Given the growing mental health challenges in medical education, this study examined the mechanisms linking academic stress to depressive mood in 484 medical students, focusing on serial mediation by rumination and ego depletion. Using validated scales, we found that academic stress is positively related to depressive mood, with rumination and ego depletion serving as mediators. Structural equation modeling further indicated that academic stress can exacerbate the occurrence of depressive mood through a serial mediated pattern of rumination and ego depletion. The total indirect effect explained 82.01% of the overall association, with the serial pathway accounting for 25.93%. The mediation model verified by this study clarified the mechanism of cognitive resource depletion underlying the association between academic stress and depressive mood in medical students and provided a theoretical basis for developing targeted interventions (e.g. cognitive-behavioral interventions to reduce rumination and self-regulation enhancement to mitigate ego depletion).
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