Table 3.

Direct and indirect effect with covariate of the original hypothesized model using quality of life as a whole (n = 241)

Path	B	SE	Lower CI	Upper CI	β	z	p
Direct effect
IMP/ATT_T1 → Self-stigma_T2	0.01	0.00	0.01	0.02	0.13	2.39	0.017
Suicidality_T1 → Self-stigma_T2	0.12	0.18	− 0.22	0.47	0.05	0.69	0.488
Self-stigma_T1 → Self-stigma_T2	0.55	0.07	0.41	0.69	0.51	7.70	< 0.001
Self-stigma_T2 → QoL_T3	− 0.93	0.15	− 1.23	− 0.63	− 0.31	− 6.05	< 0.001
Suicidality_T1 → QoL_T3	− 0.85	0.55	− 1.93	0.23	− 0.11	− 1.55	0.122
QoL_T1 → QoL_T3	0.48	0.07	0.34	0.62	0.47	6.84	< 0.001
IMP/ATT_T1 → QoL_T3	− 0.03	0.01	− 0.06	− 0.01	− 0.13	− 3.05	0.002
Self-stigma_T2 → Psychological distress_T3	5.44	0.56	4.35	6.53	0.46	9.80	< 0.001
Suicidality_T1 → Psychological distress_T3	8.25	2.61	3.13	13.37	0.28	3.16	0.002
IMP/ATT_T1 → Psychological distress_T3	0.10	0.04	0.03	0.18	0.10	2.69	0.007
Indirect effect
IMP/ATT_T1 → Self-stigma_T2 → QoL_T3	− 0.01	0.00	− 0.02	− 0.01	− 0.04	− 2.28	0.023
IMP/ATT_T1 → Self-stigma_T2 → Psychological distress_T3	0.06	0.03	0.01	0.12	0.06	2.35	0.019
Suicidality_T1 → Self-stigma_T2 → QoL_T3	− 0.11	0.16	− 0.43	0.21	− 0.01	− 0.70	0.485
Suicidality_T1 → Self-stigma_T2 → Psychological distress_T3	0.67	0.95	− 1.20	2.53	0.02	0.70	0.484
Self-stigma_T1 → Self-stigma_T2 → QoL_T3	− 0.51	0.11	− 0.73	− 0.29	− 0.16	− 4.55	< 0.001
Self-stigma_T1 → Self-stigma_T2 → Psychological distress_T3	2.98	0.55	1.90	4.05	0.24	5.43	< 0.001
Covariate
Sex → QoL_T3	− 0.07	0.22	− 0.50	0.36	− 0.02	− 0.33	0.738
Sex → Psychological distress_T3	− 0.75	0.84	− 2.39	0.89	− 0.04	− 0.90	0.369
Education → QoL_T3	− 0.14	0.10	− 0.34	0.06	− 0.07	− 1.41	0.159
Education → Psychological distress_T3	− 0.02	0.38	− 0.75	0.72	− 0.00	− 0.04	0.967
Age → QoL_T3	0.01	0.01	− 0.02	0.03	0.03	0.43	0.670
Age → Psychological distress_T3	− 0.09	0.05	− 0.18	− 0.00	− 0.12	− 2.05	0.040
Marriage → QoL_T3	0.01	0.06	− 0.11	0.13	0.01	0.14	0.886
Marriage → Psychological distress_T3	0.29	0.27	− 0.23	0.81	0.07	1.09	0.275

B Beta estimate, SE standard error, β standardized beta estimate; CI Confidence interval at 95%, IMP/ATT inattention and impulsivity symptoms, Suicidality suicide risk, QoL quality of life, Psychological distress depression, anxiety, and stress, T1 timepoint 1, T2 timepoint 2, T3 timepoint 3

A positive direct effect (e.g., IMP/ATT_T1 → Self-stigma_T2) means that higher scores on the predictor are associated with higher scores on the outcome; a negative direct effect indicates an inverse association. An indirect effect (e.g., IMP/ATT_T1 → Self-stigma_T2 → QoL_T3) quantifies how much of the predictor’s effect on the outcome is transmitted via a mediator (for example, if predictor → mediator → outcome is significant, part of predictor’s impact on outcome works by changing the mediator)