Moderating Role of Health Literacy on the Association between Alexithymia and Depressive Symptoms in Middle School Students

Abstract

Depression is a common psychological problem in adolescents. At present, few studies have described the moderating role of health literacy on the association between alexithymia and depressive symptoms among adolescents. The purpose of this study was to explore the relation among health literacy, alexithymia, and depressive symptoms and the moderating role of health literacy in middle school students. In December 2017, data were collected from a school in Shenyang by the convenient sampling method using a questionnaire including demographic information, health literacy, alexithymia, and depressive symptoms. A total of 1068 junior and senior high school students were selected as subjects, and 1062 valid questionnaires were retained for analysis. Logistic regression models were used to examine the association between health literacy and alexithymia with depressive symptoms. The prevalence of depressive symptoms was 48.2%, and the prevalence of alexithymia was 17.9%. Low health literacy was significantly associated with depressive symptoms (odds ratio (OR) (95% confidence interval (CI)) = 3.648 (2.493–5.338)). Alexithymia was significantly correlated with depressive symptoms (OR (95% CI) = 3.091 (2.156–4.429)). Low health literacy was related to a greater increase in the risk of depressive symptoms for students with alexithymia (OR (95% CI) = 10.566 (5.175–21.570)). The findings suggest that alexithymia and health literacy are important factors influencing depressive symptoms and health literacy has a moderating role on the association between alexithymia and depressive symptoms. Enhancing health literacy of middle school students with alexithymia may improve their mental health.

Social Support, Health Literacy and Depressive Symptoms among Medical Students: An Analysis of Mediating Effects

“…College students with lower HL reported more depressive symptoms. This finding is consistent with previous studies [ 21 , 22 ]; lower heath literacy may be an independent risk factor for depressive symptoms. Social support was negatively associated with depressive symptoms after potential covariates were controlled, proving protective as a factor against depression.…”

“…Our previous studies reported potential demographic or confounding variables [ 9 , 17 , 21 , 23 ]. Participant characteristics include gender, academic performance, and self-rated health (SRH).…”

“…Health literacy (HL) is described as the “cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health” [ 19 ]. Health literacy tends to be under-valued, but the evidence suggests it is an independent and direct predictor of health outcomes [ 20 , 21 , 22 ] and people with lower levels of health literacy are more likely to report worse health-related behaviors, poorer use of health care services and poorer health status [ 23 ]. In some countries, such as China and Korea, the promotion of health literacy has therefore been engaged as a key strategy to reduce health inequities [ 20 , 21 , 22 ].…”

Prevalence and Correlates of Alexithymia and Its Relationship With Life Events in Chinese Adolescents With Depression During the COVID-19 Pandemic

“…As far as we know, this is the first cross-sectional study of alexithymia and its relationship with life events in Chinese adolescent patients with depression during the pandemic. The results showed that 76.45% of adolescent patients reported alexithymia, which was significantly higher than the prevalence of alexithymia (26.75%) in adolescents with depressive symptoms before the outbreak ( 45 ). In addition, previous studies have shown that the prevalence of alexithymia ranges from 7.3 to 29.9% in adolescents ( 20 , 21 ), from 9 to 17% in males and 5 to 10% in females of working age ( 46 , 47 ), over 20% in the older age groups, and even over 30% in the oldest populations ( 48 ).…”

Moderating role of mental health literacy on the relationship between bullying victimization during the life course and symptoms of anxiety and depression in Chinese college students

“…Therefore, it is particularly important to reduce the occurrence of stress response by finding moderating factors. Our previous study has found that health literacy has a moderating role on the association between alexithymia and depressive symptoms [ 27 ]. As the extension of the concept of health literacy, mental health literacy may also have a moderating effect.…”