The Association Between Academic Stress and Perceived Academic Impairment: Eating Behaviors as Indirect Pathways in Health Sciences Students

Academic stress has been associated with psychological distress, unhealthy behaviors, and poorer academic functioning among university students, particularly in health sciences programs. This study examined the association between academic stress and perceived academic impairment, considering five eating behavior phenotypes as parallel indirect pathways. A quantitative cross-sectional study was conducted with 225 undergraduate health sciences students from a public university in southeastern Mexico. Academic stress was assessed using the SISCO Academic Stress Inventory, eating behavior phenotypes using the Eating Behavior Phenotypes Scale, and perceived academic impairment using the recoded University Academic Performance Scale. Parallel multiple-mediator path analysis with bootstrap confidence intervals was performed, adjusting for relevant sociodemographic and academic covariates. Academic stress was positively associated with all five eating behavior phenotypes, which were, in turn, positively associated with perceived academic impairment. The total indirect effect was significant, and all specific indirect pathways were supported by bootstrap confidence intervals excluding zero. The direct association between academic stress and perceived academic impairment also remained significant. These findings suggest that multidimensional eating behavior may represent an important mechanism linking academic stress with perceived academic impairment. Given the cross-sectional design, the findings should be interpreted as indirect associations rather than evidence of causal or temporal mediation.