Perceived stress, anxiety and depressive symptoms and quality of life in a low-income sample in Malaysia: a prospective study on the mediating role of coping mechanisms

Psychological stress, coping process and mental health problems are established determinants for quality of life; however, little research has explored their interrelationships among low income individuals. The present study aimed to explore the relationship between perceived stress, anxiety and depressive symptoms, and quality of life and the mediating effects of coping strategies. It conducted a three-month prospective study on 210 low-income individuals in Malaysia. At baseline (T1), perceived stress, anxiety and depressive symptoms, and coping strategies were measured using the Perceived Stress Scale, Patient Health Questionnaire-4, and the Brief-COPE 28, respectively. At follow-up (T2), the participants were administered the 36-Item Short Form Survey to assess quality of life. After controlling for covariates, perceived stress and anxiety and depressive symptoms are significantly associated with poorer subsequent physical and psychological aspects of quality of life. Confirming the hypothesis, maladaptive coping partially mediated the association between perceived stress and both domains of quality of life. The results also suggest that maladaptive coping may be one pathway by which experiencing symptoms of anxiety and depression may exert a deleterious effect on psychological domain (but not for physical domain). The current study fails to find support regarding the direct and mediation effects of adaptive coping. Our prospective findings provide important practical implications for psychological and healthcare interventions for improving quality of life, especially in low-income populations.