Abstract
BACKGROUND: Chinese medical students face rigorous academic demands and exacting professional challenges, which lead to significant psychological stress. Understanding perceived stress and psychological resilience is key to enhancing emotional regulation and empathy. This study explores the hypothesis that psychological resilience impacts the perceived stress of medical students, with the Optimistic Intelligence Quotient (OQ) and the Adversity Quotient (AQ) acting as serial mediators, thereby promoting students' mental health. METHODS: A questionnaire survey was conducted to assess psychological resilience, perceived stress, OQ, and AQ among students from the top 20 medical colleges in mainland China. Using random sampling, 60 students per institution were selected, yielding 1,024 valid responses from 1,200 distributed questionnaires. Data were analyzed using correlation and mediation analysis. RESULTS: The results showed a significant negative correlation between psychological resilience and perceived stress. OQ was significantly associated with reduced stress and enhanced overall well-being, while AQ was related to stress management skills.A serial mediation pathway was identified from psychological resilience to OQ and AQ, forming a chain influencing perceived stress. CONCLUSIONS: This study highlights the current psychological stress among Chinese medical students and the serial mediating roles of OQ and AQ. Tailored interventions in medical education should focus on enhancing psychological resilience to reduce perceived stress. Future research should explore alternative frameworks in positive psychology and develop new stress management intervention models.