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Generational analyses of prevalence, relative risks and protective factors of anxiety and depression symptoms among adult Chinese in Hong Kong
Date Issued
2026
Publisher
Elsevier BV
Journal
ISSN
0165-0327
1573-2517
Citation
Journal of Affective Disorders, 2026, vol. 393, article no. 120359.
Type
Peer Reviewed Journal Article
Abstract
Background
This study represents the first large-scale research on generational mental health and its psychosocial protective factors among adult Chinese in Hong Kong.
Method A total of 10,136 participants, aged 18 to 80, were recruited through online platforms, territory-wide street intercepts, and snowball sampling. Generation groups were categorized by age at the time of data collection: Boomers (mean age 62.52), Generation X (51.99), Generation Y (35.68) and Generation Z (23.32).
Results The overall prevalence was 20.7 % for anxiety symptoms and 17.4 % for depression symptoms, with no significant gender differences. Generation Z exhibited the highest prevalence (30 % anxiety, 22.3 % depression), followed by Generation Y (20.9 % and 19.0 %), Boomers (15.0 % and 13.5 %), and Generation X (14.3 % and 12.8 %). Psychosocial factors of individual resilience, emotional regulation, a positive life outlook, and life satisfaction were significantly linked to mental health symptoms across generations. Generation Z showed the highest risk for mental health symptoms and lowest protective factor levels, emphasizing their vulnerability. Among the protective factors, emotion regulation emerged as the strongest predictor of mental health across all generations, followed by life satisfaction for Generations X, Y, and Z. For Boomers, however, the protective roles of individual resilience and life satisfaction had limited protective roles when other protective factors were considered.
Conclusion Findings highlight the need for targeted interventions, especially for Generation Z. Strategies should focus on improving emotion regulation and life satisfaction to reduce anxiety and depression risks and enhance mental health outcomes.
Method A total of 10,136 participants, aged 18 to 80, were recruited through online platforms, territory-wide street intercepts, and snowball sampling. Generation groups were categorized by age at the time of data collection: Boomers (mean age 62.52), Generation X (51.99), Generation Y (35.68) and Generation Z (23.32).
Results The overall prevalence was 20.7 % for anxiety symptoms and 17.4 % for depression symptoms, with no significant gender differences. Generation Z exhibited the highest prevalence (30 % anxiety, 22.3 % depression), followed by Generation Y (20.9 % and 19.0 %), Boomers (15.0 % and 13.5 %), and Generation X (14.3 % and 12.8 %). Psychosocial factors of individual resilience, emotional regulation, a positive life outlook, and life satisfaction were significantly linked to mental health symptoms across generations. Generation Z showed the highest risk for mental health symptoms and lowest protective factor levels, emphasizing their vulnerability. Among the protective factors, emotion regulation emerged as the strongest predictor of mental health across all generations, followed by life satisfaction for Generations X, Y, and Z. For Boomers, however, the protective roles of individual resilience and life satisfaction had limited protective roles when other protective factors were considered.
Conclusion Findings highlight the need for targeted interventions, especially for Generation Z. Strategies should focus on improving emotion regulation and life satisfaction to reduce anxiety and depression risks and enhance mental health outcomes.
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