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<p>Patients with Major Depressive Disorder (MDD) often experience elevated perceived stress, dysregulated emotion regulation strategies (ERS), and heightened negative emotional symptoms, contributing to significant distress. While the associations among these factors are well-documented, significant inter-individual variability in emotional responses persists under similar stress levels, attributed to differences in stress appraisal and coping styles. Thus, further work should clarify links between perceived-stress subdimensions and negative emotional symptoms and assess the role of ERS in these links, particularly during adolescence and early adulthood, a key developmental window. A total of 228 youth with MDD (mean age = 17.01 ± 2.69, rang 12–30 years, 149 females) completed the Perceived Stress Scale, Emotion Regulation Questionnaire, Beck Depression Inventory, and Beck Anxiety Inventory. Correlations, multiple linear regression, path analysis, and bootstrap mediation analysis were conducted to examine associations among these variables. We found that higher perceived stress was significantly associated with greater depressive and anxiety symptom severity in youth with MDD. These associations are partially mediated by specific ERS: suppression partially mediated the stress–anxiety and stress–depression links, whereas reappraisal partially mediated only the stress–depression link. At the subdimension level, Perceived helplessness had indirect effects on both symptoms by suppression’s partial mediation; perceived efficacy, only by reappraisal’s partial mediation for depression. Overall, the findings provide empirical support for stress-coping theory and the dual-process model of emotion regulation, and suggest potential directions for targeted clinical interventions for youth with MDD.</p>

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Associations between perceived stress and emotional symptoms in youth with major depressive disorder: emotion regulation strategy-specific indirect pathways

  • 期刊论文

  • 发表日期：

    2026年6月29日

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  • Jilin Wu,
  • Min Liang,
  • Juan Deng,
  • Yu Sun,
  • Luoya Zhang,
  • Maomao Zhang,
  • Ke Gong,
  • Kezhi Liu,
  • Wei Lei,
  • Jing Chen

摘要

Patients with Major Depressive Disorder (MDD) often experience elevated perceived stress, dysregulated emotion regulation strategies (ERS), and heightened negative emotional symptoms, contributing to significant distress. While the associations among these factors are well-documented, significant inter-individual variability in emotional responses persists under similar stress levels, attributed to differences in stress appraisal and coping styles. Thus, further work should clarify links between perceived-stress subdimensions and negative emotional symptoms and assess the role of ERS in these links, particularly during adolescence and early adulthood, a key developmental window. A total of 228 youth with MDD (mean age = 17.01 ± 2.69, rang 12–30 years, 149 females) completed the Perceived Stress Scale, Emotion Regulation Questionnaire, Beck Depression Inventory, and Beck Anxiety Inventory. Correlations, multiple linear regression, path analysis, and bootstrap mediation analysis were conducted to examine associations among these variables. We found that higher perceived stress was significantly associated with greater depressive and anxiety symptom severity in youth with MDD. These associations are partially mediated by specific ERS: suppression partially mediated the stress–anxiety and stress–depression links, whereas reappraisal partially mediated only the stress–depression link. At the subdimension level, Perceived helplessness had indirect effects on both symptoms by suppression’s partial mediation; perceived efficacy, only by reappraisal’s partial mediation for depression. Overall, the findings provide empirical support for stress-coping theory and the dual-process model of emotion regulation, and suggest potential directions for targeted clinical interventions for youth with MDD.