Table 4.
Direct and indirect effect with covariate of the alternative hypothesized model using specific quality of life domains (n = 241)
| Path | B | SE | Lower CI | Upper CI | β | z | p |
|---|---|---|---|---|---|---|---|
| Direct effects | |||||||
| IMP/ATT_T1 → Self-stigma_T2 | 0.01 | 0.01 | 0.00 | 0.02 | 0.13 | 2.29 | 0.022 |
| Suicidality_T1 → Self-stigma_T2 | 0.14 | 0.19 | − 0.23 | 0.50 | 0.05 | 0.73 | 0.466 |
| Self-stigma_T1 → Self-stigma_T2 | 0.55 | 0.07 | 0.41 | 0.68 | 0.51 | 7.74 | < 0.001 |
| Self-stigma_T2 → Psychological distress_T3 | 5.54 | 0.56 | 4.43 | 6.64 | 0.46 | 9.81 | < 0.001 |
| Suicidality_T1 → Psychological distress_T3 | 8.34 | 2.72 | 3.00 | 13.68 | 0.28 | 3.06 | 0.002 |
| IMP/ATT_T1 → Psychological distress_T3 | 0.10 | 0.04 | 0.02 | 0.19 | 0.10 | 2.31 | 0.021 |
| Self-stigma_T2 → Phy_T3 | − 1.26 | 0.20 | − 1.66 | − 0.87 | − 0.36 | − 6.31 | < 0.001 |
| Suicidality_T1 → Phy_T3 | − 1.08 | 0.68 | − 2.41 | 0.25 | − 0.12 | − 1.59 | 0.112 |
| IMP/ATT_T1 → Phy_T3 | − 0.03 | 0.01 | − 0.06 | − 0.01 | − 0.11 | − 2.39 | 0.017 |
| Phy_T1 → Phy_T3 | 0.29 | 0.05 | 0.20 | 0.38 | 0.30 | 6.43 | < 0.001 |
| Self-stigma_T2 → Psy_T3 | − 1.63 | 0.25 | − 2.11 | − 1.14 | − 0.38 | − 6.53 | < 0.001 |
| Suicidality_T1 → Psy_T3 | − 1.24 | 0.78 | − 2.76 | 0.28 | − 0.11 | − 1.60 | 0.109 |
| IMP/ATT_T1 → Psy_T3 | − 0.04 | 0.02 | − 0.07 | − 0.01 | − 0.10 | − 2.38 | 0.017 |
| Psy_T1 → Psy_T3 | 0.28 | 0.05 | 0.19 | 0.37 | 0.27 | 5.99 | < 0.001 |
| Self-stigma_T2 → Soc_T3 | − 1.08 | 0.21 | − 1.49 | − 0.66 | − 0.27 | − 5.07 | < 0.001 |
| Suicidality_T1 → Soc_T3 | − 1.49 | 0.72 | − 2.90 | − 0.08 | − 0.15 | − 2.07 | 0.038 |
| IMP/ATT_T1 → Soc_T3 | − 0.04 | 0.02 | − 0.07 | − 0.00 | − 0.11 | − 1.99 | 0.046 |
| Soc_T1 → Soc_T3 | 0.39 | 0.05 | 0.29 | 0.50 | 0.40 | 7.56 | < 0.001 |
| Self-stigma_T2 → Env_T3 | − 0.87 | 0.20 | − 1.27 | − 0.48 | − 0.25 | − 4.31 | < 0.001 |
| Suicidality_T1 → Env_T3 | − 1.18 | 0.59 | − 2.35 | − 0.02 | − 0.14 | − 1.99 | 0.046 |
| IMP/ATT_T1 → Env_T3 | − 0.06 | 0.01 | − 0.09 | − 0.03 | − 0.20 | − 4.06 | < 0.001 |
| Env_T1 → Env_T3 | 0.32 | 0.05 | 0.23 | 0.42 | 0.32 | 6.50 | < 0.001 |
| Indirect effects | |||||||
| IMP/ATT_T1 → Self-stigma_T2 → Psychological distress_T3 | 0.06 | 0.03 | 0.01 | 0.12 | 0.06 | 2.24 | 0.025 |
| IMP/ATT_T1 → Self-stigma_T2 → Phy_T3 | − 0.01 | 0.01 | − 0.03 | − 0.00 | − 0.05 | − 2.18 | 0.030 |
| IMP/ATT_T1 → Self-stigma_T2 → Psy_T3 | − 0.02 | 0.01 | − 0.04 | − 0.00 | − 0.05 | − 2.13 | 0.033 |
| IMP/ATT_T1 → Self-stigma_T2 → Soc_T3 | − 0.01 | 0.01 | − 0.02 | − 0.00 | − 0.04 | − 2.14 | 0.032 |
| IMP/ATT_T1 → Self-stigma_T2 → Env_T3 | − 0.01 | 0.01 | − 0.02 | − 0.00 | − 0.03 | − 1.99 | 0.046 |
| Suicidality_T1 → Self-stigma_T2 → Psychological distress_T3 | 0.75 | 1.02 | − 1.25 | 2.74 | 0.02 | 0.73 | 0.463 |
| Suicidality_T1 → Self-stigma_T2 → Phy_T3 | − 0.17 | 0.23 | − 0.63 | 0.28 | − 0.02 | − 0.74 | 0.462 |
| Suicidality_T1 → Self-stigma_T2 → Psy_T3 | − 0.22 | 0.30 | − 0.80 | 0.36 | − 0.02 | − 0.74 | 0.458 |
| Suicidality_T1 → Self-stigma_T2 → Soc_T3 | − 0.15 | 0.20 | − 0.54 | 0.25 | − 0.01 | − 0.72 | 0.470 |
| Suicidality_T1 → Self-stigma_T2 → Env_T3 | − 0.12 | 0.16 | − 0.43 | 0.20 | − 0.01 | − 0.73 | 0.464 |
| Self-stigma_T1 → Self-stigma_T2 → Psychological distress_T3 | 3.02 | 0.55 | 1.94 | 4.10 | 0.24 | 5.47 | < 0.001 |
| Self-stigma_T1 → Self-stigma_T2 → Phy_T3 | − 0.69 | 0.15 | − 0.98 | − 0.40 | − 0.18 | − 4.71 | < 0.001 |
| Self-stigma_T1 → Self-stigma_T2 → Psy_T3 | − 0.89 | 0.18 | − 1.25 | − 0.52 | − 0.19 | − 4.80 | < 0.001 |
| Self-stigma_T1 → Self-stigma_T2 → Soc_T3 | − 0.59 | 0.14 | − 0.86 | − 0.31 | − 0.14 | − 4.18 | < 0.001 |
| Self-stigma_T1 → Self-stigma_T2 → Env_T3 | − 0.48 | 0.13 | − 0.73 | − 0.22 | − 0.13 | − 3.69 | < 0.001 |
| Covariates | |||||||
| Sex → Psychological distress_T3 | − 0.76 | 0.87 | − 2.46 | 0.95 | − 0.04 | − 0.87 | 0.385 |
| Age → Psychological distress_T3 | − 0.09 | 0.05 | − 0.20 | 0.01 | − 0.12 | − 1.81 | 0.070 |
| Marriage → Psychological distress_T3 | 0.29 | 0.27 | − 0.24 | 0.81 | 0.06 | 1.07 | 0.286 |
| Education → Psychological distress_T3 | − 0.03 | 0.41 | − 0.83 | 0.77 | − 0.00 | − 0.07 | 0.942 |
| Sex → Phy_T3 | 0.09 | 0.27 | − 0.43 | 0.61 | 0.02 | 0.34 | 0.737 |
| Age → Phy_T3 | − 0.00 | 0.02 | − 0.04 | 0.03 | − 0.02 | − 0.25 | 0.800 |
| Marriage → Phy_T3 | 0.04 | 0.08 | − 0.12 | 0.20 | 0.03 | 0.46 | 0.644 |
| Education → Phy_T3 | − 0.07 | 0.13 | − 0.32 | 0.17 | − 0.03 | − 0.56 | 0.573 |
| Sex → Psy_T3 | 0.03 | 0.32 | − 0.60 | 0.66 | 0.00 | 0.09 | 0.930 |
| Age → Psy_T3 | − 0.01 | 0.02 | − 0.05 | 0.03 | − 0.04 | − 0.50 | 0.620 |
| Marriage → Psy_T3 | 0.00 | 0.10 | − 0.19 | 0.19 | 0.00 | 0.03 | 0.977 |
| Education → Psy_T3 | − 0.17 | 0.16 | − 0.49 | 0.16 | − 0.06 | − 1.01 | 0.313 |
| Sex → Soc_T3 | − 0.19 | 0.28 | − 0.74 | 0.36 | − 0.03 | − 0.68 | 0.493 |
| Age → Soc_T3 | 0.00 | 0.02 | − 0.03 | 0.04 | 0.01 | 0.16 | 0.870 |
| Marriage → Soc_T3 | − 0.13 | 0.08 | − 0.29 | 0.04 | − 0.09 | − 1.53 | 0.126 |
| Education → Soc_T3 | − 0.37 | 0.12 | − 0.61 | − 0.12 | − 0.15 | − 2.96 | 0.003 |
| Sex → Env_T3 | 0.10 | 0.27 | − 0.44 | 0.63 | 0.02 | 0.36 | 0.716 |
| Age → Env_T3 | 0.02 | 0.02 | − 0.01 | 0.05 | 0.08 | 1.21 | 0.227 |
| Marriage → Env_T3 | 0.02 | 0.07 | − 0.12 | 0.16 | 0.02 | 0.29 | 0.773 |
| Education → Env_T3 | − 0.08 | 0.13 | − 0.33 | 0.16 | − 0.04 | − 0.67 | 0.501 |
B beta estimate, SE standard error, β standardized beta estimate, CI confidence interval at 95%, Phy physical quality of life, Psy psychological quality of life, Soc social quality of life, Env environment quality of life, IMP/ATT inattention and impulsivity symptoms, Suicidality suicide risk, 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)