The following is a summary of “Self-confidence as a mediator in the relationship between executive functioning and depression among ICU survivors: a latent variable analysis,” published in the October 2024 issue of Critical Care by Johannesson et al. 

Executive dysfunction and depression are often observed in the survivors of ICU, However, the mechanisms connecting the factors remained unclear, with self-confidence as a critical mediator between cognitive impairments and mental health outcomes.  

Researchers conducted a retrospective study to examine whether self-confidence mediated the relationship between executive functioning and depression in survivors of ICU.  

They utilized a provisional questionnaire to evaluate the QoL among 395 adult survivors who had stayed at least 72 hours in 1 of 3 ICUs at a Swedish university hospital, assessed 6 months to 3 years post-discharge. The responses related to executive function, self-confidence, and depression were analyzed. Structural equation modeling and confirmatory factor analysis were applied to explore self-confidence’s mediating effect on the link between executive function and depression and model fit was assessed using standard indicators, while measure reliability was estimated through McDonald’s Omega and Cronbach’s Alpha.  

The results showed a positive correlation between depressive symptoms and both reduced self-confidence (r = 0.80, P < 0.001) and impaired executive function (r = 0.55, P < 0.001). Additionally, lower self-confidence was linked to poorer executive function (r = 0.62, P < 0.001). Age was inversely correlated with depression, self-confidence, and executive function, while male gender was associated with higher self-confidence. Mediation analysis indicated that the influence of impaired executive function on depressive symptoms was mediated by reduced self-confidence (B = 0.45; 95% CI 0.34–0.59), as the direct effect of executive function on depression became non-significant with self-confidence in the model (B = 0.07, P = 0.18), confirming complete mediation. The overall model demonstrated a strong fit (CFI = 0.962; RMSEA = 0.075), supporting the robustness of the mediation pathway.  

Investigators concluded that self-confidence mediated the relationship between executive function and depression among survivors of ICU, suggesting that interventions targeting self-confidence could alleviate depressive symptoms in the population. 

Source: ccforum.biomedcentral.com/articles/10.1186/s13054-024-05136-2