Quality of life and death anxiety among caregivers of patients with advanced cancer: the mediating effect of trait anxious personality and the moderating effect of social support.

PURPOSE: To explore the mediating role of trait anxious personality in the association between quality of life (QoL) and death anxiety (DA), as well as to test the moderating effect of social support in the mediation model. METHODS: The Death Anxiety Scale, Quality of Life Scale, State-Trait Anxiety Scale, and Social Support Rating Scale were used to measure 588 family caregivers of advanced cancer patients. We then constructed a moderated mediation model. RESULTS: The presence of QoL was negatively associated with DA (ß = - 0.67, p < 0.01). Trait anxious personality partially mediated the relationship between QoL and DA (indirect effect ß = - 0.08, p < 0.01). Social support moderated both the antecedent and subsequent segments of the mediating paths of "QoL → trait anxious personality → DA" and the direct relationship between QoL and DA. Among caregivers with a low level of social support, the mediating effect coefficient of trait anxious personality was higher at 0.25 (95% confidence interval (CI): 0.059-0.182), in contrast to caregivers with a high level of social support, where the mediating effect coefficient of trait anxious personality was 0.11 (95% CI: 0.029-0.072). CONCLUSION: QoL is directly associated with an increased risk of DA and indirectly related to DA by increasing the risk of trait anxious personality among caregivers. Social support can moderate the mediating effect of trait anxious personality and the relationship between QoL and DA. The intervention strategy for preventing DA among caregivers who have encountered QoL reduction should focus on reducing trait anxious personality and social support.

How and when does proactive personality predict career adaptability? A study of the moderated mediation model.

In the present study, we explored the relationship between proactive personality and career adaptability to construct a cross-level moderated mediation model based on the conservation of resources (COR) theory. By conducting a time-lagged study involving three data collection points from 587 employees across 104 teams in China, we examined how and when proactive personality predicts employees' career adaptability using strengths use as a mediator and managerial coaching as boundary conditions. The results revealed that proactive personality predicted strengths use, which, in turn, influenced career adaptability, with managerial coaching moderating the indirect relationship between proactive personality and career adaptability. Consequently, our findings suggest that, in contexts where managerial coaching lacks guidance, facilitation, and inspiration, a proactive personality encourages employees to leverage their strengths, subsequently enhancing their career adaptability. Finally, we discuss the theoretical and practical implications of our findings, address limitations, and propose directions for future research.

Relationship between frailty and depressive symptoms in older adults: role of activities of daily living and sleep duration.

Introduction: Previous studies have demonstrated that frailty is associated with depressive symptoms among older people and significantly increase the risk of difficulty in activities of daily living (ADL). However, uncertainties remain regarding the mechanisms behind such relationship. The aim of this study was to investigate the mediating effect of ADL in the relationship between frailty and depressive symptoms among older adults in China, and to explore to what extend sleep duration moderated the association between ADL and depressive symptoms. Methods: In this study, we carried out cross-sectional descriptive analysis and 1,429 participants were included in the analysis. A survey was conducted using questionnaires and instruments measuring frailty, depressive symptoms, ADL and sleep duration. Bootstrap analyses served to explore the impact of ADL in mediating frailty and depressed symptoms, as well as the effect of sleep duration in moderating ADL and depressive symptoms. Results: Compared to the robust group, the mediating effects of ADL between frailty and depressive symptoms were significant in the prefrail group and the frail group. The interaction term between sleep duration and ADL was significantly presented in the regression on depressive symptoms. Specifically, the Johnson-Neyman technique determined a range from 8.31 to 10.19 h for sleep duration, within which the detrimental effect of frailty on depressive symptoms was offset. Conclusion: Sleep duration moderated the indirect effect of ADL on the association between frailty and depressive symptoms. This provides support for unraveling the underlying mechanism of the association between frailty and depressive symptoms. Encouraging older adults to enhance ADL and obtain appropriate sleep duration might improve depressive symptoms for older adults with frailty and prefrailty.

"Exploring the relationship of organizational virtuousness, citizenship behavior, job performance, and combatting ostracism" through structural equational modeling.

BACKGROUND: This theoretical model has been drawn on principles of social exchange theory to scrutinize the connection between organizational virtuousness and job performance with the mediating role of Organizational citizenship behavior and moderating role of workplace ostracism. A survey was conducted in Pakistan, gathering data from 486 employees working for various private and commercial banks. METHOD: Soft and hard questionnaires were distributed to the participants, with social media platforms used for the soft questionnaires and meetings with employees for the hard questionnaires. A 7-point Likert scale was employed in data collection, and measures for the variables were adapted from reliable and valid sources. A demographic analysis was performed to summarize the sample collected from participants. The demographics results were analyzed using SPSS, while the measurement model and path analysis were conducted using Structural Equational Modeling with Smart PLS-4. RESULTS: The study's findings showed a significant and positive relationship between organizational virtuousness and job performance, with organizational citizenship behavior serving as a mediator. Additionally, a negative moderation of workplace ostracism was observed in the mediation of organizational citizenship behavior toward the relationship between organizational virtuousness and job performance. CONCLUSION: The study's results contribute to the implementation of social exchange theory and related concepts in the banking sector of Pakistan, providing practical guidance for implementing virtuous practices within organizations and discouraging ostracism in banks to enhance overall performance. The study suggests that policies regarding the implementation of virtuous practices in organizations can be established, and workplace ostracism can be avoided by providing a platform for social gatherings and training employees. Managers should adopt appropriate leadership styles and relevant communication patterns to impact the organizational climate which can also help reduce the influence of ostracism in the organization. Additionally, a complaint cell should be established with complete confidentiality to reduce ostracism.

The Effect of Corporate Social Responsibility on Workplace Safety: The Significance of Employees' Moral Identity.

Corporate social responsibility (CSR) has gained significant attention from researchers and practitioners due to its potential impact on employee attitudes and behaviors. This study investigates the influence of CSR on employee safety behavior, examining the mediating effects of job stress and organizational identification, as well as the moderating role of moral identity. We conducted a three-wave time-lagged survey among 236 South Korean employees. Participants were recruited through a research company using stratified random sampling. Data were collected at three time points, each separated by a 4-5-week interval. Structural equation modeling (SEM) was used to test the hypothesized relationships. The findings support all of the hypothesized relationships. CSR was positively related to safety behavior and negatively related to job stress. Job stress was negatively related to organizational identification, which in turn was positively related to safety behavior. The sequential mediation of job stress and organizational identification was significant. Moral identity moderated the relationship between CSR and job stress, such that the negative effect of CSR on job stress was stronger for employees with a high moral identity. This study contributes to the CSR literature by examining the impact of CSR on safety behavior and the underlying mechanisms and boundary conditions of this relationship. The findings suggest that organizations can promote employee safety behavior by implementing CSR initiatives, which can reduce job stress and enhance organizational identification. Organizations should also consider the role of employees' moral identity when designing and communicating CSR initiatives.

Ethnocentrism and place identity in the consumption of local products.

Research on the consumption of local products is essential to promote sustainability, boost local economies, and preserve cultural identity. Although a positive relationship has been demonstrated between attitude towards local products and consumption determinants, the role of the former as a mediator has not been sufficiently explored. This study examines how the attitude towards local products mediates between consumer ethnocentrism and consumption intention, as well as between place identity and consumption intention. A total of 1325 wine and cheese consumers in the Canary Islands were surveyed using a moderated mediation model, applying PLS-SEM. The results indicate that attitude towards local products mediates the aforementioned relationships but does not moderate them according to the type of local product. Consequently, marketing strategies should focus on the emotional and cultural connection that consumers establish with local products, highlighting their value in terms of identity and belonging.

Regional brain structure mediates the association between sleep quality and intellectual abilities: the moderating role of socioeconomic status.

This study aims to reveal the association between sleep quality and crystallized intelligence (Gc), fluid intelligence (Gf), and the underlying brain structural basis. Using the data from the Human Connectome Project (N = 1087), we performed mediation analysis to explore whether regional brain structure related to sleep quality mediate the association between sleep quality and intellectual abilities, and further examined whether socioeconomic status (i.e., income and education level) moderate the mediation effect. Results showed that poorer sleep quality was associated with lower Gc rather than Gf, and worse sleep quality was associated with smaller volume and surface area in temporal lobe, including inferior temporal gyrus and middle temporal gyrus. Notably, temporal lobe structures mediated the association between sleep quality and Gc rather than Gf. Furthermore, socioeconomic status (i.e., income and education level) moderated the mediating effect, showing low socioeconomic status has a more significant mediating effect with stronger association between sleep quality and Gc as well as stronger association between temporal lobe structure and Gc in low socioeconomic status group. These findings suggest that individuals with higher socioeconomic status are less susceptible to the effect of sleep quality on Gc.

The relationship between the psychological resilience and post-traumatic growth of college students during the COVID-19 pandemic: a model of conditioned processes mediated by negative emotions and moderated by deliberate rumination.

BACKGROUND: The mental health of university students during the COVID-19 pandemic has attracted the attention of researchers. For the present study researchers constructed a mediation model to explore the relationship between psychological resilience and post-traumatic growth, the mediating role of negative emotions and the moderating role of deliberate rumination in students. METHODS: The Psychological Resilience Scale, Posttraumatic Growth Inventory, Depression-Anxiety-Stress Scale (DASS-21) and Event Related Rumination Inventory were used in a survey of 881 college students. The data were analyzed using SPSS 26.0 and the PROCESS plugin (version 3.3). RESULTS: (1) Psychological resilience is positively related with post-traumatic growth. Deliberate rumination is positively related to psychological resilience, posttraumatic growth, and negative emotions. Psychological resilience, post-traumatic growth and negative emotions are negatively related. (2) Negative emotions mediated the relationship between psychological resilience and post-traumatic growth. (3) Deliberate rumination plays a moderating role in psychological resilience affecting negative emotions. Deliberate rumination plays a moderating role in the extent to which psychological resilience influences PTG through negative emotions. CONCLUSIONS: Psychological resilience affects post-traumatic growth directly and also indirectly through negative emotions. With the increase of mental resilience, the level of negative emotion tended to decrease. When individuals are experiencing negative emotions, high levels of active rumination are more likely to promote post-traumatic growth. This study helps to explore the factors affecting the mental health of college students during the epidemic, thus providing guidance for appropriate mental health interventions.

Mediating roles of activities of daily living and depression on the relationship between sleep quality and health-related quality of life.

This study aimed to explore the mediating effects of ADL and depression on the relationship between sleep quality and HRQOL among older people in rural China, while also exploring the moderating impact of loneliness. The study gathered data from a household survey conducted among 1587 Chinese rural older adults (mean age = 73.63 years). The collected data was analyzed using SPSS version 23.0 software (IBM, New York, USA) and the PROCESS macro version 4.0 program. The findings indicated a significant correlation between sleep quality, ADL, depression, loneliness and HRQOL. ADL and depression exhibited a chain mediation effect on the relationship between sleep quality and HRQOL. Notably, the association between sleep quality and HRQOL was entirely mediated by ADL and depression. Additionally, loneliness acted as a moderator in the relationship between ADL and HRQOL. The findings of this study suggest that interventions focusing on sleep quality should prioritize strategies for enhancing older adults' ADL and depression as integral components of promoting older adults' HRQOL.

Associations of Early-Life Deprivation and Threat with Exploratory Behavior: Moderated Mediation Models of Sensation Seeking and Executive Function.

Exploratory behavior, as a crucial aspect of decision-making, plays an indispensable role in maximizing long-term benefits and is, therefore, essential in promoting adolescents' psychological well-being and social adaptation. Recent studies have shown that this adaptive behavior is influenced by previous early experiences. However, little was known about the associations between specific types of childhood maltreatment and exploratory behavior and the roles of individual motivational and cognitive factors in these relationships. The present study aimed to examine whether the subtypes of maltreatment, that is, threat and deprivation, would influence adolescents' exploratory behavior, the mediating role of sensation seeking, and the moderating role of executive function. Using a sample of 720 Chinese adolescents (Mage = 13.29, SDage = 0.82, 54.8% female), we found that sensation seeking fully mediated the relationship between threat and exploratory behavior. That is, adolescents who experienced threat were more likely to increase sensation seeking, which further promote exploratory activities. Moreover, executive function was a second-stage moderator of this full mediation pathway, with the mediating effect of sensation seeking between threat and exploratory behavior increasing with the enhancement of executive function. However, we did not observe the mediating effect of sensation seeking and the second-stage moderating effect of executive function on the relationship between deprivation and exploration. Considering the distinct impact mechanisms of threat and deprivation on exploratory behavior, our study provides empirical support for the Dimensional Model of Adversity and Psychopathology, and highlights the critical role of sensation seeking and the necessity of implementing executive function interventions for those experiencing threat experiences.

Association between non-restorative sleep and psychotic-like experiences among Chinese college students: A latent profile and moderated mediation analysis.

BACKGROUND: Non-restorative sleep (NRS) is a core symptom of insomnia that has considerable consequences for daily life. However, the association between NRS and psychotic-like experiences (PLEs) remains unclear. The current study was designed to explore the relationship between NRS and PLEs as well as the mediation/moderation role of rumination and resilience among college students in China. METHODS: 3060 college students were recruited from two universities in South China from September 21st to October 26th, 2022. Non-restorative Sleep Scale, 8-item Positive Subscale of the Community Assessment of Psychic Experiences, Ruminative Response Scale, and 10-item Connor-Davidson Resilience Scale were administered. Latent profile analysis and moderated mediation analysis were performed. RESULTS: 11.3 % participants reported frequent PLEs in the past one month. Three profiles of rumination were identified and named as "low rumination" group (27.7 %), "medium rumination" group (55.3 %), and "high rumination" group (16.9 %). NRS directly predicted PLEs, and rumination played a significant mediation role between NRS and PLEs. Resilience significantly moderated the association between NRS and rumination as well as the association between NRS and PLEs. CONCLUSIONS: NRS, rumination and resilience are important predictors to PLEs. Strategies on increasing restorative sleep, decreasing rumination, and enhancing resilience are of great significance in the prevention of PLEs.

Perceived Social Mobility and Smartphone Dependence in University Students: The Roles of Hope and Family Socioeconomic Status.

Purpose: Drawing upon the cognitive-behavioral model of pathological Internet use (PIU) and tunnel effect, this study aimed to construct a moderated mediation model from the perspective of social ecology. Specifically, the model investigated the relationship between perceived social mobility and smartphone dependence, with a focus on the mediating role of hope and the moderating effect of family socioeconomic status (SES) underlying this relationship. Methods: A cross-sectional study was conducted with 718 Chinese university students (Mage = 19.19, 70.2% female) from Beijing, Henan, and Tianjin, who anonymously filled out the Perceptions of Socioeconomic Mobility Scale, Mobile Phone Addiction Index Scale, Openness to the Future Scale, and family socioeconomic status questionnaire. Preliminary data analysis was executed using SPSS 22.0, and the moderated mediation effect was tested using the latent moderated structural equations approach in Mplus 8.3. Results: The results showed that (a) less perceived social mobility was linked with greater smartphone dependence; (b) hope mediated the aforementioned relationship; and (c) family SES moderated the first-stage path of the indirect effect through hope. For university students with low (rather than high) family SES, their level of hope increased with the improvement of perceived social mobility, and in turn, that of smartphone dependence decreased. Conclusion: These findings suggest that positive perceptions of upward social class mobility and hopeful attitudes toward future opportunities and personal development among disadvantaged university students may alleviate their reliance on smartphones. Researchers and policymakers should pay attention to the role of individuals' perceptions of the macro environment in motivating specific risky behaviors among university students. Future interventions are essential to mitigate pessimistic environmental perceptions and foster a sense of hope among university students.

From burnout to behavior: the dark side of emotional intelligence on optimal functioning across three managerial levels.

Introduction: Burnout has been typically addressed as an outcome and indicator of employee malfunctioning due to its profound effects on the organization, its members, and its profitability. Our study assesses its potential as a predictor, delving into how different sources of motivation-autonomous and controlled-act as mediational mechanisms in the association between burnout and behavioral dimensions of functioning (namely, organizational citizenship behaviors and work misbehaviors). Furthermore, the buffering effects of emotional intelligence across three different managerial levels were also examined. Methods: To this end, a total non-targeted sample of 840 Romanian managers (513 first-, 220 mid-, and 107 top-level managers) was obtained. Results: Burnout predicted motivation, which predicted work behaviors in a moderated-mediation framework. Contrary to our initial prediction, emotional intelligence augmented the negative association between burnout and motivation, exhibiting a dark side to this intelligence type. These findings are nuanced by the three managerial positions and shed light on the subtle differences across supervisory levels. Discussion: The current article suggests a relationship between multiple dimensions of optimal (mal)functioning and discusses valuable theoretical and practical insights, supporting future researchers and practitioners in designing burnout, motivation, and emotional intelligence interventions.

The effects of cyber-ostracism on college students' aggressive behavior: a moderated mediation model.

Purpose: This study used questionnaire survey to explore the influence of cyber-ostracism on the aggressive behavior of college students. Specifically, this study explored the mediation role of the basic psychological needs satisfaction, and explored the moderating role of self-integrity. Method: An online questionnaire was designed through a questionnaire website, which was linked and transferred to college students nationwide. 377 valid questionnaires were obtained after excluding invalid questionnaires. Results: Cyber-ostracism had a significant positive predictive effect on the basic psychological needs satisfaction; Basic psychological needs satisfaction play a mediation role between cyber-ostracism and aggression. Self-integrity moderates the association between basic psychological needs and aggression.

Impact of Gender-Role Attitudes and Mental Health on Hostile Sexism and Acceptance of Cosmetic Surgery.

BACKGROUND: Each year, tens of thousands of people worldwide choose to undergo cosmetic surgery in order to alter their appearance. In recent years, young people have gradually emerged to comprise the main driving force behind the increasing demand for cosmetic surgery. Previous studies have found that sexism may motivate young people to undergo such surgeries. However, few studies have been conducted to determine if this psychological mechanism influences the acceptance of cosmetic surgery among Chinese university students. METHODS: A total of 579 Chinese university students (280 girls and 299 boys, 17-20 years) volunteered to participate in the online survey. They completed a questionnaire containing the Ambivalent Sexism Inventory, the 12-item General Health Questionnaire, the Gender-Role Attitudes Questionnaire and the Acceptance of Cosmetic Surgery Scale. We firstly evaluated the underlying factor structure of the Acceptance of Cosmetic Surgery Scale using exploratory and confirmatory factor analyses, and exploring pattern of associations between the constructs was analyzed via path analysis. RESULTS: According to the findings, hostile sexism was associated with greater levels of acceptance toward cosmetic surgery. Moreover, gender-role attitudes mediated the link between hostile sexism and the acceptance of cosmetic surgery, and this mediation was positively influenced by general mental health. CONCLUSION: Our study contributes to a deeper understanding of Chinese university students' attitudes toward cosmetic surgery, hostile sexism may contribute to normalizing traditional gender stereotypes and encourage cosmetic surgery acceptability among Chinese university students. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Perceived overqualification and knowledge sharing: The role of organizational identity and psychological entitlement.

BACKGROUND: Employees' perception of being overqualified is a critical factor in influencing their knowledge sharing behavior. However previous studies have not examined the internal mechanism by which perceived overqualification affects knowledge sharing. OBJECTIVE: Drawing on social exchange theory, the present study aimed to explore the relationship between perceived overqualification and knowledge sharing and to examine the mediating effect of organizational identity and the moderating role of psychological entitlement. METHODS: Participants were 284 full-time employees from different companies in China. They answered self-report questionnaires that assessed perceived overqualification, knowledge sharing, organizational identity, and psychological entitlement. Path analyses were conducted, and the latent moderated structural equations were used to judge the significance of the mediation and moderation. RESULTS: The results revealed that overqualified employees were less willing to share knowledge, and the mediating role of organizational identity was significant. Further, the presence of high psychological entitlement would diminish the beneficial effect of organizational identity on employee knowledge sharing. CONCLUSIONS: The findings of the study enrich and expand our knowledge on the relationship between overqualification and knowledge sharing and have theoretical and practical implications for promoting constructive behavior among overqualified employees.

Negative life events and suicidality among adolescents in Western China: the mediating effect of depressive symptoms and the moderating effect of self-esteem.

OBJECTIVE: To investigate the mediating role of depressive symptoms in the relationship between negative life events (NLEs) and suicidality, as well as to test the moderating effect of self-esteem in the mediation model. METHODS: A total of 3,003 adolescents from Han, Tibetan, and Yi ethnic groups living in Western China were included in this study. Utilizing the structural equation model, a mediation model and a moderated mediation model were constructed. RESULTS: The presence of NLEs was positively associated with suicidality (ß = 0.17, p < 0.001). Depressive symptoms partially mediated the relationship between NLEs and suicidality (indirect effect ß = 0.19, p < 0.001). Self-esteem moderated both the antecedent and subsequent segments of the mediating paths of "NLEs → depressive symptoms → suicidality" and the direct relationship between NLEs and suicidality. Among adolescents with a low level of self-esteem, the mediating effect coefficient of depressive symptoms was higher at 0.18 (95% confidence interval (CI): 0.14-0.23), in contrast to adolescents with a high level of self-esteem, where the mediating effect coefficient of depressive symptoms was 0.04 (95% CI: 0.02-0.07). CONCLUSION: NLEs are directly associated with an increased risk of suicidality and indirectly related to suicidality by increasing the risk of depressive symptoms among adolescents. Self-esteem can moderate the mediating effect of depressive symptoms and the relationship between NLEs and suicidality. The intervention strategy for preventing suicidality among adolescents who have experienced NLEs should focus on reducing depressive symptoms and improving self-esteem.

Organizational climate of kindergartens and teacher professional learning: mediating effect of teachers' collective efficacy and moderating effect of mindfulness in teaching.

Introduction: This study was aimed at testing a moderated mediation model of teaching mindfulness and teachers' collective efficacy in the relationships between the organizational climate of kindergartens and teacher professional learning. Methods: A sample of 1,095 kindergarten teachers completed self-report questionnaires assessing their perceptions of the organizational climate of kindergartens, collective efficacy, teaching mindfulness, and professional learning. Results: Controlling for teaching experience and kindergarten level, the results show that kindergarten organizational climate significantly and positively predicted teacher professional learning and the collective efficacy of teachers played a partial mediating role between them.Furthermore, moderation analysis revealed that teaching mindfulness moderated the relationship between kindergarten organizational climate and teacher professional learning. Discussion: These results expand our understanding of how the organizational climate of kindergartens affects teacher professional learning. In practice, professional learning of kindergarten teachers can be facilitated by creating an open organizational climate and improving their ability to perceive the collective. Furthermore, the moderating role of teaching mindfulness suggests that intervening in teachers' teaching mindfulness possibly is an influential way to maximize the impact of kindergarten organizational climate on professional learning.

Problem Gambling and Suicidal Behaviours in Young Adult men in Ghana: A Moderated Mediation Model of Psychological Distress and Social Support : Journal of Gambling Studies.

Problem gambling has been recognised as an important public health issue because of its harmful consequences at the personal, interpersonal, and societal levels. There is a proliferation of gambling activities in Ghana owing to increased access to the internet, soaring smartphone penetration, and an influx of sports betting companies. Yet, very little research has addressed the harm associated with problem gambling in Ghana. This study assessed if the effect of problem gambling severity on suicidal behaviours (ideation, planning, and attempts) through psychological distress is contingent on the level of perceived social support. A total of 350 young adult men in the Greater Accra Region of Ghana provided the data for the current analysis. The data were analysed using a moderated mediation approach. The results showed that psychological distress is an important intervening mechanism through which problem gambling severity influences suicidality. In addition, the positive association between psychological distress and suicidal behaviours was found to be conditional on the levels of perceived social support. In other words, our results showed that problem gambling may first trigger episodes of psychological distress, which, in turn, can lead to suicidality among problem gamblers who report low to moderate levels of perceived social support. Our findings suggest that young adult problem gamblers require higher levels of social support from family, friends, and significant others to prevent those experiencing psychological distress from engaging in suicidal behaviours.

Investigating Alexithymia as a Moderator of Outcomes in a Randomized Controlled Trial of an Online Intervention for Co-Occurring Depression and Hazardous Alcohol Use: Enquête sur l'alexithymie en tant que modérateur des résultats dans un essai randomisé contrôlé d'une intervention en ligne pour la dépression concomitante et la consommation dangereuse d'alcool.

OBJECTIVE: Alexithymia is characterized by difficulty identifying and/or describing emotions, reduced imaginal processes, and externally oriented thinking. High levels of alexithymia may increase the challenge of supporting individuals with co-occurring depression and hazardous alcohol use. This secondary analysis sought to investigate whether or not alexithymia moderated the outcomes of an online intervention for depression and alcohol use. METHOD: As part of a randomized controlled trial, 988 participants were randomly assigned to receive an intervention dually focused on depression and alcohol use, or an intervention only focused on depression. The pre-specified mediation hypothesis was that changes in drinking at 3 months follow-up would effect the association between the intervention and change in depression at 6 months. This secondary analysis extends the investigation by adding alexithymia as a moderator. RESULTS: The current analysis demonstrated that including alexithymia as a moderator resulted in a conditional direct effect. Specifically, there was an intervention effect where participants who received the combined depression and alcohol intervention had larger improvements in their depression scores at 6 months, but this was only when their alexithymia score at baseline was also high (60.5 or higher). CONCLUSION: These results suggest that treatment planning and intervention effectiveness could be informed and optimized by taking alexithymia severity into consideration. This is especially merited as alexithymia can contribute to the weaker therapeutic alliance, more distress and dysphoria, shorter periods of abstinence, and more severe depression, compounding the complexity of supporting individuals with comorbid conditions. More research is needed to systematically investigate these possible modifying effects. PLAIN LANGUAGE TITLE: Does difficulty identifying/describing emotions or externally-oriented thinking influence the effectiveness of an intervention among people with both depression and hazardous alcohol use?

In a recent study we recruited participants who were concerned with both their alcohol use and low mood. We provided two different online interventions. Half of the participants received an intervention designed for both concerns and half received an intervention that addressed only depression. We hypothesized that receiving the combined intervention for both concerns would result in greater benefits, however, our results indicated no apparent difference. This analysis uses the same data, but investigated the influences of alexithymia on the effectiveness of the interventions. Alexithymia is defined as having difficulty identifying/describing emotions and/or thinking more about external events than internal feelings. It commonly co-occurs with depression and with hazardous alcohol use and can increase the challenge of supporting individuals with these co-occurring concerns. The results of this analysis showed support for our original hypothesis that participants who received the intervention that addressed both their mood and alcohol concerns had lower depression scores 6-months later, but only among individuals who also had alexithymia scores above 60.5. Taking alexithymia severity into consideration during treatment planning may help optimize the effectiveness of interventions. These results show merit for future research to consider alexithymia as a variable that could potentially impact outcomes among individuals with co-occurring depression and hazardous alcohol use.