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The multifactor chain mediation model of anxiety in the MSM population: the pathways of perceived social support, self-esteem, and psychological resilience
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  • Published: 10 April 2026

The multifactor chain mediation model of anxiety in the MSM population: the pathways of perceived social support, self-esteem, and psychological resilience

  • Yiwei Zhou1,2,3,
  • Zejie Zhang4,
  • Fanglv Xiang5,
  • Minlu Xu6 &
  • …
  • Zumu Zhou6 

Scientific Reports , Article number:  (2026) Cite this article

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We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

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  • Health care
  • Psychology

Abstract

This study investigates how perceived social support is associated with anxiety among men who have sex with men (MSM). A cross-sectional online survey was conducted from March to June, 2024, recruiting 1,070 MSM participants via internet platforms. Measures included the Perceived Social Support Scale-12 (PSSS-12), Self-Esteem Scale-10 (SES), Connor-Davidson Resilience Scale-25 (CD-RISC-25), and Generalized Anxiety Disorder Scale (GAD-7). Using PROCESS Model 6 and the Bootstrap method, a significant negative correlation was found between perceived social support and anxiety (r =  − 0.187, P < 0.01). The total effect of perceived social support on anxiety was − 0.0970 (95% CI: − 0.1181 to − 0.0759), with mediation accounting for 53.92% of the total effect. Specifically, self-esteem (effect value =  − 0.0444) and psychological resilience (effect value =  − 0.0054) significantly mediated the relationship, accounting for 45.77% and 5.57% of the total mediation effect, respectively. The joint indirect effect through self-esteem and psychological resilience accounted for an additional 2.58% of the total effect. The study highlights that social support is linked to lower anxiety in MSM by enhancing self-esteem and resilience, emphasizing their importance for MSM mental health.

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Data availability

The datasets used and analyzed in this study are available from the corresponding author on reasonable request. Because of the sensitive nature of the data collected on the mental health of MSMs, among which individuals are potentially identifiable, we cannot provide open access to our data.

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Acknowledgements

We thank all individuals who participated in this study.

Funding

This work was financially supported by National Social Science Foundation of China Post-funding Project (24FJYB002), 2022 Ministry of Education of China Humanities and Social Science Youth Foundation Project (22YJC790189), Shanghai University Young Teachers Cultivation and Support Project, Shanghai Key Laboratory of Urban Design and Urban Science, NYU Shanghai Open Topic Grants (Grant No.2023YWZhou_LOUD), Shanghai Automotive Industry Sci-Tech Development Foundation Project (2401), and Zhejiang Provincial Clinical Research Center for Mental Disorders Foundation Project.

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Authors and Affiliations

  1. Business School, University of Shanghai for Science and Technology, Shanghai, 200093, China

    Yiwei Zhou

  2. School of Intelligent Emergency Management, University of Shanghai for Science and Technology, Shanghai, 200093, China

    Yiwei Zhou

  3. Smart Urban Mobility Institute, University of Shanghai for Science and Technology, Shanghai, 200093, China

    Yiwei Zhou

  4. Qingtian Center for Disease Control and Prevention, Lishui, Zhejiang, 323900, China

    Zejie Zhang

  5. Lucheng Center for Disease Control and Prevention, Wenzhou, 325000, China

    Fanglv Xiang

  6. The Affiliated Kangning Hospital of Wenzhou Medical University，Zhejiang Provincial Clinical Research Center for Mental Disorders, Wenzhou, 325007, China

    Minlu Xu & Zumu Zhou

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Yiwei Zhou and Zumu Zhou designed the study. Minlu Xu, Zejie Zhang and Fanglv Xiang analyzed the data. Yiwei Zhou wrote a draft of the manuscript. Zumu Zhou interpreted the data and revised the manuscript. All authors have read and agreed to the published version of the manuscript.

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Zhou, Y., Zhang, Z., Xiang, F. et al. The multifactor chain mediation model of anxiety in the MSM population: the pathways of perceived social support, self-esteem, and psychological resilience. Sci Rep (2026). https://doi.org/10.1038/s41598-026-46302-6

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  • Received: 27 November 2025

  • Accepted: 25 March 2026

  • Published: 10 April 2026

  • DOI: https://doi.org/10.1038/s41598-026-46302-6

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Keywords

  • MSM
  • Perceived social support
  • Psychological resilience
  • Anxiety
  • Self-esteem
  • Chain mediation model
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