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Association Between Social Support, and Depressive Symptoms Among Firefighters: The Mediating Role of Negative Coping

  • Liang Wang (College of Public Health, Chongqing Medical University) ;
  • Fengqiong Chen (Chongqing Center for Disease Control and Prevention) ;
  • Yulu Zhang (College of Public Health, Chongqing Medical University) ;
  • Mengliang Ye (College of Public Health, Chongqing Medical University)
  • Received : 2023.06.04
  • Accepted : 2023.10.03
  • Published : 2023.12.30

Abstract

Background: Depressive symptoms (DS) can erode physical and mental health; social support (SS) is considered a buffer for DS and a promoter for improving coping and recovery abilities. However, there is almost no research on the mediating role of negative coping (NC) in SS and DS, especially among firefighters. Methods: A cross-sectional survey was conducted among firefighters in Chongqing, China, and the valid data of 407 firefighters were collected through questionnaires distributed on the WeChat platform in 2020. Statistical Product and Service Solutions (SPSS) 26.0 is used for descriptive statistics and correlation analysis. Structural equation modeling was adopted to analyze the association among SS, NC, and DS. The mediation effect is also evaluated. Results: Firefighters' detection rate of DS is 23.3%, and when they receive more SS were less likely to develop DS. NC was positively correlated with DS (β = 0.54, p < 0.001) after controlling for SS. Besides, the results of structural equation modeling showed that NC partially mediates the relationship between SS and DS (standard error = 0.039, indirect effects = 0.109, 95% confidence interval: 0.047-0.200 p < 0.001). Conclusion: NC has a partial indirect effect between SS and DS among firefighters. SS could not only affect DS directly but also indirect work on it by affecting NC. This discovery will be a novel and meaningful part of the research on the firefighter population.

Keywords

Acknowledgement

The authors would like to thank all the participants involved in this project for their contribution and dedication sincerely.

References

  1. Lu J, Xu X, Huang Y, Li T, Ma C, Xu G, Yin H, Xu X, Ma Y, Wang L, Huang Z, Yan Y, Wang B, Xiao S, Zhou L, Li L, Zhang Y, Chen H, Zhang T, Yan J, Ding H, Yu Y, Kou C, Shen Z, Jiang L, Wang Z, Sun X, Xu Y, He Y, Guo W, Jiang L, Li S, Pan W, Wu Y, Li G, Jia F, Shi J, Shen Z, Zhang N. Prevalence of depressive disorders and treatment in China: a cross-sectional epidemiological study. Lancet Psychiatry 2021;8(11):981-90.  https://doi.org/10.1016/S2215-0366(21)00251-0
  2. Ren X, Yu S, Dong W, Yin P, Xu X, Zhou M. Burden of depression in China, 1990-2017: findings from the global burden of disease study 2017. J Affect Disord 2020;268:95-101.  https://doi.org/10.1016/j.jad.2020.03.011
  3. Fullerton CS, Ursano RJ, Wang L. Acute stress disorder, posttraumatic stress disorder, and depression in disaster or rescue workers. Am J Psychiatry 2004;161(8):1370-6.  https://doi.org/10.1176/appi.ajp.161.8.1370
  4. Lourel M, Abdellaoui S, Chevaleyre S, Paltrier M, Gana K. Relationships between psychological job demands, job control and burnout among firefighters. N Am J Psychol 2008;10(3):489-96. 
  5. Rosca AC, Mateizer A, Dan CI, Demerouti E. Job demands and exhaustion in firefighters: the moderating role of work meaning. A cross-sectional study. Int J Environ Res Public Health 2021;18(18). 
  6. Van Eerd D, Irvin E, Harbin S, Mahood Q, Tiong M. Occupational exposure and post-traumatic stress disorder: a rapid review. Work 2021;68(3):721-31.  https://doi.org/10.3233/WOR-203406
  7. Wagner SL, White N, Randall C, Regehr C, White M, Alden LE, Buys N, Carey MG, Corneil W, Fyfe T, Matthews LR, Fraess-Phillips A, Krutop E. Mental disorders in firefighters following large-scale disaster. Disaster Med Public Health Prep 2021;15(4):504-17.  https://doi.org/10.1017/dmp.2020.61
  8. Chen X, Zhang L, Peng Z, Chen S. Factors influencing the mental health of firefighters in shantou city, China. Psychol Res Behav Manag 2020;13:529-36.  https://doi.org/10.2147/PRBM.S249650
  9. Tak S, Driscoll R, Bernard B, West C. Depressive symptoms among firefighters and related factors after the response to Hurricane Katrina. J Urban Health 2007;84(2):153-61.  https://doi.org/10.1007/s11524-006-9155-1
  10. Kunz KR, Turcotte K, Pawer S, Zheng A, Purewal A, Wellar A, Karmali S, Garis L, Thomas LS, Pike I. Cancer in female firefighters: the clinicobiological, psychological, and social perspectives. Front Public Health 2023;11:1126066. 
  11. Trivisonno AJ, Laffan MR, Giuliani HK, Mota JA, Gerstner GR, Smith-Ryan AE, Ryan ED. The influence of age on the recovery from worksite resistance exercise in career firefighters. Exp Gerontol 2021;152:111467. 
  12. Rush AJ, Trivedi MH, Wisniewski SR, Stewart JW, Nierenberg AA, Thase ME, Ritz L, Biggs MM, Warden D, Luther JF, Shores-Wilson K, Niederehe G, Fava M. Bupropion-SR, sertraline, or venlafaxine-XR after failure of SSRIs for depression. N Engl J Med 2006;354(12):1231-42.  https://doi.org/10.1056/NEJMoa052963
  13. Zhou Y, MacGeorge EL, Myrick JG. Mental health and its predictors during the early months of the COVID-19 pandemic experience in the United States. Int J Environ Res Public Health 2020;17(17). 
  14. Escobar D, Noll P, Jesus TF, Noll M. Assessing the mental health of Brazilian students involved in risky behaviors. Int J Environ Res Public Health 2020;17(10). 
  15. Hallgren M, Lundin A, Tee FY, Burstrom B, Forsell Y. Somebody to lean on: social relationships predict post-treatment depression severity in adults. Psychiatry Res 2017;249:261-7.  https://doi.org/10.1016/j.psychres.2016.12.060
  16. Yalcin I. [Relationships between well-being and social support: a meta analysis of studies conducted in Turkey]. Turk Psikiyatri Derg 2015;26(1):21-32. 
  17. Meshi D, Ellithorpe ME. Problematic social media use and social support received in real-life versus on social media: associations with depression, anxiety and social isolation. Addict Behav 2021;119:106949. 
  18. Fu C, Wang G, Shi X, Cao F. Social support and depressive symptoms among physicians in tertiary hospitals in China: a cross-sectional study. BMC Psychiatry 2021;21(1):217. 
  19. Cacioppo JT, Hawkley LC, Thisted RA. Perceived social isolation makes me sad: 5-year cross-lagged analyses of loneliness and depressive symptomatology in the Chicago Health, Aging, and Social Relations Study. Psychol Aging 2010;25(2):453-63.  https://doi.org/10.1037/a0017216
  20. Possel P, Burton SM, Cauley B, Sawyer MG, Spence SH, Sheffield J. Associations between social support from family, friends, and teachers and depressive symptoms in adolescents. J Youth Adolesc 2018;47(2):398-412.  https://doi.org/10.1007/s10964-017-0712-6
  21. VandenBos GR. APA dictionary of psychology. American Psychological Association; 2007. 
  22. Cheng Y, Li X, Lou C, Sonenstein FL, Kalamar A, Jejeebhoy S, Delany-Moretlwe S, Brahmbhatt H, Olumide AO, Ojengbede O. The association between social support and mental health among vulnerable adolescents in five cities: findings from the study of the well-being of adolescents in vulnerable environments. J Adolesc Health 2014;55(6 Suppl):S31-8.  https://doi.org/10.1016/j.jadohealth.2014.08.020
  23. Uchino BN. Understanding the links between social support and physical health: a life-span perspective with emphasis on the separability of perceived and received support. Perspect Psychol Sci 2009;4(3):236-55.  https://doi.org/10.1111/j.1745-6924.2009.01122.x
  24. Nowicki GJ, Slusarska B, Tucholska K, Naylor K, Chrzan-Rodak A, Niedorys B. The severity of traumatic stress associated with COVID-19 pandemic, perception of support, sense of security, and sense of meaning in life among nurses: research protocol and preliminary results from Poland. Int J Environ Res Public Health 2020;17(18). 
  25. Chu PS, Saucier DA, Hafner E. Meta-analysis of the relationships between social support and well-being in children and adolescents. J Soc Clin Psychol 2010;29(6):624-45.  https://doi.org/10.1521/jscp.2010.29.6.624
  26. Duko B, Gebeyehu A, Ayano G. Prevalence and correlates of depression and anxiety among patients with tuberculosis at WolaitaSodo university hospital and sodo health center, WolaitaSodo, south Ethiopia, cross sectional study. BMC Psychiatry 2015;15:214. 
  27. Grey I, Arora T, Thomas J, Saneh A, Tohme P, Abi-Habib R. The role of perceived social support on depression and sleep during the COVID-19 pandemic. Psychiatry Res 2020;293:113452. 
  28. Chatters LM, Taylor RJ, Woodward AT, Nicklett EJ. Social support from church and family members and depressive symptoms among older African Americans. Am J Geriatr Psychiatry 2015;23(6):559-67.  https://doi.org/10.1016/j.jagp.2014.04.008
  29. Sheffler J, Sachs-Ericsson N. Racial differences in the effect of stress on health and the moderating role of perceived social support. J Aging Health 2016;28(8):1362-81.  https://doi.org/10.1177/0898264315618923
  30. Archibald PC, Dobson Sydnor K, Daniels K, Bronner Y. Explaining African-Americans' depressive symptoms: a stress-distress and coping perspective. J Health Psychol 2013;18(3):321-31.  https://doi.org/10.1177/1359105312440297
  31. Feng L, Yin R. Social support and hope mediate the relationship between gratitude and depression among front-line medical staff during the pandemic of COVID-19. Front Psychol 2021;12:623873. 
  32. Yu H, Li M, Li Z, Xiang W, Yuan Y, Liu Y, Li Z, Xiong Z. Coping style, social support and psychological distress in the general Chinese population in the early stages of the COVID-19 epidemic. BMC Psychiatry 2020;20(1):426. 
  33. Yan L, Gan Y, Ding X, Wu J, Duan H. The relationship between perceived stress and emotional distress during the COVID-19 outbreak: effects of boredom proneness and coping style. J Anxiety Disord 2021;77:102328. 
  34. Huang Y, Su X, Si M, Xiao W, Wang H, Wang W, Gu X, Ma L, Li J, Zhang S, Ren Z, Qiao Y. The impacts of coping style and perceived social support on the mental health of undergraduate students during the early phases of the COVID-19 pandemic in China: a multicenter survey. BMC Psychiatry 2021;21(1):530. 
  35. Tong X, Chen J, Park SP, Wang X, Wang C, Su M, Zhou D. Social support for people with epilepsy in China. Epilepsy Behav 2016;64(Pt A):224-32.  https://doi.org/10.1016/j.yebeh.2016.08.010
  36. Asghar MZ, Arif S, Barbera E, Seitamaa-Hakkarainen P, Kocayoruk E. Support through social media and online class participation to enhance psychological resilience. Int J Environ Res Public Health 2021;18(22). 
  37. Rappaport LM, Amstadter AB, Neale MC. Model fit estimation for multilevel structural equation models. Struct Equ Model 2020;27(2):318-29.  https://doi.org/10.1080/10705511.2019.1620109
  38. Wang W, Bian Q, Zhao Y, Li X, Wang W, Du J, Zhang G, Zhou Q, Zhao M. Reliability and validity of the Chinese version of the Patient Health Questionnaire (PHQ-9) in the general population. Gen Hosp Psychiatry 2014;36(5):539-44.  https://doi.org/10.1016/j.genhosppsych.2014.05.021
  39. Wang J, Zhang QY, Chen HQ, Sun DY, Wang C, Liu XM, Sun YY, Li S, Yu SF. [Development of the core occupational stress scale for occupational populations in China]. Zhonghua Yu Fang Yi Xue Za Zhi 2020;54(11):1184-9. 
  40. Zhou J, Yang Y, Qiu X, Yang X, Pan H, Ban B, Qiao Z, Wang L, Wang W. Relationship between anxiety and burnout among Chinese physicians: a moderated mediation model. PLoS One 2016;11(8):e0157013. 
  41. Bentler PM. Comparative fit indexes in structural models. Psychol Bull 1990;107(2):238-46.  https://doi.org/10.1037//0033-2909.107.2.238
  42. Tibbe TD, Montoya AK. Correcting the bias correction for the bootstrap confidence interval in mediation analysis. Front Psychol 2022;13:810258. 
  43. Guardino CM, Schetter CD. Coping during pregnancy: a systematic review and recommendations. Health Psychol Rev 2014;8(1):70-94.  https://doi.org/10.1080/17437199.2012.752659
  44. de Tychey C, Spitz E, Briancon S, Lighezzolo J, Girvan F, Rosati A, Thockler A, Vincent S. Pre- and postnatal depression and coping: a comparative approach. J Affect Disord 2005;85(3):323-6.  https://doi.org/10.1016/j.jad.2004.11.004
  45. Prasertsri N, Holden J, Keefe FJ, Wilkie DJ. Repressive coping style: relationships with depression, pain, and pain coping strategies in lung cancer outpatients. Lung Cancer 2011;71(2):235-40.  https://doi.org/10.1016/j.lungcan.2010.05.009
  46. Wang DF, Zhou YN, Liu YH, Hao YZ, Zhang JH, Liu TQ, Ma YJ. Social support and depressive symptoms: exploring stigma and self-efficacy in a moderated mediation model. BMC Psychiatry 2022;22(1):117. 
  47. Fu C, Cui X, Geng L, Cao F. Association between social support and depressive symptoms among Chinese nurses with formal employment versus contractbased employment. Front Psychiatry 2023;14:1037499. 
  48. Obuobi-Donkor G, Oluwasina F, Nkire N, Agyapong VIO. A scoping review on the prevalence and determinants of post-traumatic stress disorder among military personnel and firefighters: implications for public policy and practice. Int J Environ Res Public Health 2022;19(3). 
  49. Ren J, Jiang X, Yao J, Li X, Liu X, Pang M, Chiang CL. Depression, social support, and coping styles among pregnant women after the lushan earthquake in Ya'an, China. PLoS One 2015;10(8):e0135809. 
  50. Sherbourne CD, Hays RD. Marital status, social support, and health transitions in chronic disease patients. J Health Soc Behav 1990;31(4):328-43.  https://doi.org/10.2307/2136817
  51. Eaton RJ, Bradley G. The role of gender and negative affectivity in stressor appraisal and coping selection. Int J Stress Manag 2008;15(1):94. 
  52. Gonzalez-Morales MG, Peiro JM, Rodriguez I, Greenglass ER. Coping and distress in organizations: the role of gender in work stress. Int J Stress Manag 2006;13(2):228. 
  53. Matud MP, Bethencourt JM, Ibanez I. Gender differences in psychological distress in Spain. Int J Soc Psychiatry 2015;61(6):560-8.  https://doi.org/10.1177/0020764014564801
  54. Kelly MM, Tyrka AR, Price LH, Carpenter LL. Sex differences in the use of coping strategies: predictors of anxiety and depressive symptoms. Depress Anxiety 2008;25(10):839-46.  https://doi.org/10.1002/da.20341
  55. Leach LS, Christensen H, Mackinnon AJ, Windsor TD, Butterworth P. Gender differences in depression and anxiety across the adult lifespan: the role of psychosocial mediators. Soc Psychiatry Psychiatr Epidemiol 2008;43(12):983-98.  https://doi.org/10.1007/s00127-008-0388-z
  56. Tomioka K, Morita N, Saeki K, Okamoto N, Kurumatani N. Working hours, occupational stress and depression among physicians. Occup Med (Lond) 2011;61(3):163-70.  https://doi.org/10.1093/occmed/kqr004
  57. Wang J, Zou R, Wu N, Fu H, He Y, Crawford P, Kane E, Dai J. Depressive symptoms, social support, and health-related quality of life: a community-based study in Shanghai, China. Compr Psychiatry 2022;113:152292. 
  58. Jahnke SA, Poston WS, Haddock CK, Jitnarin N. Obesity and incident injury among career firefighters in the central United States. Obesity (Silver Spring) 2013;21(8):1505-8.  https://doi.org/10.1002/oby.20436
  59. Tao Y, Liu X, Hou W, Niu H, Wang S, Ma Z, Bi D, Zhang L. The mediating role of emotion regulation strategies in the relationship between big five personality traits and anxiety and depression among Chinese firefighters. Front Public Health 2022;10:901686. 
  60. He Y, Huang L, Chen J, Long L, Zhang L, Hui X, Zhang Q, Guan M, Xie Y, Sun J. Mental health status and related influencing factors in patients with COVID19. BMC Psychol 2023;11(1):225.