The Big Five Personality Traits as Predictors of Depression and Their Relationship with Coping among Hemodialysis Patients

Abstract

Depression is one of the most common disorders among hemodialysis patients. Evidence suggests that personality traits may represent important vulnerability factors for depression; however, the specific pathway linking personality traits to depression through coping strategies remains underexplored in hemodialysis patients. This study aims to examine whether coping strategies mediate the relationship between personality traits and depression in hemodialysis patients and to explain these findings through patients’ subjective experiences. An explanatory sequential mixed-methods design was employed.In the quantitative phase, a census sample of 144 hemodialysis patients from three public hospitals in Algeria completed the Big Five Inventory-44 (BFI-44), the Arabic Brief COPE (A-BC), and the Beck Depression Inventory-II (BDI-II). Parallel mediation analysis was conducted using Hayes’ PROCESS macro. In the qualitative phase, 12 participants were purposively recruited. Data were collected through face-to-face semi-structured interviews and analyzed using thematic analysis with hybrid coding. Quantitative results indicated partial mediation by coping strategies. Neuroticism had a direct effect on depression, with indirect effects through both passive and active coping. Conscientiousness showed a direct effect, with indirect effects through active and passive coping strategies. Agreeableness showed no direct effect but exhibited indirect effects through active, passive, and support-seeking coping.Qualitative findings indicated that patients high in neuroticism reported threat appraisal, loss of control, passive coping, and higher levels of depression. Patients high in conscientiousness reported threat appraisal, resource-based control, active coping, and lower levels of depression. Patients high in agreeableness reported threat appraisal, other-based control, support-seeking coping, and moderate levels of depression.These results indicate thatNeuroticism increases vulnerability to depression through threat appraisal, loss of control, and passive coping. Conscientiousness increases active coping, which is related to self-control and lower depression.Furthermore, while agreeableness shows an indirect effect on depression through coping strategies, qualitative findings indicate that reliance on control by others is related to increased seeking support and may limit active coping, with moderate levels of depression.These findings suggest that psychosocial interventions should increase active coping to reduce vulnerability to depression.