Negative World Assumptions Mediate the Impact of Early Adversity and External Stressors on Mental Health in Young People Amid Social Unrest and COVID-19

Abstract

The increasing number of population-level stressors globally has raised concerns over their mental health consequences on young people. Few studies, however, have examined such factors in population-based youth samples, particularly with consideration of how different stressor types could affect mental health via their impacts on specific world assumptions. As part of a household-based epidemiological study, 766 young people (aged 15–25 years) participated in this study from June 2021 to 2022. We examined how negative world assumptions, assessed using the World Assumption Scale (WAS), and the subdomains of benevolence, meaningfulness, and self-worth, would mediate the impact of stressors on symptom expression. Stressors included population-level stressful events, such as those related to social unrest (TEs) and the COVID-19 pandemic (PEs), as well as personal stressful life events (SLEs) and adverse childhood experiences (ACEs). Meanwhile, symptoms included depressive, anxiety, and post-traumatic stress disorder (PTSD) symptoms. Results showed that negative meaningfulness assumptions significantly mediated the effect of social unrest–related TEs on PTSD symptoms, while benevolence and self-worth mediated the effect of ACEs on depressive and anxiety symptoms. COVID-19 PEs and SLEs showed no significant association with world assumptions. Higher overall negative world assumptions were also significantly associated with poorer functioning and health-related quality of life. The findings suggest that world assumptions play specific mediating roles between different types of external stressors and symptom outcomes, with population-level human-induced stressors and childhood adversity playing more determining roles. These observations provide opportunities for designing interventions targeting negative world assumptions.