Perceived stress and psychological resilience mediate the effects of daily hassles on depression severity in major depressive disorder

Background: Chronic hassles in life are a well-established stressor, and stress is a recognized risk factor for major depressive disorder (MDD). While psychological resilience is increasingly recognized as a protective factor against MDD severity and relapse, existing research focuses mainly on major life events and lacks a nuanced understanding of daily stressors. Aim: This research aims to clarify the role of psychological resilience in the complex interplay among daily hassles, perceived stress, and depression severity. Methods: We investigated 220 MDD patients (average age 37.85 years; 83 males, 137 females) using validated questionnaires: the Resilience Scale for Adults (RSA), the Chinese 14-item Perceived Stress Scale (CPSS), the Daily Hassles Scale (DHS) and the Hamilton Depression Rating Scale (HDRS-17). Results: A correlation analysis revealed that RSA correlated negatively with DHS, CPSS, and HDRS-17scores, while DHS showed positive correlations with CPSS and HDRS-17 scores. Serial mediation analysis revealed a significant direct effect (β = .348, p < .05, 95 % CI [.054, .641]) and an indirect effect (β = .806, 95 % CI [.694, 1.072]) of daily hassles on depression severity, mediated by perceived stress and resilience. Conclusion: This study revealed the intricate relationships among daily stressors, perceived stress, and resilience in patients with MDD. Notably, perceived stress levels and psychological resilience jointly mediate the impact of daily hassles on depression severity, emphasizing the crucial role of psychological resilience in mitigating the adverse effects of stress. These findings inform the development of targeted prevention and intervention strategies to enhance resilience and alleviate depressive symptoms in MDD patients.