The Mediating Role of Perceived Stress in the Relationship between Involvement and Academic Performance: A Study on Medical Students

Abstract Background: In contemporary educational settings, "involution" has become a core issue impacting students' mental health and academic development. This study aims to explore how perceived academic involution indirectly affects academic performance through perceived stress, and to examine the moderating roles of social support and learning engagement. Methods: A cross-sectional survey combined with a longitudinal study was conducted among 393 third-year medical students. Data were collected using validated scales for perceived involution, perceived stress, coping strategies, social support, and learning engagement. Academic performance was measured via standardized exam scores over four semesters. Statistical analyses included descriptive statistics, independent sample t-tests, binary logistic regression, and moderated mediation modeling using Mplus 8.3. Results: The study reveals that perceived involution indirectly undermines academic performance by increasing perceived stress. Social support and learning engagement significantly moderate this relationship, with family support and peer support playing crucial roles in buffering the negative impact of involution perception on stress and enhancing academic performance. Learning engagement also directly promotes academic achievement. Conclusions: The findings challenge the traditional "scarcity mindset trap" assumption in involution research and propose a "vigilance-strategy transformation" framework. This study offers insights for developing targeted psychological interventions to mitigate the negative effects of academic involution and provides an evidence-based foundation for mental health support strategies in the context of post-pandemic blended teaching.