The Associations Between Psychological Distress and Academic Burnout: A Mediation and Moderation Analysis

Figures & data

Figure 1 (A) The conceptual framework. (B) Factor scores by three latent profile. (C) The mediation model.

Table 1 Difference of Demographic Factors in Academic Burnout (Univariable Analysis)

Variables	N (%)	Academic Burnout Mean (SD)	P
Majors			0.731
Medical	499 (81.4%)	22.89 (8.76)
Nonmedical	114 (18.6%)	22.58 (8.13)
Gender			0.118
Male	283 (46.2%)	22.72 (8.99)
Female	330 (53.8%)	22.92 (8.35)
Education			0.863
Postgraduate	335 (54.6%)	22.98 (8.60)
Bachelor	278 (45.4%)	22.65 (8.71)
Grades			0.160
Year 1	231 (37.7%)	22.98 (8.11)
Year 2	139 (22.7%)	22.37 (8.02)
Year 3	171 (27.9%)	22.58 (9.64)
Year 4	54 (8.8%)	25.13 (8.17)
Year 5	18 (2.9%)	19.83 (10.54)
Birthplace			0.706
Town	300 (48.9%)	22.82 (8.87)
Village	313 (51.1%)	22.84 (8.44)
One-child family			0.816
Yes	164 (26.8%)	22.54 (8.39)
No	449 (73.2%)	22.94 (8.74)
Family income			0.355
≤2000	38 (6.2%)	25.05 (10.85)
2001–5000	162 (26.4%)	23.07 (8.90)
5001–10,000	246 (40.1%)	22.65 (8.49)
>10,000	167 (27.2%)	22.35 (8.02)
Working-experience			0.465
Yes	180 (29.4%)	23.53 (8.69)
No	433 (70.6%)	22.54 (8.62)
Marital status			0.867
Yes	15 (2.4%)	23.20 (5.08)
No	598 (97.6%)	22.82 (8.72)
Family parenting			0.707
Democratic	532 (82.8%)	22.48 (8.62)
Authoritarian	81 (13.2%)	25.10 (8.51)
Major choice			0.022
Yes	347 (56.6%)	23.88 (8.11)
No	266 (43.4%)	22.02 (8.96)
Performance			<0.001
A	136 (22.2%)	19.53 (8.98)
B	336 (54.8%)	22.85 (7.62)
C	141 (23%)	25.97 (9.45)
Relationship			<0.001
Good	141 (23%)	18.58 (8.94)
Not bad	361 (58.9%)	23.07 (7.92)
Not really good	111 (18.1%)	27.43 (8.01)

Table 2 Results of Significant Demographics (P < 0.1) by Multiple Linear Regression

Model	B	P	OR (95% CI)
Constant	28.105	<0.001	(26.248, 29.962)
Major choice	−0.654	0.333	(−1.979, 0.672)
Performance
A	−4.155	<0.001	(−6.169, −2.142)
B	−2.034	0.014	(−3.662, −0.405)
C	Reference
Relationship
Good	−7.255	<0.001	(−9.351, −5.160)
Not bad	−3.140	0.001	(−4.912, −1.369)
Not really good	Reference

Note: Bold text: highlight the variables with significance at p < 0.05 level in the multiple linear regression model.

Table 3 Differences in Academic Burnout Among Three Personality Types

Variables	Academic Burnout
	N (%)	(X±SD)
Under-controlled ①	223 (36.4%)	28.43±7.50
Resilient ②	82 (13.4%)	13.12±7.18
Over-controlled ③	308 (50.2%)	21.36±6.67
Statistic (p value)		F= 154.515 (p < 0.001)
Post-hoc test		① > ③> ② (p < 0.001)

Note: Bold text: highlight the significance (p<0.05) of the statistical results.

Table 4 Correlations Among Psychological Distress, Resilience and Academic Burnout

	Mean	SD	1	2	3	4	5	6
1.Resilience	25.87	5.64	1	−0.51**	−0.56**	−0.42**	−0.38**	−0.52**
2.Psychological distress	19.43	6.59	−0.51**	1	0.55**	0.47**	0.46**	0.37**
3.Academic burnout	22.83	8.64	−0.56**	0.55**	1	0.79**	0.83**	0.74**
4.Emotional exhaustion	7.82	3.55	−0.42**	0.47**	0.79**	1	0.58**	0.32**
5.Depersonalization	5.31	3.57	−0.38**	0.46**	0.83**	0.58**	1	0.41**
6.Low personal accomplishment	9.70	3.80	−0.52**	0.37**	0.74**	0.32**	0.41**	1

Note: **Significance at the 0.01 level (2-tailed).

Table 5 Direct and Indirect Effect of Psychological Distress on Three Dimensions of Academic Burnout

Models	Resilience			Emotional Exhaustion			Depersonalization			Low Personal Accomplishment
	B	SE	p	B	SE	p	B	SE	p	B	SE	p
Model 1
Constant	39.800	0.864	<0.001
Performance	−1.047	0.286	<0.001
Relationship	−2.049	0.305	<0.001
Psychological distress	−0.402	0.028	<0.001
Model 2
Constant				7.565	1.212	<0.001	0.416	1.213	0.731	9.885	1.220	<0.001
Performance				0.098	0.191	<0.001	0.747	0.192	<0.001	1.106	0.193	<0.001
Relationship				0.794	0.203	<0.001	0.642	0.209	0.002	0.917	0.211	<0.001
Psychological distress				0.191	0.021	<0.001	0.209	0.021	<0.001	0.096	0.022	<0.001
Resilience				−0.147	0.026	<0.001	−0.074	0.026	0.005	−0.234	0.027	<0.001
Model 3
Constant				1.683	0.586	0.004	−2.550	0.576	<0.001	0.548	0.610	0.369
Performance				0.253	0.194	0.192	0.825	0.203	<0.001	1.351	0.202	<0.001
Relationship				0.382	0.207	0.065	0.795	0.203	<0.001	1.398	0.215	<0.001
Psychological distress				0.251	0.019	<0.001	0.239	0.019	<0.001	0.190	0.021	<0.001
Indirect effect through resilience				0.060	0.011	* (0.03~0.09)	0.030	0.011	* (0.01~0.05)	0.094	0.015	* (0.06~0.12)

Notes: *The Boot (LLCI, ULCI) from bias-corrected bootstrapping test; bold text: highlight the significance (p < 0.05) of the important indicators in the mediation model.

Table 6 The Moderation Role of Personality in Path 1 and Path 2

Paths	Coefficient	SE	t	P	LLCI	ULCI
Path 1 (Outcome variable: Resilience)
Constant	39.593	1.912	20.706	<0.001	35.838	43.349
Performance	−0.777	0.276	−2.81	0.005	−1.320	−0.235
Relationship	−1.515	0.298	−5.068	<0.001	−2.102	−0.928
Psychological distress	−0.528	0.131	−4.012	<0.001	−0.787	−0.270
Psychological distress * Over-controlled (Resilient as reference)	0.289	0.142	2.031	0.042	0.009	0.569
Psychological distress * Under-controlled (Resilient as reference)	0.281	0.139	2.020	0.043	0.007	0.554
Model Summary	R^2		F			P
	0.408		59.568			<0.001
Path 2 (Outcome variable: Academic burnout)
Constant	23.762	4.347	5.465	<0.001	15.224	32.301
Performance	1.727	0.394	4.375	<0.001	0.952	2.503
Relationship	1.289	0.432	2.981	0.003	0.440	2.139
Resilience	−0.407	0.128	−3.182	0.001	−0.659	−0.156
Resilience * Over-controlled (Resilient as reference)	0.080	0.147	0.544	0.586	−0.209	−0.370
Resilience * Under-controlled (Resilient as reference)	0.060	0.157	0.381	0.703	−0.249	0.369
Model Summary	R^2		F			P
	0.460		86.335			<0.001

Note: Bold text: highlight the significance (p < 0.05) of the important indicators in the moderation model.

Figure 2 (A) The interaction between psychological distress and personality on resilience. (B) The results of moderation model.