Path Analysis of Self-Efficacy, Coping Style and Resilience on Depression in Patients with Recurrent Schizophrenia

Liyi Wang; Meizhi Li; Bi Guan; Liangnan Zeng; Xinchun Li; Xiaojian Jiang

doi:10.2147/NDT.S421731

Path Analysis of Self-Efficacy, Coping Style and Resilience on Depression in Patients with Recurrent Schizophrenia

Neuropsychiatr Dis Treat. 2023 Sep 1:19:1901-1910. doi: 10.2147/NDT.S421731. eCollection 2023.

Authors

Liyi Wang^#^{1

2}, Meizhi Li^#³, Bi Guan^#⁴, Liangnan Zeng⁴, Xinchun Li³, Xiaojian Jiang²

Affiliations

¹ Department of Oncology, Chengdu Fifth People's Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, People's Republic of China.
² College of Nursing, Hunan University of Chinese Medicine, Changsha, Hunan, People's Republic of China.
³ Hunan Provincial Brain Hospital (Hunan Second People's Hospital), Changsha, Hunan, People's Republic of China.
⁴ Department of Nursing, Fifth People's Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, People's Republic of China.

^# Contributed equally.

Abstract

Purpose: Based on the two mediating variables of self-efficacy and coping style, a multiple mediating model was constructed to explore the mechanism by which psychological resilience affects depression in patients with recurrent schizophrenia.

Methods: A total of 210 patients with recurrent schizophrenia who were hospitalized in a tertiary hospital in Hunan Province, China, were enrolled. The Connor Davidson Resilience Scale (CD-RISC), Self-rating Depression Scale (SDS), General Self-Efficacy Energy Scale (GSES) and Simplified Coping Style Questionnaire (SCSQ) were used to evaluate resilience, self-efficacy, coping style and depression. Path analysis was performed by constructing a structural equation model, and the mediating effect between variables was verified by the bias-corrected nonparametric percentile bootstrap method.

Results: Resilience, self-efficacy and positive coping together explained 53.2% of the variance in depression. (1) The total scores of self-efficacy, coping style, resilience and depression in patients with recurrent schizophrenia were 2.54±0.61, 31.73±9.62, 58.06±17.26 and 50.48±12.55, respectively. (2) Pearson analysis showed that the scores of self-efficacy, positive coping, resilience and depression were significantly correlated with depression (r=-0.24-0.51, P<0.01). (3) The path analysis showed that resilience directly affects depression (β=-0.401); additionally, resilience indirectly affects depression through self-efficacy (β=-0.179) and through the chain mediating effect of self-efficacy and positive coping style (β=-0.024).

Conclusion: There is a high incidence of depression in patients with recurrent schizophrenia in China, and intervention is needed. This research revealed that resilience directly affects depression in patients with recurrent schizophrenia and that self-efficacy and positive coping play a part in mediating resilience and depression in patients with recurrent schizophrenia in China. Implementing targeted interventions based on action paths to improve the level of resilience and reduce the incidence of depression has guiding significance in the field of occupational rehabilitation of patients with recurrent schizophrenia.

Keywords: coping style; depression; mediating role; path analysis; recurrent schizophrenia; resilience; structural equation model.

Grants and funding

This work was supported by the 2022 “Disciplinary Reveal System” project of Hunan University of Chinese Medicine (Grant no. 22JBZ044); the project funded by Research Project of Teaching Reform in Colleges and Universities in Hunan Province (Grant no. HNJG-2022-0140); the project funded by Hunan Provincial Administration of Traditional Chinese Medicine Project (Grant no. B2023123); the project funded by the 2023 Hunan Social Science Achievements Review Committee (Grant no. XSP2023GLC121) and the projects funded by Hunan Innovative Province Construction Special Funding (Grant no. 2021 SK2009).