University of Utah School of Medicine, Salt Lake City, UT, USA.
Saint Louis University School of Medicine, St. Louis, MO, USA.
Acad Psychiatry. 2019 Aug;43(4):381-385. doi: 10.1007/s40596-019-01031-z. Epub 2019 Feb 6.
While medical student wellness has been a subject of recent study and discussion, current efforts may fail to address possible underlying, harmful cognitive distortions regarding academic performance. The authors sought to examine dysfunctional thoughts (maladaptive perfectionism, impostor phenomenon) and negative feelings (shame, embarrassment, inadequacy) that may contribute to poor mental health in pre-clinical medical students.
A survey was administered to first-year medical students at Saint Louis University that included assessments for maladaptive perfectionism, impostor phenomenon, depression, and anxiety, as well as questions about feelings of shame, embarrassment, inadequacy, comparison, and self-worth.
A total of 169 students (93%) participated. Students who met criteria for maladaptive perfectionism were significantly more likely to report greater feelings of shame/embarrassment and inadequacy (P < 0.001) than their peers who did not; similar associations were observed in students who reported high/intense levels of impostor phenomenon (P < 0.001). Furthermore, students who reported feelings of shame/embarrassment or inadequacy were significantly more likely to report moderate/severe levels of depression symptoms (P < 0.001) and moderate/high levels of anxiety symptoms (P = 0.001) relative to students who did not report these negative feelings.
These preliminary data support a model for how negative thoughts may lead to negative emotions, and depression and anxiety in medical students. The authors propose strategies for preventive interventions in medical school beginning in orientation. Further research is needed to develop targeted interventions to promote student mental health through reduction of cognitive distortions and negative feelings of shame, embarrassment, and inadequacy.
尽管医学学生的健康状况是最近研究和讨论的主题，但目前的努力可能无法解决与学业成绩相关的潜在有害认知扭曲问题。作者试图研究可能导致临床前医学生心理健康状况不佳的不良思维（适应不良的完美主义、冒名顶替综合征）和负面感受（羞耻感、尴尬感、不足感）。
圣路易斯大学的一年级医学生参与了一项调查，其中包括对适应不良的完美主义、冒名顶替综合征、抑郁和焦虑的评估，以及关于羞耻感、尴尬感、不足感、比较和自我价值感的问题。
共有 169 名学生（93%）参与了调查。符合适应不良完美主义标准的学生报告的羞耻感/尴尬感和不足感明显更强烈（P<0.001），而不符合这一标准的学生则没有；在报告有强烈冒名顶替综合征的学生中也观察到了类似的关联（P<0.001）。此外，报告有羞耻感/尴尬感或不足感的学生报告中度/重度抑郁症状（P<0.001）和中度/高度焦虑症状（P=0.001）的可能性明显高于没有报告这些负面感受的学生。
这些初步数据支持了一种模型，即消极思维如何导致医学生的消极情绪以及抑郁和焦虑。作者提出了在医学院开始迎新时进行预防干预的策略。需要进一步研究制定有针对性的干预措施，通过减少认知扭曲和羞耻感、尴尬感和不足感等负面感受，促进学生的心理健康。
