Associations among internalized and perceived stigma, state mindfulness, self-efficacy, and depression symptoms among men who have sex with men in China: A serial mediation model

Caimeng Liu; Guangzhe Frank Yuan; Xiaoming Li; Hong Wang Fung; Ming Yu Claudia Wong; Jingjing Zhao; Xueyou Feng

doi:10.1016/j.apnu.2023.06.001

Associations among internalized and perceived stigma, state mindfulness, self-efficacy, and depression symptoms among men who have sex with men in China: A serial mediation model

Arch Psychiatr Nurs. 2023 Aug:45:81-88. doi: 10.1016/j.apnu.2023.06.001. Epub 2023 Jun 5.

Authors

Caimeng Liu¹, Guangzhe Frank Yuan², Xiaoming Li³, Hong Wang Fung⁴, Ming Yu Claudia Wong⁵, Jingjing Zhao⁶, Xueyou Feng⁷

Affiliations

¹ College of Teacher Education, Institute of Education Science, Leshan Normal University, Leshan, China.
² Department of Health Promotion Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA; South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, SC, USA. Electronic address: guangzhe@mailbox.sc.edu.
³ Department of Health Promotion Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA; South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, SC, USA.
⁴ Department of Social Work, Faculty of Social Sciences, The Hong Kong Baptist University, Kowloon Tong, Hong Kong.
⁵ Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong.
⁶ Department of Psychology, Beijing Forestry University, Beijing, China.
⁷ Center for Mental Health Education and Counseling, Guangzhou College of Commerce, Guangzhou, China.

PMID: 37544707
DOI: 10.1016/j.apnu.2023.06.001

Abstract

Previous research has demonstrated that stigma is strongly related to depressive symptoms among men who have sex with men (MSM). However, data are limited regarding the associations between stigma, state mindfulness, self-efficacy, and depression symptoms. The current study aimed to analyze state mindfulness and self-efficacy as possible mediators between internalized and perceived stigma and depression symptoms. A sample of 2610 Chinese MSM (M_age = 23.99, SD = 6.09, age range: 18-68 years) was recruited from an online survey platform and completed the HIV and Homosexuality Related Stigma Scale, Patient Health Questionnaire-9, the short version of Five Facet Mindfulness Questionnaire, and the Chinese General Self-Efficacy Scale. Results indicated that state mindfulness significantly mediated the linkage between internalized and perceived stigma and depressive symptoms, and self-efficacy significantly mediated the relation between state mindfulness and depression symptoms. Furthermore, internalized and perceived stigma were associated with depression symptoms through a serial mediation of state mindfulness and self-efficacy. This study highlights that state mindfulness and self-efficacy might play important roles in the psychological response of MSM to stigmatization and psychopathology symptoms.

Keywords: Depression symptoms; Internalized and perceived stigma; MSM; Self-efficacy; State mindfulness.

MeSH terms

Adolescent
Adult
Aged
China
Depression* / psychology
HIV Infections / psychology
Homosexuality, Male* / psychology
Humans
Internal-External Control*
Internet
Male
Mediation Analysis*
Middle Aged
Mindfulness*
Perception
Self Efficacy*
Social Stigma*
Surveys and Questionnaires
Young Adult