Stress sources and anxiety symptoms of medical graduate students: the mediating role of negative emotion and the moderating role of social support

Objective To explore the relationship between stress sources and anxiety symptoms of medical graduate students, as well as the mediating role of negative emotion and the moderating role of social support. Methods A questionnaire survey was conducted among 1 216 medical students of 16 medical colleges in 13 provinces (municipalities directly under the Central Government) by using graduate stressors scale, Hopkins symptom checklist, the positive and negative affect scale and perceived social support scale.Correlation analysis, regression analysis, SPSS-process mediation and adjustment methods were used for data processing. Results (1) The whole average score of stress source was (2.45±0.54), and the scores of anxiety symptoms, negative emotions and social support were (1.68±0.59), (2.26±0.70) and (5.28 ±1.01). (2) There was a positive correlation between stress and anxiety symptoms (r=0.37, P<0.01), and negative emotion (r=0.38, P<0.01) and a negative correlation between stress source and social support (r=-0.20, P<0.01). (3) Negative emotion plays a significant partial mediating role between stressors and anxiety symptoms (indirect effect value=0.24, SE=0.02, 95%CI: 0.20-0.28), accounted for 58.54% of the total effect.(4) Social support moderated the effects of stressors on negative emotion (R2=0.24) and the effects of stressors on anxiety symptoms (R2=0.44). Conclusion Negative emotion plays a partial intermediary role in stress sources and anxiety symptoms, and social support plays a multiple moderating role. Key words: Medical graduate students; Stressors; Negative emotion; Anxiety symptoms; Social support