Evidence map›Paper›PMID 41883818›Full record

ArticleFrontiers in public health2026

The mediating role of psychological inflexibility and social avoidance in relationship between body image disturbance and depression among young adults with acne in China.

Fen Xu, Mei Chan Chong, Yunxian Zhou, Junya Chen, Jiayin Ruan, Yue Sun, Juping Tang, Nor Aziyan Yahaya

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Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited 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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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Fen XuDepartment of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Mei Chan ChongDepartment of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Yunxian ZhouSchool of Nursing, Zhejiang Chinese Medical University, Hangzhou, China.
Junya ChenDepartment of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Jiayin RuanRory Meyers College of Nursing, New York University, New York, NY, United States.
Yue SunDepartment of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Juping TangNursing Department, Hangzhou Third Hospital, Hangzhou, China.
Nor Aziyan YahayaDepartment of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Acne impairs physical appearance and triggers significant psychological distress, particularly depression, in young adults, but the underlying psychological mechanisms remain underexplored. Objectives: This study aimed to examine the potential mediating associations of psychological inflexibility and social avoidance in the relationship between body image disturbance and depressive tendencies among young adults with acne in East China, based on the Acceptance and Commitment Therapy (ACT) framework. Methods: A cross-sectional survey was conducted among 201 young adults (18-29 years, 72.1% female) with acne from two tertiary hospitals in East China between December 2024 and February 2025. Validated instruments were used to assess body image disturbance (BIDQ), psychological inflexibility (AAQ-II), social avoidance (SADS-SA), and depression (PHQ-9). A serial mediation model (PROCESS Model 6) was analyzed via SPSS 29 with 5,000 bootstrap samples. Results: Correlation analysis showed significant positive relationships between body image disturbance, psychological inflexibility, social avoidance, and depression (all Conclusion: Body image disturbance indirectly influences depression primarily through the pathways of psychological inflexibility and social avoidance. Integrating ACT into dermatological care to enhance psychological flexibility may effectively alleviate depressive symptoms in acne patients.

Indexed as

Acne VulgarisBody ImageDepressionAdolescentAdultChinaCognitive FlexibilityCross-Sectional StudiesFemaleHumansMaleSurveys and QuestionnairesYoung Adultacnebody image disturbancedepressionmediationpsychological inflexibilitysocial avoidance

Identifiers

PMID41883818
PMCPMC13010312

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