Mindfulness and Mental Health Among Mainland Chinese University Students in Hong Kong: The Mediating Role of Self-Stigma

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M. Cheung, Swetang Tamang This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7750032/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objectives Recent research has highlighted the educational and mental health benefits of mindfulness. However, studies on the relation between mindfulness and stigma among ethnic and cultural minorities remain relatively scarce. Based on mindfulness-to-meaning theory, the present longitudinal study investigated the mediating role of self-stigma between mindfulness and mental health outcomes among Mainland Chinese university students residing in Hong Kong. Methods A sample of 194 university students (mean age = 21.08 years, SD = 2.01) were recruited to complete a questionnaire for three times, with an approximately three-month lag between time points. Results Path analysis revealed that mindfulness was associated with lower self-stigma and fewer depressive symptoms. Self-stigma was, in turn, associated with poorer mental health, as indexed by emotional, psychological, and social well-being, but not with depressive symptoms. Self-stigma further mediated the association between mindfulness and mental health, after controlling for baseline autoregressive effects, age, gender, income, and education level. Conclusions The present findings inform researchers of the potential significance of nurturing mindfulness for combating self-stigma and enhancing mental health among minority students. The initial findings may also serve to inform applied interventions for enhancing mental health among minority students. Preregistration This study is not preregistered. Depressive symptoms mental health mindfulness self-stigma Figures Figure 1 Introduction Over the past decades, universities globally have undergone a significant increase in internationalization (Bartell, 2003; De Wit & Altbach, 2021; Jibeen & Khan, 2015). A similar trend has also been observed in Hong Kong, where the total number of “non-local students” have surged from 15,713 in the academic year of 2015/16 to 26,643 in 2024/25 (University Grants Committee, 2025). Among them, full-time students from the Mainland China have risen from 11,876 in 2015/16 to 21,504 in 2024/25, suggesting a 81.07% increase in merely 9 years. Despite an escalation of individuals from the Mainland China (Government of Hong Kong Special Administrative Region Press Release, 2019), living in Hong Kong remains stressful, with people encountering everyday challenges including language difficulties, stigma, loneliness, and other struggles (Bhowmik et al. 2018; Jia & Yeung, 2023; Vyas & Yu, 2018). The stigma associated with being a minority has long-term implications, jeopardizing people’s psychosocial health, physical health, and other areas of functioning (Au & Zhu, 2020; Cheung et al., 2020; Guarneri et al., 2019; Yu et al., 2021). The Internalization of Stigma Stigma describes a situation in which some people belonging to “inferior” cultural groups are “disqualified from full social acceptance” (Fitzpatrick, 2008; Goffman, 1963; Zhang et al., 2021). Public stigma, further defined as the negative attitudes, stereotypes, and beliefs that the public holds towards minority groups, is crucial for triggering self-stigma (Kao et al., 2016). Importantly, self-stigmatization occurs when people belonging to a minority group internalize the public’s stigma (Corrigan et al., 2010). In other words, stigma exist in different forms and by different people belonging to both the majority and the minory groups, with negative health implications especially for the minorities (Guarneri et al., 2019; Yu et al., 2021). Indeed, Chinese societies including the Mainland China and regions such as Hong Kong share many cultural and everyday similarities, namely festivals and food. Nevertheless, differences exist in terms of areas such as language, norm of speaking, and crowdedness (Bhowmik et al., 2018). For instance, Cantonese is a dialact frequently spoken in Hong Kong, whereas Putonghua is an official language generally used in the Mainland China. Mainland Chinese people may experience acculturative stress and find communication stressful with local people in Hong Kong (Cheung et al., 2020). To date, the stigma associated with being a Mainland Chinese individual remains prevalent (Wang et al., 2025), with some local people seeing Mainlanders as “a threat”, “floods”, or other stereotypical characterizations (Lin et al., 2022). As discussed earlier, public stigma not only gives rise to self-stigma (Kao et al., 2016). Both types of stigma can further dampen people’s psychosocial and physical health, as well as students’ academic performance (Au & Zhu, 2020; Guarneri et al., 2019; Pachankis et al., 2018; Yu et al., 2021). Therefore, it is pivotal to identify the factors and mechanisms associated with stigma among minorities. The Protective Role of Mindfulness Mindfulness may serve as a protective factor of mental health for cultural and ethnic minorities (Fung et al., 2019; Spears, 2019). According to Kabat-Zinn (1994), mindfulness refers to the awareness arising from purposefully paying attention to the present moment without judgment. Mindfulness-to-meaning theory (Garland et al., 2015) postulates that mindfulness could enhance people’s abilities to pause, undertake skillful responses, and reappraise stressful experiences and situations positively. These abilities may curtail the internalization of stigma and lessen psychological distress. Facing daily stressors including language barriers, stigma, and the pressure to acculturate, ethnic and cultural minorities may adopt a negative appraisal toward their difficult situations. They may also have automatic reactions towards these situations by engaging in fight, flight, or freeze coping mechanisms (Dallinger-Lain, 2016). Mindfulness enables people to decenter from their thoughts, emotions, and other sensations, such that they could dis-identify themselves from negative experiences (e.g., diserning that “I am not my beliefs” or “this pain is not me”). Consequently, people are more likely to be open to other viewpoints and engage in “wise reasoning” (Kross & Grossmann, 2012), initiating cognitive reappraisal (e.g., detecting that “other people’s beliefs are not my beliefs”), undertaking prosocial actions (e.g., seeking resources for self and others), and combating stigma (Chan et al., 2018). Through the cultivation of “wise reasoning”, mindfulness may therefore alleviate minority members’ internalization of stigma and facilitate better psychosocial functioning (e.g., Chang et al., 2024; Tomlinson et al., 2018). The Present Study The present longitudinal study investigated self-stigma as an underlying process between mindfulness and mental health among Mainland Chinese university students residing in Hong Kong. Given the escalation of university students from the Mainland China (Government of Hong Kong Special Administrative Region Press Release, 2019), it is key to identify the risk and protective processes of their overall well-being. Based on mindfulness-to-meaning theory (Garland et al., 2015), we hypothesized that mindfulness would be associated with lower self-stigma and better mental health outcomes, encompassing emotional well-being, social well-being, and psychological well-being, and fewer depressive symptoms. Self-stigma would, in turn, be negatively associated with poorer mental health outcomes. We further hypothesized that self-stigma would mediate the longitudinal relation between mindfulness and mental health, after controlling for autoregressive effects and covariates, namely age, gender, household income, and education level. These covariates were included in the mediation analysis, given that they were associated with the study variables in past research (e.g., Ma et al., 2024; Mak & Cheung, 2010; Pingani et al., 2016). Methods Participants Assuming alpha = .05, df = 27, null RMSEA = .10, and alternative RMSEA = .06, a sample of of 202 individuals could achieve a power of .80 for the path analysis. In this study, a total of 194 Mainland Chinese university students (9.79% men; 90.21% women) were recruited at a public university in Hong Kong through mass emails, announcements on social media platforms, and flyers posted at the university’s notice boards. Participants completed a questionnaire for three times, with an approximate three-month lag between the study time points. The participants had a mean age of 21.08 years ( SD = 2.01). A majority of the participants were undergraduate students (62.30%), followed by 37.17% of postgraduate students and high school graduate (.52%). The median monthly household income was RMB¥10,001 – 20,000 (~US$1,407.68 – 2,815.08) which was lower than both the median household income in Hong Kong (HK$30,000, i.e., ~ US$3842.16; Hong Kong Census and Statistics Department, 2025). Participants reported having lived in Hong Kong for 1.69 years ( SD = 1.88). Of the participants, 81.10% reported that they spoke Cantonese, a dialect commonly used in Hong Kong, ranging from “proficient” (6.71%), “somewhat” (24.39%), to “a little” (50.00%). In the present study, the attrition rate was 7.22% ( n = 14) from T1 to Time 2 (T2), and 7.22% ( n = 13) from T2 to Time 3 (T3). The participants who dropped out did not differ from the retained participants for all variables under study, p s > .05. Procedures The study was approved by the Research Ethics Committee at a public university in Hong Kong [MASKED FOR PEER REVIEW]. Prior to their participation, informed consent was sought from the participants. Participants completed the paper-based survey at each time point in a quiet setting. Upon completion at T3, they received a maximum of HK$200 (~US$28.15) worth of supermarket coupons to compensate for their time. The amount varied across the participants, depending on the number of time points they participated in the study. Measures Mindfulness The 10-item Cognitive and Affective Mindfulness Scale-Revised (CAMS-R; Feldman et al., 2007) was used at T1 to assess the extent to which people mindfully experienced their thoughts and feelings. The subscales included present focus, attention, awareness, and acceptance. The sample items included, “I try to notice my thoughts without judging them” and “I am able to focus on the present moment.” The items were rated on a 4-point scale from 1 ( rarely or not at all ) to 4 ( almost always ). The score of one of the items “I am easily distracted” was reversed. The scores of the 10 items were averaged, with higher averaged scores indicated a greater level of mindfulness. In this study, Cronbach’s alpha = .82 and McDonald’s Omega = .81. Self-stigma The 9-item Self-Stigma Scale-Short (SSS-S; Mak & Cheung, 2010) was used to measure self-stigma. The subscales included affective, behavioral, and cognitive aspects of self-stigma. The sample items included, “I fear that others would know that I am a Mainland Chinese individual” and “My identity as a Mainland Chinese Mainland individual is a burden to me.” Participants rated on a 4-point scale ranging from 1 ( highly disagree ) to 5 ( highly agree ). The item scores were averaged, with higher averaged scores indicating greater self-stigma. The measure was validated in Hong Kong, with adequate validity and reliability (Mak & Cheung, 2010). In this study, Cronbach’s alpha = .92 at T1 and .93 at T2. McDonald’s Omega = .92 at T1 and .93 at T2. Mental Health The 14-item Mental Health Continuum Short Form (MHC-SF; Keyes, 2009) was used to assess mental health over the last month. The subscales included emotional well-being, social well-being, and psychological well-being. The sample items included, “How often did you feel that you are interested in life?” and “How often did you feel that your life has a sense of direction or meaning to it?” Participants rated on a 6-point scale ranging from 0 ( never ) to 5 ( every day ). The item scores were averaged, with higher averaged scores indicating greater mental health. The MHC-SF demonstrated adequate validity and reliability in China (Guo et al., 2015). In the present study, Cronbach’s alpha = .93 at T1 and .95 at T3. McDonald’s Omega = .94 at T1 and .95 at T3. Depressive Symptoms The 9-item Patient Health Questionnaire depression module (PHQ-9; Kroenke et al., 2002) was used to assess depressive symptoms. The items assessed depressive symptoms such as difficulties in concentration, fatigue, and depressive thoughts over the past two weeks. Upon reading the instructions, “Over the last two weeks, how often have you been bothered by any of the following problems?”, participants responded to items such as “Little interest or pleasure in doing things” and “Feeling down, depressed, or hopeless” on a 4-point scale from 0 ( not at all ) to 3 ( almost every day ). The item scores were summed, with greater summed scores indicating a greater severity of depressive symptoms. In this study, the summed scores were 5.44 ( SD = 4.44) at T1 and 6.67 ( SD = 5.51) at T3. These scores were comparable to those from community samples and university students residing in Hong Kong (Cheung, 2025; Lun et al., 2018). In the present study, Cronbach’s alpha = .87 at T1 and .91 at T3. McDonald’s Omega = .87 at T1 and .91 at T3. Demographics. Participants provided demographic information including age, gender, household income, education level, number of years in Hong Kong, as well as Cantonese proficiency. Analytic Plan Descriptive statistics and zero-order correlations were conducted using IBM SPSS Statistics 29 (SPSS Inc., Chicago, IL, USA). Path analysis was then conducted using MPLUS, Version 8.8 (Muthén & Muthén, 2012-2023). Demographic variables including age, gender, household income, and education level were included as covariates. Maximum likelihood method was utilized to examine the fit of the model to the observed variance and covariance matrices. Full information maximum likelihood estimation was used to handle the missing data. Bootstrapping was used to examine the mediation effects of self-stigma. This study was not preregistered. The data and syntax are available in the supplemental materials (see Appendix 1 and Appendix 2). Results The means, standard deviations, and correlations are shown in Table 1 . Zero-order correlations that the variables under study were associated at p < .01. Regarding the path analysis, the hypothesized model fits well to the data, χ 2 (27) = 37.71, p = .08, CFI = .97, TLI = .97, RMSEA = .05 (see Fig. 1 ). Controlling for the covariates and baseline effects of self-stigma, mental health, and depressive symptoms, T1 mindfulness predicted lower T2 self-stigma (β = − .12, p = .04), better T3 mental health (β = .18, p = .01), and lower T3 depressive symptoms (β = − .19, p = .01). T2 self-stigma predicted poorer T3 mental health (β = .25, p = .022). However, T2 self-stigma was not related to T3 depressive symptoms (β = .25, p = .022). The autoregressive control variables were all significant at p s < .001. Being a woman was related to both better mental health (β = .18, p = .002) and greater depressive symptoms (β = − .15, p = .01). The unstandardized estimates, standard errors, and standardized estimates of the model are indicated in Table 2 . The mediating effect of T2 self-stigma between T1 mindfulness and T3 mental health was examined using bootstrapping based on 10,000 bootstrap samples with replacement. The 95% confidence interval (CI) indicated that the standardized indirect effect of T1 mindfulness on T3 mental health did not include a zero [CI: (.002, .057)], suggesting that T2 self-stigma was a mediator. Discussion Guided by mindfulness-to-meaning theory (Garland et al., 2015 ), the present longitudinal study partially supported self-stigma as a mediating process for the relation between mindfulness and mental health outcomes among Mainland Chinese university students in Hong Kong, over and above the effects of autoregressive control variables and covariates. Specifically, mindfulness was associated with lower self-stigma and fewer depressive symptoms. Self-stigma, in turn, was associated with poorer mental health (i.e., emotional, social, and psychological well-being), but not with depressive symptoms, after accounting for autoregressive effects and the covariates. Self-stigma further mediated the association between mindfulness and mental health. Taken together, the findings added to the growing literature concerning the processes of well-being among ethnic and cultural minorities (e.g., Cheung et al., 2020 ; Cogan et al., 2024 ; Yeung et al., 2021 ), particularly among Mainland Chinese students residing in Hong Kong (Cheung et al., 2020 ). The present study extended mindfulness-to-meaning theory (Garland et al., 2015 ) to the minority context of Hong Kong, highlighting the potential benefits of mindfulness on lower self-stigma and fewer depressive symptoms. When people orient themselves intentionally and nonjudgmentally to the present moment, they are better at holding fewer self-stigmatizing beliefs. This inverse relation may be explained by mindful individuals’ greater ability to decenter from stress, to combat stigma, and to uncouple the relation between the public’s beliefs and their own beliefs, thereby reducing the level of stigma internalization (Chan et al., 2018 ; Kross & Grossmann, 2012 ). Consistent with the literature (e.g., Pachankis et al., 2018 ), in this study we found that self-stigma was detrimental for mental health outcomes, including emotional, social, and psychological well-being. Taken together, the findings not only highlighted mindfulness as a protective factor and self-stigma as a risk factor of mental health, but also revealed lower self-stigma as an underlying process for the association between mindfulness and better mental health among Mainland Chinese students in Hong Kong. Somewhat surprisingly, self-stigma was unrelated to depressive symptoms, after controlling for the covariates and baseline depressive symptoms. Nevertheless, the zero-order correlations (see Table 1 ) did suggest positive associations between self-stigma and depressive symptoms. Given that depressive symptoms are typically stable (Musliner et al., 2016 ), it might be that the three-month lag between time points was too brief to show significant effects, especially after including the autoregressive control variable of depressive symptoms. Therefore, future research should extend the duration between the time points and replicate the present findings over a longer period. To further understand the correlates of mental health and psychological distress among Mainland Chinese individuals, researchers may also collect longitudinal data from clinically depressed vs. non-clinical samples. Limitations and Future Directions Although we identified the precursors of mental health among Mainland Chinese university students in Hong Kong, the findings must be interpreted in light of several limitations. First and foremost, the use of self-report gave rise to method bias (Podsakoff et al., 2012 ). As such, future studies should utilize a multi-method, multi-informant approach. Second, even though the present study adpoted a longitudinal design, we were unable to control for all of the variables across all time points. Therefore, cross-lagged analyses should be conducted in the future to draw conclusions on self-stigma as a mediator between mindfulness and mental health (Maxwell & Cole, 2007 ). Third, our sample was slightly smaller than the sample size based on power analysis, with 90.21% being women. To foster generalizability, a larger and gender-balanced sample is needed. Fourth, the median monthly household income of the participants was lower than that of the people in Hong Kong. As socioeconomic status can significantly impact mental health outcomes (Maurer et al., 2025 ), future research should include participants from diverse socioeconomic backgrounds to provide a more comprehensive understanding of the variables under study. Finally, as the ethnic and cultural composition is constantly changing (e.g., Government of Hong Kong Special Administrative Region Press Release, 2019), replication studies are needed to model the trends of self-stigma and mental health across cultural groups. The present study advanced the literature by substantiating the longitudinal relations between mindfulness, self-stigma, and mental health outcomes among university students from the Mainland China. In the wake of persisting stigma towards Mainland Chinese individuals, the findings underscore the potential importance of mindfulness practice as one of the ways to promote better mental health. 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The association between implicit culture beliefs and intercultural sensitivity: Negative intercultural expectations and stigma as underlying processes . Social Psychology of Education, 28 , 61. https://doi.org/10.1007/s11218-025-10030-y Yeung, N. C., Kan, K. K., Wong, A. L., & Lau, J. T. (2021). Self-stigma, resilience, perceived quality of social relationships, and psychological distress among Filipina domestic helpers in Hong Kong: A mediation model. Stigma and Health, 6 (1), 90-99. https://doi.org/10.1037/sah0000246 Yu, N. X., Ni, M. Y., & Stewart, S. M. (2021). A moderated mediation analysis on the association between perceived discrimination and physical symptoms among immigrant women from mainland China into Hong Kong: Evidence from the FAMILY cohort. Journal of Immigrant and Minority Health, 23 (3), 597-605. https://doi.org/10.1007/s10903-020-01042-1 Zhang, R., Wang, M. S., Toubiana, M., & Greenwood, R. (2021). Stigma beyond levels: Advancing research on stigmatization. Academy of Management Annals, 15 (1), 188-222. https://doi.org/10.5465/annals.2019.0031 Tables Table 1. Correlations, means, and standard deviations of the variables under study. Variable (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (1) Gender - (2) Age -.01 - (3) Family income .11 -.06 - (4) Education level -.06 .85 *** -.00 - (5) T1 Mindfulness .06 -.12 .22 ** -.13 - (6) T1 Self-stigma -.03 -.08 .23 ** -.03 -.22 ** - (7) T1 Mental health .10 -.10 .14 -.18 * .63 *** -29 *** - (8) T1 Depressive symptoms -.02 .12 -.03 .12 -.47 *** .31 *** -.62 *** - (9) T2 Self-stigma .01 .00 .02 .04 -.28 *** .65 *** -.31 *** .33 *** - (10) T3 Mental Health .19 * -.09 .21 * -.08 .49 *** -.25 ** .59 *** -.44 *** -.32 *** - (11) T3 Depressive symptoms -.15 * .10 -.12 .09 .45 *** .23 ** -.44 *** .62 *** .23 ** -.64 *** - M - 21.08 2.62 3.83 2.85 1.47 4.47 5.44 1.51 4.14 6.66 SD - 2.00 1.32 1.93 .42 .51 .87 4.43 .55 .92 5.50 Note. * p < .05, ** p < .01, *** p < .001. Ψ 1 = ¥50,001. † 0 = Secondary school, 1 = 1 st year undergraduate, 2 = 2 nd year undergraduate, 3 = 3 rd year undergraduate, 4 = 4 th year undergraduate, 5 = 5 th year undergraduate, 6 = 1 st year postgraduate, 7 = 2 nd year postgraduate. Table 2 is available in the Supplementary Files section. Additional Declarations No competing interests reported. Supplementary Files Appendix1data.pdf Appendix2syntax20250911.docx Table2.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7750032","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Short Report","associatedPublications":[],"authors":[{"id":543865152,"identity":"0dfa3cfe-9b4d-42d5-bfa9-ddeadd3359c7","order_by":0,"name":"Rebecca Y. M. 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.05, \u003csup\u003e**\u003c/sup\u003e\u003cem\u003ep\u003c/em\u003e \u0026lt; .01, \u003csup\u003e***\u003c/sup\u003e\u003cem\u003ep\u003c/em\u003e \u0026lt; .001. Standardized parameter estimates are presented. Gender, age, household income, and education were included as covariates. The non-significant parameter is shown in a dashed arrow for clarity.\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7750032/v1/86b5cd7bddbf71849d81d19c.png"},{"id":96453029,"identity":"ba1d8899-e5a3-4a07-9a81-61d1de0caf87","added_by":"auto","created_at":"2025-11-21 09:57:34","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":676544,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7750032/v1/47400120-36fe-4503-9540-e2d8342cb001.pdf"},{"id":96365186,"identity":"6c529dc2-8917-4bba-a0b0-8d8183e40599","added_by":"auto","created_at":"2025-11-20 10:10:04","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":240636,"visible":true,"origin":"","legend":"","description":"","filename":"Appendix1data.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7750032/v1/d47d2cb9a43f7c7a6bc464f1.pdf"},{"id":96308805,"identity":"d9487221-a7ff-41c6-8737-cc9737ad6d54","added_by":"auto","created_at":"2025-11-19 15:53:03","extension":"docx","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":13838,"visible":true,"origin":"","legend":"","description":"","filename":"Appendix2syntax20250911.docx","url":"https://assets-eu.researchsquare.com/files/rs-7750032/v1/9fcff286132e63e32a1ff0ba.docx"},{"id":96308801,"identity":"3711d876-37a0-4577-90bf-b00200923938","added_by":"auto","created_at":"2025-11-19 15:53:03","extension":"docx","order_by":3,"title":"","display":"","copyAsset":false,"role":"supplement","size":41120,"visible":true,"origin":"","legend":"","description":"","filename":"Table2.docx","url":"https://assets-eu.researchsquare.com/files/rs-7750032/v1/5e74d1e9b3eea94cb5d134e3.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Mindfulness and Mental Health Among Mainland Chinese University Students in Hong Kong: The Mediating Role of Self-Stigma","fulltext":[{"header":"Introduction","content":"\u003cp\u003eOver the past decades, universities globally have undergone a significant increase in internationalization (Bartell, 2003; De Wit \u0026amp; Altbach, 2021; Jibeen \u0026amp; Khan, 2015). A similar trend has also been observed in Hong Kong, where the total number of \u0026ldquo;non-local students\u0026rdquo; have surged from 15,713 in the academic year of 2015/16 to 26,643 in 2024/25 (University Grants Committee, 2025). Among them, full-time students from the Mainland China have risen from 11,876 in 2015/16 to 21,504 in 2024/25, suggesting a 81.07% increase in merely 9 years. Despite an escalation of individuals from the Mainland China (Government of Hong Kong Special Administrative Region Press Release, 2019), living in Hong Kong remains stressful, with people encountering everyday challenges including language difficulties, stigma, loneliness, and other struggles (Bhowmik et al. 2018; Jia \u0026amp; Yeung, 2023; Vyas \u0026amp; Yu, 2018). The stigma associated with being a minority has long-term implications, jeopardizing people\u0026rsquo;s psychosocial health, physical health, and other areas of functioning (Au \u0026amp; Zhu, 2020; Cheung et al., 2020; Guarneri et al., 2019; Yu et al., 2021).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThe Internalization of Stigma\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eStigma describes a situation in which some people belonging to \u0026ldquo;inferior\u0026rdquo; cultural groups are \u0026ldquo;disqualified from full social acceptance\u0026rdquo; (Fitzpatrick, 2008; Goffman, 1963; Zhang et al., 2021). Public stigma, further defined as the negative attitudes, stereotypes, and beliefs that the public holds towards minority groups, is crucial for triggering self-stigma (Kao et al., 2016). Importantly, self-stigmatization occurs when people belonging to a minority group internalize the public\u0026rsquo;s stigma (Corrigan et al., 2010). In other words, stigma exist in different forms and by different people belonging to both the majority and the minory groups, with negative health implications especially for the minorities (Guarneri et al., 2019; Yu et al., 2021).\u003c/p\u003e\n\u003cp\u003eIndeed, Chinese societies including the Mainland China and regions such as Hong Kong share many cultural and everyday similarities, namely festivals and food. Nevertheless, differences exist in terms of areas such as\u0026nbsp;language, norm of speaking, and crowdedness (Bhowmik et al., 2018). For instance,\u0026nbsp;Cantonese is a dialact frequently spoken in Hong Kong, whereas Putonghua is an official language generally used in the Mainland China. Mainland Chinese people may experience acculturative stress and find communication stressful with local people in Hong Kong (Cheung et al., 2020). To date,\u0026nbsp;the stigma associated with being a Mainland Chinese individual remains prevalent (Wang et al., 2025), with some local people seeing Mainlanders as \u0026ldquo;a threat\u0026rdquo;, \u0026ldquo;floods\u0026rdquo;, or other stereotypical characterizations (Lin et al., 2022). As discussed earlier, public stigma not only gives rise to self-stigma (Kao et al., 2016). Both types of stigma can further dampen people\u0026rsquo;s psychosocial and physical health, as well as students\u0026rsquo; academic performance (Au \u0026amp; Zhu, 2020; Guarneri et al., 2019;\u0026nbsp;Pachankis et al., 2018;\u0026nbsp;Yu et al., 2021). Therefore, it is pivotal to identify the factors and mechanisms associated with stigma among minorities.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThe Protective Role of Mindfulness\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMindfulness may serve as a protective factor of mental health for cultural and ethnic minorities (Fung et al., 2019; Spears, 2019). According to Kabat-Zinn (1994), mindfulness refers to the awareness arising from purposefully paying attention to the present moment without judgment. Mindfulness-to-meaning theory (Garland et al., 2015) postulates that mindfulness could enhance people\u0026rsquo;s abilities to pause, undertake skillful responses, and reappraise stressful experiences and situations positively. These abilities may curtail the internalization of stigma and lessen psychological distress.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eFacing daily stressors including language barriers, stigma, and the pressure to acculturate, ethnic and cultural minorities may adopt a negative appraisal toward their difficult situations. They may also have automatic reactions towards these situations by engaging in fight, flight, or freeze coping mechanisms (Dallinger-Lain, 2016). Mindfulness enables people to decenter from their thoughts, emotions, and other sensations, such that they could dis-identify themselves from negative experiences (e.g., diserning that \u0026ldquo;I am not my beliefs\u0026rdquo; or \u0026ldquo;this pain is not me\u0026rdquo;). Consequently, people are more likely to be open to other viewpoints and engage in \u0026ldquo;wise reasoning\u0026rdquo; (Kross \u0026amp; Grossmann, 2012), initiating cognitive reappraisal (e.g., detecting that \u0026ldquo;other people\u0026rsquo;s beliefs are not my beliefs\u0026rdquo;), undertaking prosocial actions (e.g., seeking resources for self and others), and combating stigma (Chan et al., 2018). Through the cultivation of \u0026ldquo;wise reasoning\u0026rdquo;, mindfulness may therefore alleviate minority members\u0026rsquo; internalization of stigma and facilitate better psychosocial functioning (e.g., Chang et al., 2024; Tomlinson et al., 2018).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThe Present Study\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe present longitudinal study investigated self-stigma as an underlying process between mindfulness and mental health among Mainland Chinese university students residing in Hong Kong. Given the escalation of university students from the Mainland China (Government of Hong Kong Special Administrative Region Press Release, 2019), it is key to identify the risk and protective processes of their overall well-being. Based on mindfulness-to-meaning theory (Garland et al., 2015), we hypothesized that mindfulness would be associated with lower self-stigma and better mental health outcomes, encompassing emotional well-being, social well-being, and psychological well-being, and fewer depressive symptoms. Self-stigma would, in turn, be negatively associated with poorer mental health outcomes. We further hypothesized that self-stigma would mediate the longitudinal relation between mindfulness and mental health, after controlling for autoregressive effects and covariates, namely age, gender, household income, and education level. These covariates were included in the mediation analysis, given that they were associated with the study variables in past research (e.g., Ma et al., 2024; Mak \u0026amp; Cheung, 2010; Pingani et al., 2016).\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cstrong\u003eParticipants\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAssuming alpha = .05, \u003cem\u003edf\u003c/em\u003e = 27, null RMSEA = .10, and alternative RMSEA = .06, a sample of of 202 individuals could achieve a power of .80 for the path analysis. In this study, a total of 194 Mainland Chinese university students (9.79% men; 90.21% women) were recruited at a public university in Hong Kong through mass emails, announcements on social media platforms, and flyers posted at the university\u0026rsquo;s notice boards. Participants completed a questionnaire for three times, with an approximate three-month lag between the study time points. The participants had a mean age of 21.08 years (\u003cem\u003eSD\u003c/em\u003e = 2.01). A majority of the participants were undergraduate students (62.30%), followed by 37.17% of postgraduate students and high school graduate (.52%). The median monthly household income was RMB\u0026yen;10,001 \u0026ndash; 20,000 (~US$1,407.68 \u0026ndash; 2,815.08) which was lower than both the median household income in Hong Kong (HK$30,000, i.e., ~ US$3842.16; Hong Kong Census and Statistics Department, 2025). Participants reported having lived in Hong Kong for 1.69 years (\u003cem\u003eSD\u003c/em\u003e = 1.88). Of the participants, 81.10% reported that they spoke Cantonese, a dialect commonly used in Hong Kong, ranging from \u0026ldquo;proficient\u0026rdquo; (6.71%), \u0026ldquo;somewhat\u0026rdquo; (24.39%), to \u0026ldquo;a little\u0026rdquo; (50.00%). In the present study, the attrition rate was 7.22% (\u003cem\u003en\u003c/em\u003e = 14) from T1 to Time 2 (T2), and 7.22% (\u003cem\u003en\u003c/em\u003e = 13) from T2 to Time 3 (T3). The participants who dropped out did not differ from the retained participants for all variables under study, \u003cem\u003ep\u003c/em\u003es \u0026gt; .05.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eProcedures\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was approved by the Research Ethics Committee at a public university in Hong Kong [MASKED FOR PEER REVIEW]. Prior to their participation, informed consent was sought from the participants. Participants completed the paper-based survey at each time point in a quiet setting. Upon completion at T3, they received a maximum of HK$200 (~US$28.15) worth of supermarket\u0026nbsp;coupons to compensate for their time. The amount varied across the participants, depending on the number of time points they participated in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMeasures\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eMindfulness\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe 10-item\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eCognitive and Affective Mindfulness Scale-Revised (CAMS-R; Feldman et al., 2007) was used at T1 to assess the extent to which people mindfully experienced their thoughts and feelings. The subscales included present focus, attention, awareness, and acceptance. The sample items included, \u0026ldquo;I try to notice my thoughts without judging them\u0026rdquo; and \u0026ldquo;I am able to focus on the present moment.\u0026rdquo; The items were rated on a 4-point scale from 1 (\u003cem\u003erarely or not at all\u003c/em\u003e) to 4 (\u003cem\u003ealmost always\u003c/em\u003e). The score of one of the items \u0026ldquo;I am easily distracted\u0026rdquo; was reversed. The scores of the 10 items were averaged, with higher averaged scores indicated a greater level of mindfulness. In this study, Cronbach\u0026rsquo;s alpha = .82 and McDonald\u0026rsquo;s Omega = .81.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSelf-stigma\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe 9-item Self-Stigma Scale-Short (SSS-S; Mak \u0026amp; Cheung, 2010) was used to measure self-stigma. The subscales included affective, behavioral, and cognitive aspects of self-stigma. The sample items included, \u0026ldquo;I fear that others would know that I am a Mainland Chinese individual\u0026rdquo; and \u0026ldquo;My identity as a Mainland Chinese Mainland individual is a burden to me.\u0026rdquo; Participants rated on a 4-point scale ranging from 1 (\u003cem\u003ehighly disagree\u003c/em\u003e) to 5 (\u003cem\u003ehighly agree\u003c/em\u003e). The item scores were averaged, with higher averaged scores indicating greater self-stigma. The measure was validated in Hong Kong, with adequate validity and reliability (Mak \u0026amp; Cheung, 2010). In this study, Cronbach\u0026rsquo;s alpha = .92 at T1 and .93 at T2. McDonald\u0026rsquo;s Omega = .92 at T1 and .93 at T2.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eMental Health\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe 14-item Mental Health Continuum Short Form (MHC-SF; Keyes, 2009) was used to assess mental health over the last month. The subscales included emotional well-being, social well-being, and psychological well-being. The sample items included, \u0026ldquo;How often did you feel that you are interested in life?\u0026rdquo; and \u0026ldquo;How often did you feel that your life has a sense of direction or meaning to it?\u0026rdquo; Participants rated on a 6-point scale ranging from 0 (\u003cem\u003enever\u003c/em\u003e) to 5 (\u003cem\u003eevery day\u003c/em\u003e). The item scores were averaged, with higher averaged scores indicating greater mental health. The MHC-SF demonstrated adequate validity and reliability in China (Guo et al., 2015). In the present study, Cronbach\u0026rsquo;s alpha = .93 at T1 and .95 at T3. McDonald\u0026rsquo;s Omega = .94 at T1 and .95 at T3.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eDepressive Symptoms\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe 9-item Patient Health Questionnaire depression module (PHQ-9; Kroenke et al., 2002) was used to assess depressive symptoms. The items assessed depressive symptoms such as difficulties in concentration, fatigue, and depressive thoughts over the past two weeks. Upon reading the instructions, \u0026ldquo;Over the last two weeks, how often have you been bothered by any of the following problems?\u0026rdquo;, participants responded to items such as \u0026ldquo;Little interest or pleasure in doing things\u0026rdquo; and \u0026ldquo;Feeling down, depressed, or hopeless\u0026rdquo; on a 4-point scale from 0 (\u003cem\u003enot at all\u003c/em\u003e) to 3 (\u003cem\u003ealmost every day\u003c/em\u003e). The item scores were summed, with greater summed scores indicating a greater severity of depressive symptoms.\u0026nbsp;In this study, the summed scores were 5.44 (\u003cem\u003eSD\u003c/em\u003e = 4.44) at T1 and 6.67 (\u003cem\u003eSD\u003c/em\u003e = 5.51) at T3. These scores were comparable to those from community samples and university students residing in Hong Kong (Cheung, 2025; Lun et al., 2018).\u0026nbsp;In the present study, Cronbach\u0026rsquo;s alpha = .87 at T1 and .91 at T3.\u0026nbsp;McDonald\u0026rsquo;s Omega = .87 at T1 and .91 at T3.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDemographics.\u003c/strong\u003e Participants provided demographic information including age, gender, household income, education level, number of years in Hong Kong, as well as Cantonese proficiency.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAnalytic Plan\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDescriptive statistics and zero-order correlations were conducted using IBM SPSS Statistics 29 (SPSS Inc., Chicago, IL, USA). Path analysis was then conducted using MPLUS, Version 8.8 (Muth\u0026eacute;n \u0026amp; Muth\u0026eacute;n, 2012-2023). Demographic variables including age, gender, household income, and education level were included as covariates. Maximum likelihood method was utilized to examine the fit of the model to the observed variance and covariance matrices. Full information maximum likelihood estimation was used to handle the missing data. Bootstrapping was used to examine the mediation effects of self-stigma. This study was not preregistered. The data and syntax are available in the supplemental materials (see Appendix 1 and Appendix 2).\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe means, standard deviations, and correlations are shown in Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e. Zero-order correlations that the variables under study were associated at \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.01. Regarding the path analysis, the hypothesized model fits well to the data, \u003cem\u003e\u0026chi;\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e(27)\u0026thinsp;=\u0026thinsp;37.71, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.08, CFI\u0026thinsp;=\u0026thinsp;.97, TLI\u0026thinsp;=\u0026thinsp;.97, RMSEA\u0026thinsp;=\u0026thinsp;.05 (see Fig. \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e). Controlling for the covariates and baseline effects of self-stigma, mental health, and depressive symptoms, T1 mindfulness predicted lower T2 self-stigma (\u0026beta; = \u0026minus;\u0026thinsp;.12, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.04), better T3 mental health (\u0026beta;\u0026thinsp;=\u0026thinsp;.18, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.01), and lower T3 depressive symptoms (\u0026beta; = \u0026minus;\u0026thinsp;.19, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.01). T2 self-stigma predicted poorer T3 mental health (\u0026beta;\u0026thinsp;=\u0026thinsp;.25, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.022). However, T2 self-stigma was not related to T3 depressive symptoms (\u0026beta;\u0026thinsp;=\u0026thinsp;.25, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.022). The autoregressive control variables were all significant at \u003cem\u003ep\u003c/em\u003es\u0026thinsp;\u0026lt;\u0026thinsp;.001. Being a woman was related to both better mental health (\u0026beta;\u0026thinsp;=\u0026thinsp;.18, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.002) and greater depressive symptoms (\u0026beta; = \u0026minus;\u0026thinsp;.15, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.01). The unstandardized estimates, standard errors, and standardized estimates of the model are indicated in Table \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e\n\u003cp\u003eThe mediating effect of T2 self-stigma between T1 mindfulness and T3 mental health was examined using bootstrapping based on 10,000 bootstrap samples with replacement. The 95% confidence interval (CI) indicated that the standardized indirect effect of T1 mindfulness on T3 mental health did not include a zero [CI: (.002, .057)], suggesting that T2 self-stigma was a mediator.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eGuided by mindfulness-to-meaning theory (Garland et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2015\u003c/span\u003e), the present longitudinal study partially supported self-stigma as a mediating process for the relation between mindfulness and mental health outcomes among Mainland Chinese university students in Hong Kong, over and above the effects of autoregressive control variables and covariates. Specifically, mindfulness was associated with lower self-stigma and fewer depressive symptoms. Self-stigma, in turn, was associated with poorer mental health (i.e., emotional, social, and psychological well-being), but not with depressive symptoms, after accounting for autoregressive effects and the covariates. Self-stigma further mediated the association between mindfulness and mental health. Taken together, the findings added to the growing literature concerning the processes of well-being among ethnic and cultural minorities (e.g., Cheung et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Cogan et al., \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Yeung et al., \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e2021\u003c/span\u003e), particularly among Mainland Chinese students residing in Hong Kong (Cheung et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2020\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe present study extended mindfulness-to-meaning theory (Garland et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2015\u003c/span\u003e) to the minority context of Hong Kong, highlighting the potential benefits of mindfulness on lower self-stigma and fewer depressive symptoms. When people orient themselves intentionally and nonjudgmentally to the present moment, they are better at holding fewer self-stigmatizing beliefs. This inverse relation may be explained by mindful individuals\u0026rsquo; greater ability to decenter from stress, to combat stigma, and to uncouple the relation between the public\u0026rsquo;s beliefs and their own beliefs, thereby reducing the level of stigma internalization (Chan et al., \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2018\u003c/span\u003e; Kross \u0026amp; Grossmann, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2012\u003c/span\u003e). Consistent with the literature (e.g., Pachankis et al., \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e2018\u003c/span\u003e), in this study we found that self-stigma was detrimental for mental health outcomes, including emotional, social, and psychological well-being. Taken together, the findings not only highlighted mindfulness as a protective factor and self-stigma as a risk factor of mental health, but also revealed lower self-stigma as an underlying process for the association between mindfulness and better mental health among Mainland Chinese students in Hong Kong.\u003c/p\u003e\u003cp\u003eSomewhat surprisingly, self-stigma was unrelated to depressive symptoms, after controlling for the covariates and baseline depressive symptoms. Nevertheless, the zero-order correlations (see Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e) did suggest positive associations between self-stigma and depressive symptoms. Given that depressive symptoms are typically stable (Musliner et al., \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e2016\u003c/span\u003e), it might be that the three-month lag between time points was too brief to show significant effects, especially after including the autoregressive control variable of depressive symptoms. Therefore, future research should extend the duration between the time points and replicate the present findings over a longer period. To further understand the correlates of mental health and psychological distress among Mainland Chinese individuals, researchers may also collect longitudinal data from clinically depressed vs. non-clinical samples.\u003c/p\u003e\u003cdiv id=\"Sec15\" class=\"Section2\"\u003e\u003ch2\u003eLimitations and Future Directions\u003c/h2\u003e\u003cp\u003eAlthough we identified the precursors of mental health among Mainland Chinese university students in Hong Kong, the findings must be interpreted in light of several limitations. First and foremost, the use of self-report gave rise to method bias (Podsakoff et al., \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e2012\u003c/span\u003e). As such, future studies should utilize a multi-method, multi-informant approach. Second, even though the present study adpoted a longitudinal design, we were unable to control for all of the variables across all time points. Therefore, cross-lagged analyses should be conducted in the future to draw conclusions on self-stigma as a mediator between mindfulness and mental health (Maxwell \u0026amp; Cole, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2007\u003c/span\u003e). Third, our sample was slightly smaller than the sample size based on power analysis, with 90.21% being women. To foster generalizability, a larger and gender-balanced sample is needed. Fourth, the median monthly household income of the participants was lower than that of the people in Hong Kong. As socioeconomic status can significantly impact mental health outcomes (Maurer et al., \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2025\u003c/span\u003e), future research should include participants from diverse socioeconomic backgrounds to provide a more comprehensive understanding of the variables under study. Finally, as the ethnic and cultural composition is constantly changing (e.g., Government of Hong Kong Special Administrative Region Press Release, 2019), replication studies are needed to model the trends of self-stigma and mental health across cultural groups.\u003c/p\u003e\u003cp\u003eThe present study advanced the literature by substantiating the longitudinal relations between mindfulness, self-stigma, and mental health outcomes among university students from the Mainland China. In the wake of persisting stigma towards Mainland Chinese individuals, the findings underscore the potential importance of mindfulness practice as one of the ways to promote better mental health.\u003c/p\u003e\u003c/div\u003e"},{"header":"Declarations","content":"\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eRYMC conceived of the study, participated in statistical analysis, interpretation of the data, and drafted the manuscript; ST critically revised the manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAu, R. K., \u0026amp; Zhu, C. (2020). Unmet need for belonging and loneliness in determining life satisfaction of mainland Chinese new immigrants in Hong Kong. \u003cem\u003ePsychologia, 62\u003c/em\u003e(3-4), 270-288. https://doi.org/10.2117/psysoc.2019-A118\u003c/li\u003e\n\u003cli\u003eBartell, M. (2003). 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Evidence for the indirect effects of perceived public stigma on psychosocial outcomes: The mediating role of self-stigma. \u003cem\u003ePsychiatry Research, 240,\u003c/em\u003e 187-195. https://doi.org/10.1016/j.psychres.2016.04.030\u003c/li\u003e\n\u003cli\u003eKeyes, C. L. M. (2009). \u003cem\u003eBrief description of the mental health continuum short form (MHC-SF).\u003c/em\u003e Emory University, Department of Sociology. http://www.sociology.emory.edu/ckeyes/\u003c/li\u003e\n\u003cli\u003eKroenke, K., \u0026amp; Spitzer, R. L. (2002). The PHQ-9: A new depression diagnostic and severity measure. \u003cem\u003ePsychiatric Annals\u003c/em\u003e, \u003cem\u003e32\u003c/em\u003e(9), 509\u0026ndash;515. https://doi.org/10.3928/0048-5713-20020901-06\u003c/li\u003e\n\u003cli\u003eKross, E., \u0026amp; Grossmann, I. (2012). Boosting wisdom: distance from the self enhances wise reasoning, attitudes, and behavior. \u003cem\u003eJournal of Experimental Psychology: General, 141\u003c/em\u003e(1), 43-48. https://doi.org/10.1037/a0024158\u003c/li\u003e\n\u003cli\u003eLin, Y., Chen, M., \u0026amp; Flowerdew, J. (2022). \u0026lsquo;Same, same but different\u0026rsquo;: representations of Chinese mainland and Hong Kong people in the press in post-1997 Hong Kong. \u003cem\u003eCritical Discourse Studies, 19\u003c/em\u003e(4), 364-383. https://doi.org/10.1080/17405904.2021.1905015\u003c/li\u003e\n\u003cli\u003eLun, K., Chan, C., Ip, P., Ma, S., Tsai, W., Wong, C., \u0026hellip; (2018). Depression and anxiety among university students in Hong Kong. \u003cem\u003eHong Kong Medical Journal, 24\u003c/em\u003e(5), 466\u0026ndash;472.\u003c/li\u003e\n\u003cli\u003eMa, Q., Whipple, C. R., Kaynak, \u0026Ouml;., Saylor, E., \u0026amp; Kensinger, W. S. (2024). Somebody to lean on: Understanding self-stigma and willingness to disclose in the context of addiction. \u003cem\u003eInternational Journal of Environmental Research and Public Health, 21\u003c/em\u003e(8), 1044. https://doi.org/10.3390/ijerph21081044\u003c/li\u003e\n\u003cli\u003eMak, W. W., S., \u0026amp; Cheung, R. Y. M. (2010). Self-stigma among concealable minorities in Hong Kong: Conceptualization and unified measurement. \u003cem\u003eAmerican Journal of Orthopsychiatry, 80\u003c/em\u003e(2), 267-281. http://doi.org/10.1111/j.1939-0025.2010.01030.x\u003c/li\u003e\n\u003cli\u003eMaurer, J., Meyrose, A. K., Kaman, A., Mauz, E., Ravens-Sieberer, U., \u0026amp; Reiss, F. (2025). Socioeconomic status, protective factors, and mental health problems in transition from adolescence to emerging adulthood: results of the longitudinal BELLA study. \u003cem\u003eChild Psychiatry \u0026amp; Human Development, 56\u003c/em\u003e(3), 649-660. https://doi.org/10.1007/s10578-023-01582-1\u003c/li\u003e\n\u003cli\u003eMaxwell, S. E., \u0026amp; Cole, D. A. (2007). Bias in cross-sectional analyses of longitudinal mediation. \u003cem\u003ePsychological Methods, 12\u003c/em\u003e(1), 23\u0026ndash;44. https://doi.org/10.1037/1082-989x.12.1.23 \u003c/li\u003e\n\u003cli\u003eMusliner, K. L., Munk-Olsen, T., Eaton, W. W., \u0026amp; Zandi, P. P. (2016). Heterogeneity in long-term trajectories of depressive symptoms: Patterns, predictors and outcomes. \u003cem\u003eJournal of Affective Disorders, 192\u003c/em\u003e, 199-211. https://doi.org/10.1016/j.jad.2015.12.030\u003c/li\u003e\n\u003cli\u003eMuth\u0026eacute;n, L. K., \u0026amp; Muth\u0026eacute;n, B. O. (2012-2023). \u003cem\u003eMPLUS: Statistical analysis with latent variables: User\u0026rsquo;s guide (Version 8).\u003c/em\u003e Muth\u0026eacute;n \u0026amp; Muth\u0026eacute;n. \u003c/li\u003e\n\u003cli\u003ePachankis, J. E., Hatzenbuehler, M. L., Wang, K., Burton, C. L., Crawford, F. W., Phelan, J. C., \u0026amp; Link, B. G. (2018). The burden of stigma on health and well-being: A taxonomy of concealment, course, disruptiveness, aesthetics, origin, and peril across 93 stigmas. \u003cem\u003ePersonality and Social Psychology Bulletin, 44\u003c/em\u003e(4), 451-474. https://doi.org/10.1177/0146167217741313\u003c/li\u003e\n\u003cli\u003ePingani, L., Catellani, S., Del Vecchio, V., Sampogna, G., Ellefson, S. E., Rigatelli, M., ... \u0026amp; Corrigan, P. W. (2016). Stigma in the context of schools: Analysis of the phenomenon of stigma in a population of university students. \u003cem\u003eBMC Psychiatry, 16\u003c/em\u003e(1), 29. https://doi.org/10.1186/s12888-016-0734-8\u003c/li\u003e\n\u003cli\u003ePodsakoff, P. M., MacKenzie, S. B., \u0026amp; Podsakoff, N. P. (2012). Sources of method bias in social science research and recommendations on how to control it. \u003cem\u003eAnnual Review of Psychology, 63\u003c/em\u003e(1), 539-569. https://doi.org/10.1146/annurev-psych-120710-100452\u003c/li\u003e\n\u003cli\u003eRoberts, S. O., Bareket-Shavit, C., Dollins, F. A., Goldie, P. D., \u0026amp; Mortenson, E. (2020). Racialinequality in psychological research: Trends of the past and recommendations for the future. \u003cem\u003ePerspectives on Psychological Science, 15\u003c/em\u003e(6), 1295-1309. https://doi.org/10.1177/1745691620927709\u003c/li\u003e\n\u003cli\u003eSpears, C. A. (2019). Mindfulness-based interventions for addictions among diverse and underserved populations. \u003cem\u003eCurrent Opinion in Psychology, 30,\u003c/em\u003e 11-16. https://doi.org/10.1016/j.copsyc.2018.12.012\u003c/li\u003e\n\u003cli\u003eTomlinson, E. R., Yousaf, O., Vitters\u0026oslash;, A. D., \u0026amp; Jones, L. (2018). Dispositional mindfulness and psychological health: A systematic review. \u003cem\u003eMindfulness, 9\u003c/em\u003e(1), 23-43. https://doi.org/10.1007/s12671-017-0762-6\u003c/li\u003e\n\u003cli\u003eUniversity Grants Committee (2025). \u003cem\u003eInternationalisation.\u003c/em\u003e CDCF Statistics. Retrieved September 3, 2025, from https://cdcf.ugc.edu.hk/stat/index.html#/topic/internationalisation\u003c/li\u003e\n\u003cli\u003eVyas, L., \u0026amp; Yu, B. (2018). An investigation into the academic acculturation experiences of Mainland Chinese students in Hong Kong. \u003cem\u003eHigher Education, 76\u003c/em\u003e(5), 883-901. https://doi.org/10.1007/s10734-018-0248-z\u003c/li\u003e\n\u003cli\u003eWang, I. Y., Cheung, R. Y. M., Jiang, D., Yum, C. Y. N. (2025). The association between implicit culture beliefs and intercultural sensitivity: Negative intercultural expectations and stigma as underlying processes\u003cem\u003e. Social Psychology of Education, 28\u003c/em\u003e, 61. https://doi.org/10.1007/s11218-025-10030-y\u003c/li\u003e\n\u003cli\u003eYeung, N. C., Kan, K. K., Wong, A. L., \u0026amp; Lau, J. T. (2021). Self-stigma, resilience, perceived quality of social relationships, and psychological distress among Filipina domestic helpers in Hong Kong: A mediation model. \u003cem\u003eStigma and Health, 6\u003c/em\u003e(1), 90-99. https://doi.org/10.1037/sah0000246\u003c/li\u003e\n\u003cli\u003eYu, N. X., Ni, M. Y., \u0026amp; Stewart, S. M. (2021). A moderated mediation analysis on the association between perceived discrimination and physical symptoms among immigrant women from mainland China into Hong Kong: Evidence from the FAMILY cohort. \u003cem\u003eJournal of Immigrant and Minority Health, 23\u003c/em\u003e(3), 597-605. https://doi.org/10.1007/s10903-020-01042-1\u003c/li\u003e\n\u003cli\u003eZhang, R., Wang, M. S., Toubiana, M., \u0026amp; Greenwood, R. (2021). Stigma beyond levels: Advancing research on stigmatization. \u003cem\u003eAcademy of Management Annals, 15\u003c/em\u003e(1), 188-222. https://doi.org/10.5465/annals.2019.0031\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cem\u003eTable 1.\u0026nbsp;\u003cem\u003eCorrelations, means, and standard deviations of the variables under study.\u003c/em\u003e\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" align=\"\" width=\"860\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24px;\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e(1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e(2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e(3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e(4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e(5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e(6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e(7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e(8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e(9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e(10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e(11)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24px;\"\u003e\n \u003cp\u003e(1) Gender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24px;\"\u003e\n \u003cp\u003e(2) Age\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24px;\"\u003e\n \u003cp\u003e(3)\u0026nbsp;Family income\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24px;\"\u003e\n \u003cp\u003e(4) Education level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.85\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24px;\"\u003e\n \u003cp\u003e(5) T1 Mindfulness\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.22\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24px;\"\u003e\n \u003cp\u003e(6) T1 Self-stigma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.23\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.22\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24px;\"\u003e\n \u003cp\u003e(7) T1 Mental health\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.18\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.63\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-29\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24px;\"\u003e\n \u003cp\u003e(8) T1 Depressive symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.47\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.31\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.62\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e-\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24px;\"\u003e\n \u003cp\u003e(9) T2 Self-stigma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.28\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.65\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.31\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e.33\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24px;\"\u003e\n \u003cp\u003e(10) T3 Mental Health\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.19\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.21\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.49\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.25\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.59\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e-.44\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e-.32\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24px;\"\u003e\n \u003cp\u003e(11) T3 Depressive symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.15\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.45\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.23\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.44\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e.62\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e.23\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e-.64\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e-\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24px;\"\u003e\n \u003cp\u003e\u003cem\u003eM\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e21.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e2.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e3.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e2.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e1.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e4.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e5.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e1.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e4.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e6.66\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 24px;\"\u003e\n \u003cp\u003e\u003cem\u003eSD\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e2.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e1.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e1.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e4.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e5.50\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNote. \u003csup\u003e*\u003c/sup\u003e\u003cem\u003ep\u0026nbsp;\u003c/em\u003e\u0026lt; .05, \u003csup\u003e**\u003c/sup\u003e\u003cem\u003ep\u0026nbsp;\u003c/em\u003e\u0026lt; .01, \u003csup\u003e***\u003c/sup\u003e\u003cem\u003ep\u0026nbsp;\u003c/em\u003e\u0026lt; .001. \u003csup\u003e\u0026Psi;\u003c/sup\u003e1 = \u0026lt; \u0026yen;10,001, 2 = \u0026yen;10,001 - \u0026yen;20,000, 3 = \u0026yen;20,001 - \u0026yen;30,000, 4 = \u0026yen;30,001 - \u0026yen;40,000, 5 = \u0026yen;40,001 - \u0026yen;50,000, 6 \u0026gt; \u0026yen;50,001. \u003csup\u003e\u0026dagger;\u003c/sup\u003e0 =\u0026nbsp;Secondary school, 1 = 1\u003csup\u003est\u003c/sup\u003e year undergraduate, 2 = 2\u003csup\u003end\u003c/sup\u003e year undergraduate, 3 = 3\u003csup\u003erd\u003c/sup\u003e year undergraduate, 4 = 4\u003csup\u003eth\u003c/sup\u003e year undergraduate, 5 = 5\u003csup\u003eth\u003c/sup\u003e year undergraduate, 6 = 1\u003csup\u003est\u003c/sup\u003e year postgraduate, 7 = 2\u003csup\u003end\u003c/sup\u003e year postgraduate.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2 is available in the Supplementary Files section.\u003c/strong\u003e\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Depressive symptoms, mental health, mindfulness, self-stigma","lastPublishedDoi":"10.21203/rs.3.rs-7750032/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7750032/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eObjectives\u003c/h2\u003e\u003cp\u003eRecent research has highlighted the educational and mental health benefits of mindfulness. However, studies on the relation between mindfulness and stigma among ethnic and cultural minorities remain relatively scarce. Based on mindfulness-to-meaning theory, the present longitudinal study investigated the mediating role of self-stigma between mindfulness and mental health outcomes among Mainland Chinese university students residing in Hong Kong.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eA sample of 194 university students (mean age\u0026thinsp;=\u0026thinsp;21.08 years, \u003cem\u003eSD\u003c/em\u003e\u0026thinsp;=\u0026thinsp;2.01) were recruited to complete a questionnaire for three times, with an approximately three-month lag between time points.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003ePath analysis revealed that mindfulness was associated with lower self-stigma and fewer depressive symptoms. Self-stigma was, in turn, associated with poorer mental health, as indexed by emotional, psychological, and social well-being, but not with depressive symptoms. Self-stigma further mediated the association between mindfulness and mental health, after controlling for baseline autoregressive effects, age, gender, income, and education level.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e\u003cp\u003eThe present findings inform researchers of the potential significance of nurturing mindfulness for combating self-stigma and enhancing mental health among minority students. The initial findings may also serve to inform applied interventions for enhancing mental health among minority students.\u003c/p\u003e\u003ch2\u003ePreregistration\u003c/h2\u003e\u003cp\u003eThis study is not preregistered.\u003c/p\u003e","manuscriptTitle":"Mindfulness and Mental Health Among Mainland Chinese University Students in Hong Kong: The Mediating Role of Self-Stigma","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-19 15:52:58","doi":"10.21203/rs.3.rs-7750032/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"463ee955-47d9-422c-9aa2-ecb54aef94ba","owner":[],"postedDate":"November 19th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-04-03T10:23:57+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-19 15:52:58","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7750032","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7750032","identity":"rs-7750032","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}