| Summary: | Subthreshold depression represents specific depressive symptoms in
individuals that fall short of meeting the diagnostic criteria for major depression and
is highly prevalent among medical students facing heavy workloads and competitive
pressures. This study examined the relationships among subthreshold depression,
stressors, resilience, burnout, negative emotion regulation, and negative coping
styles, and evaluated the effect of Tai Chi among Chinese medical students. The
study also investigated the effect of Tai Chi intervention on subthreshold depression
among students at Jiangsu Medicine College in Yancheng City through two study
phases: a cross-sectional survey and a subsequent randomized controlled trial. In the
phase 1,811 participants completed questionnaires, which were translated using
forward and backward translation methods, and a structural equation model was used
to examine the relationships between study variables. The Chinese version of the
Center for Epidemiology Research Self-Rating Depression Scale (CES-D), Medical
Student Stressor Questionnaire (MSSQ), Medical Professionals Resilience Scale
(MeRS), Oldenburg Burnout Inventory (OLBI), Cognitive Emotion Regulation
Questionnaire (CERQ), and Simple Coping Style Questionnaire (SCSQ) were used
to measure subthreshold depression, stressors, resilience, burnout, emotion
regulation, and coping styles among medical students. After establishing the validity
and reliability of the questionnaires and determining the relationships between variables, the second phase of the study was conducted. The phase 2 assessed the
effectiveness of Tai Chi intervention on subthreshold depression among medical
students. A randomized controlled trial was conducted with 72 participants who were
randomly assigned to either a 10-week Tai Chi program (three 40-minute sessions
per week) or a no-intervention control group. Both groups completed questionnaires
before and after the intervention. Data analysis was conducted using SPSS 29.0 and
Mplus 8.3 software. Repeated measures analysis of variance (RM ANOVA) and
repeated measures multivariate analysis of variance (RM MANOVA) were used to
analyse the results of Phase 2. In the phase 1, the final structural model showed good
fit with the data ( c2/df = 1.446, CFI = 0.984, TLI = 0.982, RMSEA = 0.023, SRMR
= 0.030), revealing that stressors, burnout, negative emotion regulation, and negative
coping styles were positively associated with subthreshold depression, whereas
resilience was negatively associated. In the second phase, there were significant time
and interaction effects for subthreshold depression, stressors, negative coping styles,
and resilience (p < 0.001), burnout was significant in the interaction effect (p <
0.001), and negative emotion regulation was significant in the group effect (p <
0.001). In summary, this study: 1) confirmed the reliability and validity of the above
scales among Chinese medical students; 2) revealed the relationships among
subthreshold depression, stressors, resilience, burnout, negative emotion regulation,
and negative coping styles; and 3) emphasised the positive effects of a 10-week Tai
Chi course in reducing the level of subclinical depression among Chinese medical
students
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