The Association between Psychological Suzhi and Psychological Distress among Students: A Systematic Review and Three-level Meta-analysis.

Psychological suzhi, a culturally rooted construct born of China’s quality-oriented education reform, denotes an integrated collection of positive psychological qualities in children and adolescents, forming a dynamic inner system buffers distress and fosters mental health. Numerous studies have investigated the relationship between psychological suzhi and psychological distress among students, yet a definitive consensus remains elusive. A three-level meta-analysis was conducted to synthesize results from existing research and examine the relationship. Moderator analysis was used to investigate potential sources of research heterogeneity. Through a systematic literature search, a total of 52 studies with 191 effect sizes were retrieved, and 136, 216 students from primary school to university (45.40% male, age range 8–26) were included. Results revealed a negative correlation between psychological suzhi and psychological distress (r = -0.367). The indicators of psychological distress (depressive symptoms, anxiety symptoms, social anxiety, negative affect and suicidal ideation), dimensions of psychological suzhi (cognitive quality, individuality quality and adaptability), psychological suzhi measurement tools (general version and healthy version), and types of study design (longitudinal study and cross-sectional study) significantly moderated the relationship. Moreover, the association between adaptability and depressive symptoms was moderated by gender (percentage of male participants). Specifically, the relationship between psychological suzhi and depressive symptoms was the closest, followed by the relationship with suicidal ideation, anxiety symptoms, social anxiety and negative affect. Individuality quality and adaptability are more strongly associated with psychological distress than cognitive quality. The correlation was more pronounced when using the healthy version of the psychological suzhi scale than the general version. The relationship between psychological suzhi and psychological distress was stronger in cross-sectional study than in longitudinal study. The relationship between adaptability and depressive symptoms was stronger among female students. Educational stages (primary school, secondary school, and university) showed no significant moderating effects. This meta-analysis suggested that cultivating psychological suzhi throughout students’ educational trajectories from primary school to university may help alleviate psychological distress, particularly depressive symptoms and suicidal ideation.