Psychological flexibility, neuroticism, and subjective well-being among medical students: a latent profile and mediation analysis

Medical students’ subjective well-being is closely associated with academic stress, psychological flexibility, and neuroticism; however, the heterogeneity of psychological flexibility and the potential indirect association through neuroticism remain underexplored. The present study, therefore, sought to examine the associations among psychological flexibility, neuroticism, and subjective well-being, and to examine whether neuroticism accounted for an indirect association between psychological flexibility and subjective well-being. A total of 3565 full-time medical students were recruited in China between September 2022 and March 2023 using a convenience sampling method. Psychological flexibility, neuroticism, and subjective well-being were assessed using validated self-report measures. Correlation and regression analyses were conducted, latent profile analysis was used to identify psychological flexibility profiles, and mediation analysis was performed to examine the indirect association through neuroticism. The results showed that the sample consisted mainly of females and undergraduate students. The latent profile analysis identified three psychological flexibility profiles: Moderate Psychological Flexibility (44.2%), High Psychological Flexibility (29.6%), and Psychological Inflexibility (26.2%). Subjective well-being differed significantly across the three profiles, with the High Psychological Flexibility profile reporting the highest scores and the Psychological Inflexibility profile the lowest. Mediation analysis indicated significant indirect associations between psychological flexibility and subjective well-being through neuroticism. The psychological flexibility of medical students is characterized by heterogeneity, and neuroticism showed a statistically significant indirect association between psychological flexibility and subjective well-being. The findings support the need for targeted psychological support for students with low psychological flexibility.