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ORIGINAL RESEARCH article

Front. Psychiatry

Sec. Perinatal Psychiatry

This article is part of the Research TopicPerinatal mental health: Depression, Anxiety, Stress, and FearView all 37 articles

Perceived Stress and Anxiety as Mediators Linking Self-Disclosure to Post-Abortion Depressive Symptoms

Provisionally accepted
Jin  XuJin Xu1Xiulian  XuXiulian Xu2Bingcui  SunBingcui Sun2Ying  ChenYing Chen2Yan  HuangYan Huang2Xiaofang  ChengXiaofang Cheng2Jing  ZhaoJing Zhao2*
  • 1School of Nursing and Rehabilitation, Shandong University, Jinan, China
  • 2Qilu Hospital of Shandong University, Jinan, China

The final, formatted version of the article will be published soon.

Objective: To examine the mediating roles of anxiety and perceived stress in the relationship between distress disclosure and depressive symptoms among women following induced abortion. Methods: A cross-sectional study was conducted with 359 post-abortion women recruited from a hospital in China. Participants completed self-report measures including the Distress Disclosure Index, Generalized Anxiety Disorder-7, Perceived Stress Scale-4, and Patient Health Questionnaire-9. Multiple mediation and subgroup analyses by marital status were performed using SEM model. Results: Distress disclosure had a significant total effect on depressive symptoms (β = -0.140, P < 0.001), but no direct effect (β = -0.017, P = 0.546). The association was fully mediated by anxiety and perceived stress. Subgroup analyses revealed that this mediating model was significant among unmarried women but not among married women. Conclusion: Distress disclosure is associated with depressive symptoms indirectly by reducing anxiety and perceived stress, particularly among unmarried women. These findings support integrated interventions combining emotional disclosure with anxiety and stress management to optimize psychological recovery for post-abortion women.

Keywords: Anxiety, depressive symptoms, Distress disclosure, perceived stress, Post-Abortion Women

Received: 12 Dec 2025; Accepted: 12 Feb 2026.

Copyright: © 2026 Xu, Xu, Sun, Chen, Huang, Cheng and Zhao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Jing Zhao

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