Social and psychosocial factors associated with mood states among adolescents: A questionnaire-based study

Promoting adolescent mental health is essential for long-term well-being. While cultivating supportive social environments and psychological resilience is critical for the early prevention of internalizing symptoms, particularly within the family as a core support system, research remains limited on how family support interacts with stigmatizing environments to jointly influence internalizing symptoms. To clarify how experiences of stigma in the family context influence internalizing symptoms among adolescents, we drew on the stress-buffering model and emotion socialization perspectives, and we conceptualized internalized stigma as “toxic shame.” We hypothesized that the perceived lack of social support indirectly exacerbates adolescents’ internalizing symptoms by elevating levels of internalized stigma. In this process, internalized stigma not only mimics pressures associated with stigmatizing environments but also undermines the protective role of social support for mental health. Furthermore, public stigma may increase barriers to seeking help by being internalized, directly exacerbating psychological distress. Using cross-sectional survey data from 98 adolescents, we used linear regression analysis to test these hypotheses. Our results indicated that internalized stigma mediated the relationship between family support and internalizing symptoms. Additionally, we observed a marginal, non-significant moderation effect, which suggested that social support might have mitigated the impact of internalized stigma on internalizing symptoms. Overall, our findings identified internalized stigma as a key vulnerability factor that both transmits stress from stigmatizing environments and undermines social support resources. This underscores the critical importance of fostering supportive family environments and alleviating shame-induced self-deprecation in promoting adolescent mental health and combating stigma.