{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:54:10Z","timestamp":1790790850739,"version":"4.1.0"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T00:00:00Z","timestamp":1754956800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>This study aims to investigate the mediating role of emotional regulation in the relationship between physical exercise and suicidal ideation among Chinese medical students. The study specifically examined how exercise-induced enhancement of emotional regulatory capacity may mitigate suicide risk through neurobiological and psychological pathways.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cross-sectional study assessed 852 medical students using the Physical Activity Rating Scale-3 (PARS-3) to categorize exercise intensity (low: 51.9%; moderate: 25.9%; high: 22.2%). Suicidal ideation was measured with the Positive and Negative Suicide Ideation Scale (PANSI), emotional regulation capacity with the Emotion Regulation Questionnaire (ERQ), and psychological symptoms with the Symptom Checklist-90 (SCL-90). Independent t-tests, ANOVA tests, and mediation modeling were used for analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The prevalence of suicidal ideation was 8.10% (69\/852), consistent with national epidemiological data. Males exhibited significantly lower depression (\u0394\u202f=\u202f\u22121.24, <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.05) and anxiety (\u0394\u202f=\u202f\u22120.87, <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.05) scores than females. Students engaging in high\/moderate-intensity exercise demonstrated lower rates of depression and psychosis compared to low-intensity exercisers (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.05). Emotional regulation mediated 38.1% of the protective effect of exercise against suicidal ideation (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.01), aligning with established neurobiological pathways linking physical activity to mood regulation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The physical exercise habits of medical students are intricately linked to their mental and emotional well-being. It is recommended that medical institutions intensify efforts to promote physical exercise and encourage greater participation among medical students. This proactive approach can contribute to reducing suicidal ideation among medical students and enhancing their overall mental health.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpsyg.2025.1609415","type":"journal-article","created":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T14:55:41Z","timestamp":1755010541000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":8,"title":["The impact of physical exercise on mental health and the relationship among physical exercise, emotional regulation and suicidal ideation in Chinese medical students"],"prefix":"10.3389","volume":"16","author":[{"given":"Yiqi","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junlin","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han","family":"Ruan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pin","family":"Yao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guoliang","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,8,12]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1186\/s12909-020-02039-y","article-title":"Stress coping strategies among medical students and trainees in Saudi Arabia: a qualitative study","volume":"20","author":"Abouammoh","year":"2020","journal-title":"BMC Med. 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Public Health"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"925","DOI":"10.1007\/s11845-020-02423-z","article-title":"The mental health and well-being benefits of exercise during the COVID-19 pandemic: a cross-sectional study of medical students and newly qualified doctors in the UK","volume":"190","author":"Coyle","year":"2021","journal-title":"Ir. J. Med. Sci."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1309","DOI":"10.1007\/s11606-017-4171-2","article-title":"The impact of a required longitudinal stress management and resilience training course for first-year medical students","volume":"32","author":"Dyrbye","year":"2017","journal-title":"J. Gen. Intern. Med."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1465","DOI":"10.1007\/s11606-019-05376-x","article-title":"Relationship between burnout, professional behaviors, and cost-conscious attitudes among US physicians","volume":"35","author":"Dyrbye","year":"2020","journal-title":"J. Gen. Intern. Med."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1186\/s12888-020-02583-3","article-title":"Physical exercise, mental health problems, and suicide attempts in university students","volume":"20","author":"Grasdalsmoen","year":"2020","journal-title":"BMC Psychiatry"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/1047840X.2014.940781","article-title":"Emotion regulation: current status and future prospects","volume":"26","author":"Gross","year":"2015","journal-title":"Psychol. Inq."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"137","DOI":"10.22156\/CS4SMB.2019.9.5.137","article-title":"A convergent study on the effects of peer relationships and parent relationships on suicidal ideation in elementary school students: the mediating effect of anxiety","volume":"9","author":"Jang","year":"2019","journal-title":"J. Convergence Inf. Technol."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1016\/j.copsyc.2015.01.014","article-title":"The role of emotion dysregulation in suicide as considered through the ideation to action framework","volume":"3","author":"Law","year":"2015","journal-title":"Curr. Opin. Psychol."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"716","DOI":"10.1123\/jpah.10.5.716","article-title":"The relations of suicidal ideation and attempts with physical activity among Korean adolescents","volume":"10","author":"Lee","year":"2013","journal-title":"J. Phys. Act. Health"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1161\/CIRCULATIONAHA.121.058162","article-title":"Long-term leisure-time physical activity intensity and all-cause and cause-specific mortality: a prospective cohort of US adults","volume":"146","author":"Lee","year":"2022","journal-title":"Circulation"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"14","DOI":"10.3969\/j.issn.1004-8790.2021.05.004","article-title":"The relationship between physical activity and suicidal ideation among medical students as related to emotional regulation","volume":"40","author":"Lei","year":"2021","journal-title":"Fujian Sports Sci. Technol."},{"key":"ref15","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1159\/000509213","article-title":"To be or not to be improved: patients' perception of symptom improvement-linking the SCL-90-R to patient-rated global improvement in a large real-world treatment sample","volume":"89","author":"Leichsenring","year":"2020","journal-title":"Psychother. Psychosom."},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1023","DOI":"10.1186\/s12889-024-18433-w","article-title":"Influence of moderate-to-high intensity physical activity on depression levels: a study based on a health survey of Chinese university students","volume":"24","author":"Li","year":"2024","journal-title":"BMC Public Health"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"524","DOI":"10.1186\/1471-2458-12-524","article-title":"Factors associated with suicidal behaviors in mainland China: a meta-analysis","volume":"12","author":"Li","year":"2012","journal-title":"BMC Public Health"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1952","DOI":"10.1017\/S0033291720001555","article-title":"Psychological distress among health professional students during the COVID-19 outbreak","volume":"51","author":"Li","year":"2021","journal-title":"Psychol. Med."},{"key":"ref19","doi-asserted-by":"publisher","first-page":"982469","DOI":"10.3389\/fpsyt.2022.982469","article-title":"Mental burden among Chinese undergraduate medical students: a prospective longitudinal study before, during, and after the COVID-19 outbreak","volume":"13","author":"Liao","year":"2022","journal-title":"Front. Psych."},{"key":"ref20","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1016\/j.appet.2016.11.028","article-title":"Health status, physical activity, and orthorexia nervosa: a comparison between exercise science students and business students","volume":"109","author":"Malmborg","year":"2017","journal-title":"Appetite"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"783","DOI":"10.2466\/pr0.1998.82.3.783","article-title":"The positive and negative suicide ideation inventory: development and validation","volume":"82","author":"Osman","year":"1998","journal-title":"Psychol. Rep."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"855","DOI":"10.1016\/j.jad.2023.08.076","article-title":"The emotion regulation questionnaire-short form (ERQ-S): a 6-item measure of cognitive reappraisal and expressive suppression","volume":"340","author":"Preece","year":"2023","journal-title":"J. Affect. Disord."},{"key":"ref23","doi-asserted-by":"publisher","first-page":"283","DOI":"10.4103\/psychiatry.IndianJPsychiatry_533_18","article-title":"Relationship between life skills, repetitive negative thinking, family function, and life satisfaction in attempted suicide","volume":"62","author":"Ram","year":"2020","journal-title":"Indian J. Psychiatry"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"e0261785","DOI":"10.1371\/journal.pone.0261785","article-title":"Risk factors for suicidal ideation and suicide attempt among medical students: a meta-analysis","volume":"16","author":"Seo","year":"2021","journal-title":"PLoS One"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1080\/13811118.2019.1616018","article-title":"Interpersonal relationships and suicidal ideation in youth with bipolar disorder","volume":"24","author":"Sewall","year":"2020","journal-title":"Arch. Suicide Res."},{"key":"ref26","doi-asserted-by":"publisher","first-page":"1332","DOI":"10.7507\/1672-2531.201706124","article-title":"Incidence of suicidal ideation of medical students in China's mainland over the past ten years: a meta-analysis","volume":"17","author":"Shen","year":"2017","journal-title":"Chin. J. Evid. Based Med."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"809","DOI":"10.1123\/jpah.2015-0315","article-title":"Relationship between physical activity and suicidal behaviors among 65, 182 middle school students","volume":"13","author":"Southerland","year":"2016","journal-title":"J. Phys. Act. Health"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1007\/s40279-013-0090-5","article-title":"The effects of stress on physical activity and exercise","volume":"44","author":"Stults-Kolehmainen","year":"2014","journal-title":"Sports Med."},{"key":"ref29","doi-asserted-by":"publisher","first-page":"198","DOI":"10.4103\/npmj.npmj_414_21","article-title":"Prevalence and factors associated with depression among medical students in Nigeria","volume":"28","author":"Suraj","year":"2021","journal-title":"Niger. Postgrad. Med. J."},{"key":"ref30","doi-asserted-by":"publisher","first-page":"e13525","DOI":"10.1111\/tct.13525","article-title":"Physical activity, burnout and quality of life in medical students: a systematic review","volume":"19","author":"Taylor","year":"2022","journal-title":"Clin. Teach."},{"key":"ref31","doi-asserted-by":"publisher","first-page":"438","DOI":"10.1016\/j.jad.2017.08.070","article-title":"Physical activity and suicidal ideation: a systematic review and meta-analysis","volume":"225","author":"Vancampfort","year":"2018","journal-title":"J. Affect. Disord."},{"key":"ref32","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1016\/j.eurpsy.2003.03.006","article-title":"Attitudes towards suicide and suicidal patients among medical students","volume":"18","author":"Wallin","year":"2003","journal-title":"Eur. Psychiatry"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.3390\/nu14245375","article-title":"Physical fitness, nutrition and quality of life in German medical students","volume":"14","author":"Walnik","year":"2022","journal-title":"Nutrients"},{"key":"ref34","article-title":"Symptom Checklist (SCL-90) (No. 2, 68-70)","author":"Wang","year":"1984","journal-title":"Shanghai Arch Psychiatry."},{"key":"ref35","doi-asserted-by":"publisher","first-page":"2241","DOI":"10.12677\/AP.2023.136277","article-title":"The effect of physical exercise on anxiety of college students: the mediating effect of psychological capital","volume":"6","author":"Wang","year":"2023","journal-title":"Adv. Psychol."},{"key":"ref36","doi-asserted-by":"publisher","first-page":"176","DOI":"10.3760\/cma.j.cn113661-20220902-00248","article-title":"The effect of anhedonia, childhood abuse and depression on suicidal ideation of adolescents: a moderated mediating model","volume":"56","author":"Yang Du","year":"2023","journal-title":"Chin. J. Psychiatry."},{"key":"ref37","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1186\/s13034-023-00622-x","article-title":"Risk and protective factors related to changes in mental health among adolescents since COVID-19 in Hong Kong: a cross-sectional study","volume":"17","author":"Yeung","year":"2023","journal-title":"Child Adolesc. Psychiatry Ment. 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Med."}],"container-title":["Frontiers in Psychology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2025.1609415\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T22:10:18Z","timestamp":1755123018000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2025.1609415\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,12]]},"references-count":38,"alternative-id":["10.3389\/fpsyg.2025.1609415"],"URL":"https:\/\/doi.org\/10.3389\/fpsyg.2025.1609415","relation":{},"ISSN":["1664-1078"],"issn-type":[{"value":"1664-1078","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,12]]},"article-number":"1609415"}}