Mechanisms connecting insomnia to hopelessness among Chinese older adults: Serial mediating roles of fatigue and social support.

BACKGROUND: Hopelessness and insomnia remain growing mental health issues worldwide, their relationship has been neglected by international development policies, especially in the countries with rapidly aging population like China. However, there is little conclusive evidence on the mechanisms through which insomnia severity influences hopelessness. Based on previous research regarding the significant associations among fatigue, social support, insomnia and hopelessness, this study aims to investigate the relationship between insomnia and hopelessness as well as how insomnia affects hopelessness through fatigue and social support. METHODS: A population-based data including 946 community-dwelling older adults extracted from "Elderly Care Household Survey in 2019" in Beijing were used. The age of the participants ranged from 66 to 97 years old, and 53.3% of the respondents were female. Intercorrelations among insomnia, fatigue, social support and hopelessness were examined. Serial multiple mediation models were analyzed by the bootstrapping method to assess whether fatigue and social support serially mediate the relationship between insomnia and hopelessness. RESULTS: Higher level of insomnia severity (coefficient = 0.0421, p < 0.001), higher level of fatigue (coefficient = 0.0171, p < 0.001), and lower level of social support (coefficient = -0.0320, p < 0.001) were significantly associated with higher level of hopelessness. Fatigue and social support in serial, mediated the relationship between insomnia and hopelessness (total effect: coefficient = 0.0623, 95% CI [0.0466, 0.0780]; total direct effect: coefficient = 0.0421, 95% CI [0.0262, 0.0581]; total indirect effect: coefficient = 0.0202, 95% CI [0.0147, 0.0272]). CONCLUSIONS: Improving sleep quality and eliminating fatigue could effectively alleviate the sense of hopelessness among Chinese older adults. In addition, establishing stronger social support brought by social network from family and friends could confer resilience against the negative effects of despair brought by insomnia. Our findings highlighted the mechanism connecting insomnia to hopelessness, which would inspire the future practice.

How is physical attractiveness associated with depression in China: A moderated mediation analysis.

Rewarding beauty has never fallen out of vogue in human history. Attractive people enjoy many social and economic advantages. This study aims to investigate the relationship between physical attractiveness and depression and its potential mechanism among Chinese residents. A population-based data including 12,172 Chinese adults from 3 waves of CFPS (2012, 2016, 2020) were used. Moderated-mediation models were utilized to assess the mediation effect of unfair experiences and the moderation effect of socioeconomic-status (SES), in the linkage between physical attractiveness and depression. Firstly, our results demonstrated that physical attractiveness is negatively associated with depression. Secondly, the effect of unfair experiences as a mediator between physical attractiveness and depression is statistically significant. Lastly, socioeconomic status (SES) performs a crucial moderating role. Among Chinese residents, the mitigating effect of physical attractiveness on unfair experiences and depression would be stronger among those with a lower SES compared to those with a higher SES.