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Edlund K, Nigicser I, Sansone M, Identeg F, Hedelin H, Forsberg N, Tranaeus U. Protocol for a 2-year longitudinal study of eating disturbances, mental health problems and overuse injuries in rock climbers (CLIMB). BMJ Open 2023; 13:e074631. [PMID: 37709336 PMCID: PMC10503345 DOI: 10.1136/bmjopen-2023-074631] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 08/30/2023] [Indexed: 09/16/2023] Open
Abstract
INTRODUCTION Rock climbing is a rapidly growing sport in which performance may be affected by participant's weight and leanness, and there may be pressure on athletes with respect to their eating behaviour and body weight. However, there is sparse research performed on climbers, constituting a knowledge gap which the present study aims to fill. The primary outcomes of the study are to examine disordered eating and overuse injuries in rock climbers. Secondary variables are body image, indicators of relative energy deficiency, mental health problems, compulsive training, perfectionism, sleep quality and bone density. METHOD AND ANALYSIS This prospective longitudinal study aims to recruit Swedish competitive rock climbers (>13 years) via the Swedish Climbing Federation. A non-athlete control group will be recruited via social media (n=equal of the climbing group). Data will be collected using streamlined validated web-based questionnaires with three follow-ups over 2 years. Inclusion criteria for rock climbers will be a minimum advanced level according to International Rock-Climbing Research Association. The non-athlete control group is matched for age and gender. Exclusion criteria are having competed at an elite level in any sport as well as training more often than twice per week. Statistical analyses will include multinominal logistic regression, multivariate analysis of variance (MANOVA) and structural equation modelling (SEM). We will assess effect measure modification when relevant and conduct sensitivity analyses to assess the impact of lost to follow-up. ETHICS AND DISSEMINATION The Rock-Climbers' Longitudinal attitudes towards Injuries, Mental health and Body image study, CLIMB, was approved by the Swedish ethics authority (2021-05557-01). Results will be disseminated through peer-reviewed research papers, reports, research conferences, student theses and stakeholder communications. TRIAL REGISTRATION NUMBER NCT05587270.
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Affiliation(s)
- Klara Edlund
- Department of Health Promotion Science, Sophiahemmet University, Stockholm, Sweden
- Unit of Intervention Research on Worker Health, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | | | | | | | | | | | - Ulrika Tranaeus
- Department of FNB, Swedish School of Sport and Health Sciences, Stockholm, Sweden
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
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Mark Anderson D, Diris R, Montizaan R, Rees DI. The effects of becoming a physician on prescription drug use and mental health treatment. JOURNAL OF HEALTH ECONOMICS 2023; 91:102774. [PMID: 37451143 DOI: 10.1016/j.jhealeco.2023.102774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 05/16/2023] [Accepted: 05/26/2023] [Indexed: 07/18/2023]
Abstract
There is evidence that physicians disproportionately suffer from substance use disorder and mental health problems. It is not clear, however, whether these phenomena are causal. We use data on Dutch medical school applicants to examine the effects of becoming a physician on prescription drug use and the receipt of treatment from a mental health facility. Leveraging variation from lottery outcomes that determine admission into medical schools, we find that becoming a physician increases the use of antidepressants, anxiolytics, opioids, and sedatives. Increases in the use of antidepressants, anxiolytics, and sedatives are larger among female physicians than among their male counterparts.
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Affiliation(s)
- D Mark Anderson
- Department of Agricultural Economics and Economics, Montana State University, NBER, United States; IZA - Institute of Labor Economics, Bonn, Germany.
| | - Ron Diris
- Department of Economics, Leiden University, the Netherlands; IZA - Institute of Labor Economics, Bonn, Germany
| | - Raymond Montizaan
- Research Centre for Education and the Labour Market, Maastricht University, the Netherlands; IZA - Institute of Labor Economics, Bonn, Germany
| | - Daniel I Rees
- Department of Economics, Universidad Carlos III de Madrid, Spain
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Gao X, Zhong J, Li H, Pei Y, Li X, Zhang S, Yue Y, Xiong X. The relationship between perfectionism, self-perception of orofacial appearance, and mental health in college students. Front Public Health 2023; 11:1154413. [PMID: 37213631 PMCID: PMC10196033 DOI: 10.3389/fpubh.2023.1154413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 04/14/2023] [Indexed: 05/23/2023] Open
Abstract
Background In dental clinical practice, self-perception of orofacial appearance is highly correlated with treatment satisfaction. Therefore, it is important to explore factors correlated with self-perception of orofacial appearance. Perfectionism may be one such factor. This study investigated the role of perfectionism in self-perception of orofacial appearance. Methods Participants completed an online questionnaire that included demographic data, a measure of perfectionism, a measure of self-perception of orofacial appearance (including body image, smile appearance concern, and self-esteem), and a measure of anxiety and depression. Results High perfectionism scores significantly predicted greater age, body image, smile appearance concern, and mental health scores and lower self-esteem scores (p < 0.005). After adjusting for possible confounding variables, smile appearance concern largely disappeared. Mental health acted as a mediator in the relationships between perfectionism and three orofacial appearance characteristics. Conclusion High perfectionism predicted higher self-perception of body image, and lower mental health and self-esteem in college students. Mental health could mediate the relationships between perfectionism and self-perception of orofacial appearance.
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Affiliation(s)
- Xinlin Gao
- Department of Orthodontics, National Clinical Research Center for Oral Diseases, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jiawei Zhong
- Department of Orthodontics, National Clinical Research Center for Oral Diseases, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Hanchao Li
- Department of Orthodontics, National Clinical Research Center for Oral Diseases, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yapeng Pei
- Department of Orthodontics, National Clinical Research Center for Oral Diseases, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xixin Li
- Department of Orthodontics, National Clinical Research Center for Oral Diseases, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Siyu Zhang
- Department of Orthodontics, National Clinical Research Center for Oral Diseases, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yuan Yue
- Department of Prosthodontics, National Clinical Research Center for Oral Diseases, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xin Xiong
- Department of Orthodontics, National Clinical Research Center for Oral Diseases, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Temporomandibular Joint, National Clinical Research Center for Oral Diseases, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Fernández-García O, Gil-Llario MD, Castro-Calvo J, Morell-Mengual V, Ballester-Arnal R, Estruch-García V. Academic Perfectionism, Psychological Well-Being, and Suicidal Ideation in College Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:85. [PMID: 36612403 PMCID: PMC9819691 DOI: 10.3390/ijerph20010085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/15/2022] [Accepted: 12/17/2022] [Indexed: 06/17/2023]
Abstract
High levels of perfectionism in college students can compromise their academic performance and psychological well-being. This study aims to analyze the implication of perfectionism in psychological well-being and suicidal ideation in the last year. A total of 1.287 students from different degrees reported their academic performance in the previous academic year and completed questionnaires on academic perfectionism, psychological well-being, and suicidal thoughts in the last year. In both men and women, academic perfectionism correlates positively with academic performance and negatively with the different dimensions of psychological well-being. Likewise, both the average grade in the previous year (β = 0.364) and the level of demand of the degree (β = -0.461) are mediating variables between perfectionism and psychological well-being. Furthermore, the interaction between perfectionism and academic performance is related positively to psychological well-being, but not to with suicidal ideation. So, the relation between suicidal ideation and perfectionism is positive (OR = 1.075), but this is negative with academic performance (OR = 0.900), although both variables show a mild predictive capacity. These findings suggest that the levels of perfectionism are associated differently with the mental health of students, since if perfectionism is effective (high academic performance), psychological well-being is high, although in our results, this interaction is not as important for suicidal thoughts.
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Affiliation(s)
- Olga Fernández-García
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Valencia, 46010 Valencia, Spain
| | - María Dolores Gil-Llario
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Valencia, 46010 Valencia, Spain
| | - Jesús Castro-Calvo
- Department of Personality, Assessment, and Psychological Treatments, Faculty of Psychology, University of Valencia, 46010 Valencia, Spain
| | - Vicente Morell-Mengual
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Valencia, 46010 Valencia, Spain
| | - Rafael Ballester-Arnal
- Department of Basic and Clinical Psychology and Psychobiology, Faculty of Health Sciences, Jaume I University, 12007 Castellón de la Plana, Spain
| | - Verónica Estruch-García
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Valencia, 46010 Valencia, Spain
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Eley DS, Leung J, Cloninger KM. A longitudinal cohort study observed increasing perfectionism and declining resilience, ambiguity tolerance and calling during medical school which is not explained by student personality. BMC MEDICAL EDUCATION 2022; 22:784. [PMID: 36371205 PMCID: PMC9655808 DOI: 10.1186/s12909-022-03850-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 10/31/2022] [Indexed: 05/19/2023]
Abstract
BACKGROUND The medical degree is a long and challenging program, not just academically, but regarding the expectations engrained in the culture of medical education. The recent proliferation of literature on the poor mental well-being among students suggests a dilemma that often lays the onus on students to improve their health. The link between personality and vulnerability to psychological distress is acknowledged. This longitudinal study looked at personality in 1st-year and changes in levels of certain psychological traits, as proxy indicators of well-being, in 4th-year. We aimed to determine to what extent changes in psychological traits over time may be attributed to personality. METHODS Medical students completed surveys at the start (1st-year: baseline) and finish (4th-year: follow-up) of their medical degree (N = 154). Temperament and character personality, Perfectionism-Concern over mistakes (CoM), Ambiguity Tolerance, Resilience, Calling to medicine, and demographic variables were measured. Paired t-tests compared changes in psychological traits from baseline to follow-up. Linear regression examined whether personality at baseline would predict levels of psychological traits at follow-up. RESULTS The temperament and character profile of the sample was as expected, and congruent with previous studies, which describe a mature personality. Over four years, levels of Perfectionism-CoM significantly increased, while Resilience, Ambiguity Tolerance and Calling to medicine decreased. Harm Avoidance, Persistence, Self-Directedness and Cooperativeness at baseline significantly predicted levels of these traits at follow-up, but effect sizes were weak. Correlations were in the expected direction and weak. CONCLUSIONS Most commencing medical students, including this cohort, have mature personalities with an industrious temperament and an adaptable character. Yet over four years of medicine, Ambiguity Tolerance, Resilience and Calling declined while Perfectionism-CoM, already elevated at baseline, continued to increase to the final year. Of concern is the increased perfectionism that is strongly associated with poor mental health and psychological distress. The findings suggest a closer look at the entirety of the education environment and how its culture, including secondary school and the medical school admissions processes may influence these trends in students. As medical educators we should question why the pathway to medicine places such unhealthy pressure on students who aspire to be doctors.
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Affiliation(s)
- Diann S. Eley
- Academy of Medical Education, Medical School, The University of Queensland, 288 Herston Road, Brisbane, QLD 4006 Australia
| | - Janni Leung
- National Centre for Youth Substance Use Research (NCYSUR), The University of Queensland, 17 Upland Road, St Lucia, QLD 4072 Australia
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Edlund K, Sundberg T, Johansson F, Onell C, Rudman A, Holm LW, Grotle M, Jensen I, Côté P, Skillgate E. Sustainable UNiversity Life (SUN) study: protocol for a prospective cohort study of modifiable risk and prognostic factors for mental health problems and musculoskeletal pain among university students. BMJ Open 2022; 12:e056489. [PMID: 35379630 PMCID: PMC8980731 DOI: 10.1136/bmjopen-2021-056489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Mental health problems and musculoskeletal pain are common health problems among young adults including students. Little is known about the aetiology and prognosis of these problems in university students. We aim to determine the role of personal, sociodemographic, academic and environmental factors for risk and prognosis of symptoms of depression, anxiety and stress as well as musculoskeletal pain in university students. The constructs that will be studied are based on the biopsychosocial model and psychopathology associated with disabling pain. This model acknowledges illness to consist of interrelated mechanisms categorised into biological, psychological, environmental and social cues. METHODS AND ANALYSIS This cohort study aims to recruit around 5000 Swedish full-time students. Data will be collected using five online surveys during one academic year. A subgroup (n=1851) of the cohort, recruited before the COVID-19 pandemic, receive weekly text messages with three short questions assessing mood, worry and pain, sent through the web-based platform SMS-track . Statistical analyses will include Kaplan-Meier estimates, Cox regression analyses, multinomial logistic regression analyses and generalised estimating equations. We will assess effect measure modification when relevant and conduct sensitivity analyses to assess the impact of lost to follow-up. PROTOCOL AMENDMENTS Due to opportunity and timing of the study, with relevance to the outbreak of the COVID-19 pandemic, this study further aims to address mental health problems, musculoskeletal pain and lifestyle in university students before and during the pandemic. ETHICS AND DISSEMINATION The Sustainable UNiversity Life study was approved by the Swedish ethics authority (2019-03276; 2020-01449). Results will be disseminated through peer-reviewed research papers, reports, research conferences, student theses and stakeholder communications. TRIAL REGISTRATION NUMBER NCT04465435.
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Affiliation(s)
- Klara Edlund
- Department of Health Promotion Science, Sophiahemmet University, Stockholm, Sweden
- Unit of Intervention Research on Worker Health, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Tobias Sundberg
- Department of Health Promotion Science, Sophiahemmet University, Stockholm, Sweden
- Unit of Intervention Research on Worker Health, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Fred Johansson
- Department of Health Promotion Science, Sophiahemmet University, Stockholm, Sweden
- Unit of Intervention Research on Worker Health, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Clara Onell
- Department of Health Promotion Science, Sophiahemmet University, Stockholm, Sweden
- Unit of Intervention Research on Worker Health, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Ann Rudman
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Health and Welfare, Dalarna University, Falun, Sweden
| | - Lena W Holm
- Department of Health Promotion Science, Sophiahemmet University, Stockholm, Sweden
- Unit of Intervention Research on Worker Health, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Margreth Grotle
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
| | - Irene Jensen
- Unit of Intervention Research on Worker Health, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Pierre Côté
- Communication and Research Unit for Musculoskeletal Health (Formi), Oslo University Hospital, Oslo, Norway
- Centre for Disability Prevention and Rehabilitation, Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
| | - Eva Skillgate
- Department of Health Promotion Science, Sophiahemmet University, Stockholm, Sweden
- Unit of Intervention Research on Worker Health, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
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Wang Q, Wu H. Associations Between Maladaptive Perfectionism and Life Satisfaction Among Chinese Undergraduate Medical Students: The Mediating Role of Academic Burnout and the Moderating Role of Self-Esteem. Front Psychol 2022; 12:774622. [PMID: 35069356 PMCID: PMC8777005 DOI: 10.3389/fpsyg.2021.774622] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 11/01/2021] [Indexed: 01/07/2023] Open
Abstract
Empirical research has shown that maladaptive perfectionism may lead to lower life satisfaction. However, the relationship between maladaptive perfectionism and life satisfaction among medical students and the mechanism underlying this relationship still need to be further explored. The present study used a large sample of undergraduate medical students to examine the associations between maladaptive perfectionism and life satisfaction and to explore the mechanism underlying the associations. Specifically, the present study tried to probe the mediating role of academic burnout and the moderating role of self-esteem in the relationship between maladaptive perfectionism and life satisfaction in medical students. We invited 1628 undergraduate medical students from two medical universities in Northeastern China to participate in the survey. Among the students recruited, 1377 medical students (response rate: 84.6%) completed questionnaires including the Frost Multidimensional Perfectionism Scale (FMPS) maladaptive perfectionism subscales, the Chinese College Student Academic Burnout Inventory (CCSABI), the Satisfaction With Life Scale (SWLS), the Rosenberg Self-Esteem Scale (RSES) and demographic information. Results show that maladaptive perfectionism was significantly negatively related to life satisfaction among medical students and academic burnout played a significant mediating role (β = -0.10, BCa 95%CI: -0.12, -0.07) in this relationship. Moderated mediation analyses reveal that the mediating effect of maladaptive perfectionism on life satisfaction via academic burnout was moderated by self-esteem. Maladaptive perfectionism exerted a stronger effect on life satisfaction via the mediating role of academic burnout for medical students with high self-esteem [β = -0.026, SE = 0.009, 95%CI = (-0.047, -0.011)] than for medical students with low self-esteem [β = -0.019, SE = 0.009, 95%CI = (-0.038, -0.001)]. Medical institutions can implement effective interventions to decrease medical students' maladaptive perfectionism levels and academic burnout levels, and increase their self-esteem levels in order to enhance their life satisfaction.
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Affiliation(s)
- Qinghua Wang
- Institute of Foreign Languages, China Medical University, Shenyang, China
| | - Huazhang Wu
- Department of Health Service Administration, College of Health Management, China Medical University, Shenyang, China
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Prevalence of Second Victims, Risk Factors, and Support Strategies among German Nurses (SeViD-II Survey). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010594. [PMID: 34682342 PMCID: PMC8535996 DOI: 10.3390/ijerph182010594] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 10/06/2021] [Accepted: 10/08/2021] [Indexed: 12/13/2022]
Abstract
Background: Second victim phenomena (SVP) are critical to workplace and patient safety, and epidemiological data are limited to investigate the causes and impact on German health care. We investigated SVP in German nurses regarding prevalence, causes, and predisposition compared to a preceding study on German physicians (Second Victims in Deutschland/SeViD-I). Methods: We conducted a nationwide anonymous cross-sectional online study in 2020 using a modified SeViD questionnaire including the BFI-10 (personality traits). Statistical analysis was conducted using chi² tests and binary logistic regression models. Results: Of 332 nurses, 60% reported to experience SVP at least once a working lifetime, with a 12-month prevalence among SVP of 49%. Of the nurses, 24% reported recovery times of more than 1 year. In contrast to physicians from SeViD-I, a main cause for becoming a second victim was aggressive behavior by patients. High neuroticism values, higher age, and medium work life experience, but neither gender nor workplace position, were predisposing for SVP. Like SeViD-I, nurses reported demand for an institutional response in cases of SVP. Conclusions: SVP is common among German nurses and comprises other causes and a different course than in physicians. Further research should concentrate on specific prevention strategies, e.g., profession- and workplace-based educational programs.
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Eley DS, Bansal V, Leung J. Perfectionism as a mediator of psychological distress: Implications for addressing underlying vulnerabilities to the mental health of medical students. MEDICAL TEACHER 2020; 42:1301-1307. [PMID: 32805157 DOI: 10.1080/0142159x.2020.1805101] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Medical students have personalities that are often shown to be perfectionistic. Perfectionism can manifest as maladaptive and lead to psychological distress. This study examined the mediating role of perfectionism on the association between personality trait profiles and levels of psychological distress. METHODS First-year medical students completed a questionnaire containing measures of personality, perfectionism (Concern over Mistakes: CoM), stress, anxiety and depression. Latent profile analysis classified students based on their personality traits and identified a profile vulnerable to psychological distress. Structural equation models examined the mediation effects of perfectionism on the relationship between the vulnerable personality profile and distress. RESULTS The sample totalled 376 (84% response). The vulnerable personality profile was highest in Harm Avoidance, lowest in Self-Directedness, and significantly correlated with the highest Perfectionism-CoM. High Perfectionism-CoM was associated with the highest levels of stress, anxiety and depression. Perfectionism-CoM was a significant mediator for the relationship between personality and higher levels of psychological distress. CONCLUSION Certain personality profiles are predisposed to psychological distress such as anxiety, stress and depression. Perfectionism, as a mediator between personality and psychological distress, may be a target strategy to help increase students' self-acceptance, and self-awareness of their perfectionistic tendencies and lower their vulnerability to poor mental health.
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Affiliation(s)
- Diann S Eley
- Office of Medical Education, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Vikas Bansal
- Office of Medical Education, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Janni Leung
- School of Psychology, The University of Queensland, Brisbane, Australia
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Atkinson SR. Elevated psychological distress in undergraduate and graduate entry students entering first year medical school. PLoS One 2020; 15:e0237008. [PMID: 32776950 PMCID: PMC7416945 DOI: 10.1371/journal.pone.0237008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 07/17/2020] [Indexed: 02/07/2023] Open
Abstract
Background Psychological distress in medical students is a global issue and poses a risk to their health, academic performance, and ability to care for patients as clinicians. There has been limited research on psychological distress levels in students prior to starting medicine and no direct comparison between undergraduate and graduate-entry students. Methods Psychological distress was assessed using the 21-item Depression Anxiety and Stress Scale in 168 undergraduate-entry and 84 graduate-entry medical students at two separated campuses of the same university in the orientation week prior to starting classes. Mean scores and severity proportions were compared between the two cohorts of students. Demographic data was also collected and compared to distress scores using subgroup analysis. Results The response rate for the study was 60.9%. The majority of undergraduate and graduate-entry medical students were within the normal limits for depression (67.2% versus 70.2%, p = 0.63), anxiety (56.5% versus 44.0%, p = 0.06), and stress scores (74.4% versus 64.2%, p = 0.10). There was no significant difference between severity groups except for severe stress (2.3% versus 9.5%, p = 0.01). The mean scores of the clinically distressed groups indicated moderate levels of depression, moderate anxiety, and moderate stress scores. There were no significant differences between undergraduate or graduate-entry students for depressive ( x¯ = 17.02 versus 15.76, p = 0.43), anxiety ( x¯ = 14.22 versus 13.28, p = 0.39), and stress scores ( x¯ = 20.83 versus 22.46, p = 0.24). Female gender and self-believed financial concerns were found be associated with higher levels stress in graduate entry students. Conclusions The majority of medical students enter medical school with normal levels of psychological distress. However, a large number of undergraduate and graduate-entry medical students have significant levels of depressive, anxiety, and stress levels, without a significant difference between undergraduate or graduate-entry students. There are several limitation of this study but the results suggest that education and intervention may be required to support students from the earliest weeks of medical school.
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Affiliation(s)
- Sean R. Atkinson
- School of Rural Health, Monash University, Churchill, Australia
- * E-mail:
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11
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Hou Y, Xiao R, Yang X, Chen Y, Peng F, Zhou S, Zeng X, Zhang X. Parenting Style and Emotional Distress Among Chinese College Students: A Potential Mediating Role of the Zhongyong Thinking Style. Front Psychol 2020; 11:1774. [PMID: 32849051 PMCID: PMC7399746 DOI: 10.3389/fpsyg.2020.01774] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 06/29/2020] [Indexed: 11/17/2022] Open
Abstract
Previous studies suggested that parenting style was associated with college student’s emotional distress. However, little is known about the underlying mechanisms of this relation in Chinese culture. The present study investigated the associations between parenting style and college student’s emotional distress (depression and anxiety symptoms), examined the mediating effects of Confucian personality-Zhongyong thinking, and explored whether gender, age, and socioeconomic status (SES) moderated the direct and/or indirect effects of parenting style on emotional distress. Results from a large representative sample of Chinese college students (n = 3943) indicated that (a) parental rejection and overprotection was positively and mildly associated with depressive and anxiety symptoms and negatively and mildly related to Zhongyong thinking. Parental warmth significantly correlated with the three variables in the opposite direction; Zhongyong thinking correlated negatively and moderately with depression, and mildly with anxiety; (b) Zhongyong thinking partially mediated the associations of parental rejection and warmth with emotional distress. Specifically, to the extent that students perceived less rejection and more warmth, they were more likely to develop Zhongyong thinking associated with decreased emotional distress; (c) gender and SES moderated the association between parenting style and Zhongyong thinking. Specifically, for students with low SES, the negative relationship between parental overprotection and Zhongyong thinking was stronger; for males and high SES students, the positive link between parental warmth and Zhongyong thinking were stronger. Results highlight the importance of researching potential effects of college student’s Zhongyong thinking within the family system in Chinese culture.
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Affiliation(s)
- Yanfei Hou
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Rong Xiao
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Xueling Yang
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Yu Chen
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Fei Peng
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Shegang Zhou
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Xihua Zeng
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Xiaoyuan Zhang
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
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Gärtner J, Bußenius L, Prediger S, Vogel D, Harendza S. Need for cognitive closure, tolerance for ambiguity, and perfectionism in medical school applicants. BMC MEDICAL EDUCATION 2020; 20:132. [PMID: 32345278 PMCID: PMC7189591 DOI: 10.1186/s12909-020-02043-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 04/13/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Physicians have to deal with uncertainty on a daily basis, which requires high tolerance for ambiguity. When medical decisions have to be made in ambiguous situations, low levels of need for cognitive closure and high levels of adaptive perfectionism are beneficial. It might be useful to measure such personality traits during medical school selection processes. In our study, we explored the expression of need for cognitive closure, tolerance for ambiguity, and perfectionism in medical school applicants who participated in a multiple mini-interview selection process with respect to the final decision of admission or rejection. METHODS After participating in the multiple mini-interview procedure (HAM-Int) at Hamburg Medical School in August 2019, 189 medical school applicants filled out a questionnaire including the Multidimensional Perfectionism Scale by Hewitt and Flett (MPS-H), the Multidimensional Perfectionism Scale by Frost (MPS-F), the Tolerance for Ambiguity Scale (TAS), the 16-Need for Cognitive Closure Scale (16-NCCS), and sociodemographic data. After the final admission decision, the scores of need for cognitive closure, tolerance for ambiguity, and perfectionism of admitted and rejected applicants were compared. We also assessed the predictive power of need for cognitive closure and age for the admission decision in a binary logistic regression model. RESULTS Compared to the admitted applicants, the rejected applicants showed a significantly higher need for cognitive closure (p = .009). A high need for cognitive closure correlated significantly positively with maladaptive perfectionism (p < .001) and significantly negatively with tolerance for ambiguity (p < .001). Low need for cognitive closure and older age were associated with a positive admission decision. CONCLUSIONS Regarding the personality traits need for cognitive closure, tolerance for ambiguity, and perfectionism we identified interesting differences and correlations of relevance for physicians' daily work in medical school applicants who were admitted or rejected after participating in a multiple mini-interview selection procedure. Further studies are needed to investigate these characteristics and their development longitudinally in medical students and to correlate them with students' medical performance.
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Affiliation(s)
- Julia Gärtner
- III. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lisa Bußenius
- Department of Biochemistry and Molecular Cell Biology, Center for Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sarah Prediger
- III. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Daniela Vogel
- III. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sigrid Harendza
- III. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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