رابطه خودانتقادگری و احساس تنهایی با افسردگی در سالمندان: نقش میانجی نشخوار فکری

Considering the rapid aging process of the population, it seems necessary to investigate important factors in the formation and control of depression. Therefore, the aim of this study was to investigate the relationship between self-criticism and loneliness with depression in older adults through the mediating role of rumination. This was a descriptive research with the structural equation modeling (SEM) method. The statistical population consisted of all people over 60 living in Shahryar and Quds nursing homes in Karaj, Iran, 2022-2023, among whom 195 people (119 women, 76 men) were selected using convenience sampling method. In order to collect information, Nolen Hoeksma and Maro’s rumination, Thomson and Zarav’s self-criticism, Russell et al.’s loneliness, and Beck’s depression questionnaires were used. SEM was used to test the hypotheses. Data analysis was conducted using SPSS-24 and Smart-PLS 3.2.8. The findings indicated that there is a positive and significant relationship between internal and comparative self-criticism and depression, as well as between rumination and depression, but the relationship between loneliness and depression did not reach significance level, and rumination plays a mediating role in the relationship between inner self-criticism and loneliness with Depression. According to the results of the present study, psychologists are recommended to train the techniques of controlling and stopping rumination, and self-critical thoughts in the treatment of depression in older adults, so that the loneliness of older adults may not lead them to feel depresssion.
EXTENDED ABSTRACT
Introduction
Based on studies in the field of depression, old age is a stressful period due to the presence of multiple factors, and the prevalence of depression among older adults has been reported to be high. Understanding the factors contributing to the development of depression plays a significant role in its prevention and control. Various psychological factors can influence the onset of depression, and examining these factors is crucial for improving and managing the condition. Previous studies have identified relationships between depression and shame, self-criticism, guilt, and attachment styles, indicating that depression results from the interaction of several different factors. Research findings have confirmed a direct relationship between loneliness and self-criticism with depression. However, no study has investigated the mediating role of rumination in the relationship between self-criticism and loneliness with the level of depression among older residents in nursing homes, who are at risk of depression due to being away from their family members and loved ones. Therefore, given the existing gap, the present study seeks to answer the question of whether rumination mediates the relationship between self-criticism and loneliness with the level of depression in older adults.
Method
This was a descriptive research, of structural equation modeling (SEM) type. The statistical population consisted of all individuals over 60 years old residing in nursing homes Shahriar and Qods in in Karaj, Iran during the years 2022-2023. Regarding sample size, Steven’s analysis recommends considering 15 cases for each predictor variable in multiple regression analysis using the ordinary least squares method, which is considered a good rule of thumb. Based on this, 195 individuals (119 women, 76 men) were selected from this population using convenience sampling. To collect data, Nolen Hoeksma and Maro’s rumination, Thomson and Zarav’s self-criticism, Russell et al.’s loneliness, and Beck’s depression questionnaires were applied. Out of 210 distributed questionnaires, 15 were excluded due to being incomplete, resulting in 195 questionnaires being considered as the final data for the study. The inclusion criteria were: (1) being over 60 years old, (2) having at least six years of formal education, and (3) the ability to communicate verbally. The exclusion criteria included: (1) a history of severe physical illnesses such as stroke, (2) cognitive impairments such as Alzheimer’s and dementia, and (3) the presence of other psychological disorders besides depression. In order to test the research question, SEM was used in in SPSS-24 and Smart-PLS 3.2.8 software.
 Results
To evaluate the measurement model, three criteria were used: reliability, convergent validity, and discriminant validity. Composite reliability and Cronbach’s alpha were assessed to measure the model’s reliability. The validity of the questionnaire was examined using convergent and discriminant validity criteria. The AVE (Average Variance Extracted) values for all constructs were above 0.50, confirming the convergent validity of the model and the adequacy of the measurement models’ fit. The coefficient of determination (R²) for the variables of depression and rumination was found to be at a moderate level (0.33< R²< 0.67). The Q² value indicated that the average predictive power of the model was at a moderate and acceptable level (0.15<Q²<0.35). Therefore, the predictive power of the model’s constructs was satisfactory. The average shared variance was 0.231, and the average coefficient of determination for the mentioned variables was 0.547. Loneliness and internal self-criticism had a positive indirect relationship with the level of depression through rumination. There was a positive relationship between loneliness (β=0.413) and internal self-criticism with a coefficient of (β=0.206) with the rumination, which in turn is associated with depression (β=0.239). Therefore, rumination mediates the relationship between internal self-criticism and loneliness with the level of depression. However, the relationship between comparative self-criticism and depression through rumination was not significant and was not confirmed. There was a direct positive relationship between (1) internal self-criticism and the level of depression with a coefficient of 0.14 (P<0.05) and comparative self-criticism and the level of depression with a coefficient of 0.34 (p < 0.01). (2) There was no direct relationship between loneliness and the level of depression. (3) Rumination had a direct relationship with the level of depression with a coefficient of 0.23 (P< 0.01).
 Conclusion
The presence of rumination significantly increases the tendency to dwell on negative issues. When an individual constantly thinks about the possibility of bad luck or adverse events, the process of negative thinking gradually intensifies, leading to a profound sense of depression. Moreover, the lack of control over thoughts about past mistakes, flaws, or failures results in the recollection of negative memories, overshadowing positive present experiences and thereby fostering hopelessness and depression. In general, it can be stated that rumination, by amplifying negative emotions and feelings, creates conditions where individuals feel considerable anxiety and worry in various situations and when facing new challenges, eventually leading to depression. Individuals experiencing loneliness often harbor numerous negative thoughts about different aspects of their lives. For instance, a person might think they are alone because they are not worthy of others spending time with them. Such negative thoughts lead to self-criticism and the belief that they cannot connect with others, perpetuating rumination on these issues. Rumination leads to introspection and increases feelings of loneliness. Therefore, it can be concluded that rumination stemming from feelings of loneliness causes dissatisfaction with one’s life, feelings of inadequacy, anger, and humiliation, thereby paving the way for the onset of depression.
Ethical Consideration
Ethical Code
This study was conducted as part of a Master’s thesis at Payame Noor University
Financial Support
This study had no financial support
Authors’ Contributions
M.M: Conceptualization, methodology, writing – original draft, writing – review & editing, project administration, supervision, visualization; H.D: Software, validation, statistical analysis, data curation, data management
Conflict of Interest
The author had no conflicts of interest.
Acknowledgments
We extend our heartfelt gratitude to all the elderly participants, as well as the staff, nurses, and doctors at the nursing homes, for their patient cooperation throughout all stages of this research. 
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