다. 즉, 의학전문 대학원생의 사회부과 완벽주의는 학업소진에 직접적인 영향을 미치지는 못하지만, 우울을 통해 학업소진에 간접적으로 영향을 미친다는 것이다. 이러한 결과는 사회부과 완벽주의 성향이 높은 의학전문 대학원생일수록 우울을 매개하여 학업소진 수준이 높을 수 있으므로, 심리상담을 통한 완벽주의 및 우울에 대한 인지행동적 개입, 학업소진 완화 프로그램 등 학생들을 위한 맞춤형 교육적 개입이 필요함을 시사한다.

Relationships between psychological flexibility and internet gaming disorder among adolescents: Mediation effects of depression and maladaptive cognitions.

Psychological flexibility may reduce addictive behaviours by adaptive and flexible emotional and cognitive processes. This study tested a mediation model of internet gaming disorder (IGD) in which psychological flexibility would reduce depression and maladaptive cognitions related to internet gaming and in turn lower the risk of IGD. A cross-sectional study surveyed 2102 secondary 1-4 students from seven schools during March to November 2021 in Hong Kong, China. The results showed that 12.7% and 52.2% of the students were classified as having probable IGD and depression, respectively. The proposed mediation model fitted the data well: χ2/df = 8.00, CFI = .99, NNFI = .99, RMSEA = .01. Psychological inflexibility was directly and positively associated with IGD (B = .01, β = .07, p = .003) and indirectly and positively associated with IGD via depressive symptoms (B = .01, β = .07, p = .001, PM = 23.7%) and maladaptive cognitions (B = .03, β = .15, p = .001, PM = 50.8%). Multi-group analyses showed that gender significantly moderated the associations between psychological inflexibility and maladaptive cognitions (Δχ2/Δdf = 8.69/1, p < .05), between maladaptive cognitions and IGD (Δχ2/Δdf = 4.33/1, p < .05), and between psychological inflexibility and IGD (Δχ2/Δdf = 5.46/1, p < .05). Depression and maladaptive cognitions may be significant mediators that could explain the relationship between psychological flexibility and IGD. Also, gender difference may exist. Based on the findings, intervention strategies for IGD reduction are discussed.

Influence of academic stress and school bullying on self-harm behaviors among Chinese middle school students: The mediation effect of depression and anxiety.

The purpose of this study was to explore the relationship between academic stress, school bullying and self-harm behaviors among Chinese middle school students and to further explore the impact of anxiety and depression on this relationship. The students (aged 12-16 years) in a middle school in Changsha city were invited to respond to a questionnaire through an online platform. The Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were used to assess the severity of anxiety and depressive symptoms, respectively. The experience of being bullied, academic stress, and self-harm behaviors were assessed using several questions on the basis of previous studies. A total of 1,313 middle school students completed the study, and 3.40% and 4.10% of them reported suicide attempts (SAs) and non-suicidal self-injury (NSSI), respectively. Univariate logistic regression analysis revealed that anxiety symptoms (OR = 1.23, 95% CI: 1.18-1.28; OR = 1.25, 95% CI: 1.19-1.31), depressive symptoms (OR = 1.20, 95% CI: 1.16-1.25; OR = 1.26, 95% CI: 1.20-1.31), school bullying (OR = 3.8, 95% CI: 2.11-6.89; OR = 2.76, 95% CI: 1.39-5.47), and academic stress (OR = 2.20, 95% CI: 1.27-3.80; OR = 3.80, 95% CI: 1.20-7.25) were common factors of NSSI and SAs. In addition, depressive symptoms showed a mediating effect on the association of school bullying and academic stress with SAs or NSSI, and anxiety symptoms showed a mediating effect on the association of school bullying and academic stress with NSSI only. Appropriate strategies are needed to reduce academic pressure and prevent school bullying. Meanwhile, negative emotions such as depression and anxiety should be evaluated and intervened in to prevent self-harm behaviors among middle school students.

Social distancing and trouble sleeping during COVID-19 pandemic among older adults in Europe: Mediating and moderating effects.

We examined the association between social distancing and trouble sleeping during the COVID-19 outbreak in adults 65+, and underlying potential mechanisms. We used data from the extensive Survey of Health, Aging, and Retirement in Europe (SHARE). Logistic regression analysis tested the direct and indirect associations between social distancing and trouble sleeping during the pandemic, the mediation effect of depression, and the moderating-mediation effects of perceived economic status and employment status. Social distancing was associated with a higher probability of sleeping problems, partially mediated by depression and moderated by employment status and perceived economic status. Depression had a greater effect on trouble sleeping among those unemployed and those who perceived their economic status as difficult or partially difficult. COVID-19 policy of lockdowns and physical distancing has negative consequences on sleeping and the development of depressive symptoms among older adults. Clinicians should be aware of sleep problems in older adults during the pandemic and after, and try to reduce depressive symptoms. Policymakers should determine future policies and regulations that encourage employment among older adults and improve their economic resilience during pandemics.

Effects of Fear of Coronavirus Disease 2019 and Social Distancing on Women's Suicidal Ideation: Mediating Effect of Depression

This study aimed to identify the mediating effects of depression amid the influence of fear and social distancing arising from Coronavirus disease 2019 (COVID-19) in Korean women's suicidal ideation. A descriptive correlation study was conducted. Study participants, recruited by Hankook Research from March 2 to March 5, 2021, included 300 women aged 19 to 49 living in South Korea, and 100 people were randomly allocated and enlisted for each age group out of 700,000 Hankook Research Panels recruited in advance from 17 cities and provinces nationwide. Data were collected through a self-reported questionnaire and analyzed using Pearson's correlation coefficient and Hayes' Process Macro Model 4 with 95% bias-corrected bootstrap confidence interval via SPSS statistics 27.0. Suicidal ideation was significantly correlated with fear of COVID-19 (r = .16, p = .006) and depression (r = .65, p < .001). The mediation effect of depression in the relationship between the fear of COVID-19 and suicidal ideation was found to be significant (B = 0.40, boot 95% CI: 0.21~0.61). However, social distancing did not significantly affect suicidal ideation via depression (B = -0.79, boot 95% CI: -1.94~0.26). It is necessary to develop and apply interventions to prevent depression and suicidal behaviors by continuously observing and reducing the negative psychological responses caused by COVID-19.

The Effect of Post-Traumatic Stress Disorders(PTSD) on Suicidal Ideation in Firefighters, the Mediation Effect of Depression, and the Moderated Mediation Effect of Resilience and Social Support

본 연구는 소방공무원의 외상 후 스트레스 장애가 자살생각에 미치는 영향을 규명하고 우울의 매개효과와 회복탄력성 및 사회적 지지의 조절된 매개효과를 분석함으로써 소방공무원의 자살 생각에 대한 효과적인 예방대책을 마련할 뿐만 아니라 추후 이들 분야의 기초자료를 제공하고 시사점을 도출하고자 시행되었다. 경남지역에 소속된 소방공무원을 대상으로 하였으며, 구글 설문지를 이용한 자기 기입식 설문 조사로 조사기간은 IRB승인 후 2020년 1월부터 약 1개월간 실시하였으며, 총 224부를 실증분석 자료에 이용하였다. 통계분석은 SPSS 26.0 및 SPSS PROCESS Macro, AMOS 24.0을 이용하여 분석하였다. 외상 후 스트레스 장애 요인 중 과각성, 침습, 수면장애/정서마비/해리는 우울에 유의한 정(+)의 영향을 미쳤으며 우울은 자살생각에 유의한 직접효과가 있었고 외상 후 스트레스 장애의 하위요인들은 자살생각에 직접효과가 없었다. 매개효과를 분석한 결과, 과각성과 자살생각 간의 인과관계에서 우울은 유의한 매개효과가 있었고, 수면장애/정서마비/해리와 자살생각 사이에 있어서도 우울은 유의한 매개효과가 있었다. 다만, 침습과 자살생각간의 인과관계에서는 우울이 경계역에서 유의한 매개효과가 있었다. 소방공무원의 외상 후 스트레스장애가 자살생각에 미치는 영향에 있어 우울의 매개효과가 있었으므로 외상 후 스트레스 장애가 있는 소방공무원의 경우 소방청에서 제시하고 있는 정신건강 지원 사업의 하나인 치료단계에서 건강정보 통합관리시스템, 치료비 지급 및 안심 프로그램을 적시에 적용함으로써 우울을 줄일 수 있는 것으로 생각되며 이에 따라 자살 생각을 감소시킬 수 있다고 판단될 뿐만 아니라, 본 연구로 추후 이들 분야에서 기초자료로 활용될 수 있을 것으로 생각된다.

The mediation effect of depression and alcohol use disorders on the association between post-traumatic stress disorder and obstructive sleep apnea risk in 51,149 Korean firefighters: PTSD and OSA in Korean firefighters

Background: Post-traumatic stress disorder (PTSD) is shown to be linked to a higher risk of obstructive sleep apnea (OSA). Firefighters are at high risk for PTSD given the increased exposure to trauma. However, the relationship between PTSD and OSA remains unclear in firefighters. Moreover, alcohol use disorders (AUDs) and depression – also common in firefighters – show a high comorbidity rate with both PTSD and OSA. The purpose of this study was to investigate the association of PTSD, depression, and AUDs with OSA in a national sample of Korean firefighters. Methods: A total of 51,149 Korean firefighters completed self-reported questionnaires, assessing the severity of PTSD, OSA, depression, and alcohol misuse. Multivariable logistic regression and mediation analyses were performed. Results: PTSD, depression, and AUDs were significantly associated with OSA. In the mediation analyses, PTSD had both direct and indirect effects mediated by depression and AUDs on OSA. Depression had both direct and indirect effects on OSA, with the latter mediated by AUDs. Limitations: First, high-risk of OSA was measured using the Berlin Questionnaire. Second, other medical comorbidities or mediation use were not considered. Third, self-report questionnaires were used for assessment, which are prone to subjectivity and recollection bias. Finally, the majority of the study population were male and all Korean, limiting generalizability. Conclusions: PTSD had both direct and indirect effects on OSA, mediated by depression and AUDs. In patients with both PTSD and OSA, depression and AUD symptoms should be screened routinely.

The Effect of Chronotype on Burnout among Shift and Non-Shift Workers: Mediation Effect of Depression and Stress Response Study

The Effect of Chronotype on Burnout among Shift and Non-Shift Workers: Mediation Effect of Depression and Stress Response Study

학교 밖 청소년이 인식하는 지역사회 무질서가 게임중독에 미치는 영향: 우울과 충동성의 이중매개효과를 중심으로

본 연구는 학교 밖 청소년이 인식하는 지역사회 무질서가 게임중독에 미치는 영향 및 우울과 충동성의 이중매개효과를 검증했다. 이를 위해 본 연구는 한국청소년정책연구원에서 수행한 학업중단 청소년 패널 조사의 1차년도 자료를 기반으로 2차 자료 분석을 실행하였다. 1차년도 조사를 진행할 당시에 학교를 중단한 상태였던 733명을 대상으로 PROCESS macro for SPSS의 모델 6을 활용하여 분석을 수행하였다. 분석의 결과는 첫째, 학교 밖 청소년이 인식하는 지역사회 무질서는 게임중독에 정적으로 유의미한 영향을 미쳤다. 둘째, 학교 밖 청소년의 우울이 지역사회 무질서가 게임중독에 미치는 영향을 매개했다. 셋째, 학교 밖 청소년의 충동성이 지역사회 무질서가 게임중독에 미치는 영향을 매개했다. 넷째, 학교 밖 청소년의 우울과 충동성이 지역사회 무질서가 게임중독에 미치는 영향을 이중매개했다. 본 연구의 결과를 기반으로 학교 밖 청소년의 게임중독을 다루기 위한 다양한 개입 방안을 논의했다.

청소년의 부모애착과 사이버비행과의 관계에서 우울, 공격성의 매개 효과

청소년의 부모애착과 사이버비행과의 관계에서 우울, 공격성의 매개 효과

학교 밖 청소년이 경험하는 사회적 낙인감이 생활 만족도에 미치는 영향: 우울감과 자아존중감의 이중매개효과를 중심으로

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