{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T06:15:49Z","timestamp":1783577749362,"version":"3.55.0"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:00:00Z","timestamp":1783555200000},"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. Psychiatry"],"abstract":"\n Introduction<\/jats:title>\n Medical students are vulnerable to academic burnout, particularly those with a history of adverse childhood experiences (ACEs). Although early adversity has been linked to burnout, the precise psychological processes underlying this association remain insufficiently understood. This study examined whether rumination, self-control, and resilience were statistically associated with the relationship between ACEs and academic burnout among medical students.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A cross-sectional questionnaire survey was conducted among 1,889 medical students from Heilongjiang University of Chinese Medicine. Measures included ACEs, academic burnout, rumination, self-control, and resilience. Pearson correlation analysis, and serial mediation analyses were performed. Sensitivity analyses were conducted using alternative ACE codings, and supplementary analyses were used to compare alternative mediator orderings.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n ACEs were positively associated with academic burnout (\u03b2 = 0.187, p &lt; 0.001). Rumination, self-control, and resilience were each statistically linked to the ACEs-burnout association through significant indirect pathways. After inclusion of the mediators, the direct association between ACEs and academic burnout was no longer significant. The overall pattern was broadly consistent across continuous, binary, and ordinal ACE operationalizations. Supplementary analyses further indicated that several alternative mediator orderings were also statistically plausible.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n These findings suggest that rumination, self-control, and resilience are statistically associated with the relationship between ACEs and academic burnout. However, because the study was cross-sectional, causal ordering cannot be established. Longitudinal studies are needed to clarify the temporal sequence of these psychological processes and to determine whether targeting them may help reduce academic burnout.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fpsyt.2026.1829698","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T05:36:40Z","timestamp":1783575400000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Adverse childhood experiences and academic burnout among Chinese traditional medicine students: the serial mediating role of rumination, self-control, and resilience"],"prefix":"10.3389","volume":"17","author":[{"given":"Youwen","family":"Wang","sequence":"first","affiliation":[{"name":"Graduate School, Heilongjiang University of Chinese Medicine","place":["Harbin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuailin","family":"Du","sequence":"additional","affiliation":[{"name":"Graduate School, Heilongjiang University of Chinese Medicine","place":["Harbin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Tan","sequence":"additional","affiliation":[{"name":"Graduate School, Heilongjiang University of Chinese Medicine","place":["Harbin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuexuan","family":"Wu","sequence":"additional","affiliation":[{"name":"Graduate School, Heilongjiang University of Chinese Medicine","place":["Harbin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boying","family":"Yu","sequence":"additional","affiliation":[{"name":"Graduate School, Heilongjiang University of Chinese Medicine","place":["Harbin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xusheng","family":"Tian","sequence":"additional","affiliation":[{"name":"First Clinical Medical College, Heilongjiang University of Chinese Medicine","place":["Harbin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1177\/00207640221106691","article-title":"Prevalence of burnout in medical students: a systematic review and meta-analysis","volume":"68","author":"Almutairi","year":"2022","journal-title":"Int J Soc Psychiatry"},{"key":"B2","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1016\/j.burn.2014.11.001","article-title":"Measuring job and academic burnout with the Oldenburg Burnout Inventory (OLBI): factorial invariance across samples and countries","volume":"2","author":"Reis","year":"2015","journal-title":"Burnout Res"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1097\/JTE.0000000000000222","article-title":"Reliability and validity of the student version of the Oldenburg Burnout Inventory in physical therapist students","volume":"36","author":"Smith","year":"2022","journal-title":"J Phys Ther Educ"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1037\/a0019408","article-title":"Burnout and work engagement: a thorough investigation of the independency of both constructs","volume":"15","author":"Demerouti","year":"2010","journal-title":"J Occup Health Psychol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"386","DOI":"10.1186\/s12909-025-06956-8","article-title":"Risk and protective factors of student burnout among medical students: a multivariate analysis","volume":"25","author":"Kiss","year":"2025","journal-title":"BMC Med Educ"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.3390\/medicina60040575","article-title":"Is there a burnout epidemic among medical students? 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