The relationship between depression and adjustment disorder among a clinical sample of college freshmen: the mediating roles of resilience and perceived social support

Background This study aimed to examine the association between depression and adjustment disorder in a clinical sample of college freshmen, and to investigate the mediating roles of resilience and perceived social support in this relationship. Methods A cross-sectional survey was conducted among 402 college freshmen enrolled in the Pediatric Psychology Department of Zhumadian Second People’s Hospital. General data, the Patient Health Questionnaire (PHQ-9), Connor-Davidson Resilience Scale (CD-RISC), Perceived Social Support Scale (PSSS) and Adjustment Disorder–New Module 20 (ADNM-20) were completed by the participants. Descriptive, chi-square, and Pearson correlation analyses were conducted to characterize the sample and assess bivariate relationships, as appropriate for variable type. Hierarchical linear regression and path analysis were employed to examine the mediating roles of resilience and perceived social support between depression and adjustment disorder. Results ① Chi-square revealed no significant differences in adjustment disorder based on gender, age, only child status, childhood trauma experience, and educational level (P > 0.05). ② Pearson correlation analysis demonstrated significant relationships among the main study variables. Depression showed a strong positive correlation with adjustment disorder (r=0. 574, p<0.001), while both resilience (r=-0.653, p<0.001) and perceived social support (r=-0.550, p<0.001) were negatively correlated with adjustment disorder. ③ Hierarchical linear regression analysis indicated that the level of depression positively predicted adjustment disorder (β=0.278, P<0.001), whereas resilience (β=-0.459, P<0.001) and perceived social support (β=-0.364, P<0.001)negatively predicted adjustment disorder among college freshmen. Conclusions In a clinical sample of college freshmen, the impact of depression on adjustment disorder is partially mediated by resilience and perceived social support. Our results supported a model in which depression contributed to adjustment disorder both directly and by eroding personal resilience and perceptions of social support.