{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T13:51:19Z","timestamp":1783432279245,"version":"3.54.6"},"reference-count":31,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:00:00Z","timestamp":1760140800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["EJIHPE"],"abstract":"<jats:p>Background: Aviation is one of the most demanding professions, exposing pilots to persistent stressors such as fatigue, irregular schedules, and high safety responsibility. These conditions heighten vulnerability to depression, anxiety, and stress (DAS), yet the protective mechanisms mitigating such effects remain less well understood. Objective: This study examined the roles of resilience, coping strategies, and fatigue in predicting DAS among commercial airline pilots. Method: A sample of 200 pilots completed validated self-report measures: the Connor\u2013Davidson Resilience Scale (CD-RISC), the Coping Inventory for Stressful Situations (CISS), the Fatigue Severity Scale (FSS), and the Depression Anxiety Stress Scale (DASS-21). Data were analyzed using bivariate correlations, hierarchical multiple regression, and mediation\/moderation analyses via the PROCESS macro. Results: Resilience was negatively correlated with total DAS scores (r = \u22120.46, p &lt; 0.001), while fatigue (r = 0.42, p &lt; 0.001) and avoidance coping (r = 0.38, p &lt; 0.001) were positively correlated. The regression model accounted for 46% of the variance in DAS (R2 = 0.46). Task-focused coping predicted lower stress levels, whereas avoidance coping predicted higher anxiety and depression. Resilience moderated the relationship between stress and depression, buffering the impact of stress on mood outcomes. Mediation analyses indicated that coping styles partially explained the protective effect of resilience. ANOVA results confirmed that pilots with high resilience reported significantly lower depression scores than those with medium or low resilience, F(2, 197) = 6.72, p &lt; 0.01. Conclusions: Resilience emerged as both a direct and indirect buffer against psychological strain in aviation. These findings underscore the importance of promoting adaptive coping and resilience training, alongside effective fatigue management, to enhance pilot well-being and maintain safety in aviation systems.<\/jats:p>","DOI":"10.3390\/ejihpe15100206","type":"journal-article","created":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T13:13:27Z","timestamp":1760361207000},"page":"206","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Moderating Role of Resilience in the Relationship Between Occupational Stressors and Psychological Distress Among Aviation Pilots in Pakistan"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-1425-5683","authenticated-orcid":false,"given":"Ali","family":"Ijaz","sequence":"first","affiliation":[{"name":"Department of Psychology, University of Karachi, Karachi 75270, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anila Amber","family":"Malik","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Karachi, Karachi 75270, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tayyeba","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Department of Psychology, National University of Modern Languages, Islamabad 38000, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waqas","family":"Hassan","sequence":"additional","affiliation":[{"name":"Department of Psychology, Riphah Institute of Clinical and Professional Psychology, Lahore 54660, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3350-6679","authenticated-orcid":false,"given":"Sofia","family":"Mastrokoukou","sequence":"additional","affiliation":[{"name":"Department of Political and Social Sciences, University of Salerno, 84084 Fisciano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8457-6554","authenticated-orcid":false,"given":"Claudio","family":"Longobardi","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Turin, 10124 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1007\/s11325-017-1565-7","article-title":"Assessment of sleepiness, fatigue, and depression among Gulf Cooperation Council commercial airline pilots","volume":"22","author":"Aljurf","year":"2018","journal-title":"Sleep and Breathing"},{"key":"ref_2","unstructured":"American Psychological Association (2020). Publication manual of the American psychological association 2020, American Psychological Association."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1037\/ocp0000056","article-title":"Job demands\u2013resources theory: Taking stock and looking forward","volume":"22","author":"Bakker","year":"2017","journal-title":"Journal of Occupational Health Psychology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1080\/24721840.2020.1858714","article-title":"Pilot work related stress (WRS), effects on wellbeing and mental health, and coping methods","volume":"31","author":"Cahill","year":"2021","journal-title":"The International Journal of Aerospace Psychology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1207\/s15327558ijbm0401_6","article-title":"You want to measure coping but your protocol\u2019s too long: Consider the Brief COPE","volume":"4","author":"Carver","year":"1997","journal-title":"International Journal of Behavioral Medicine"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.trpro.2022.12.003","article-title":"The relationship between civil pilots\u2019 resilience, psychological well-being and work performance","volume":"66","author":"Cherng","year":"2022","journal-title":"Transportation Research Procedia"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1002\/da.10113","article-title":"Development of a new resilience scale: The Connor-Davidson Resilience Scale (CD-RISC)","volume":"18","author":"Connor","year":"2003","journal-title":"Depression and Anxiety"},{"key":"ref_8","unstructured":"Cullen, P., Cahill, J., and Gaynor, K. (, January October). Pilot wellbeing [Paper presentation]. Flight Safety Foundation 2017\u201470th International Air Safety Submit (IASS), Dublin, Ireland."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1037\/0022-3514.58.5.844","article-title":"Multidimensional assessment of coping: A critical evaluation","volume":"58","author":"Endler","year":"1990","journal-title":"Journal of Personality and Social Psychology"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"G\u00f6rlich, Y., and Stadelmann, D. (2020). Mental health of flying cabin crews: Depression, anxiety, and stress before and during the COVID-19 pandemic. Frontiers in Psychology, 11.","DOI":"10.3389\/fpsyg.2020.581496"},{"key":"ref_11","unstructured":"Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach, The Guilford Press."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1080\/00273171.2010.498290","article-title":"Quantifying and testing indirect effects in simple mediation models when the constituent paths are nonlinear","volume":"45","author":"Hayes","year":"2010","journal-title":"Multivariate Behavioral Research"},{"key":"ref_13","unstructured":"International Civil Aviation Organization (ICAO) (2023). Manual for the oversight of fatigue management approaches, ICAO. [2nd ed.]. Doc 9966."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.trpro.2025.05.005","article-title":"Work schedules, Fatigue and Regeneration in modern Aviation","volume":"88","author":"Kallus","year":"2025","journal-title":"Transportation Research Procedia"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Krupp, L. B., LaRocca, N. G., Muir-Nash, J., and Steinberg, A. D. (1989). Fatigue severity scale (FSS) [Database record], APA PsycTests.","DOI":"10.1037\/t25491-000"},{"key":"ref_16","unstructured":"Lazarus, R. S., and Folkman, S. (1984). Stress, appraisal, and coping, Springer Publishing Company."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1080\/00140139.2022.2139416","article-title":"Effect of quick coherence technique (QCT) on commercial pilots\u2019 resilience during COVID-19 pandemic stress","volume":"66","author":"Li","year":"2023","journal-title":"Ergonomics"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/0005-7967(94)00075-U","article-title":"The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories","volume":"33","author":"Lovibond","year":"1995","journal-title":"Behaviour Research and Therapy"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1080\/1047840X.2015.1012041","article-title":"Pathways to integrated resilience science","volume":"26","author":"Masten","year":"2015","journal-title":"Psychological Inquiry"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1080\/07448481.2023.2237598","article-title":"Sleep quality and stress: An investigation of collegiate aviation pilots","volume":"73","author":"Mendonca","year":"2025","journal-title":"Journal of American College Health"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Mendonca, F. A. C., Michaelson, T., Timothy, K., and Bowyer, S. (2024). The role of mental health training and education in achieving resilience for collegiate aviation pilots. Collegiate Aviation Review International, 42, (2).","DOI":"10.22488\/okstate.24.100245"},{"key":"ref_22","first-page":"1","article-title":"Examining the relationship between burnout and job satisfaction of flight crew: An analysis on the critical fatigue risk factors in the aviation industry","volume":"3","author":"Ozel","year":"2021","journal-title":"International Journal of Business Ecosystem & Strategy"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.slsci.2016.05.003","article-title":"Sleep complaints and fatigue of airline pilots","volume":"9","author":"Reis","year":"2016","journal-title":"Sleep Science"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1080\/08995605.2021.1989236","article-title":"Cognitive performance, fatigue, emotional, and physiological strains in simulated long-duration flight missions","volume":"34","author":"Rosa","year":"2022","journal-title":"Military Psychology"},{"key":"ref_25","unstructured":"Tabachnick, B. G., Fidell, L. S., and Ullman, J. B. (2007). Using multivariate statistics, Pearson."},{"key":"ref_26","first-page":"4","article-title":"Interactions of international pilots\u2019 stress, fatigue, symptoms of depression, anxiety, common mental disorders and wellbeing","volume":"9","author":"Venus","year":"2022","journal-title":"International Journal of Aviation, Aeronautics, and Aerospace"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1186\/s12940-016-0200-6","article-title":"Airplane pilot mental health and suicidal thoughts: A cross-sectional descriptive study via anonymous web-based survey","volume":"15","author":"Wu","year":"2016","journal-title":"Environmental Health"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Xu, Q., Wu, Y., Ji, M., Wang, M., Pan, C., Ma, J., and You, X. (2022). Proactive coping and mental health among airline pilots during China\u2019s regular prevention and control of COVID-19: The role of perceived stress and social support. Frontiers in Public Health, 10.","DOI":"10.3389\/fpubh.2022.890145"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Yu, F., Li, X., and Yang, J. (2022). Investigation of pilots\u2019 mental health and analysis of influencing factors in China: Based on structural equation model. BMC Public Health, 22, (1).","DOI":"10.1186\/s12889-022-13764-y"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"219","DOI":"10.3357\/AMHP.6581.2025","article-title":"Mediating roles of resilience and stress in emotion regulation strategies and pilot job burnout","volume":"96","author":"Zhao","year":"2025a","journal-title":"Aerospace Medicine and Human Performance"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1080\/10803548.2024.2430112","article-title":"Effective strategies for reducing pilots\u2019 job burnout: Cognitive reappraisal guided by high resilience with perceived stress as a mediator","volume":"31","author":"Zhao","year":"2025b","journal-title":"International Journal of Occupational Safety and Ergonomics"}],"container-title":["European Journal of Investigation in Health, Psychology and Education"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2254-9625\/15\/10\/206\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T15:26:54Z","timestamp":1760369214000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2254-9625\/15\/10\/206"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,11]]},"references-count":31,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["ejihpe15100206"],"URL":"https:\/\/doi.org\/10.3390\/ejihpe15100206","relation":{},"ISSN":["2254-9625"],"issn-type":[{"value":"2254-9625","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,11]]}}}