Mediating effect of resilience on the relationship between rumination and suicide attempts in Chinese adolescents with mood disorders

Abstract

To the editor: Mood disorders (MD) are serious mental illnesses that commonly affect adolescents, leading to a high incidence of suicidal behaviour.1 In China, the suicide attempt (SA) rate for adolescents with MD is 51.96%,2 and over 500 000 adolescent SA are reported annually in the USA due to depression.3 Risk factors for SA include gender, hormone levels, family conflict and, particularly, negative cognitive styles such as rumination.2–6 Our recent study2 has demonstrated a significant positive association between rumination and SA in adolescents with MD; rumination fully mediated the relationship between depression and SA. Additionally, our previous finding has revealed a negative correlation between rumination and resilience and that resilience mediates the relationship between rumination and depression.5 Furthermore, the protective model of resilience suggests that higher resilience buffers the harmful effects of risk and adversity, reduces adverse consequences, enhances cognitive flexibility and reduces rumination tendencies.7 However, there is a lack of evidence on the potential mediating role of resilience in the relationship between rumination and SA among adolescents with MD. Therefore, the main aims of this study are as follows: (1) to examine possible associations between rumination, resilience and SA in Chinese adolescents with MD; and (2) to test whether resilience mediates the relationship between rumination and SA in Chinese adolescents with MD. ### Participants In our current cross-sectional study, 611 adolescents with depressive episodes were recruited from October 2019 to June 2022 in the child and adolescent outpatient and inpatient departments of the Third People’s Hospital (a psychiatric hospital) in Ganzhou, Jiangxi Province, China. All patients were included if they met the following criteria: (1) Han Chinese, aged 11–18 with at least 5 years of education; (2) met the criteria of a current depressive episode as independently determined by two experienced psychiatrists and according …