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

Abstract

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.

Keywords

Self-discrepancy resilience depression anxiety

Introduction

Self-concept is complex and multifaceted, involving various self-states depending on the social context. According to Higgins’s self-discrepancy theory, discrepancy is often associated with psychological distress and negative emotions (Higgins, 1987). The theory encompasses both the actual self (i.e. the person you actually are) and two self-guides: the ideal self and the ought self. The term ‘ideal self’ refers to the person you aspire to be, embodying an individual’s wishes, hopes and aspirations (Rogers, 1961). The ought self is the attribute that an individual believes he or she is obligated to possess. Discrepancies between these self-representations may result in negative psychological situations involving emotional and motivational states (Lewin, 1951), contributing to cognitive vulnerability. More importantly, it may also be a risk factor for psychopathology and mental disorders.

Ideal-actual self-discrepancy is particularly associated with dejection-related emotions, including sadness, dissatisfaction and disappointment (Higgins, 1987). These dysphoric emotions arise as a result of a motivational state characterised by a loss of outcome, in which one’s hopes and wishes are unfulfilled (Lewin, 1951). In general, people are motivated to pursue both low and high aspirations and goals. Ideal-actual self-discrepancy impairs goal attainment by interfering with adaptive goal-directed self-regulation, resulting in increased psychological distress (Kelly et al., 2015). These negative motivational states may function as cognitive vulnerability mechanisms and have been linked to the onset and maintenance of emotional disorders.

The associations between ideal-actual self-discrepancy and depression (Roelofs et al., 2007; Vergara-Lopez & Roberts, 2012; Woodman & Steer, 2011), as well as anxiety (Ozgul et al., 2003; Watson et al., 2014), are rather well reported, while a few studies have extended it to other psychiatric conditions, such as eating disorders (Mason et al., 2016), suicidal ideation (Cornette et al., 2009), personality disorder (Parker et al., 2006) and paranoia (Hartmann et al., 2014). The findings indicate that ideal-actual self-discrepancy may generate negative emotions, increasing the risk of developing psychiatric symptoms, which has been supported by a recent meta-analysis of 70 studies on the role of self-discrepancy in psychopathology (Mason et al., 2019). This study reinforces the notion that self-discrepancy constitutes a transdiagnostic risk factor for psychopathology, possibly as a result of increased negative emotion and decreased positive emotion brought by increased cognitive vulnerability (Mason et al., 2019).

Notably, as the meta-analysis revealed, the majority of studies focused on explaining the association between self-discrepancy and mental health conditions, with very few having paid attention to the underlying mechanisms linking the two. According to Higgin’s (Higgins, 1998) other theory – regulatory focused theory – individuals possess a promotion system that is responsible for advancement, nurturing and fulfilling hopes. Ideal-actual self-discrepancy refers to the failure to live up to ideals, which represents failure to achieve promotional goals, eliciting negative affective responses. Chronic failure to promote the system results in systemic downregulation (Higgins, 2006), thereby increasing vulnerability to pathogenic changes and thus the risk of psychopathology. Negative promotion on a repeated basis might erode the engagement of the system, resulting in decreased optimism, which makes individuals less likely to pursue promotional goals (Miller & Markman, 2007). It can spiral into a self-perpetuating, vicious cycle resulting in dysphoric emotions, which is reflected by the weakening of resilience (defined as tenacity in the face of adverse experiences) (Herrman et al., 2011). While previous research has established that resilience is a significant moderator of depression in adults and the elderly (Dowrick et al., 2008; Laird et al., 2019), it piques our interest in whether the association between resilience also plays a moderating role between ideal-actual self-discrepancy and mental disorders. While a recent study showed that resilience indeed plays a moderating role in the relationship between ideal self-discrepancy and depression but not anxiety among young adults (Gürcan-Yıldırım & Gençöz, 2022), we therefore would like to ask whether such a finding is also generalisable to younger youths when the emotion regulation system is still in the process of maturation.

In the current study, we aim to examine the role of resilience in the association between self-discrepancy and mental disorders. While a previous study established that stressful life events (SLEs) are significant predictors of depression and anxiety (Bonanno, 2012), we also investigated whether the role of resilience changes following substantial exposure to recent SLEs. We hypothesised that greater self-discrepancy would be associated with an increased risk of depression and anxiety, with the associations being moderated by resilience. In addition to the severity of depressive and anxiety symptoms, we also examined the relationships using a probable mental disorder state through diagnostic interviews. We additionally hypothesised that when individuals are exposed to high levels of SLEs, the link between self-discrepancy and resilience breaks down, and resilience can no longer protect individuals from developing mental health conditions.

Methods

Participants

As part of the ongoing Hong Kong Youth Epidemiological Study of Mental Health (HK-YES) project, the participants of the current study were recruited from May 19, 2019, to April 12, 2021. The HK-YES project is currently underway using a stratified multistage cluster sampling design similar to previous large-scale epidemiological studies in Hong Kong (Lam et al., 2015). Hong Kong residents between the ages of 15 and 24 who lived in randomly selected addresses obtained from the local government were contacted via mail to see if they were interested in joining the programme. All data collection occurred via face-to-face interviews, either in person or via online video conferences, as determined by the participant. This study examined a variety of factors, including ideal-actual self-discrepancy, psychiatric conditions, resilience, and recent SLEs. Only basic demographic profiles, namely, age, gender and education level, were analysed in the current study. The data for this study were analysed from 1,144 participants who provided complete information on the variables being examined.

Measures

Self-discrepancy

Participants’ self-discrepancies were derived by comparing the endorsement of 14 descriptors to the ideal self and actual self-identities. Operationally, the participant chose 0 if a descriptor was not applicable to the identity or 1 if it was applicable. The descriptors selected were aggressive, calculating, capable, compromising, dishonest, excluding, helpful, gossiping, hostile, investigative, powerful, reliable, vengeful and manipulative, which were found to be able to reflect one’s self-concept (Longenecker et al., 2016). Self-discrepancy is operationalised as the percentage difference in the matching of descriptors endorsed for the ideal and actual self. Matching means either participants selected ‘1’ or ‘0’ for the descriptors in both ideal and actual self-identities. The following formula was used:

\frac{U I S + U A S}{I A S} \times 100 %

Unmatched ideal self (UIS) = No. of descriptors endorsed for the ideal self-identity − no. of matched descriptors between the ideal self and actual self-identities

Unmatched actual self (UAS) = No. of descriptors endorsed for the actual self-identity − no. of matched descriptors between the ideal self and actual self-identities

Ideal or actual self (IAS) = No. of descriptors endorsed for ideal self-identity + No. of descriptors endorsed for actual self-identity

Examples of the calculations are presented in Supplemental Material S1. A higher percentage indicates a greater difference in descriptors endorsed, showing greater self-discrepancy and lower concurrence between the ideal and actual self.

Mental health measures

The Composite International Diagnostic Interview Screening Scale (CIDI-SC) (Kessler et al., 2013) was used to screen for the 12-month prevalence of major depressive episodes (MDEs) and generalised anxiety disorder (GAD). Both include an entry question regarding the frequency of symptoms on a 5-point Likert scale ranging from 1 (none of the time) to 5 (all or almost of the time). A series of follow-up questions will be administered if the entry question is endorsed. The assessment was administered by research staff who received regular supervision from team psychiatrists.

The severity of depressive and anxiety symptoms was measured by the Patient Health Questionnaire 9-item version (PHQ-9) (Kroenke et al., 2001) and the Generalised Anxiety Disorder 7-item version (GAD-7) (Spitzer et al., 2006), respectively. Both scales are self-administered screening instruments based on DSM-IV criteria that assess participants’ recent symptom experience. The questionnaire employs a four-point Likert scale with a range of 0 (not at all) to 3 (nearly every day). Cronbach’s alpha values of .889 for the PHQ-9 and .925 for the GAD-7 indicate high reliability in our sample.

Resilience

Participants’ level of resilience was measured using the Connor-Davidson Resilience Scale 10-item Chinese version (Campbell-Sills & Stein, 2007; Connor & Davidson, 2003). The items are rated on a 5-point Likert scale ranging from 0 (Not at all true) to 5 (True nearly all the time). Cronbach’s alpha of .901 indicates high reliability in our sample.

Stressful life events

An adapted version of the List of Threatening Experiences (LTE) was used to evaluate participant exposure to SLEs in the recent year (Brugha et al., 1985). Life stressors such as serious illness, the death of an immediate or distant relative, the loss of a steady relationship, and having lost something of value are all included in this 12-item binary checklist (Brugha et al., 1985; Rosmalen et al., 2012). To improve the relevancy of the scale on the youth population, an alternative option to ‘sacked from job’ is ‘expelled from school’, while ‘dropped out of school’ is also an option to ‘unemployment’. A composite SLEs score was created by summing the responses. We further categorised participants with the highest 10% SLE exposure (i.e. SLEs > 3) as the high SLE group, while the remaining 90% were categorised as the low SLE group.

Statistical analysis

All statistical analyses were performed using SPSS version 28.0 (IBM SPSS Statistics, New York) and R version 4.1.2, and the statistical significance was set at the p < .05 level. Descriptive statistics were generated for all variables. The prevalence of 12-month MDEs and GAD were weighted according to age and sex data from the 2016 Hong Kong Census to increase their representativeness.

To initially examine the crude associations between the measures of interest, correlation analysis was conducted between self-discrepancy, resilience, SLE, PHQ-9, and GAD-7. The association of these variables with the 12-month MDEs and GAD was examined using the Mann–Whitney U test (due to the nonnormally distributed data).

Separate hierarchical linear or logistic regression models were used to examine, in step 1, the relationship between self-discrepancy and severity of depressive and anxiety symptoms, as well as 12-month MDEs and GAD, respectively, with adjustment for demographic characteristics. In step 2, we entered resilience into the models to examine the impact of resilience on the relationships observed in step 1.

The moderation analysis was conducted using model 1 of the PROCESS macro version 4.0 in SPSS software (Hayes, 2017). We reported the bootstrapped unstandardised regression coefficients (b) and 95% CIs for all models that were adjusted for demographic characteristics and bootstrapped for 5,000 resamplings. As we did not observe a clear moderating role of resilience, we additionally conducted an exploratory moderation analysis to determine whether resilience plays a mediating role in the relationship between self-discrepancy and mental health conditions. A significant indirect effect (IE) indicated that the relationship was mediated by resilience. We also calculated the percent mediated, which is operationalised as the proportion of the indirect effect of the total effect.

To estimate the relative contributions of the potential pathways linking self-discrepancy and depressive and anxiety symptoms, we used four-way decomposition analysis (VanderWeele, 2014). This methodology enables us to assess the extent to which the total effect of self-discrepancy on depressive and anxiety symptoms is explained by alternative pathways involving (or not involving) resilience. Specifically, the method decomposes the total association between self-discrepancy and depressive and anxiety symptoms into the following four components: controlled direct effect (CDE), reference interaction (INTref), mediated interaction (INTmed), and pure indirect effect (PIE) (VanderWeele, 2014) (see Supplemental Material S3 for the illustration).

Our findings indicated that the total effect of self-discrepancy on depressive or anxiety symptoms was mostly explained by resilience as a mediator. The mediation analyses were conducted separately on participants in the low and high SLE groups.

Results

Participant demographic profile

Participants in the current study had an average age of 20.1 (SD 2.89). More of them were female (n = 659, 57.5%) and had a secondary or below education (n = 720, 63.0%) (Table 1).

Table 1.

Hierarchical regression models showing the associations between self-discrepancy, resilience, severity of depressive and anxiety symptoms, and 12-month MDE and GAD, with adjustment for demographic characteristics.

Linear regression models		PHQ-9		GAD-7
	Mean (SD)	Step 1	Step 2	Step 1	Step 2
	Mean (SD)	b [95% CI]	b [95% CI]	b [95% CI]	b [95% CI]
Age (years)	20.1 (2.89)	0.04 [−0.09, 0.18]	0.06 [−0.07, 0.19]	0.12 [−0.01, 0.24]	0.13 [0.02, 0.24]*
Gender, n (%)
Male	485 (42.4)	Reference	Reference	Reference	Reference
Female	659 (57.6)	0.53 [−0.047, 1.11]	0.37 [−0.17, 0.90]	0.82 [0.30, 1.33]**	0.68 [0.20, 1.16]**
Education (%)
⩽Secondary	720 (63.0)	Reference	Reference	Reference	Reference
⩾Post-secondary	424 (37.0)	−0.05 [−0.88, 0.77]	0.09 [−0.67, 0.85]	0.05 [−0.69, 0.78]	0.17 [−0.52, 0.85]
Self-discrepancy	57.0 (30.10)	0.03 [0.02, 0.04]***	0.008 [−0.002, 0.02]	0.02 [0.01, 0.03]***	0.001 [−0.01, 0.01]
Resilience	24.2 (6.25)	n/a	−0.32 [−0.47, −0.28]***	n/a	−0.27 [−0.31, −0.23]***
R ²		.033	.175	.032	.159
Logistic regression models		12-month MDE		12-month GAD
		Step 1	Step 2	Step 1	Step 2
		aOR [95% CI]	aOR [95% CI]	aOR [95% CI]	aOR [95% CI]
Age (years)		1.10 [1.02, 1.19]*	1.11 [1.03, 1.21]**	1.15 [0.91, 1.45]	1.16 [0.92, 1.48]
Gender, n (%)
Male		Reference	Reference	Reference	Reference
Female		1.99 [1.42, 2.78]***	2.02 [1.43, 2.86]***	0.95 [0.42, 2.16]	0.90 [0.40, 2.07]
Education (%)
⩽Secondary		Reference	Reference	Reference	Reference
⩾Post-secondary		0.70 [0.45, 1.10]	0.70 [0.44, 1.11]	2.06 [0.63, 6.67]	2.09 [0.65, 6.71]
Self-discrepancy		1.01 [1.00, 1.02]***	1.002 [0.996, 1.01]	1.02 [1.00, 1.03]*	1.01 [0.99, 1.02]
Resilience		n/a	0.88 [0.86, 0.91]***	n/a	0.90 [0.84, 0.96]**
% Correct classification		84.4	84.8	97.9	97.9

Note. SD = Standardised deviation; PHQ-9 = Patient Health Questionnaire 9-item version; GAD-7 = Generalised Anxiety Disorder 7-item version; b = unstandardised regression coefficient; CI = confidence interval; MDE = Major Depression Episode; GAD = Generalised Anxiety Disorder; aOR = adjusted odds ratio.

***

p < .001. **p < .01. *p < .05.

Crude associations between self-discrepancy, resilience, SLE and mental health measures

The Spearman rank-ordered correlation analyses revealed that all variables were mildly to strongly correlated (coefficients ranged from −.418 to .705), with the exception of the relationship between SLE and self-discrepancy and resilience (see S2 in the Supplemental Material). The 12-month MDE and GAD were consistently associated with lower resilience and higher PHQ-9 and GAD-7 scores, but only the 12-month MDE was associated with greater self-discrepancy and more reports of SLEs.

Self-discrepancy and severity of depressive and anxiety symptoms and prevalence of 12-month MDEs and GAD

After weighting, the average level of self-discrepancy was 57.0% (SD = 30.1%); the average PHQ-9 and GAD-7 scores were 6.3 (SD 5.03) and 4.6 (4.46), and the 12-month prevalence of MDEs and GAD was 15.6% and 2.1%, respectively.

Association between self-discrepancy and mental health

Self-discrepancy was associated with more severe depressive (b = 0.03, 95% CI [0.02, 0.04]) and anxiety symptoms (b = 0.02, 95% confidence interval [CI] [0.01, 0.03]) and higher odds of 12-month MDEs (adjusted OR 1.01, 95% CI [1.0, 1.02]) and GAD (adjusted OR 1.02, 95% CI [1.00, 1.0]). The observed associations were attenuated and became nonsignificant when resilience was added in all models.

Examination of the potential moderating role of resilience in the association between self-discrepancy and mental health

The findings of the moderation analysis suggested that the moderating role of resilience in the relationships between self-discrepancy and depressive symptoms or 12-month MDE was not supported (Figure 1 and Supplemental Material S2). The moderating role of resilience in the relationship between self-discrepancy and 12-month GAD, but not anxiety symptoms, was supported (interaction effect: adjusted OR = 0.997,95% CI [0.995, 0.999]).

Figure 1.

The moderating effect (bootstrapped unstandardised regression coefficients and 95% CI) of resilience between self-discrepancy and (a) depression symptoms measured by the PHQ-9, (b) anxiety symptoms measured by the GAD-7, (c) 12-month MDEs and (d) 12-month GAD.

Examination of the potential mediating role of resilience in the association between self-discrepancy and mental health

Mediation analysis showed that resilience fully mediated the association between self-discrepancy and all mental health measures, including the PHQ-9, GAD-7, 12-month MDE, and 12-month GAD (Figure 2). The percentages mediated were 77.8%, 96.1%, 88.9%, and 50.0%, respectively.

Figure 2.

The mediating effect of resilience between self-discrepancy and (a) depression measured by the PHQ-9, (b) anxiety measured by the GAD-7, (c) 12-month MDEs and (d) 12-month GAD.

The relative contributions of the potential pathways linking self-discrepancy and depressive and anxiety symptoms

Table 2 shows the results from the four-way decomposition analysis. There was strong evidence for the PIE only for both the PHQ-9 and GAD-7 models (coefficient: .02; 95% CI [0.02, 0.03] and coefficient: .02; 95% CI [0.01, 0.02], respectively), which accounted for 72.1% and 93.1% of the total effect estimate for the respective models. The proportion of attributable interactions was 81% and 27%, the proportion eliminated was 153% and 120%, and the estimated proportion mediated was 72% and 93%, respectively.

Table 2.

Four-way decomposition of the estimated effect of self-discrepancy on depressive and anxiety symptoms mediated by resilience.

	PHQ-9		GAD-7
	Estimated effect [95% CI]	Proportion attributable	Estimated effect [95% CI]	Proportion attributable
Total effect	0.03 [0.02, 0.05]	N/A	0.02 [0.01, 0.03]	N/A
CDE	−0.02 [−0.06, 0.02]	−53.1%	0.00 [−0.04, 0.03]	−20.2%
INTref	0.03 [−0.01, 0.07]	81.2%	0.01 [−0.03, 0.04]	27.1%
INTmed	0.00 [0.00, 0.00]	0.2%	0.00 [0.00, 0.00]	−0.1%
PIE	0.02 [0.02, 0.03]	72.1%	0.02 [0.01, 0.02]	93.1%
Proportion attributable to interaction	0.81 [−0.14, 2.11]		0.27 [−1.22, 3.02]
Proportion eliminated	1.53 [0.52, 2.80]		1.20 [−0.47, 3.64]
Proportion mediated	0.72 [0.40, 0.90]		0.93 [0.18, 1.22]

Differential effect of resilience on the associations between self-discrepancy and mental health by low and high SLE groups in the recent year

The mediating role of resilience was found only in the association of self-discrepancy with all mental health measures among participants in the low SLE group (Supplemental Material S4). Among participants with high SLEs exposure, the mediating role of resilience was not found in the relationships between self-discrepancy and 12-month MDEs and GAD but between self-discrepancy and depressive (IE: b = 0.043,95% CI [0.019, 0.070]) and anxiety symptoms (IE: b = 0.039, 95% CI [0.017, 0.063]).

Discussion

The purpose of this study is to examine the role of resilience in the relationship between self-discrepancy and mental conditions. We also examined how the role of resilience changes in the face of recent adversity. To begin with, as the authors are aware, this is likely the first study to report the relationship between self-discrepancy and mental health conditions at the probable diagnostic level, rather than just self-reported measures. Our findings confirmed a negative relationship between self-discrepancy and mental health conditions, which is in line with a recent meta-analysis (Mason et al., 2019). These relationships were revealed for both the depression and anxiety measures, implying that the effect is not limited to the more commonly reported depressive emotions but is also linked to a broader range of psychopathologies. The findings support the notion that having a smaller ideal-actual self-discrepancy is associated with better mental health.

The role of resilience was investigated in the current study as a potential mechanism for how self-discrepancy is associated with mental health conditions. Resilience was found to be a significant mediator of the relationship between ideal-actual self-discrepancies across all mental health measures. In particular, low ideal-actual self-discrepancy is associated with high resilience, which may be explained by the close association between resilience, confidence and optimism (Lee et al., 2013). According to regulatory-focused theory, ideal-actual self-discrepancy is linked to lower self-esteem (Mason et al., 2016) and reduced optimism (Hardin & Leong, 2005), which leads to a lower level of resilience. In the current study, resilience was found to be correlated with high scores on mental health indicators for depression and anxiety, which was in line with previous research (Dowrick et al., 2008; Laird et al., 2019). As a result, the gap between our ideal and actual selves is likely to affect our resilience, which in turn affects our mental health.

Resilience was also found to be a significant moderator of the relationship between ideal-actual self-discrepancy and the 12-month prevalence of GAD in the current study. This suggests that resilience may protect against anxiety by buffering the negative effects of self-discrepancy. One explanation is that people with high resilience are more likely to set attainable goals (Gürcan, 2015). It has also been found that people with high resilience have a positive attitude towards life even in difficult situations and are more likely to see positive opportunities to solve problems (Izydorczyk et al., 2018). It is possible that they have a higher tolerance for failure because they have a more positive perspective on problems and are more open to new challenges. As a result, they are likely to be less vulnerable to the negative emotions induced by the downregulation of the self-regulatory system, implying that resilience plays a role in the relationship between ideal-actual self-discrepancy and mental health.

Given that the nonsignificant interaction effect of resilience contradicts findings from a recent study (which found that resilience interacts with ideal self-discrepancy) (Gürcan-Yıldırım & Gençöz, 2022), we used four-way decomposition analysis to investigate the components of the total effect with severity scales. The findings indicated that both interaction and mediation effects existed and accounted for the total effect. However, only the mediation models were found to be statistically significant, while the moderation models were not. The results could be explained by the fact that the moderation effect does not consistently exist in all participants (which led to a wide confidence interval). Nonetheless, findings based on four-way decomposition suggested that, as previously reported, moderation exists and contributes to the effect of resilience on the associations between self-discrepancies and mental health conditions to some extent.

The findings of the subgroup analysis found that the mediating effect of resilience was more prominent among individuals who recently experienced more adversity. Previous research has demonstrated negative immediate outcomes after recent collective trauma, including greater global distress, functional impairment, posttraumatic stress symptoms and poorer life satisfaction (Seery et al., 2010). Hence, in the face of recent adversity, resilience might play an even more important role in regulating emotions by acting as a protective factor buffering against negative impacts from not only self-discrepancies but also current stressful experiences. While adverse experiences may interact with other potential factors to influence resilience propensity (Seery, 2011), high levels of adversity may foster perceived helplessness which results in a lack of toughness and disruption to the development of resilience. In fact, some exposure to prior adversity might help promote resilience and predict positive psychological outcomes (Seery et al., 2010). Although it is possible that recent adversity influences individuals’ resilience level and thereby increases its effect on the relationship between ideal-actual self-discrepancy and mental wellbeing, it is also possible that the changes in the relationships are due to the overreporting of mental health issues among those whose mental state was highly stressed out by the adversity and presented with poorer resilience (Crosswell & Lockwood, 2020; Kagan, 2016). Despite the fact that participants who reported more SLEs also reported more mental health problems, the number of SLEs was not found to be related to the resilience level. Future studies should attempt to distinguish between the two effects, despite our continued scepticism regarding the influence of SLE on the association between self-discrepancy and mental disorders.

Our findings have important clinical implications for considering self-discrepancies as a treatment target, given the links between ideal-actual self-discrepancy and mental health conditions. A previous study found that reducing self-discrepancies is linked to improved quality of life in people treated for personality or mood disorders (Gibbons et al., 2009), and the current findings suggested that this could be accomplished by increasing resilience. A previous study reported that resilience-focused interventions are effective in reducing depressive and anxiety symptoms in the short term, especially when combined with cognitive behavioural therapy (Dray et al., 2017). Of note, our research also suggests that clinicians should consider recent adversity when prescribing treatments, as resilience could affect symptom severity but has no effect on an ill state.

Our research does, however, have some limitations. The study’s reliance on a questionnaire-based data collection method (except the CIDI-SC assessment) may have resulted in substantial report bias, particularly, as mentioned, with respect to the overreporting of mental health problems among those who have recently experienced more stressful events. Longitudinal studies are needed to investigate how ideal-actual self-discrepancy potentiates mental disorders and provide evidence for potential causal explanations. To investigate longitudinal associations, the effect of changes in self-discrepancies should also be investigated. Furthermore, because our research focused on common mental disorders (such as depression and anxiety), its generalisability to other psychopathologies is limited. This emphasises the importance of studying the mechanism of how ideal-actual self-discrepancy affects other mental health issues.

Conclusion

Our findings supported the negative associations between ideal-actual self-discrepancy and mental health conditions. Specifically, we found that resilience is a significant mediator of the relationships and that its effect is more prominent in the face of recent adverse events. The study sheds light on the use of resilience-focused interventions in the treatment of individuals with depressive and anxiety symptoms and a high ideal-actual self-discrepancy. To ensure the efficacy of interventions, it is recommended to consider the presence of recent stressful events during initial assessments. To further investigate the impact of resilience on the relationships between self-discrepancies on mental health, longitudinal studies and studies that examine it on other mental health disorders are warranted.

Supplemental Material

sj-docx-1-isp-10.1177_00207640231152691 – Supplemental material for 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

Supplemental material, sj-docx-1-isp-10.1177_00207640231152691 for 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 by Suen Yi Nam, Ling Cheuk Ying Crystal, Cheung Charlton, Hui Lai Ming Christy, Wong Ming Yin Stephanie, Wong Tak Hing Michael, Chan Kit Wa Sherry, Lee Ho Ming Edwin and Chen Yu Hai Eric in International Journal of Social Psychiatry

Footnotes

Funding

The author(s) disclosed receipt of the following financial supportfor the research, authorship, and/or publication of this article: This work is supported by the Food and Health Bureau of the Government of the Hong Kong Special Administrative Region (HMRF Commissioned Study on Mental Health Survey (MHS-PI, Part 2)).

ORCID iDs

Suen Yi Nam

Chan Kit Wa Sherry

Supplemental material

Supplemental material for this article is available online.

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