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Serial multiple mediation of demoralization and depression in the relationship between hopelessness and suicidal ideation
Author(s) -
Liu Su Ting,
Wu Xia,
Wang Ning,
Zhao Qian Qian,
Xiao Lin,
Fang Chun Kai,
Yu Ya,
Lin Dong Mei,
Zhang Li Li
Publication year - 2020
Publication title -
psycho‐oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.41
H-Index - 137
eISSN - 1099-1611
pISSN - 1057-9249
DOI - 10.1002/pon.5439
Subject(s) - suicidal ideation , beck hopelessness scale , clinical psychology , psychology , mediation , depression (economics) , rating scale , psychiatry , psychological intervention , suicide prevention , beck depression inventory , poison control , medicine , developmental psychology , medical emergency , political science , law , economics , macroeconomics , anxiety
Objective Suicidal ideation is common in cancer patients and may be associated with hopelessness, demoralization, and depression. This study aims to investigate the serial multiple mediation of demoralization and depression in the relationship between hopelessness and suicidal ideation in cancer patients. Methods A total of 244 cancer patients were investigated by using the following standardized self‐reported questionnaires: self‐rating idea of suicide scale, Beck hopelessness scale, demoralization scale‐Mandarin version, and patient health questionnaire depression scale‐9. The mediation hypothesis was tested with a serial multiple mediation model (PROCESS model 6). An exploratory graph analysis was performed to detect the correlations among the dimensions of the mental conditions measured by these instruments. Results Bootstrap analyzes indicate that there were direct and indirect effects of hopelessness on suicidal ideation mediated solely by demoralization ( B = 2.3074, SE = 0.1724, P < .001) or by demoralization together with depression ( B = 0.1605, SE = 0.0303, 95% confidence interval [CI] = 0.1102 to 0.2303). The mediation of depression alone in the relationship between hopelessness and suicidal ideation was insignificant ( B = 0.1541, SE = 0.0519, 95% CI = −0.0565 to 0.0715). The exploratory graph analysis suggests that the strongest edge of dimensions between demoralization and suicidal ideation was desperation‐disheartenment (0.62). Conclusions The results of the study support the hypothesis that demoralization and depression mediate between hopelessness and suicidal ideation. The early identification of and interventions for hopelessness, demoralization, and depression may prevent cancer patients from developing suicidal ideation.