Abstract
OBJECTIVE: Suicidal ideation, with an estimated prevalence of 25%, has become a significant concern among medical students in Iran, underscoring the urgent need to identify its underlying contributing factors in this population. The present study was conducted with the aim of investigating the mediating role of repetitive negative thinking and feelings of loneliness in the relationship between perfectionism and suicidal ideation among Iranian medical students. METHOD: The current study employed a descriptive-correlational design utilizing structural equation modeling (SEM). The study population consisted of all medical students of Shahid Beheshti University of Medical Sciences (SBMU) in Tehran in 2024. From this population, 505 individuals were selected through a convenience sampling method. Tehran Multidimensional Perfectionism Scale (TMPS, 2007), Beck Scale for Suicidal Ideation (BSSI, 1997), Repetitive Negative Thinking Questionnaire (RNTQ, 2010) and UCLA Loneliness Scale (UCLA-LS, 1980) were used to collect data. Data were analyzed using structural equation analysis. RESULTS: Based on the results, 150 individuals (29.7%) reported no suicidal ideation, while 355 individuals (70.3%) reported experiencing suicidal ideation. The findings also showed that the research model had a excellent goodness of fit. Although perfectionism was not directly related to suicidal ideation (p > 0.01), it could indirectly affect suicidal ideation in medical students (p > 0.001) through repetitive negative thinking (β = 0.14) and feelings of loneliness (β = 0.19). In addition, perfectionism, repetitive negative thinking and feelings of loneliness explained a total of 30% of the variance in suicidal ideation (R(2) = 0.301). CONCLUSION: Based on the above findings, it can be concluded that the perfectionism leads to an increase in suicidal ideation among medical students by increasing repetitive negative thinking and feelings of loneliness. Accordingly, it is recommended that psychotherapists and policymakers give focused attention to these mediating factors to effectively reduce suicidal ideation in perfectionistic medical students.