The Mediating Role of Resilience in the Relationship between Big Five Personality and Anxiety among Chinese Medical Students: A Cross-Sectional Study

BACKGROUNDS The psychological distress of medical students is a major concern of public health worldwide. However, few studies have been conducted to evaluate anxiety symptoms of medical students in China. The purpose of this study was to investigate the anxiety symptoms among Chinese medical students, to examine the relationships between big five personality traits and anxiety symptoms among medical students, and to explore the mediating role of resilience in these relationships. METHODS This multicenter cross-sectional study was conducted in June 2014. Self-reported questionnaires consisting of the Zung Self-Rating Anxiety Scale (SAS), Big Five Inventory (BFI), Wagnild and Young Resilience Scale (RS-14) and demographic section were distributed to the subjects. A stratified random cluster sampling method was used to select 2925 medical students (effective response rate: 83.57%) at four medical colleges and universities in Liaoning province, China. Asymptotic and resampling strategies were used to explore the mediating role of resilience. RESULTS The prevalence of anxiety symptoms was 47.3% (SAS index score≥50) among Chinese medical students. After adjusting for the demographic factors, the traits of agreeableness, conscientiousness and openness were all negatively associated with anxiety whereas neuroticism was positively associated with it. Resilience functioned as a mediator in the relationships between agreeableness/conscientiousness/openness and anxiety symptoms. CONCLUSIONS Among Chinese medical students, the prevalence of anxiety symptoms was high and resilience mediated the relationships between big five personality traits and anxiety symptoms. Identifying at-risk individuals and undertaking appropriate intervention strategies that focus on both personality traits and resilience might be more effective to prevent and reduce anxiety symptoms.