The Relationship Between Self-Criticism and Alexithymia with the Mediating Role of Hopelessness in Depressed Patients

Abstract

This study aimed to examine the relationship between self-criticism and alexithymia with hopelessness in depressed patients, focusing on the mediating role of alexithymia in this relationship. A descriptive–correlational design was employed. The study population included depressed patients attending counseling and psychotherapy centers in Tehran. Based on the Morgan and Krejcie table, 400 participants were selected using convenience sampling. Instruments included the Beck Hopelessness Scale, the Levels of Self-Criticism Scale, and the 20-item Toronto Alexithymia Scale. Data were analyzed using Pearson correlation in SPSS-27 and structural equation modeling (SEM) in AMOS-21. Results indicated significant positive correlations between self-criticism and hopelessness (r = .52, p < .01), alexithymia and hopelessness (r = .49, p < .01), and self-criticism and alexithymia (r = .46, p < .01). The structural model demonstrated good fit (χ²/df = 1.74, GFI = .94, CFI = .96, RMSEA = .043). Self-criticism had significant direct effects on alexithymia (B = 0.51, β = 0.48, p = .001) and hopelessness (B = 0.18, β = 0.36, p = .001). Alexithymia significantly predicted hopelessness directly (B = 0.15, β = 0.33, p = .001). The indirect effect of self-criticism on hopelessness via alexithymia was significant (B = 0.08, β = 0.16, p = .001). Both self-criticism and alexithymia significantly contribute to hopelessness among depressed patients, with alexithymia mediating part of the effect of self-criticism on hopelessness. Therapeutic interventions simultaneously targeting the reduction of self-criticism and the enhancement of emotional processing may effectively reduce hopelessness in this population.