The impact of social support on academic burnout among medical students: the mediating effects of anxiety and depression, and the role of urban-rural differences

Purpose An increasing amount of evidence suggests that the prevalence of academic burnout among adolescents is on the rise, especially among high-pressure student groups such as medical students. This study examined the protective effect of social support on academic burnout, the mediating impacts of anxiety and depression in this relationship, and the role of urban-rural differences from medical students. Methods We conducted a cross-sectional study, including 1883 medical students. Data were collected using validated self-report questionnaires assessing social support, anxiety, depression, and academic burnout. Perform Pearson correlation analysis and structural equation modeling to examine the associations between social support, anxiety, depression, and academic burnout. And group difference analysis was used in structural equation modeling to explore the impact of urban-rural differences on these relationships. Results Correlation analysis revealed a significant negative correlation between social support and academic burnout (r=-0.352, p < 0.001). And anxiety and depression showed positive correlations with academic burnout (r=0.509, p < 0.001 and r=0.569, p < 0.001, respectively). The mediation model indicated that social support had a significant negative impact on academic burnout ( β= -0.174, 95%CI=-0.215, -0.134). Depression partially mediated the relationship between social support and academic burnout ( β= -0.153, 95%CI=-0.194, -0.125). Group difference analysis showed that urban-rural differences significantly influenced the relationship between social support and depression (CRD = 2.151, p < 0.05). Conclusion Social support negatively predicted academic burnout, with depression playing a mediating role. Urban-rural differences had a significant impact on the relationship between social support and depression. Intervention measures should focus on improving social support level and regulating depressive symptoms, and adopting targeted approaches for urban and rural medical students.