Financial stress as a mediator of financial position and depressive symptoms among rural Nepali women

Int J Soc Psychiatry. 2025 May 17:207640251340820. doi: 10.1177/00207640251340820. Online ahead of print.

ABSTRACT

BackgroundAssets, income, socioeconomic status, and other measures of financial position are consistent predictors of depression. Although financial stress has been proposed as a mediator of this relationship, no study has explored this hypothesis using a rigorous longitudinal design or outside of high-income countries.AimsWe address this gap using longitudinal cohort data across four timepoints.MethodThe sample comprised 831 women (M = 35.9 years old) living in Nawalpur, a rural district in the Gandaki province of Nepal; the majority were married (88%) and of Janajati caste/ethnicity (61%). The direct effect of financial position on depressive symptoms and its indirect effect through financial stress were estimated using a cross-lagged panel mediation model (CLPM); we also conducted cross-sectional mediation models – of the sort typically employed in mediation analyses – for comparison and bias estimation.ResultsIn the CLPM, financial stress significantly mediated the financial position-depressive symptom relationship between timepoints one and three, but not between timepoints two and four (likely due to loss of power). After accounting for financial stress as a mediator, the direct effects of financial position on depressive symptoms were not statistically significant. The cross-sectional models overestimated the relationship between financial stress and depressive symptoms; otherwise, results between the CLPM and cross-sectional models were comparable.ConclusionsOur findings suggest that interventions addressing financial stress may improve depressive symptoms. Methodologically, we argue that more researchers should employ longitudinal designs when investigating mediation processes.

PMID:40380863 | DOI:10.1177/00207640251340820