{
  "abstract": "Background: Childhood adversity is a well-established distal determinant of suicide risk, yet the proximal psychological mechanisms linking it to suicidal vulnerability during medical training remain poorly understood.\n\nObjective: To examine whether depressive symptoms, anxiety symptoms, and perceived academic stress mediate the association between childhood emotional and physical maltreatment with suicide risk among medical students.\n\nMethods: This cross-sectional study included 670 second year medical students from a large public university in Mexico, assessed with validated measures of childhood maltreatment (CTQ-SF), depressive symptoms (PHQ-9), anxiety symptoms (GAD-7), academic stress (SISCO Inventory), and suicide risk (Plutchik Suicide Risk Scale). Group comparisons used chi-square and independent-samples t tests; parallel multiple mediation analyses were conducted using PROCESS (Model 4) with 5,000 bias-corrected bootstrap resamples.\n\nResults: Overall, 26.0% of students were classified at high suicide risk (Plutchik score ≥ 6). Compared with low-risk students, those at high risk reported greater childhood emotional and physical maltreatment, more severe depressive and anxiety symptoms, and higher academic stress. Parallel mediation analyses showed significant indirect effects of both emotional and physical maltreatment on suicide risk through psychological distress, with bootstrap 95% confidence intervals excluding zero. All three specific indirect pathways through depressive symptoms, anxiety symptoms, and academic stress were statistically significant in both models, with depressive symptoms showing the largest specific indirect effects [emotional: B = 0.08, 95% CI (0.06, 0.10); physical: B = 0.12, 95% CI (0.08, 0.16)].\n\nConclusions: Depressive symptoms, anxiety symptoms, and academic stress partially mediate the association between childhood maltreatment and suicide risk among medical students. These findings identify psychological distress as a clinically relevant and potentially modifiable pathway linking early adversity to suicide risk and support trauma-informed prevention strategies that integrate early detection and management of psychological distress within medical education.",
  "abstract_shown": true,
  "affiliations": [
    "Departamento de Genética, Dirección y Subdirección de Investigaciones Biomédicas en Salud Mental, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico",
    "Laboratorio de Epidemiología Clínica, Dirección y Subdirección de Investigaciones Biomédicas en Salud Mental, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico",
    "Departamento de Fisiología, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, Mexico"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Gabriela A. Martínez-Levy"
    },
    {
      "affs": [
        1
      ],
      "name": "Ana Fresán-Orellana"
    },
    {
      "affs": [
        0
      ],
      "name": "Magdalena Briones-Velasco"
    },
    {
      "affs": [
        2
      ],
      "name": "Pedro G. Romero-Silva"
    },
    {
      "affs": [
        2
      ],
      "name": "Diana P. Guizar-Sánchez"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/8na6x14s6kk8q.bib",
  "cited_by": 0,
  "doi": "10.3389/fpsyg.2026.1970728",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13731280/",
  "id": "8na6x14s6kk8q",
  "issns": [
    "1664-1078"
  ],
  "landing_url": "https://doi.org/10.3389/fpsyg.2026.1970728",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "3203|Suicide and Self-Harm Studies"
    ]
  ],
  "openalex": "W7223133533",
  "pdf_url": "https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2026.1970728/pdf",
  "pmcid": "PMC13731280",
  "pmid": "42984782",
  "published": "2026-10-21",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/8na6x14s6kk8q.ris",
  "sources": [
    {
      "first_seen": "2026-11-08T12:21:30Z",
      "native_id": "PMC13731280",
      "source": "pmc",
      "url": "https://doi.org/10.3389/fpsyg.2026.1970728"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:3203|Suicide and Self-Harm Studies",
      "subfield": "psychiatry"
    }
  ],
  "title": "Early wounds, minds in training: childhood adversity and the mediating effect of psychological distress in suicidal risk among medical students",
  "title_text": "Early wounds, minds in training: childhood adversity and the mediating effect of psychological distress in suicidal risk among medical students",
  "type": "peer-reviewed",
  "updated_at": "2026-11-08T12:21:30Z",
  "url": "https://research.draconitic.com/paper/8na6x14s6kk8q",
  "venue": "Frontiers in Psychology",
  "versions": []
}