Basic psychological needs and psychache: associations with cognitive reappraisal and stress mindset in a cross-sectional sample

Introduction: This study examined the associations between basic psychological needs (BPN) and psychache among medical students and tested whether cognitive reappraisal statistically accounted for part of this association and whether these associations varied across levels of stress mindset. Methods: A cross-sectional survey was conducted among medical students from five medical schools in Shandong Province, China. A total of 2,157 valid questionnaires were included in the analyses. Structural equation modeling was used to test the hypothesized associations. Results: Higher BPN was associated with lower psychache. Higher BPN was also associated with greater cognitive reappraisal, which in turn was associated with lower psychache. The indirect association via cognitive reappraisal was significant at low and average levels of stress mindset, but not at high levels. In addition, the negative associations of both BPN and cognitive reappraisal with psychache were weaker at higher levels of stress-is-enhancing mindset. Discussion: These findings suggest that motivational resources, emotion regulation, and stress-related beliefs should be considered jointly when examining psychache in medical students. Because all variables were assessed at one time point in a geographically restricted and educationally homogeneous sample, the findings should be interpreted as context-specific cross-sectional associations rather than evidence of temporal or causal processes.