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ORIGINAL RESEARCH article
Front. Psychiatry
Sec. Public Mental Health
Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1560653
The Mediating Role of Feelings of Hopelessness and Repetitive Negative Thinking in the Relationship between Perfectionism and Depressive Symptoms among Medical Students with Suicidal Ideation
Provisionally accepted
Ali Hosseinzadeh Oskouei 1
Reyhaneh Sardarzehi 1 Mohammad Sadegh Zamani Zarchi 2
Seyed Alireza Tavallaei Zavareh 1
Jamal Shams 3
Amir Sam Kianimoghadam 1
Abbas Masjedi Arani 1*- 1 Department of Clinical Psychology, Shahid Beheshti University of Medical Science, Tehran, Alborz, Iran
- 2 Faculty of Psychology and Educational Sciences, Kharazmi University, Tehran, Alborz, Iran
- 3 Behavioral Science Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Alborz, Iran
Background: Perfectionism and depressive symptoms are among psychological concerns in medical students with suicidal ideation. While studies suggest a link between perfectionism and depression, the role of mediating mechanisms remains unclear.Objective: This study aimed to examine the mediating role of hopelessness and repetitive negative thinking in the relationship between perfectionism and depressive symptoms among Iranian medical students.The research employed a descriptive-correlational design using structural equation modeling (SEM). The study population comprised all medical students in Tehran in 2024, from which 355 individuals were selected through purposive sampling. Data were collected using the Beck Scale for Suicidal Ideation (BSSI), Tehran Multidimensional Perfectionism Scale (TMPS), Beck Depression Inventory (BDI-II), Repetitive Negative Thinking Questionnaire (RNTQ), and the Beck Hopelessness Scale (BHS). The data were analyzed using structural equation modeling.The results indicated that the proposed model demonstrated an excellent fit, and perfectionism was significantly and directly associated with depressive symptoms (p < 0.01). Additionally, perfectionism indirectly predicted depressive symptoms (p < 0.001) through hopelessness (β = 0.35) and repetitive negative thinking (β = 0.37). Together, perfectionism, hopelessness, and repetitive negative thinking accounted for 58% of the variance in depressive symptoms (R² = 0.58).Conclusions: These findings suggest that perfectionism contributes to an increase in depressive symptoms both directly and indirectly, by intensifying feelings of hopelessness and repetitive negative thinking.
Keywords: Depression, Hopelessness, Medical students, Negative thinking, perfectionism, Suicidal Ideation
Received: 14 Jan 2025; Accepted: 27 Mar 2025.
Copyright: © 2025 Hosseinzadeh Oskouei, Sardarzehi, Zamani Zarchi, Tavallaei Zavareh, Shams, Kianimoghadam and Masjedi Arani. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Abbas Masjedi Arani, Department of Clinical Psychology, Shahid Beheshti University of Medical Science, Tehran, 198396-3113, Alborz, Iran
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