Too Heavy Too Bear? Examining the Predictors of Psychological Distress Among Hong Kong Youth during the Series of Social Incidents in 2019-20

Background and Purpose:
The Hong Kong Extradition Bill, proposed in 2019, evoked fears among citizens that they would be under the scrutiny of the legal system in Mainland China. Public protests ensued shortly after the bill proposal. Given that these events were highly distressing and widely reported by mass media, and that they concurred temporally with the COVID-19 pandemic, an understanding of factors that impact youth psychological well-being amidst these social hardships is necessary. The current study examined sense of coherence, hope, and traumatic distress as predictors of depressive and anxiety symptoms among Hong Kong youth.

Method:
Participants (N = 712, 492 females) between 15 and 25 years (M = 20.63, SD = 3.03) were recruited from educational institutions and community bodies to complete an online survey in early 2020. The Sense of Coherence Scale was adopted to measure respondents’ ability to understand and integrate events in their lives. The Hope Scale assessed levels of hope among participants. The Impact of Event Scale-Revised measured traumatic distress (i.e., intrusion, avoidance, and hyperarousal) resulting from exposure to a stressful event in the past seven days. The Depression Anxiety Stress Scale was used to assess participants’ levels of depression, anxiety, and stress in the past seven days.

Results:
Results showed that 12%, 21% and 25% of the respondents were suffering from severe to extremely severe levels of stress, depression, and anxiety, respectively. Most respondents (n = 703, 98.73%) experienced traumatic distress arising from at least one stressful event in the past seven days. Common stressful events reported by participants were related to academics (36.56%), COVID-19 (15.5%), work (11.4%), and sociopolitical events (8.8%).

Multiple linear regressions revealed that sense of coherence, hope, and traumatic distress significantly predicted levels of depression, F(10, 692) = 105, p < .001, R² = .60, anxiety, F(10, 692) = 70.2, p < .001, R² = .50, and stress, F(10, 692) = 86.5, p < .001, R² = .56. Sense of coherence negatively predicted depression, β = -.30, p < .001, anxiety, β = -.26, p < .001, and stress, β = -.36, p < .001. Hope negatively predicted depression, β = -.17, p < .001. Intrusion symptoms positively predicted stress, β = .11, p < .05. Avoidance symptoms positively predicted depression, β = .12, p < .001 and anxiety, β = .08, p < .05. Finally, hyperarousal symptoms positively predicted depression, β = .19, p < .001, anxiety, β = .40, p < .001, and stress, β = .42, p < .001.

Conclusions and Implications:
The current study emphasizes Hong Kong youth’s needs for psychosocial support, especially in light of the social hardships. In view of the significant number of participants that suffered from severe to extremely severe distress, it is recommended that platforms be established to deliver clinical support for youth. The study also highlights the significance of sense of coherence and hope in influencing youth’s well-being. These two factors may be explored as protective factors and integrated into interventions for those impacted by the social hardships.