Interpersonal Distress and Health-Related Quality of Life in Primary Care: Do Hope, Optimism, and Depression Explain the Association?

Among primary care patients, hope and optimism, and depressive symptoms, serially mediated the relation between perceived burdensomeness and physical health-related quality of life. Greater levels of perceived burdensomeness and thwarted belongingness were associated with less hope and optimism and, in turn, to more depressive symptoms and worse perceived physical health.