The Chain Mediating Role Of Self-esteem And Rumination Between Childhood Psychological Maltreatment And Suicidal Ideation Among Medical Students

Around 800,000 people worldwide die by suicide each year.College students are two to four times more likely to commit suicide than the general population,and the rate is on the rise.Suicidal ideation is the thought and idea related to the end of life,and it is the inevitable psychological process of suicidal behavior.Although suicidal ideation has not been put into practice and is in the cognitive stage,it is helpful for early assessment of suicide risk and effective warning of psychological crisis.As the saying goes,"The doctor does not cure himself,and the ferry is difficult to cross himself." As the main force and talent reserve of medical and health services in the future,the mental health of medical students is particularly important and not optimistic.Childhood psychological maltreatment will accompany the growth of individuals and have a negative impact on them,leading to the formation of suicidal ideation.As an important indicator of individual mental health,low suicide risk can help medical students to correctly accept their own growth experience and improve their sense of intrinsic value in advance,guide them to establish a good thinking feedback mode,help medical students to build a self-motivation and protection mechanism,and help medical students to prevent stressful events in the future work mode.However,there are relatively few studies on the relationship between childhood psychological maltreatment and suicidal ideation among medical students.The Childhood Psychological Maltreatment Scale(CPMS),the Self-rating Idea of Suicide Scale(SIOSS),the Self-Esteem Scale(SES)and the Rumination Response Scale-Chinese Version(RRS-CV)were used for testing.1029 medical subjects were selected from medical colleges and universities in Nanchang,Ganzhou and other places to respond.Data analysis is performed using SPSS26.0,Mplus7.4,plug-ins for Process macros,etc.Studies have shown that:(1)The positive rate of childhood psychological maltreatment among medical students was 34.98%,the significant positive rate was 8.55%,and the overall reported rate of suicidal ideation was 10.30%.(2)Medical students of different genders had significant differences in the dimensions of connivance,obsessive thinking and despair.Medical students of different grades and family structure had significant differences in the scores of childhood psychological maltreatment and its dimensions(except connivance).The scores of rumination and its dimensions were significantly different among medical students of different grades.Different family structures affect the scores of medical students in selfesteem,suicidal ideation and despair dimensions.At the level of parents’ education,the scores of medical students in the dimension of neglect and interference showed significant differences;Being the only child or not and the place of origin can only affect the scores of medical students on the neglect dimension.(3)There is a significant correlation between variables and each dimension.Childhood psychological maltreatment can positively predict rumination and suicidal ideation and negatively predict self-esteem.Self-esteem negatively predicted rumination and suicidal ideation.Rumination can positively predict suicidal ideation.(4)Childhood psychological maltreatment can directly affect the suicidal ideation of medical students,and can also indirectly affect the suicidal ideation of medical students through the partial mediating effect and the chain mediating effect of selfesteem and rumination.In the mediation model,the indirect effect of each intermediary path accounted for 36.04%,31.98% and 11.38% of the total effect,respectively.This study is based on medical college students,on the basis of previous studies and theories,the protective factors and risk factors affecting medical students’ suicidal ideation are integrated,and the chain mediation model of self-esteem and rumination is constructed.This paper discusses the internal influence mechanism of childhood psychological maltreatment and suicidal ideation,in order to arouse the attention of all circles to childhood psychological maltreatment,provide reference clues for timely evaluation and prediction of suicidal ideation,and effectively help medical students "self-medicine" and "self-redemption",so as to maintain the physical and mental health of medical students and ensure the healthy development of Chinese medicine and health undertakings.