The mediating role of resilience in the relationships between posttraumatic growth and depression as well as anxiety among survivors of nasopharyngeal carcinoma: a cross-sectional study

Abstract

Background: Nasopharyngeal carcinoma (NPC) survivors demonstrate heightened vulnerability to depression and anxiety, while posttraumatic growth (PTG) and resilience have been reported as important protective factors for mental health. This study examined the mediating role of resilience in the associations between PTG and both depression and anxiety among NPC survivors. Methods: A total of 773 NPC survivors were recruited through convenience sampling at Sun Yat-sen University Cancer Center (Guangzhou, China). Participants completed a self-administered structured questionnaire measuring sociodemographic and clinical characteristics, depression (PHQ-9), anxiety (GAD-7), posttraumatic growth (PTGI), and resilience (CD-RISC10). Mediation analyses were performed using structural equation modeling. Results: The average time since cancer diagnosis was 2.68 (SD = 1.80) years, with 55.0% diagnosed for over 2 years. Among the participants, 44.2% reported mild to severe depressive symptoms, and 35.3% reported mild to severe anxiety. Higher PTG was significantly associated with lower symptoms of depression (β = −0.23, p < 0.001) and anxiety (β = −0.19, p < 0.001). Additionally, greater resilience was associated with reduced symptoms of depression (β = −0.37, p < 0.001) and anxiety (β = −0.33, p < 0.001). Further, resilience fully mediated the relationship between PTG and both anxiety (86.50%) and depression (74.13%). Conclusion: PTG and resilience are negatively associated with depression and anxiety in NPC survivors, with resilience acting as a complete mediator in these relationships.