Brief ReportsDistress Concealment and Depression Symptoms in a National Sample of Canadian Men Feeling Understood and Loneliness as Sequential MediatorsCox, Daniel W. PhD∗; Ogrodniczuk, John S. PhD†; Oliffe, John L. PhD‡,§; Kealy, David PhD†; Rice, Simon M. PhD∥; Kahn, Jeffrey H. PhD¶Author Information ∗Counselling Psychology Program †Psychotherapy Program, Department of Psychiatry ‡School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada §Department of Nursing ∥Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia ¶Psychology Department, Illinois State University, Normal, Illinois. Send reprint requests to Daniel W. Cox, PhD, Counselling Psychology Program, University of British Columbia, 2125 Main Mall, Vancouver, British Columbia, Canada V6T1Z4. E-mail: firstname.lastname@example.org. This study was funded by Movember Canada (grant #11R18455). The Journal of Nervous and Mental Disease: June 2020 - Volume 208 - Issue 6 - p 510-513 doi: 10.1097/NMD.0000000000001153 Buy Metrics Abstract Men's tendency to conceal their distress has been linked with increased depressive symptoms. Although interpersonal connectedness has been associated with distress concealment and depression, it is unclear how connectedness mediates this association. The aim of the present study was to examine the mediating effects of feeling understood and loneliness—two facets of interpersonal connectedness—in the association between distress concealment and depressive symptoms in men. A sample of 530 Canadian men was selected based on age- and region-stratification that reflects the national population. Participants completed measures of depression symptoms, distress concealment, loneliness, and feeling understood. Mediation analyses were conducted. Results supported a sequential mediation model: concealing distress was associated with not feeling understood, not feeling understood was associated with loneliness, and loneliness was associated with depressive symptoms. These findings shed light on how distress concealment is associated with depressive symptoms among men. Implications for practice and theory are discussed. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.