Fear of Intimacy, Self-Identity, and Self-Disclosure among Chinese Medical College Students

Medical students face unique interpersonal challenges due to academic intensity and clinical training demands, yet the mechanisms linking self-identity, self-disclosure, and fear of intimacy in this population remain underexplored. This study examined the relationships among fear of intimacy (FOI), self-identity (SI), and self-disclosure (SD) and tested the mediating role of self-disclosure in the association between self-identity and fear of intimacy. A descriptive-correlational design was employed with 847 medical students (63.8% female; ages 17–25) recruited from a university in Guangdong, China. Participants completed the Fear of Intimacy Scale (FIS), Extended Objective Measure of Ego Identity Status-2 (EOM-EIS-2), and Self-Disclosure Index (SDI). Results indicated moderate-to-high FOI levels (M = 100.16, SD = 15.18) and moderate SD levels (M = 39.02, SD = 8.76). Self-identity was characterized by relatively higher identity moratorium and achievement scores, with lower identity foreclosure. FOI correlated negatively with SD (r = -0.347, p < .001) and identity achievement (r = -0.235, p < .001), and positively with identity diffusion (r = 0.227, p < .001). Mediation analysis indicated that self-disclosure statistically mediated the association between self-identity (operationalized as an index derived from the EOM-EIS-2) and fear of intimacy (indirect effect = 1.101, 95% CI [0.555, 1.817]), with the direct effect becoming non-significant after accounting for self-disclosure. These findings suggest that identity development may influence intimacy-related anxiety primarily through its association with emotional expression patterns. Psychological interventions targeting medical students' emotional communication skills and identity integration may help reduce fear of intimacy and support interpersonal adaptation.