The Relationship Between Intolerance Of Uncertainty And Psychological Health Among Students In Two Medical Universities From China And Mongolia:The Moderating Role Of Self-compassion

Research BackgroundUncertainty is an inherent property of medical care,so cultivating medical students’ ability to cope with uncertainty is an important task of medical education.However,the current training of medical education for coping with uncertainty focuses on clinically specific coping skills,neglecting the cultivation of psychological tolerance for uncertainty and positive psychological coping resources.In the context of humans struggling with COVID-19,it is of great practical relevance to study how to enhance medical students’ psychological ability to cope with uncertainty in more targeted ways.Intolerance of uncertainty is a negative factor that affects individuals’ mental health,increasing their level of depression and anxiety and decreasing their level of well-being.In recent years,studies have shown controversies in the effects of prospective anxiety and inhibitory anxiety as two factors of intolerance of uncertainty on mental health,which need to be clarified.In addition,self-compassion is considered to be an effective psychological resource for coping with uncertain threats,and how the positive and negative components of self-compassion,as two different ways of dealing with uncertain threats,interact with prospective anxiety and inhibitory anxiety affect mental health has not been investigated.In this study,we used the two-factor structure of intolerance of uncertainty and self-compassion to investigate the relationship between intolerance of uncertainty and mental health,and the moderating effect of self-compassion at both positive and negative mental health levels,which has theoretical and practical value in examining this influence mechanism comprehensively.Research ObjectiveTo understand the influence of the tolerance of uncertainty of medical students on their mental health and whether self-compassion can moderate this relationship as an effective psychological resource,the present study examined the mental health,intolerance of uncertainty and self-compassion among medical students from two medical universities in China and Mongolia,and respectively investigated the relationship between intolerance of uncertainty(prospective anxiety and inhibitory anxiety)and mental health(depression,anxiety and flourishing)and the possible moderating role of self-compassion(positive component and negative component)among Chinese and Mongolian medical students.The results were discussed from the perspective of relevant theories and the cultural differences between China and Mongolia,which will help to enhance the psychological coping skills of medical students in the face of uncertainty and improve mental health education based on cultures in China and Mongolia.Subject and methodsA total of 932 medical students from a medical university in China and 504 medical students from universities in Mongolia were selected by convenient sampling to conduct the study with a self-designed general information questionnaire,shortform intolerance of uncertainty scale,self-compassion scale,patient health questionnaire,generalized anxiety disorder questionnaire,and flourishing scale.Multivariate analysis of variance was used to examine the mental health,intolerance of uncertainty and self-compassion of medical students in two medical universities in China and Mongolia,and multilevel regression analysis was used to investigate the moderating role of self-compassion on the relationship between intolerance of uncertainty and the mental health of Chinese and Mongolian medical students.Results(1)Mongolian medical students had significantly higher levels of depression and anxiety than Chinese medical students,and there was no significant difference between the two medical universities’ students in terms of their level of flourishing.(2)The significant main effect of the subjective family economic level was found on medical students’ mental health,intolerance of uncertainty and selfcompassion.Overall,the higher the subjective family economic level of medical students,the higher the level of flourishing and positive component of selfcompassion,and the lower the level of depression,anxiety,prospective anxiety,inhibitory anxiety,and the negative component of self-compassion.(3)The significant interaction of nationality and family living location was found in depression,anxiety,inhibitory anxiety and the negative component of selfcompassion.Mongolian medical students living in urban areas had significantly higher levels of depression,anxiety,inhibitory anxiety and the negative component of self-compassion compared with those whose families lived in rural areas.No significant urban-rural differences existed for Chinese medical students on any of these variables.(4)Among Chinese and Mongolian medical students,inhibitory anxiety was significantly positively related to depression and anxiety,and significantly negatively related to flourishing.Chinese medical students’ prospective anxiety was significantly positively correlated with depression,anxiety and flourishing,while Mongolian medical students’ prospective anxiety was significantly positively correlated with depression and anxiety,but not significantly correlated with flourishing.(5)Among Chinese medical students,a significant moderating role of the positive component of self-compassion was found in the relation between inhibitory anxiety and depression,anxiety and flourishing,and the relation between prospective anxiety and anxiety,flourishing.Specifically,the positive component of selfcompassion weakened the positive relationship between inhibitory anxiety and depression as well as anxiety,and enhanced the negative relationship between inhibitory anxiety and flourishing;In addition,the positive component of selfcompassion enhanced the positive relationship between prospective anxiety and anxiety,and weakened the positive relationship between prospective anxiety and flourishing.No significant moderating effect of self-compassion on the relationship between intolerance of uncertainty and mental health was found among Mongolian medical students.Conclusions(1)Mental health situations of medical students in both China and Mongolia were far from optimistic,especially Mongolian medical students having significantly higher levels of depression and anxiety.However,both Chinese and Mongolian medical students have moderate to high levels of flourishing.(2)Of the two factors of intolerance of uncertainty,inhibitory anxiety was the less adaptive factor,strongly relating to depression and anxiety and flourishing among students in Chinese and Mongolian medical universities.Prospective anxiety of medical students has both positive and negative effects on their mental health,specifically can increase the level of depression,anxiety and flourishing.The positive effect of medical students’ prospective anxiety on increasing flourishing was more pronounced in the Chinese cultural context,which emphasizes long-term orientation.(3)In China,the positive component of self-compassion of medical students can buffer the negative effects of inhibitory anxiety on mental health but enhance the negative influence of prospective anxiety on mental health.(4)No significant moderating effect of self-compassion on the relation between intolerance of certainty and mental health was found among Mongolian medical students.