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Unpacking the link between adverse childhood experiences and mental health disparities among Chinese men who have sex with men: The mediating role of filial piety and internalized homophobia.

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Title: Unpacking the link between adverse childhood experiences and mental health disparities among Chinese men who have sex with men: The mediating role of filial piety and internalized homophobia.
Authors: Liang, Zurong1 (AUTHOR) joeliang@zju.edu.cn, Song, Boxuan1 (AUTHOR), Xiang, Yetong2 (AUTHOR), Li, Qiang3 (AUTHOR)
Source: Child Abuse & Neglect. Mar2026, Vol. 173, pN.PAG-N.PAG. 1p.
Subject Terms: *Adverse childhood experiences, *Mental depression, *Cultural values, Filial piety, Mental health, Chinese people, Homophobia, Gay identity
Geographic Terms: China
Abstract: While growing evidence links Adverse Childhood Experiences (ACEs) to mental health disparities among sexual minorities, the mechanisms underlying this relationship, particularly in Chinese context, remain insufficiently understood. The intersection of ACEs, cultural values, and internalized stigma among Chinese men who have sex with men (MSM) represents a critical, yet underexplored, area of investigation. This study aimed to examine the relationship between ACEs and depressive symptoms among Chinese MSM, focusing on the serial mediating effects of filial piety (pragmatic obligations and compassionate reverence) and internalized homophobia. Participants were recruited between October 2023 and May 2024 from a gay-friendly NGO in Zhejiang Province, China, with 1085 MSM completing a self-administered, anonymous questionnaire after screening for eligibility. Serial mediation analyses were conducted using PROCESS macro model 80 with bootstrapping procedures to test direct and indirect effects. The study confirmed the significant total effect of ACEs on depressive symptoms (b = 0.8327, p < 0.001). Analysis revealed distinct mediating pathways through compassionate reverence (β = 0.0696, 95% CI [0.0222, 0.1238]) and internalized homophobia (β = 0.0622, 95% CI [0.0288, 0.1039]). A significant negative serial mediation effect was observed through pragmatic obligations and internalized homophobia (β = −0.0177, 95% CI [−0.0311, −0.0079]), revealing the complex role of cultural values in mental health outcomes. These findings emphasize the complex interplay between ACEs, cultural values, and sexual identity in shaping mental health outcomes among Chinese MSM. They suggest the need for culturally sensitive interventions that address both traditional values and sexual identity concerns. • ACEs link to depression among Chinese MSM through compassionate reverence and internalized homophobia as mediators. • A negative serial mediation effect is observed through pragmatic obligations and internalized homophobia. • Culturally sensitive interventions should address ACEs, cultural values, and sexual identity concerns. [ABSTRACT FROM AUTHOR]
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Database: Education Research Complete
Description
Abstract:While growing evidence links Adverse Childhood Experiences (ACEs) to mental health disparities among sexual minorities, the mechanisms underlying this relationship, particularly in Chinese context, remain insufficiently understood. The intersection of ACEs, cultural values, and internalized stigma among Chinese men who have sex with men (MSM) represents a critical, yet underexplored, area of investigation. This study aimed to examine the relationship between ACEs and depressive symptoms among Chinese MSM, focusing on the serial mediating effects of filial piety (pragmatic obligations and compassionate reverence) and internalized homophobia. Participants were recruited between October 2023 and May 2024 from a gay-friendly NGO in Zhejiang Province, China, with 1085 MSM completing a self-administered, anonymous questionnaire after screening for eligibility. Serial mediation analyses were conducted using PROCESS macro model 80 with bootstrapping procedures to test direct and indirect effects. The study confirmed the significant total effect of ACEs on depressive symptoms (b = 0.8327, p < 0.001). Analysis revealed distinct mediating pathways through compassionate reverence (β = 0.0696, 95% CI [0.0222, 0.1238]) and internalized homophobia (β = 0.0622, 95% CI [0.0288, 0.1039]). A significant negative serial mediation effect was observed through pragmatic obligations and internalized homophobia (β = −0.0177, 95% CI [−0.0311, −0.0079]), revealing the complex role of cultural values in mental health outcomes. These findings emphasize the complex interplay between ACEs, cultural values, and sexual identity in shaping mental health outcomes among Chinese MSM. They suggest the need for culturally sensitive interventions that address both traditional values and sexual identity concerns. • ACEs link to depression among Chinese MSM through compassionate reverence and internalized homophobia as mediators. • A negative serial mediation effect is observed through pragmatic obligations and internalized homophobia. • Culturally sensitive interventions should address ACEs, cultural values, and sexual identity concerns. [ABSTRACT FROM AUTHOR]
ISSN:01452134
DOI:10.1016/j.chiabu.2025.107876