The Mediating Role of Neuroticism in the Association Between Psychological Distress and Professional Identity Among First-Year Medical Students

Abstract

Objective This study examined the association between psychological distress and professional identity among first-year medical students and investigated whether neuroticism mediated this association. Methods Using the cluster‑sampling method, 898 first-year medical students from a university in Guangdong Province were randomly selected as research subjects. Questionnaires were administered using the NEO Five-Factor Inventory (NEO-FFI), Kessler Psychological Distress Scale(K10), and College Students’ Professional Identity Scale as research instruments. Results Psychological distress was positively correlated with neuroticism (r =0.660, P<0.01), whereas psychological distress was negatively correlated with professional identity (r = −0.308, P < 0.01). Neuroticism was also negatively correlated with professional identity (r = −0.323, P < 0.01). Psychological distress was significantly negatively associated with professional identity (total effect: B = −0.527, t = −9.648, P < 0.001). When neuroticism was included in the model, the association between psychological distress and professional identity remained significant (B = −0.287, t = −3.996, P < 0.001). Psychological distress was positively associated with neuroticism (B = 0.749, t = 26.217, P < 0.001), while neuroticism was negatively associated with professional identity (B = −0.322, t = −5.082, P < 0.001). The indirect effect was significant (B = −0.241, 95% CI [−0.341, −0.145]), accounting for 45.6% of the total effect, indicating a partial mediating role of neuroticism. ConclusionPsychological distress was negatively associated with professional identity among first-year medical students, and this association was partly mediated by neuroticism. These findings suggest that interventions aimed at strengthening professional identity should address not only psychological distress but also individual differences in emotional stability and stress-related coping. Integrating psychological support with professional identity education may help first-year medical students adapt to the academic and psychological demands of medical education.