Relationship between extraversion and mental health literacy in Chinese adolescents: a chain mediation model

Background and aim: Approximately one-quarter of the global population experiences mental disorders, with onset frequently occurring during adolescence. Low mental health literacy (MHL) is a crucial barrier to help-seeking. Although extraversion, social support, and psychological help-seeking all facilitate access to mental health information, their combined and sequential roles in influencing MHL remain underexplored. Using the Capability, Opportunity, Motivation, and Behavior (COM-B) model, this study examined the serial mediating roles of social support and psychological help-seeking in the relationship between extraversion and MHL in Chinese adolescents. Methods: A cross-sectional online survey was conducted involving 482 adolescents (ages 16-19; 56.43% girls) from Hunan Province, China. The participants completed the Extraversion Personality Questionnaire, Social Support Rating Scale (SSRS), General Help-Seeking Questionnaire (GHSQ), and Mental Health Literacy Questionnaire (MHLQ). Data were analyzed using correlation and chain mediation analyses (bootstrapping with 5,000 samples), while controlling for gender and birthplace. Results: < 0.001). (2) Path analysis revealed that social support (β = 0.072, 95% CI [0.033, 0.125]) and psychological help-seeking (β = 0.037, 95% CI [0.013, 0.072]) independently mediated the relationship between extraversion and MHL. (3) Additionally, these factors also serially mediated this relationship (β = 0.046, 95% CI [0.026, 0.073]). However, the direct effect of extraversion on MHL was not significant (β = 0.021, 95% CI [-0.071, 0.113]), indicating full mediation. Conclusion: Social support and psychological help-seeking sequentially and fully mediate the relationship between extraversion and MHL in adolescents. Enhancing social support systems and promoting proactive help-seeking may effectively improve MHL, even among individuals with low extraversion.