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. 2020 Jan 15;20(1):22.
doi: 10.1186/s12888-020-2436-5.

Mediation and Moderation Analyses: Exploring the Complex Pathways Between Hope and Quality of Life Among Patients With Schizophrenia

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Free PMC article

Mediation and Moderation Analyses: Exploring the Complex Pathways Between Hope and Quality of Life Among Patients With Schizophrenia

Wei-Liang Wang et al. BMC Psychiatry. .
Free PMC article

Abstract

Background: The underlying mechanism between hope and quality of life is as yet unknown. We aim to examine the potential mediating effect of depression and resilience and the moderated effect of sex in this well-established association.

Methods: Two hundred seven patients diagnosed with schizophrenia were administered a questionnaire battery that measured hope, depression, resilience and QOL. A multiple mediation model was used to examine the mediating effect of resilience and depression on the association between hope and QOL. A subgroup analysis was performed and a moderated mediation model was examined to find and test the moderated effect of sex on the mediation model. We used Mplus to perform moderation and mediation analyses so that the mediators and moderator could function together in the same model.

Result: Sex was the moderator on the direct path between hope and QOL. The relationship between hope and QOL was mediated by resilience and depression in both sexes. When compared with female patients, the effect of hope on QOL was completely mediated by resilience and depression in males. In female patients, the model was partially mediated, and the direct effect of hope on QOL was significantly negatively correlated with the level of hope.

Conclusion: We present a conceptual model containing the mediated effects of resilience and depression and the moderated effect of sex between hope and QOL, which we believe facilitates the understanding of these associations. This model should be useful in the formulation of strategies to improve QOL.

Keywords: Depression; Hope; Moderated mediation; Quality of life; Resilience; Schizophrenia.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
(Panel a: H1 and H2) Conceptual framework of the potential mediating effect of resilience and depression on the relationship between hope and QOL. (Panel b: H3) Model of the potential moderating effects on the paths. *p<0.05; **p<0.01; ***p<0.001 QOL: quality of life; H: hypothesis
Fig. 2
Fig. 2
The conceptual (panel a) and statistical (panel b) forms of the conditional process model (moderated mediation). *p<0.05; **p<0.01; ***p<0.001 QOL: quality of life. In this model, the indirect effect of hope on QOL through depression and resilience and the direct effect of hope on QOL are supposed to be moderated by sex
Fig. 3
Fig. 3
Moderating effect of sex on the direct effect between hope and QOL

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