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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]
Copyright of Child Abuse & Neglect is the property of Pergamon Press - An Imprint of Elsevier Science and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Education Research Complete
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PubType: Academic Journal
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  Data: 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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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Liang%2C+Zurong%22&quot;&gt;Liang, Zurong&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;i&gt; joeliang@zju.edu.cn&lt;/i&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Song%2C+Boxuan%22&quot;&gt;Song, Boxuan&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Xiang%2C+Yetong%22&quot;&gt;Xiang, Yetong&lt;/searchLink&gt;&lt;relatesTo&gt;2&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Li%2C+Qiang%22&quot;&gt;Li, Qiang&lt;/searchLink&gt;&lt;relatesTo&gt;3&lt;/relatesTo&gt; (AUTHOR)
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Child+Abuse+%26+Neglect%22&quot;&gt;Child Abuse &amp; Neglect&lt;/searchLink&gt;. Mar2026, Vol. 173, pN.PAG-N.PAG. 1p.
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– Name: Abstract
  Label: Abstract
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  Data: 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 &lt; 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]
– Name: AbstractSuppliedCopyright
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  Data: &lt;i&gt;Copyright of Child Abuse &amp; Neglect is the property of Pergamon Press - An Imprint of Elsevier Science and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1016/j.chiabu.2025.107876
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 1
        StartPage: N.PAG
    Subjects:
      – SubjectFull: Adverse childhood experiences
        Type: general
      – SubjectFull: Mental depression
        Type: general
      – SubjectFull: Cultural values
        Type: general
      – SubjectFull: Filial piety
        Type: general
      – SubjectFull: Mental health
        Type: general
      – SubjectFull: Chinese people
        Type: general
      – SubjectFull: Homophobia
        Type: general
      – SubjectFull: Gay identity
        Type: general
      – SubjectFull: China
        Type: general
    Titles:
      – TitleFull: 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.
        Type: main
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      – PersonEntity:
          Name:
            NameFull: Liang, Zurong
      – PersonEntity:
          Name:
            NameFull: Song, Boxuan
      – PersonEntity:
          Name:
            NameFull: Xiang, Yetong
      – PersonEntity:
          Name:
            NameFull: Li, Qiang
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            – D: 01
              M: 03
              Text: Mar2026
              Type: published
              Y: 2026
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              Value: 01452134
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              Value: 173
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            – TitleFull: Child Abuse & Neglect
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