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AIMS Public Health

2025, Volume 12, Issue 1: 1-15. doi: 10.3934/publichealth.2025001
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Medical students' distress during the transition to the endemic phase of COVID-19 in China: The association with temperament traits and attachment styles

  • 1.
    Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Policlinico Universitario, University of Messina, Messina, Italy
  • 2.
    Research Center of Narrative Medicine, Shunde Hospital; Department of General Education, Southern Medical University, Guangdong, China
  • 3.
    Williams College, Williamstown, MA, USA
  • 4.
    Department of Medical Sciences, Hackensack Meridian School of Medicine, Nutley, NJ, USA
  • 5.
    Department of Neurology, Hackensack Meridian School of Medicine, Nutley, NJ, USA
  • 6.
    The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
  • 7.
    Department of Psychology, Hunan Normal University, Changsha, China
  • † These two authors contributed equally.
  • Received: 01 May 2024 Revised: 18 June 2024 Accepted: 05 July 2024 Published: 03 January 2025

  • Objective 

    The transition of COVID-19 into the endemic phase in China has posed additional challenges to medical student's well-being, and increased the odds of mental distress. Although affective temperament traits and adult attachment styles accompany crisis-induced stress, whether this applies to medical students in the endemic phase has yet to be determined. The aim of present study is to test if temperament traits and adult attachment style can predict stress in Chinese medical students.

    Methods 

    Medical students (N = 402) enrolled in the undergraduate medical program at the Southern Medical University, Guangdong, China completed an online survey in May 2022. Most participants were female (62.4%), with a mean age of (21.3 ± 3.1). The individual temperament traits and adult attachment styles were assessed using the Chinese version of the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-auto-questionnaire short version (TEMPS-A), and the Attachment Style Questionnaire (ASQ).

    Results 

    The participants showed significant distress as assessed with the K10: 19 (15–24) (median, Q1, Q3). Furthermore, a multiple linear regression analysis indicated that cyclothymic (β = 2.1, p = 0.048) and depressive (β = 1.2, p = 0.001) temperament traits and an insecure attachment (ASQ-anxious: β = 0.19, p = 0.006; ASQ-avoidant: β = 0.07, p < 0.001) predicted pandemic-related distress.

    Conclusions 

    Dimensions of both affective temperaments and attachment styles were associated with stress in the medical students during the transition to the endemic phase. The investigations of these psychological variables provided new information regarding risk factors for endemic-related distress, and pointed to potential targets for counseling and developing programs to support the medical students' mental health.

    Citation: Carmenrita Infortuna, Xiaolin Yang, Ray Wang, Gianluca Pandolfo, Ilona Cazorla, Julian Dupont, Veolette Hanna, Valerie Iosim, Mirai Mikhail, Alex Yu, Stanley R. Terlecky, Florian P. Thomas, Jing Ren, Wenhua Cao, Zhiyong Han, Fortunato Battaglia. Medical students' distress during the transition to the endemic phase of COVID-19 in China: The association with temperament traits and attachment styles[J]. AIMS Public Health, 2025, 12(1): 1-15. doi: 10.3934/publichealth.2025001

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  • Objective 

    The transition of COVID-19 into the endemic phase in China has posed additional challenges to medical student's well-being, and increased the odds of mental distress. Although affective temperament traits and adult attachment styles accompany crisis-induced stress, whether this applies to medical students in the endemic phase has yet to be determined. The aim of present study is to test if temperament traits and adult attachment style can predict stress in Chinese medical students.

    Methods 

    Medical students (N = 402) enrolled in the undergraduate medical program at the Southern Medical University, Guangdong, China completed an online survey in May 2022. Most participants were female (62.4%), with a mean age of (21.3 ± 3.1). The individual temperament traits and adult attachment styles were assessed using the Chinese version of the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-auto-questionnaire short version (TEMPS-A), and the Attachment Style Questionnaire (ASQ).

    Results 

    The participants showed significant distress as assessed with the K10: 19 (15–24) (median, Q1, Q3). Furthermore, a multiple linear regression analysis indicated that cyclothymic (β = 2.1, p = 0.048) and depressive (β = 1.2, p = 0.001) temperament traits and an insecure attachment (ASQ-anxious: β = 0.19, p = 0.006; ASQ-avoidant: β = 0.07, p < 0.001) predicted pandemic-related distress.

    Conclusions 

    Dimensions of both affective temperaments and attachment styles were associated with stress in the medical students during the transition to the endemic phase. The investigations of these psychological variables provided new information regarding risk factors for endemic-related distress, and pointed to potential targets for counseling and developing programs to support the medical students' mental health.



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    Acknowledgments


    This study has not been funded by any agency and was conducted by the authors independently.

    Authors' contribution


    Carmenrita Infortuna: Conceptualization, Formal analysis, Critical review and editing, Writing original draft; Xiaolin Yang: Conceptualization, Supervision, Critical review and editing; Ray Wang: Data collection, Formal analysis, Critical review and editing; Gianluca Pandolfo: Supervision, Critical review and editing; Ilona Cazorla: Formal analysis, Critical review and editing; Julian Dupont: Formal analysis, Critical review and editing; Veolette Hanna: Formal analysis, Critical review and editing; Valerie Iosim: Formal analysis, Critical review and editing; Mirai Mikhail: Formal analysis, Critical review and editing; Alex Yu: Formal analysis, Critical review and editing; Stanley R. Terlecky: Supervision, Critical review and editing; Florian P. Thomas: Supervision, Critical review and editing; Jing Ren: Data collection, Critical review and editing; Wenhua Cao: Data collection, Critical review and editing; Zhiyong Han: Conceptualization, Supervision, Critical review and editing, Writing original draft; Fortunato Battaglia: Conceptualization, Supervision, Formal analysis, Writing original draft, Critical review and editing.

    Conflicts of interest


    The authors state that there is no conflict of interest in this document.

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