When Saying “Yes” Hurts: The Relationship Between Compliance and Psychological Distress Across Cultural Values in China

Background: Young adult mental health is a critical global concern. This study aims to investigate the relationship between compliance and psychological distress in young adults, paying particular attention to the mediating role of affect and the moderating role of cultural values in China. Methods: A large-scale cross-sectional study was conducted, with 11,038 (Mage = 20.58 ± 4.11) young adults recruited. A series of self-reported questionnaires was used, including measures of psychological distress, cultural factors, and compliance. Latent structural equation modelling was applied to investigate how the compliance trait links to psychological distress. Results: Findings revealed a positive association between compliance and psychological distress. The analysis further demonstrated that both positive and negative affect served as significant mediators in this association. Additionally, the association was moderated by cultural factors, particularly individualism. Individualism significantly buffered both the direct effect of compliance on psychological distress and the mediating effect of negative affect. Conclusions: These results contribute to a deeper understanding of the social and psychological determinants of youth mental health, a key priority for public health practice.