This study found that LBC-MS were more likely to use ES as their emotion regulation strategy compared to non-LBC-MS, which is in line with a previous study [12]. The correlational analysis found ES and anxiety are positively correlated indicating LBC-MS who use ES to regulate their emotions are more likely to become anxious. In addition, ES was found significantly inversely correlated with psychological resilience and self-esteem in LBC-MS. However, psychological resilience and self-esteem were positively correlated, in other words, LBC-MS who were more resilient in facing and adapting to adversities were more likely to have a higher self-esteem. Psychological resilience and self-esteem were negatively associated with anxiety respectively. Psychological resilience and self-esteem may buffer an individual’s vulnerability to anxiety [14, 36, 37]. After the continuous variables were standardized and controlling for sex, parental relationship, family economic status, and the effects of psychological resilience and self-esteem, ES remained to have a significant correlation with higher anxiety in LBC-MS, significant single mediating and chain mediating effects of psychological resilience and self-esteem in the relationship between ES and anxiety were also found.
First, we found a significant positive correlation between ES and anxiety in LBC-MS which supports our first hypothesis. A previous study on social anxiety also suggested that individuals who believe expressing their emotions is a personal disadvantage often maintain a constant fear of losing emotional control through the frequent use of ES [38]. Similarly, in LBC-MS who hold similar beliefs, their social functions and interpersonal relationships can be impaired due to social withdrawal, and the habitual use of ES is positively associated with greater social anxiety [39]. The more an LBC-MS tries to suppress the emotion, the more socially anxious one can be due to exhaustion of positive mental self-regulatory resources. Conversely, individuals who are more socially open are more expressive of their emotions, regardless of whether these emotions are positive or negative. Less social support may contribute to the development of anxiety in various ways, and individuals who use ES may provide and perceive less social support to and from others [40]. A lack of parental modeling in social interaction may predispose LBC-MS to social withdrawal, and parental expectations for them to take care of themselves may further predispose and precipitate LBC-MS for their fears of losing control in various contexts in their daily life. LBC-MS may be more frequently regulate their emotions using ES due to lack of sense of security, understanding from others, and parental support when facing different types of stressors, thus, leading to more increased feelings of abandonment and loneliness [8, 41]. When stressors persist for a prolonged period without intervention, continued maintenance of fear dependent on false beliefs contributes to the development of anxiety in LBC-MS.
Second, this study examined the mediating mechanism of psychological resilience in the relationship between ES and anxiety, and further reveals that the use of ES is associated with higher levels of anxiety in LBC-MS. Consistent with our second hypothesis, psychological resilience plays a mediating role between ES and anxiety in LBC-MS. Psychological resilience is commonly defined as the ability to adapt and maintain a positive mental state in the face of adversity and can be further divided into internal and external resilience. Internal resilience involves the use of one’s internal assets to buffer the effects of adversity (e.g., self-efficacy) and external resilience involves the use of external resources to ameliorate the impact of adversity (e.g., social and family support) [16, 42, 43]. The reason why ES can affect anxiety by reducing psychological resilience may be that the negative emotional experiences weaken individuals’ ability to actively use and distribute internal and external resources to adapt to adversity in the face of stressors, which leads to the reduction of psychological resilience and ultimately leads to various psychological imbalance problems [44]. This result indicated that ES, a maladaptive emotion regulation strategy, is significantly associated with certain areas of resilience [19]. In addition, in LBC-MS, it is possible that both internal and external resilience may not be fully developed due to parental absence in terms of guidance and modeling in response to adversities. Greenberg et al. proposed that psychological resilience is a protective factor to reduce maladaptive outcomes under risk conditions, and these scholars also identified three categories of protective factors which are individual, quality of the child’s relationships, and environmental factors [45]. Given limited resources and unadvanced education system in the less developed areas where LBC-MS reside, compared to other major cities in China, it is possible that these LBC-MS cannot access learning for emotion regulation strategies and support from their curriculum or from their parents and neighborhoods result in pessimistic interpretations of aversive stimuli and poor adaptability.
Third, in this study, self-esteem was found to mediate the relationship between ES and anxiety in LBC-MS. LBC-MS with lower self-esteem were more frequently employed ES and were more likely to be anxious in response to adversities. This finding was also shown in the young adults in the UK [46]. Compared to non-LBC-MS, LBC-MS are more likely to have lower self-esteem due to parental absence and poor parent-child relationships and communication, which result in more inferior feelings and unsuccessful establishment of social connections. They may also improperly use social support during stressful situations that lead to abusive relationships and low self-esteem. Mouatsou & Koutra illustrated in their study in Greek emerging young adults that frequent use of CR is associated with higher self-esteem, on the other hand, frequent use of ES is associated with lower self-esteem [19]. Moreover, our previous study suggests that LBC-MS with lower self-esteem have increased anxiety [13]. In LBC-MS who use ES, their emotions may be hidden and perceived as a psychological burden and these individuals carry this burden psychologically as part of their self-concept creating inconsistency between inner experience and outer expression, thus, result in low self-esteem and anxiety problems [9].
Moreover, LBC-MS with lower self-esteem may have poor self-evaluation system and feel less optimistic and incompetent in the face of adversity, thus, more likely to adopt maladaptive emotion regulation strategy and further exacerbate anxiety. In person with secure type of attachment style, anxiety may be buffered through their relationship with their parents. Terror management theory (TMT) suggested children’s successful establishment of secure attachment and high self-esteem during the infantile period with parents may buffer the negative effect of anxiety [16, 36,37,38,39,40,41,42,43,44,45,46,47]. This is accomplished through the socialization process by living up to the cultural world values and elevate to immortality, thus, diminishing the threats of anxiety [48, 49]. However, the deficient parent-child interaction and unsuccessful secure type of attachment style in LBC-MS may lead to the development of low self-esteem and poor mental health. These conditions may further be precipitated and perpetuated by daily and other types of stressors.
Finally, this study revealed a chain-mediated pathway of psychological resilience and self-esteem between ES and anxiety in LBC-MS, which may add to our understanding of the relationship between ES and anxiety. It was proven that frequent use of ES is linked to decreased psychological resilience and self-esteem, and increased anxiety symptoms, and psychological resilience and self-esteem were positively correlated in LBC-MS. Mouatsou & Koutra illustrated that individuals may have greater adaption and feel more self-worthy and competent by reappraising the meaning of the stressful situations, which contribute significantly to both development of psychological resilience and self-esteem [19]. In LBC-MS, they might not acquire the reinterpreting skill prior the occurrence of stressful stimuli, thus, end up with poor adaptation and become less resilient. The positive correlation between psychological resilience and self-esteem is also consistent with a study in Australian young adults. Benetti & Kambouropoulos supported the notion that psychologically resilient individuals tend to use positive affect to “bounce back” from aversive stressful experiences, and this “bounce back” using positive affect, a significant mediator, in turn promoted development of high self-esteem, which allows individuals to cope effectively to those challenging stressors [50]. However, it is obvious that LBC-MS may have more negative affect which have been prominently studied such as depression and anxiety [19, 51]. Thus, anxiety can be triggered by the inability to “bounce back” through the use of positive emotions or failure to establish the healthy attachment type proposed by TMT as an anxiety-buffer.
These results suggest that the inclusion of modules improving emotion regulation strategies, reinforcing psychological resilience and self-esteem in prophylactic and therapeutic programs may be beneficial to improving the mental health in LBC-MS. Tam et al. launched one of the first pilot studies on the effectiveness of a resilience-based intervention program in China and incorporated this program into regular school hours targeting mental health problems that LBC have (e.g., depression) [52]. In that study, the resilience-based intervention program lasted 6 weeks and 80 minutes per session and incorporated context-specific content for LBC (e.g., setting positive expectations about migration, improving self-efficacy via cultural adaptation, and facilitating social connection with others). In addition to those programs, it may be necessary to advance the education system. Huang et al. suggested that schools to provide individual or group counseling to students, and that teachers to be trained to become competent in engaging in positive day-to-day communication with students, which may facilitate positive interpersonal, resilience, and self-esteem development [51]. Thus, the combined benefits of external and internal resilience through these programs may offset the deleterious effects of risk factors and other negative and traumatic events.
In addition to the principles of previous research on psychological resilience and self-esteem intervention programs aimed at such as increasing parent-child and peer interaction and advancing education system, factors such as dosage effect and cultural adaptation should be considered. First, it needs to be considered whether the duration of the intervention programs is long enough to detect its effectiveness in LBC-MS. Furthermore, many programs were created by nonnative scholars. Thus, programs that are culturally adaptive such that incorporating eight core Taoist principles in the Chinese Taoist Cognitive Psychotherapy (CTCP) may become especially effective due to the nativity of the religion and the level of understandability when implemented for sufficient duration and tailored to specific contexts by decreasing ES, increasing psychological resilience and self-esteem [53]. Although CTCP was especially effective in treating generalized anxiety disorder (GAD) in adult, given the continuing development of LBC-MS, these programs may be beneficial for long-term mental health for LBC-MS [53].
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