Double mediating effects of daily life changes and anxiety on the relationship between occupation and depression in Korea during the COVID-19 pandemic | BMC Public Health

By | August 6, 2022

General characteristics of the participants

Table 1 presents the descriptive statistics of the main sociodemographic characteristics of the study participants used in this study: 68,207 economically active adults aged 19-65 years. The analysis results for gender, education level, region of residence, type of household, marital status and occupation are as follows (in decreasing order of frequency): female (55.3%), male (44.7%); ≥ university (66.4%), high school (27.7%), ≤ high school (5.9%); non-metropolitan areas (66.4%), metropolitan areas (41.6%); co-residential households (88.8%), single-person households (11.2%); married (64.1%), single (25.7%), divorced/widowed/divorced (10.2%); service workers (61.5%), office workers (38.5%).

Table 1 Demographics of the participants

Correlation analysis and multicollinearity between key variables

Table 2 presents the results of the correlation analysis between the main variables. The correlation coefficients between the main variables did not exceed the threshold of 0.8, with absolute values ​​ranging from 001 to 0.637. Similarly, with the variance inflation factors values ​​ranging from 1,040 to 2,203, well below the threshold of 10, there was no problem of multicollinearity.

Table 2 Correlation analysis

Mediating and dual mediating effects of COVID-19 related changes in daily life changes and anxiety

For two mediator variables, as is the case with this research model, a three-step regression analysis is performed using Model 6 of PROCESS macro to analyze the simple and double mediating effects. Accordingly, we analyzed the dual mediation of variations in daily life due to COVID-19 and anxiety induced thereby in the mental health relationship between occupation and depression, depending on the type of occupation. The analysis results are shown in Table 3.

Table 3 Relationship between occupations and depression during the COVID-19 pandemic: double mediating effects

Step 1 of Table 3 shows the results of multiple linear regression analysis regarding the effect of the independent variable on mediator variable 1 (changes in daily life due to COVID-19), which was performed as the first process step of data analysis in Model 6 The explanatory power of the model was 11.2%, which was statistically significant (F = 93.247, p < .001). In this model, the independent variable – occupational type – was found to have a negative effect on mediator variable 1 – changes in daily life due to COVID-19 (B = − 2,199, p < .001). It meant that service workers experienced a higher level of perceived changes in daily life as a result of COVID-19 than office workers. For the control variables, the following groups reported more acutely perceived changes in daily life due to COVID-19 than the opposite groups: women (B = -3,198, p < .000), younger age groups (B = -.134, p < .000), metropolitan area (B = 1.041, p<. 000), single-person households (B = 1,172, p < .000), and a lower income (B = -.930, p < .000).

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Step 2 of Table 3 shows the results of analyzes regarding the effects of the independent variable (occupational type) and mediator variable 1 (changes in daily life due to COVID-19) on mediator variable 2 (anxiety caused by COVID-19), which were performed as the second process step of data analysis in Model 6. The step 2 analysis model was also statistically significant (F = 569,948, p < .001), where the independent variable had a negative effect on moderator variable 1 (B = -.043, p < .001), and moderator variable 1 had a positive effect on moderator variable 2 (B = .006, p < .001), both with statistical significance. This shows that the fear due to COVID-19 increased to a greater extent among service workers than among office workers and that the greater the degree of perceiving changes in daily life due to COVID-19, the greater the fear caused by COVID-19 -19. As for the control variables, the following groups reported a greater increase in anxiety caused by COVID-19 compared to the opposite groups: women (B = -.180, p < .000), older age groups (B = .001, p < .000), at lower education level (B = -.098, p < .000), non-urban areas (B = -.076, p < .000), co-residential households (B = -.057, p < .000), and a lower income (B = -.033, p < .000).

Finally, step 3 of Table 3 shows the results of analyzes regarding the effects of the independent variable and mediator variables 1 and 2 on the dependent variable, depression, which were performed as the third step of data analysis in model 6. Similarly, step 3 analysis model was statistically significant (F = 233,661, p < .001), which found that depression was significantly influenced by occupational type (B = -.011, p < .001), changes in daily life due to COVID-19 (B = .001, p < .001), and anxiety due to COVID-19 (B = .017, p < .001). In other words, depression increased more in service workers than in office workers. The greater the degree of perceiving changes in daily life due to COVID-19 and the higher the level of anxiety caused by COVID-19, the greater the increase in depression due to COVID-19. Furthermore, regarding the control variables, the following groups reported a greater increase in depression compared to the opposite groups: women (B = -.044, p < .000), younger age groups (B = -.003, p < .000), lower educational level (B = -.013, p < .000), metropolitan area (B = .030, p < .000), single-person households (B = .054, p < .000), single (B = .018, p < .000), and a lower income (B = -.017, p < .000).

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Figure 2 is a schematic summary of the analysis results for the dual mediating effects of COVID-19-related changes in daily life and anxiety on the relationship between occupational type and depression, as shown in Table 3.

Fig. 2
Figure 2

Table 4 presents the results of statistical significance tests of mediating effects via the bootstrap method performed after completion of the 3-step regression analysis performed in Model 6 of PROCESS macro. The results confirm the statistical significance of the overall mediating effect (.0032; Boot CI: .0038 to −.0026), establishing the model fit of the dual mediation model evaluated in this study. Regarding the mediating effects of each pathway, the effect of occupational type on depression via mediator variable 1 – changes in daily life due to COVID-19 – was found to be statistically significant (Boot CI: −.0027 to -.0018), since the effect was via mediator variable 2 – anxiety due to COVID-19 (Boot CI: .0010 to .0005). Similarly, the dual mediating effects, which the occupational type has on depression from changes in daily life and anxiety due to COVID-19, were found to be statistically significant (−.0002; Boot CI: .0003 to .0002).