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Impact of alexithymia on suicidal ideation among patients with ovarian cancer: a moderated mediation model of self-perceived burden and general self-efficacy

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Abstract

Purpose

Suicidal ideation (SI) and alexithymia are common psychological problems among patients with cancer. Studying how alexithymia predicts SI is helpful for its intervention and prevention strategies. The present study aimed to investigate whether self-perceived burden (SPB) mediates the impact of alexithymia on SI and if general self-efficacy moderates the associations of alexithymia with SPB and SI.

Methods

To measure SI, alexithymia, SPB, and general self-efficacy, 200 patients with ovarian cancer at all stages regardless of the type of treatment completed the Chinese version of the Self-Rating Idea of Suicide Scale, Toronto Alexithymia Scale, Self-Perceived Burden Scale, and General Self-Efficacy Scale in a cross-sectional study. The PROCESS macro for SPSS v4.0 procedure was applied to perform moderated mediation analysis.

Results

SPB significantly mediated the positive impact of alexithymia on SI (a×b = 0.082, 95% confidence interval [CI]: 0.026, 0.157). General self-efficacy significantly moderated the positive association between alexithymia and SPB (β = −0.227, P < 0.001). The mediating role of SPB was gradually reduced as general self-efficacy grew (low: 0.087, 95% CI: 0.010, 0.190; medium: 0.049, 95% CI: 0.006, 0.108; high: 0.010, 95% CI: −0.014, 0.046). Thus, a moderated mediation model involving SPB and general self-efficacy for explaining how alexithymia causes SI was supported.

Conclusion

Alexithymia could cause SI by inducing SPB among patients with ovarian cancer. General self-efficacy could attenuate the association between alexithymia and SPB. Interventions aimed at reducing SPB and enhancing general self-efficacy could reduce SI by partially preventing and attenuating the impact of alexithymia.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

The authors would like to thank all the patients who voluntarily participated in this study.

Funding

This study was funded by the China Postdoctoral Science Foundation (project number: 2021M693915).

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Authors and Affiliations

  1. Department of Social Medicine, School of Health Management, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning, China

    Li Liu, Yu Sun, Nansheng Luo, Ru Bai & Hui Wu

  2. Department of Gynecology, The First Affiliated Hospital of China Medical University, No. 155 Nanjing North Street, Heping District, Shenyang, 110001, Liaoning, China

    Li Liu, Yajing Wang, Meizhu Pan, Yuli Song & Yi Zhang

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  1. Li Liu
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Contributions

Hui Wu, Yi Zhang, and Li Liu contributed to the study’s conception and design. Data collection was performed by Yu Sun, Yajing Wang, Nansheng Luo, Ru Bai, Meizhu Pan, and Yuli Song. Li Liu and Hui Wu performed data analysis. Li Liu wrote the first draft of the manuscript and all authors commented on previous versions. All authors read and approved the final manuscript.

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Correspondence to Yi Zhang or Hui Wu.

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The study was approved by the Ethics Committee of China Medical University (2021M693915), and the study procedures adhere to the principles of the Declaration of Helsinki. Written or verbal informed consent was obtained from all individual participants included in the study.

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Liu, L., Sun, Y., Wang, Y. et al. Impact of alexithymia on suicidal ideation among patients with ovarian cancer: a moderated mediation model of self-perceived burden and general self-efficacy. Support Care Cancer 31, 177 (2023). https://doi.org/10.1007/s00520-023-07610-z

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