Serial mediating roles of cognitive distortion and hopelessness in the associations of stressful life events with subclinical depressive and anxiety symptoms
10.11886/scjsws20251116001
- VernacularTitle:认知歪曲和绝望感在应激事件与亚临床抑郁和焦虑症状之间的链式中介作用
- Author:
Xiaolin SUN
1
;
Xinpeng XU
2
;
Weigang PAN
2
;
Ying YANG
1
;
Siyuan LIU
1
;
Xiaohong LI
2
Author Information
1. Beijing Anding Hospital， Capital Medical University， National Clinical Research Center for Mental Disorders， Beijing Key Laboratory of Mental Disorders， Beijing 100088， China
2. Beijing Huilongguan Hospital， Capital Medical University， 100096 Beijing， China
- Publication Type:Journal Article
- Keywords:
Subclinical depression;
Subclinical anxiety;
Stressful life events;
Cognitive distortion
- From:
Sichuan Mental Health
2026;39(4):375-380
- CountryChina
- Language:Chinese
-
Abstract:
BackgroundStressful life events are associated with subclinical depressive and anxious symptoms， which may increase the risk of subsequent depressive and anxiety disorders. However， the mechanisms linking stressful life events to subclinical emotional symptoms remain unclear. ObjectiveTo explore the clinical characteristics of individuals with subclinical depression and anxiety following stressful events， and to analyze the mechanisms by which stressful events affect subclinical depressive and anxious symptoms， so as to provide a reference for the early identification and intervention of emotional symptoms in individuals under stress. MethodsFrom December 2024 to April 2025， 80 individuals with subclinical depression and/or anxiety （study group） and 80 healthy controls were recruited via the online official accounts of Beijing Anding Hospital， Capital Medical University and Beijing Huilongguan Hospital， Capital Medical University. Participants completed the Patients' Health Questionnaire Depression Scale-9 item （PHQ-9）， the Generalized Anxiety Disorder Scale-7 item （GAD-7）， the Life Event Scale （LES）， the Self-rating Idea of Suicide Scale （SIOSS）， and the Dysfunctional Attitude Scale （DAS）. Spearman rank correlation analysis was used to examine the associations in the study group. Serial mediation analyses were conducted using model 6 of Process version 4.1， to test whether cognitive distortion and hopelessness mediated the associations of stressful life events with subclinical depressive and anxious symptoms. ResultsCompared with healthy controls， participants with subclinical depressive and anxious symptoms had higher scores on PHQ-9， GAD-7， LES， SIOSS hopelessness subscale， and DAS scores （Z/t=10.294， 9.197， 4.659， 6.918， 3.517， P<0.01）. In the study group， GAD-7 score was positively correlated with LES， DAS， and SIOSS hopelessness subscale scores （rs=0.233， 0.465， 0.588， P<0.05）； SIOSS hopelessness subscale score was positively correlated with DAS and LES scores （rs=0.393， 0.309， P<0.01） and cognitive distortion was positively correlated with stressful life events（rs=0.432， P<0.01）. Stressful life events were directly associated with subclinical anxiety symptoms （β=0.040， 95% CI： 0.015–0.065， P<0.05）， and showed a significant serial indirect association with subclinical anxiety symptoms （indirect effect=0.006， 95% CI： 0.001–0.017， P<0.01）， accounting for 7.15% of the total effect. Stressful life associated with subclinical depressive symptoms （β=0.087， 95% CI： 0.060–0.115， P<0.01）， however， the indirect effect through cognitive distortion and hopelessness were not statistically significant. ConclusionAfter experiencing stressful events， individuals with subclinical depression and anxiety exhibit more pronounced cognitive distortions and hopelessness. Stressful events can both directly affect subclinical anxiety symptoms and indirectly affect them through the serial mediating effects of cognitive distortion and hopelessness. Stressful events have a direct effect on subclinical depressive symptoms， whereas the mediating effects of cognitive distortion and hopelessness are no statistically significant. ［Funded by the Training Program for the Development of High-level Public Health Technical Talents （number， Academic Leader-01-22）； www.chictr.org.cn number， ChiCTR2400093516］
