Evidence map›Paper›PMID 41280454›Full record

ArticleFrontiers in psychiatry2025

The association between cumulative distal and proximal adversity with depression and anxiety among township grassroots civil servants in China.

Xiong Zhu, Yawen Zheng, Mengting Wang, Wenqian Jian, Hong Pan, Li Chen, Xiaoyue Liu

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Article in Frontiers in psychiatry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Xiong Zhu *Department of Psychiatry, The Third People's Hospital of Huzhou Municipal, The Affiliated Hospital of Huzhou University, Huzhou, China.
Yawen Zheng *Lishui Second Affiliated Hospital of Wenzhou Medical University, Lishui, China.
Mengting WangSchool of Mental Health, Wenzhou Medical University, Wenzhou, China.
Wenqian JianSchool of Mental Health, Wenzhou Medical University, Wenzhou, China.
Hong PanSchool of Mental Health, Wenzhou Medical University, Wenzhou, China.
Li ChenSchool of Mental Health, Wenzhou Medical University, Wenzhou, China.
Xiaoyue LiuThe Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Depression and anxiety are significant public health concerns among township grassroots civil servants, the largest segment of China's civil service. This study aims to investigate the prevalence of depression and anxiety within this population, identify key distal and proximal adversity factors using the Developmental Adaptation Model, explore the association between cumulative adversity and mental health outcomes, and analyze the underlying pathways of association. Methods: A cross-sectional study of 1,275 township grassroots civil servants collected data on demographics, distal adversities (e.g., left-behind experiences, emotional abuse), proximal adversities (e.g., parent-child conflict, divorce intentions, work stress), depression and anxiety using self-report questionnaires. Logistic regression was used to identify predictors, while ANOVA and hierarchical regression were used to examine the functional form of the relationship between cumulative adversity and mental health. Finally, mediation analysis was conducted to explore the role of proximal adversity in linking distal adversity to mental health outcomes. Results: The prevalence of depression and anxiety among township grassroots civil servants was high, at 36.7% and 29.6%, respectively. Multiple distal and proximal factors were significantly associated with both outcomes. Among distal adversities, domestic violence (aOR = 3.42) and emotional abuse (aOR = 2.89) were the strongest correlates of depression; among proximal adversities, work stress (aOR = 5.02) and economic poverty (aOR = 4.92) had the most substantial associations. Cumulative adversity was significantly and positively associated with both depression and anxiety ( Conclusion: This study highlights an alarming prevalence of depression and anxiety among township grassroots civil servants. The findings underscore that while early life adversity creates a foundation of risk, current (proximal) stressors are the primary mechanism through which this risk translates into psychological distress. These insights can help government agencies develop more effective, targeted interventions by focusing on mitigating current work and life pressures.

Indexed as

anxietyChinacumulativedepressiondistal and proximal adversitytownship grassroots civil servants

Identifiers

PMID41280454
PMCPMC12633748

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.