The mediating effect of life satisfaction and the moderated mediating effect of social support on the relationship between depression and suicidal behavior among older adults

A systematic review of psychosocial protective factors against suicide and suicidality among older adults

BACKGROUND

Research on suicide rarely focuses on protective factors. The goal of this systematic review was to assess the evidence of the associations between protective factors and reduced suicidality among older adults.

METHOD

First, a scoping review was conducted to identify pertinent terms that refer to various protective factors against suicidality. A systematic review, following the PRISMA guidelines, was then conducted on a selection of 15 protective factors (e.g., perceived control, well-being and quality of life, life satisfaction, purpose-in-life, resilience, coping, religiosity, hope, self-regulation, sense of belonging, mattering, positive relationship, social support, social connectedness, and social participation), with separate searches performed on each factor in five databases. Empirical studies were eligible if participants were adults aged 60 years and over, and if the studies reported predictive statistical analysis.

RESULTS

A total of 70 studies were retained for the review. Suicidal ideation was the main outcome measure (91%). Significant associations were consistently observed between all protective factors and reduced suicidal ideations or behaviors, particularly for purpose-in-life, resilience, and positive relationships, indicating that these are solid components for suicide prevention. Using scales, instead of a single item, to measure protective factors (e.g. life satisfaction) was more efficient to capture the associations. On the other hand, results were similar whether studies used subjective (e.g., sense of belonging) or objective (e.g., social connectedness) measures.

CONCLUSION

Protective factors were inversely associated with suicidal ideation. Improving protective factors is essential for the development of late-life suicide prevention and interventions, instead of merely focusing on risk factors.

An International Classification of Functioning, Disability and Health Model-Based Analysis of Suicidal Ideation among 9920 Community-Dwelling Korean Older Adults

BACKGROUND

Many complex factors contribute to suicide in older adults. The suicidal ideation that precedes suicide is an especially direct predictor of suicide. This study aimed to identify the effects between variables affecting suicidal ideation among older adults using the International Classification of Functioning, Disability and Health (ICF) model and understand the causal relationships to systematize complex factors.

METHODS

This study used data from 9920 community-dwelling older adults who completed a national survey in 2020 to classify predictors of suicidal ideation (e.g., depression, subjective health status, sociodemographic factors, health factors, social support, instrumental activities of daily living (IADL), and social participation) by using the ICF model. To determine the causal relationship between variables, this study examined significance based on the critical ratio (C.R.) and squared multiple correlation (SMC) by using a path model.

RESULTS

Gender, education level, economic level, age, IADL, relationship satisfaction with a child, depression, and the number of chronic diseases significantly affected suicidal ideation, while age, employment status, participation in social groups, formal and informal support, satisfaction with a friend/neighbor relationship, and subjective health status did not significantly influence it. Moreover, depression mediated the relationship between each of these variables and suicidal ideation.

CONCLUSIONS

It was found that depression was the most direct and mediating factor in suicidal ideation among many factors affecting the suicidal ideation of community-dwelling older adults. Additional studies should be conducted to develop community-level strategies based on these factors and understand causal relationships.

Depression and life satisfaction after Kahramanmaraş earthquakes: The serial mediation roles of life meaning and coping with earthquake stress

This study aims to examine the meaning of life, and the mediating effect of strategies for coping with earthquake stress in the relationship between depression, and life satisfaction in survivors of the 2023 Kahramanmaraş centered earthquakes. The participants of this study were 472 adults (31.1% male, 68.9% female; Mage = 24.52) who were affected by earthquakes. The data of the study were tested with the bootstrapping-based PROCESS macro program (Model-81). The results showed that depression negatively predicted life satisfaction. Meaning of life mediated the relationship between depression and life satisfaction. However, problem solving and cognitive avoidance coping strategies reduced the effects of depression and the meaning of life on life satisfaction. These results can be a resource for mental health services for earthquake victims. At the same time, the study provides evidence that protecting personal resources in disaster situations positively affects life satisfaction in terms of conservation of resources theory (COR).

The mediating role of coping styles in the relationship between second victim experience and professional quality of life among nurses: a cross-sectional study

BACKGROUND

Studies have shown that second-victim experiences could increase risks of the compassion fatigue while support from individuals and organisations is most often protection. However, the risk for poor compassion satisfaction and increased compassion fatigue in nurses aroused by adverse events remains an underestimated problem, meanwhile, litter known about the role of positive and negative coping styles among nurses suffering from adverse events. This study aims to investigate the effect of second-victim experiences on the professional quality of life among nurses and to determine the mediating role of coping styles in the relationship between second-victim experiences and professional quality of life.

METHODS

Multistage sampling was used to recruit registered nurses from Hunan province in China. Registered nurses who identified themselves as experiencing adverse events from nine tertiary hospitals were included in this study. Participants were recruited to complete a survey on the second victim experience and support tool, the simplified coping style questionnaire, and the professional quality of life scale. The stress coping theory was used to develop the framework in this study. The structural equation modelling approach was used for conducting the mediating effects analysis via IBM SPSS Statistics 26.0 and Mplus 8.3.

RESULTS

In total, 67% (n = 899) of nurses reported a second victim experience during their careers. In a bivariate analysis, both second-victims experiences and coping styles were significantly associated with their professional quality of life. The results showed that the effects of second victim experiences on their professional quality of life were fully mediated by coping styles. A total of 10 significantly indirect pathways were estimated, ranging from -0.243 to 0.173.

CONCLUSIONS

Second-victim experiences are common among nurses in this study. Since the mediating effects of coping styles were clarified in this study, it is imperative to promote the perception of negative coping styles and encourage nurses to adopt more positive coping styles with adequate support systems.

Suicidal ideation of people living with HIV and its relations to depression, anxiety and social support

BACKGROUND

The HIV/AIDS (human immunodeficiency virus/acquired immune deficiency syndrome) remains a global threat to health. Suicidal ideation has been a serious public health problem among people living with HIV (PLWH). However, the suicide prevention mechanism among PLWH still unclear. This study aims to analyze the suicidal ideation and its related factors in PLWH, and further explore the relationships between suicidal ideation and depression, anxiety and perceived social support.

METHODS

This is a cross-sectional study. A total of 1146 PLWH were investigated by the general information questionnaire, the perceived social support scale (PSSS), the Beck scale for suicide ideation of Chinese version (BSI-CV), the generalized anxiety disorder scale-2 (GAD-2) and the patient health questionnaire-2 (PHQ-2) though the WeChat in China in 2018. By using statistical description and the binary unconditional logistic regression, we assessed the incidence of suicidal ideation and its related factors in PLWH. Besides, the intermediary effect of social support between anxiety, depression and suicidal ideation were explored by the stepwise test and Bootstrap method.

RESULTS

The incidence of suicide ideation was 54.0% (619/1146) among the PLWH in the last week or during the most serious depression. Binary logistic regression analysis results showed that the PLWH who with short time for HIV positive diagnosis (aOR (adjusted odd ratio) = 1.754, 95% CI (confidence interval):1.338-2.299), low monthly income (aOR = 1.515, 95%CI:1.098-2.092), other chronic diseases except HIV (aOR = 1.555, 95%CI:1.134-2.132), irregular lovers (aOR = 1.369, 95%CI:1.021-1.837), anxiety (aOR = 2.711, 95%CI:1.767-4.161), depression (aOR = 1.614, 95%CI:1.078-2.417), low PSSS (aOR = 2.139, 95%CI:1.345-3.399) had high risk of suicide ideation.The social support played a mediating role between the anxiety (the mediating effect accounted for 30.43% of the total effect), depression (the mediating effect accounted for 23.76% of the total effect) and the suicide ideation among PLWH.

CONCLUSION

The incidence of suicide ideation of PLWH was high. Anxiety, depression, and social support are the key factors of suicide ideation of PLWH. Social support plays a partial mediating role between anxiety, depression and suicidal ideation, which provides a new approach for prevention of suicidal ideation in PLWH and should be known widely for people to prevent suicide.

The mediating effects of social support on the association between depression and life satisfaction among patients with schizophrenia or bipolar disorder

Patients with schizophrenia or bipolar disorders in community had poor psychosocial functioning, social support, and life satisfaction. However, the interaction effects of social support and depression on life satisfaction remains unclear. Thus, we examined these associations among patients with schizophrenia or bipolar disorder. This cross-sectional study was conducted from October to December 2020 in Shenzhen, China. Information on social support, depression, and life satisfaction was assessed by standardized questionnaires through a face-to-face interview. Hierarchical multiple regression analysis was performed to estimate the associations of social support and depression with life satisfaction and to explore the mediation effect of social support. A total of 293 patients aged 39.7 ± 11.1 years (males: 47.1 %) were included in this study. Social support was positively associated with high life satisfaction (explaining 7.2% of the variance), while depression was negatively associated with life satisfaction (explaining 17.8% of the variance). Furthermore, social support mediated 12.5% of the association between depression and life satisfaction. Social support and depression were significantly associated with life satisfaction in patients with schizophrenia or bipolar disorders. Moreover, social support mediated the association between depression and life satisfaction in this population. Health interventions that benefit social support should be promoted to alleviate the negative impact of depression on their life satisfaction.

Relationship between subjective well-being and depressive disorders: Novel findings of cohort variations and demographic heterogeneities

This paper uses a large-scale nationally representative dataset, the Chinese General Social Survey, to examine the relationship between subjective well-being and depressive disorders. Statistical results indicate that higher levels of subjective well-being help decrease perceived depression. Robustness checks are carried out using different types of explanatory and dependent variables, various regression models, penalized machine learning methods, instrumental variable approaches, and placebo tests, all of which lend further credence to the above findings. Based on it, heterogeneities in the relationship between subjective well-being and self-rated mental disorders are explored. In respect of variations in age cohorts, it is found that the absolute values of happiness's estimated coefficients are smaller in the 20-30 and 30-40 age groups, while that in the 40-50 age group increase substantially. In older cohorts, the estimates remain at higher levels while fluctuating to some degree. Furthermore, the significantly negative interaction between happiness and age proves that age amplifies subjective well-being's effect on perceived depressive disorders. With age increasing, the impact of happiness on reducing perceived depression tends to be stronger. Therefore, for older people, subjective well-being plays a more important role in suppressing self-rated depression. Heterogeneities of the relationship between happiness and perceived depressive disorders in subgroups with different demographic characteristics are also investigated. It is found that the negative correlation between subjective well-being and self-rated depression is stronger among those with higher educational levels, living in urban areas, being members of the Communist Party of China, having pensions, and owning more housing assets. However, gender, ethnic identity, religious belief, and marital status exert no significant moderating effects.

Self-reported anxiety and depression problems and suicide ideation among black and latinx adults and the moderating role of social support

Suicide is a critical public health problem. Over the past decade, suicide rates have increased among Black and Latinx adults in the U.S. Though depression is the most prevalent psychiatric contributor to suicide risk, Black and Latinx Americans uniquely experience distress and stress (e.g., structural adversity) that can independently operate to worsen suicide risk. This makes it important to investigate non-clinical, subjective assessment of mental health as a predictor of suicide ideation. We also investigate whether social support can buffer the deleterious impact of poor mental health on suicide ideation.We analyzed data from 1,503 Black and Latinx participants of the Washington Heights Community Survey, a 2015 survey of residents of a NYC neighborhood. Multivariable logistic regression was conducted to examine the effect of subjectively experienced problems with anxiety and depression on suicide ideation independent of depression diagnosis, and the role of social support as a moderator.Estimated prevalence of past two-week suicide ideation was 5.8%. Regression estimates showed significantly increased odds of suicide ideation among participants reporting moderate (OR = 8.54,95% CI = 2.44-29.93) and severe (OR = 16.84,95% CI = 2.88-98.46) versus no problems with anxiety and depression, after adjustment for depression diagnosis. Informational support, i.e., having someone to provide good advice in a crisis, reduced the negative impact of moderate levels of anxiety and depression problems on suicide ideation.Findings suggest that among Black and Latinx Americans, subjective feelings of anxiety and depression account for a significant portion of the suicide ideation risk related to poor mental health. Further, social support, particularly informational support, may provide protection against suicide ideation.

Determinants of Suicide Ideation in the Romanian Population

BACKGROUND

Suicide ideation and behaviors are directly linked to the risk of death by suicide. In Romania, as well as worldwide, increased suicide rates were observed in the recent past, more so in the context of the COVID-19 pandemic. The purpose of this study was to investigate the influence of psychosocial factors, quality of life (QOL), and loneliness dimensions and adverse life antecedents on suicide ideation (SI) and prolonged sadness (PS).

METHODS

This cross-sectional quantitative research study used a CATI data gathering method to investigate 1102 randomly selected individuals over 18 years of age regarding various determinants of SI and PS. Data were collected in June 2021. Descriptive, inferential, and multivariate statistics were used for data analysis.

RESULTS

SI was negatively correlated with all the assessed psychosocial factors, more significantly with family relationships, wealth, health, social relationships, and affective life. Stronger correlations were observed when investigating the state of prolonged sadness, sex, and affective lives along with health and income, which were more influential. SI was negatively correlated with QOL and positively correlated with adverse life events and total loneliness scores. Lesser educated youngsters with reduced overall happiness and a history of depression, self-harm, and trauma were at greater risk of developing SI.

CONCLUSIONS

This is the first national study exploring the suicide ideation and prolonged sadness in relation to psychosocial factors, quality of life, and adverse life events. These results have important implications for suicide prevention programs, which should be designed in accordance with similar studies.