Effect of stressors on depressive mood among long-term high-altitude workers: a moderated mediation analysis

Abstract

Background: Diathesis-stress theory of depression is well known, which stresses that stressor is an inducing factor for depression in general population. High altitude, a combination of variety of stressors, is a special environment that may cultivate more depression. However, how different types of stressors contribute to depression and its underlying mechanisms in high-altitude populations remain unrevealed. The study aimed to reveal the effect of different stressors on depressive mood among long-term high-altitude workers in China and further explore the mediation of emotion regulation and moderation of parent-child alienation. Methods: 2065 Chinese workers at altitude of approximate 4200 m completed a cross-sectional survey with the Baker Depression Inventory-II scale, the Emotional Regulation scale, the Parent-child Alienation scale, and the Stressors scale (i.e., environmental factors, low social support, working challenges, accommodation, personal affairs, and cognitive factors). Results: Correlation analysis showed positive correlations between stressors and depressive mood (r = 0.05–0.94, p < 0.05). Regression analysis indicated that low social support stressor was the strongest predictor of depressive mood (β = 0.21), while working challenges, personal affairs, and cognitive factors also positively predicted depressive mood. The mediating model showed that expression inhibition played a partial mediating (promoting) role between stressors and depressive mood, accounting for 3.13% of total variance. The moderating model showed that parent-child alienation played a moderating role in the model (β = 0.01, p < 0.001); a lower level of parent-child alienation effectively alleviated the impacts of stressors on depressive mood. Conclusions: Stressors (working challenges, personal affairs, cognitive factors, and especially low social support) positively predict the depressive mood of long-term high-altitude workers in China. Expression inhibition plays a promoting mediation in the relationship between stressors and depressive mood. A good parent-child relationship alleviates the negative impact of stressors on depressive mood. Findings provide new empirical support for diathesis-stress theory and attract further attention to less expression inhibition and better parent-child relationships in depression prevention.