Emotional blackmail and depression among Taiwanese nurses: a cross‐sectional study using the stress process model with coping strategies as mediator and social support as moderator

Lai, M, Lin, C, Griffiths, MD ORCID: https://orcid.org/0000-0001-8880-6524 and Hou, W, 2025. Emotional blackmail and depression among Taiwanese nurses: a cross‐sectional study using the stress process model with coping strategies as mediator and social support as moderator. Journal of Psychiatric and Mental Health Nursing. ISSN 1351-0126

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Abstract

Introduction: Emotional blackmail is a persistent workplace stressor that can negatively influence nurses' psychological well-being.

Aims: The present study examined the relationship between emotional blackmail and depression among Taiwanese nurses, incorporating the Stress Process Model (SPM) to explore the mediating role of coping strategies and the moderating effect of social support.

Methods: A cross-sectional survey was conducted with 297 nurses at a regional hospital in Taiwan. Self-reported questionnaires were used to assess emotional blackmail, coping strategies, social support, and depressive symptoms. Data analyses included correlation, mediation, and moderation models.

Results: Among 297 nurses, negative emotional blackmail was indirectly associated with depression through negative coping (B = 0.09, 95% CI [0.03, 0.16]), while positive emotional blackmail showed a direct inverse association with depression (B = −1.11, 95% CI [−2.17, −0.45]). Social support was directly associated with lower depression (B = −0.33, 95% CI [−0.47, −0.18]) and moderated the association between positive emotional blackmail and depression (B = 0.01, 95% CI [0.002, 0.02]). However, in the negative emotional blackmail model, social support had a marginal direct association with depression (B = −0.14, 95% CI [−0.31, 0.02]) but did not moderate the association between passive emotional blackmail and depression.

Discussion: Coping strategies and social support significantly influence how emotional blackmail affects nurses' mental health. The findings partially support the SPM, suggesting its contextual relevance.

Limitations: Single-site design and self-reported data may limit generalisability and introduce bias.

Implications: Mental health interventions in nursing must consider contextual and interpersonal dynamics of stress.

Recommendations: Tailored support systems and coping-skills training are essential, as social support may not uniformly buffer stress.

Reporting Method: The study followed STROBE guidelines for cross-sectional studies.

Relevance Statement: The present study addresses an underexplored workplace issue—emotional blackmail—and its impact on nurses' mental health. Using the Stress Process Model, it highlights how coping and social support influence outcomes. Findings support the development of targeted interventions such as coping-skills training and context-specific support. This research informs mental health nurses and managers on recognizing and addressing subtle interpersonal stressors that affect staff well-being in clinical settings.

Item Type:	Journal article
Publication Title:	Journal of Psychiatric and Mental Health Nursing
Creators:	Lai, M., Lin, C., Griffiths, M.D. and Hou, W.
Publisher:	Wiley
Date:	25 November 2025
ISSN:	1351-0126
Identifiers:	Number Type 10.1111/jpm.70067 DOI 2538483 Other
Rights:	This is the peer reviewed version of the following article: Lai, M., Lin, C., Griffiths, M. D., & Hou, W. (2025). Emotional blackmail and depression among Taiwanese nurses: a cross‐sectional study using the stress process model with coping strategies as mediator and social support as moderator. Journal of Psychiatric and Mental Health Nursing, which has been published in final form at https://doi.org/10.1111/jpm.70067 This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.
Divisions:	Schools > School of Social Sciences
Record created by:	Laura Borcherds
Date Added:	28 Nov 2025 09:49
Last Modified:	28 Nov 2025 09:49
URI:	https://irep.ntu.ac.uk/id/eprint/54820

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