Psychology research and behavior management · 2026
The Effect of Negative Perfectionism on Hollow Syndrome in Medical Students: Serial Mediation of Self-Esteem and Achievement Motivation and Moderating Role of Subjective Well-Being.
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Bai Haoge, Jin Yan, Wang Yiju, Xie Hui, Meng Yang, Xu Yinan, Sun Hao
Аннотация
BACKGROUND: Hollow Syndrome is a prevalent psychological adjustment problem in medical students, while the mechanism underlying the association between negative perfectionism (a common personality trait in medical education) and this condition remains unclear.
METHODS: A total of 2977 medical students from a medical university in Shandong, China were recruited via cluster sampling. Data were collected using the Chinese Hollow Syndrome Questionnaire (CHQ), Chinese Frost Multidimensional Perfectionism Scale (CFMPS), Self-Esteem Scale (SES), Achievement Motivation Scale (AMS), and Subjective Well-being Scale for Chinese Citizens (SWBS-CC20). Serial mediation and moderated mediation analyses were conducted using SPSS 26.0 and the PROCESS macro.
RESULTS: Negative perfectionism was significantly negatively associated with Hollow Syndrome symptom scores (lower scores indicate more severe symptoms). Self-esteem and achievement motivation mediated the association through three distinct pathways, with the total indirect effect accounting for 74.26% of the total effect; the direct effect of negative perfectionism was not statistically significant after including the mediators, indicating a full mediation pattern. Subjective well-being significantly moderated both the pathway from self-esteem to Hollow Syndrome and the pathway from achievement motivation to Hollow Syndrome, with the strength of all three indirect effects decreasing as subjective well-being increased.
CONCLUSION: Negative perfectionism is associated with more severe Hollow Syndrome among medical students, mainly through reduced self-esteem and achievement motivation, and subjective well-being acts as a protective buffer against this adverse association. These findings provide clear, actionable targets for mental health interventions among medical students, and offer an empirical basis for alleviating Hollow Syndrome by protecting self-esteem, enhancing achievement motivation, and fostering subjective well-being.
METHODS: A total of 2977 medical students from a medical university in Shandong, China were recruited via cluster sampling. Data were collected using the Chinese Hollow Syndrome Questionnaire (CHQ), Chinese Frost Multidimensional Perfectionism Scale (CFMPS), Self-Esteem Scale (SES), Achievement Motivation Scale (AMS), and Subjective Well-being Scale for Chinese Citizens (SWBS-CC20). Serial mediation and moderated mediation analyses were conducted using SPSS 26.0 and the PROCESS macro.
RESULTS: Negative perfectionism was significantly negatively associated with Hollow Syndrome symptom scores (lower scores indicate more severe symptoms). Self-esteem and achievement motivation mediated the association through three distinct pathways, with the total indirect effect accounting for 74.26% of the total effect; the direct effect of negative perfectionism was not statistically significant after including the mediators, indicating a full mediation pattern. Subjective well-being significantly moderated both the pathway from self-esteem to Hollow Syndrome and the pathway from achievement motivation to Hollow Syndrome, with the strength of all three indirect effects decreasing as subjective well-being increased.
CONCLUSION: Negative perfectionism is associated with more severe Hollow Syndrome among medical students, mainly through reduced self-esteem and achievement motivation, and subjective well-being acts as a protective buffer against this adverse association. These findings provide clear, actionable targets for mental health interventions among medical students, and offer an empirical basis for alleviating Hollow Syndrome by protecting self-esteem, enhancing achievement motivation, and fostering subjective well-being.