{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T11:57:35Z","timestamp":1785585455559,"version":"3.56.0"},"posted":{"date-parts":[[2026,7,29]]},"group-title":"Public and Global Health","reference-count":39,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,7,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Medical students face significant mental health challenges, yet psychological distress and post-traumatic stress remain insufficiently characterized in lower-resource settings like Vietnam. Among potential stressors, sexual violence (SV) exposure represents a critical but understudied risk factor. This study evaluated the severity of psychological distress (PD) and post-traumatic stress symptoms (PTSS) among medical students in Northern Vietnam and examined their associations with past-year non-contact and contact SV exposure.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A cross-sectional survey was conducted in May 2025 using REDCap among a probability sample of 555 medical students (years 2\u20135). Mental health outcomes were evaluated using validated instruments: the 21-item Depression, Anxiety, and Stress Scales (DASS-21) for past-week PD and the PTSD Checklist for DSM-5 (PCL-5) for past-month PTSS. Past-year non-contact and contact SV exposures were measured using the Sexual Experiences Survey\u2013Victimization (SES-V). Multivariable linear regression modeled adjusted associations between SV exposure types and mental health symptom severity, testing for sex-specific differences.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>\n                    Overall mental health symptom scores escalated significantly with SV exposure. Median PTSS scores increased from 11 among unexposed students to 20 for non-contact SV and 30 for contact SV (\n                    <jats:italic>p<\/jats:italic>\n                    &lt; 0.001). Similarly, median PD scores increased from 7 (unexposed) to 11.5 (non-contact SV) and 21 (contact SV) (\n                    <jats:italic>p<\/jats:italic>\n                    &lt; 0.001). Adjusted linear models demonstrated robust associations where both non-contact and contact SV exposure were strong independent predictors of heightened PD and PTSS severity, with no significant moderation by sex. In terms of exposure prevalence, 21.26% of students reported non-contact SV (higher in females: 26.24% vs. males: 16.12%) and 10.66% reported contact SV.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Vietnamese medical students exposed to sexual violence experience a heavy mental health burden marked by elevated psychological distress and post-traumatic stress symptoms. To protect student mental health in lower-resource settings, medical institutions must establish comprehensive trauma-informed psychological support, confidential counseling services, and targeted intervention strategies addressing both contact and non-contact stress exposures.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Highlights<\/jats:title>\n                  <jats:list list-type=\"bullet\">\n                    <jats:list-item>\n                      <jats:p>Prior-year non-contact and contact sexual violence are common in medical students in Northern Vietnam.<\/jats:p>\n                    <\/jats:list-item>\n                    <jats:list-item>\n                      <jats:p>Non-contact sexual violence is more common among female than male students.<\/jats:p>\n                    <\/jats:list-item>\n                    <jats:list-item>\n                      <jats:p>Contact sexual violence is more common among sexual-minority than heterosexual students.<\/jats:p>\n                    <\/jats:list-item>\n                    <jats:list-item>\n                      <jats:p>Non-contact and especially contact sexual violence are positively associated with psychological distress and post-traumatic stress.<\/jats:p>\n                    <\/jats:list-item>\n                    <jats:list-item>\n                      <jats:p>Inclusive, preventive and response services are needed to address sexual violence and its psychological impacts.<\/jats:p>\n                    <\/jats:list-item>\n                  <\/jats:list>\n                <\/jats:sec>","DOI":"10.64898\/2026.07.25.26358649","type":"posted-content","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T15:10:17Z","timestamp":1785337817000},"source":"Crossref","is-referenced-by-count":0,"title":["Psychological Distress and Post-Traumatic Stress Symptoms among Medical Students in Vietnam: Associations with Non-Contact and Contact Sexual Violence Exposure"],"prefix":"10.64898","author":[{"given":"Phan Thi Minh","family":"Ngoc","sequence":"first","affiliation":[{"name":"Department of Physiology, Hanoi Medical University, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hoang Thi Hai","family":"Van","sequence":"additional","affiliation":[{"name":"Department of Research Methodology and Biostatistics, School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tran Quynh","family":"Anh","sequence":"additional","affiliation":[{"name":"Department of Environmental Health, School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leah E.","family":"Daigle","sequence":"additional","affiliation":[{"name":"Department of Criminal Justice and Criminology, Georgia State University, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doan Ngoc Thuy","family":"Tien","sequence":"additional","affiliation":[{"name":"Department of Health Economics and Population Studies, School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn M.","family":"Yount","sequence":"additional","affiliation":[{"name":"Hubert Department of Global Health, Rollins School of Public Health, and Department of Sociology, College of Arts and Sciences, Emory University, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54368","reference":[{"key":"2026080104300565000_2026.07.25.26358649v1.1","unstructured":"Global and regional estimates of violence against women. 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