ORIGINAL RESEARCH article
Front. Psychiatry
Sec. Aging Psychiatry
The association between experiential avoidance, depressive symptoms, and suicidal ideation in hospitalized older adults with functional impairments: the moderating role of resilience
Provisionally accepted
- 1Hunan Normal University, Changsha, China
- 2Kiang Wu Nursing College of Macau, Macau, Macao, SAR China
- 3Hunan Provincial People's Hospital, Changsha, China
- 4The Second Xiangya Hospital of Central South University, Changsha, China
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Background: Experiential avoidance (EA) has been linked to intensified negative emotions among hospitalized older adults experiencing functional impairment due to physical limitations and the loss of autonomy, and this is linked to elevated suicidal ideation (SI) risk. This study examined the association between EA and SI, proposing depressive symptoms as a mediator and resilience as a moderator. Methods: 717 hospitalized older adults with functional impairments were recruited from four hospitals. Participants completed validated questionnaires assessing EA, SI, depressive symptoms, and resilience. Mediation and moderation analyses were conducted using Hayes' PROCESS macro (Model 4, 7 and 14) in SPSS. Results: The study revealed a significant positive association between EA and SI among hospitalized older adults with functional impairments ( =0.164, <0.01), with depressive symptoms demonstrating a partial mediating effect in this association ( =0.356, <0.01). Resilience played a dual moderating role in the associations: the strength of the association between EA and SI is weaker with higher resilience ( =-0.003, <0.05) and concurrently mitigated the association between depressive symptoms and SI ( =-0.012, <0.05). Conclusion: EA is associated with SI in hospitalized older adults with functional impairments, with depressive symptoms exerting a partial mediating role in this association. Resilience moderated the associations such that it weakened both the direct link between EA and SI, as well as the link between depressive symptoms and SI. Healthcare professionals should implement targeted suicide prevention strategies, including interventions to reduce EA, depressive symptoms, and enhance resilience, thereby mitigating SI in older adults.
Keywords: depressive symptoms, experientialavoidance, hospitalized older adults with functional impairments, resilience, Suicidal Ideation
Received: 06 Nov 2025; Accepted: 28 Nov 2025.
Copyright: © 2025 Tang, Tao, Zhang, Zou, He and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xiaofen Wang
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