{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:27:20Z","timestamp":1787027240718,"version":"build-2736575974"},"reference-count":48,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T00:00:00Z","timestamp":1753920000000},"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>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Medical students have become a group with a high prevalence of depression and are particularly vulnerable to it. Recognizing the factors affecting depression among medical students is crucial. This study was aimed at exploring the effects of perceived stress on medical students\u2019 depression under the mediating role of the rumination and the moderating role of the emotional intelligence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A survey was conducted with 648 medical students in XX Province, XX (blind review). Participants provided responses to measures of perceived stress, rumination, emotional intelligence, and depression. Data analysis was performed in SPSS version 26 and the SPSS PROCESS Macro.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The results revealed significant positive associations between perceived stress (\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f0.63,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.01) and rumination (\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f0.59,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.01) with depression. Rumination plays a mediating role between perceived stress and depression, with the mediation effect accounting for 31.67% (SE\u202f=\u202f0.10, 95% CI\u202f=\u202f0.15, 0.26). Furthermore, emotional intelligence significantly moderated the direct effect (moderated mediation\u202f=\u202f\u22120.01, SE\u202f=\u202f0.01, 95% CI\u202f=\u202f\u22120.01, \u22120.00).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Rumination serves as a mediator in the relationship between perceived stress and depression, while emotional intelligence significantly moderates the impact of perceived stress on depression.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyg.2025.1620067","type":"journal-article","created":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T05:37:27Z","timestamp":1753940247000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Associations of perceived stress with depression in medical students: the mediating role of rumination and the moderating role of emotional intelligence"],"prefix":"10.3389","volume":"16","author":[{"given":"Youjuan","family":"Hong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zixuan","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siyu","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaofan","family":"Bao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,7,31]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e2268","DOI":"10.17795\/ijpbs-2268","article-title":"Emotional intelligence and depressive symptoms as predictors of happiness among adolescents","volume":"9","author":"Abdollahi","year":"2015","journal-title":"Iran. J. Psychiatry Behav. Sci."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1016\/j.paid.2016.07.015","article-title":"Emotional intelligence moderates perceived stress and suicidal ideation among depressed adolescent inpatients","volume":"102","author":"Abdollahi","year":"2016","journal-title":"Pers. Individ. Differ."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"247","DOI":"10.5964\/psyct.v10i2.226","article-title":"Impacts of psychological security, emotional intelligence and self-efficacy on undergraduates\u2019 life satisfaction","volume":"10","author":"Afolabi","year":"2017","journal-title":"Psychol. Thought"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"840","DOI":"10.4135\/9781529734348","article-title":"Frequency and perceived causes of depression, anxiety and stress among medical students of a private medical institute in Karachi: a mixed method study","volume":"69","author":"Azim","year":"2019","journal-title":"J. Pak. Med. Assoc."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"383","DOI":"10.31729\/jnma.4911","article-title":"Perceived stress and stressors among medical and dental students of Bhairhawa, Nepal: a descriptive cross-sectional study","volume":"58","author":"Bali","year":"2020","journal-title":"JNMA J. Nepal Med. Assoc."},{"key":"ref9001","doi-asserted-by":"publisher","first-page":"e71","DOI":"10.1002\/smi.1337","article-title":"Work stressors and impaired sleep: rumination as a mediator","volume":"27","author":"Berset","year":"2011","journal-title":"Stress and health: Journal of the International Society for the Investigation of Stress."},{"key":"ref9002","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1037\/a0018821","article-title":"Examining the relations between rumination and adjustment: do ethnic differences exist between Asian and European Americans? Asian Am","volume":"1","author":"Chang","year":"2010","journal-title":"J. Psychol."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"448","DOI":"10.1016\/j.jad.2023.08.047","article-title":"The impact of family functioning on depression in college students: a moderated mediation model","volume":"340","author":"Chen","year":"2023","journal-title":"J. Affect. Disord."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"627","DOI":"10.1186\/s12909-022-03683-2","article-title":"Association of depression symptoms and sleep quality with state-trait anxiety in medical university students in Anhui Province, China: a mediation analysis","volume":"22","author":"Chen","year":"2022","journal-title":"BMC Med. Educ."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"534","DOI":"10.3389\/fnhum.2016.00534","article-title":"Perseverative cognition and health behaviors: a systematic review and Meta-analysis","volume":"10","author":"Clancy","year":"2016","journal-title":"Front. Hum. Neurosci."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"385","DOI":"10.2307\/2136404","article-title":"A global measure of perceived stress","volume":"24","author":"Cohen","year":"1983","journal-title":"J. Health Soc. Behav."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"799","DOI":"10.1016\/j.jad.2020.04.020","article-title":"Perceived stress and depression in 45 low- and middle-income countries","volume":"274","author":"Crist\u00f3bal-Narv\u00e1ez","year":"2020","journal-title":"J. Affect. Disord."},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1260","DOI":"10.1177\/00207640231157258","article-title":"Mental health throughout the medical career: a comparison of depression, anxiety, and stress levels among medical students, residents, and physicians","volume":"69","author":"de Sa e Camargo","year":"2023","journal-title":"Int. J. Soc. Psychiatry"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1017\/S1041610222000370","article-title":"Associations of perceived stress, depressive symptoms, and caregiving with inflammation: a longitudinal study","volume":"35","author":"Elayoubi","year":"2023","journal-title":"Int. Psychogeriatr."},{"key":"ref15","doi-asserted-by":"publisher","first-page":"438","DOI":"10.6018\/analesps.34.3.313681","article-title":"The role of emotional dependence in the relationship between attachment and impulsive behavior","volume":"34","author":"Est\u00e9vez","year":"2018","journal-title":"An. Psicol."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1016\/j.jad.2019.11.121","article-title":"Gender differences in depression, anxiety, and stress among college students: a longitudinal study from China","volume":"263","author":"Gao","year":"2020","journal-title":"J. Affect. Disord."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1186\/s12909-018-1133-2","article-title":"Perceived stress, reasons for and sources of stress among medical students at Rabigh medical college, king Abdulaziz university, Jeddah, Saudi Arabia","volume":"18","author":"Gazzaz","year":"2018","journal-title":"BMC Med. Educ."},{"key":"ref19","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1016\/j.paid.2016.08.022","article-title":"Perceived emotional intelligence as a predictor of depressive symptoms during mid-adolescence: a two-year longitudinal study on gender differences","volume":"104","author":"Gomez-Baya","year":"2017","journal-title":"Pers. Individ. Differ."},{"key":"ref20","first-page":"550","article-title":"Chinese version of Nolen-Hoeksema ruminative responses scale (RRS) used in 912 college students: reliability and validity","volume":"17","author":"Han","year":"2009","journal-title":"Chin. J. Clin. Psychol."},{"key":"ref21","volume-title":"Introduction to mediation, moderation, and conditional process analysis: a regression-based approach","author":"Hayes","year":"2013"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1953","DOI":"10.1177\/0886260513511697","article-title":"The role of rumination in elevating perceived stress in posttraumatic stress disorder","volume":"29","author":"Hu","year":"2014","journal-title":"J. Interpers. Violence"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"354","DOI":"10.4103\/0971-5916.156571","article-title":"Stress, anxiety and depression among medical undergraduate students and their socio-demographic correlates","volume":"141","author":"Iqbal","year":"2015","journal-title":"Indian J. Med. Res."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1016\/j.brat.2016.07.007","article-title":"Examining emotion regulation in depression: a review and future directions","volume":"86","author":"Joormann","year":"2016","journal-title":"Behav. Res. Ther."},{"key":"ref25","doi-asserted-by":"publisher","first-page":"576","DOI":"10.1176\/appi.ajp.2020.19111213","article-title":"A prehistory of the diathesis-stress model: predisposing and exciting causes of insanity in the 19th century","volume":"177","author":"Kendler","year":"2020","journal-title":"Am. J. Psychiatry"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"104517","DOI":"10.1016\/j.childyouth.2019.104517","article-title":"The effect of social anxiety on mobile phone dependence among Chinese adolescents: a moderated mediation model","volume":"108","author":"Kong","year":"2020","journal-title":"Child Youth Serv. Rev."},{"key":"ref29","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1016\/j.jad.2021.05.028","article-title":"Association between perceived stress and depression among medical students during the outbreak of COVID-19: the mediating role of insomnia","volume":"292","author":"Liu","year":"2021","journal-title":"J. Affect. Disord."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"782","DOI":"10.1186\/s12888-023-05280-z","article-title":"A cross-sectional analysis of the relationships between anxiety sensitivity and youth irritability: the mediated roles of insomnia and selective attention for threat","volume":"23","author":"Li","year":"2023","journal-title":"BMC Psychiatry"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"5896","DOI":"10.3390\/jcm11195896","article-title":"The consequences of the pandemic on medical students' depressive symptoms and perceived stress: a repeated cross-sectional survey with a nested longitudinal subsample","volume":"11","author":"Lo Moro","year":"2022","journal-title":"J. Clin. Med."},{"key":"ref9003","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1016\/j.beth.2006.03.003","article-title":"The effects of worry and rumination on affect states and cognitive activity","volume":"38","author":"McLaughlin","year":"2007","journal-title":"Behav. Ther."},{"key":"ref31","doi-asserted-by":"publisher","first-page":"2729","DOI":"10.2147\/RMHP.S261489","article-title":"The mediating role of perceived stress in associations between self-compassion and anxiety and depression: further evidence from Chinese medical workers","volume":"13","author":"Meng","year":"2020","journal-title":"Risk Manag Healthc Policy"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"393","DOI":"10.2147\/AMEP.S302897","article-title":"Depression and anxiety among medical students: a brief overview","volume":"12","author":"Mirza","year":"2021","journal-title":"Adv. Med. Educ. Pract."},{"key":"ref9004","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1016\/j.brat.2018.01.009","article-title":"Processes and pathways mediating the experience of social anxiety and negative rumination","volume":"103","author":"Modini","year":"2018","journal-title":"Behav. Res. Ther."},{"key":"ref34","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1037\/\/0022-3514.61.1.115","article-title":"A prospective study of depression and posttraumatic stress symptoms after a natural disaster: the 1989 Loma Prieta earthquake","volume":"61","author":"Nolen-Hoeksema","year":"1991","journal-title":"J. Pers. Soc. Psychol."},{"key":"ref35","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1111\/j.1745-6924.2008.00088.x","article-title":"Rethinking rumination","volume":"3","author":"Nolen-Hoeksema","year":"2008","journal-title":"Perspect. Psychol. Sci."},{"key":"ref36","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1186\/s40359-024-01707-8","article-title":"The personality traits with depression and suicidal ideation among Thai medical students: a university-based multiregional study","volume":"12","author":"Pitanupong","year":"2024","journal-title":"BMC Psychol."},{"key":"ref9005","doi-asserted-by":"publisher","first-page":"879","DOI":"10.1037\/0021-9010.88.5.879","article-title":"Common method biases in behavioral research: a critical review of the literature and recommended remedies","volume":"88","author":"Podsakoff","year":"2003","journal-title":"J. Appl. Psychol."},{"key":"ref37","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1007\/s10608-016-9782-0","article-title":"Stress-related symptoms and suicidal ideation: the roles of rumination and depressive symptoms vary by gender","volume":"40","author":"Polanco-Roman","year":"2016","journal-title":"Cogn. Ther. Res."},{"key":"ref38","doi-asserted-by":"publisher","first-page":"2214","DOI":"10.1001\/jama.2016.17324","article-title":"Prevalence of depression, depressive symptoms, and suicidal ideation among medical students: a systematic review and meta-analysis","volume":"316","author":"Rotenstein","year":"2016","journal-title":"JAMA"},{"key":"ref9006","doi-asserted-by":"publisher","first-page":"185","DOI":"10.2190\/DUGG-P24E-52WK-6CDG","article-title":"Emotional intelligence","volume":"9","author":"Salovey","year":"","journal-title":"Imagin. Cogn. Pers."},{"key":"ref39","doi-asserted-by":"publisher","first-page":"921","DOI":"10.1016\/j.paid.2006.09.003","article-title":"A meta-analytic investigation of the relationship between emotional intelligence and health","volume":"42","author":"Schutte","year":"2007","journal-title":"Pers. Individ. Differ."},{"key":"ref40","doi-asserted-by":"publisher","first-page":"9142","DOI":"10.3390\/ijerph19159142","article-title":"Climate change related depression, anxiety and stress symptoms perceived by medical students","volume":"19","author":"Schwaab","year":"2022","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1007\/s40596-020-01193-1","article-title":"How to cope with the challenges of medical education? Stress, depression, and coping in undergraduate medical students","volume":"44","author":"Steiner-Hofbauer","year":"2020","journal-title":"Acad. Psychiatry"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s10608-016-9801-1","article-title":"Treatment of depression from a self-regulation perspective: basic concepts and applied strategies in self-system therapy","volume":"41","author":"Strauman","year":"2017","journal-title":"Cogn. Ther. Res."},{"key":"ref43","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1111\/medu.13770","article-title":"Prevalence of depressive symptoms among medical students: overview of systematic reviews","volume":"53","author":"Tam","year":"2019","journal-title":"Med. Educ."},{"key":"ref44","doi-asserted-by":"publisher","first-page":"660234","DOI":"10.3389\/fpsyg.2021.660234","article-title":"Perceived stress and smartphone addiction in medical college students: the mediating role of negative emotions and the moderating role of psychological capital","volume":"12","author":"Wang","year":"2021","journal-title":"Front. Psychol."},{"key":"ref45","doi-asserted-by":"publisher","first-page":"103573","DOI":"10.1016\/j.brat.2020.103573","article-title":"Reflecting on rumination: consequences, causes, mechanisms and treatment of rumination","volume":"127","author":"Watkins","year":"2020","journal-title":"Behav. Res. Ther."},{"key":"ref46","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1007\/s10608-011-9361-3","article-title":"Brooding and reflection reconsidered: a factor analytic examination of rumination in currently depressed, formerly depressed, and never depressed individuals","volume":"35","author":"Whitmer","year":"2011","journal-title":"Cogn. Ther. Res."},{"key":"ref48","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1001\/archpsyc.1965.01720310065008","article-title":"A self-rating depression scale","volume":"12","author":"Zung","year":"1965","journal-title":"Arch. Gen. Psychiatry"}],"container-title":["Frontiers in Psychology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2025.1620067\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T05:37:28Z","timestamp":1753940248000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2025.1620067\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,31]]},"references-count":48,"alternative-id":["10.3389\/fpsyg.2025.1620067"],"URL":"https:\/\/doi.org\/10.3389\/fpsyg.2025.1620067","relation":{},"ISSN":["1664-1078"],"issn-type":[{"value":"1664-1078","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,31]]},"article-number":"1620067"}}