Unpacking the mediating role of resilience in the relationship between ideal-actual self-discrepancy, stressful life events, depression and anxiety: Results from 1,144 young people in an epidemiological study in Hong Kong

• Published in: International journal of social psychiatry 2023-08, Vol.69 (5), p.1166-1175
• Main Authors: Nam, Suen Yi, Cheuk Ying Crystal, Ling, Charlton, Cheung, Lai Ming Christy, Hui, Ming Yin Stephanie, Wong, Tak Hing Michael, Wong, Kit Wa Sherry, Chan, Ho Ming Edwin, Lee, Yu Hai Eric, Chen
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Adversity; Anxiety; Anxiety - epidemiology; Anxiety - psychology; Anxiety disorders; Anxiety Disorders - epidemiology; Depression - epidemiology; Depression - psychology; Depressive Disorder, Major - epidemiology; Discrepancies; Epidemiologic Studies; Generalized anxiety disorder; Hong Kong - epidemiology; Humans; Life events; Mental depression; Mental disorders; Mental health; Resilience; Resilience, Psychological; Selfdiscrepancy; Symptoms; Youth
• ISSN: 0020-7640; 1741-2854
• DOI: 10.1177/00207640231152691

Background: Self-discrepancy is associated with poorer mental health, yet its mechanism is understudied. A recent study found that resilience plays a moderating role in the relationship between self-discrepancy and depressive symptoms in adults. The current study investigated whether there were any similar relationships among young people aged 15 to 24 years. Methods: As part of the ongoing Hong Kong Epidemiological Study of Mental Health (HK-YES) project, the current study analysed data from 1,144 participants who provided complete data on ideal-actual selfdiscrepancy, psychiatric conditions, resilience level and recent stressful life events (SLEs). Results: Ideal-actual self-discrepancies were associated with increased depressive and anxiety symptoms, as well as odds of 12-month major depressive episodes (MDEs) and generalised anxiety disorder (GAD). All these associations became nonsignificant after adjusting for resilience. Separate models found resilience mediating rather than moderating the relationship. According to four-way decomposition, the pure indirect effect explained most of the total effects of self-discrepancy on mental health conditions. The mediation effects on symptom severity were recently revealed to be more prominent among individuals with substantial exposure to SLE. Conclusions: Resilience functions mainly as a mediator in the relationship between self-discrepancy and mental health conditions, and its effect is weakened by the exposure of SLEs. Important implications are discussed regarding the use of resilience-focused interventions and the consideration of recent adversity.