Positive childhood experiences and loneliness in medical students: the role of adaptive emotion regulation

Background Loneliness is a highly prevalent issue among medical students, associated with anxiety, depression, and reduced academic performance. Developmental research suggests that positive childhood experiences (PCEs) may foster adaptive emotion regulation (ER) skills, which in turn buffer against loneliness. Relying on developmental psychopathology and emotion regulation frameworks, this study examined whether adaptive ER mediates the relationship between PCEs and loneliness. Methods A cross-sectional survey was conducted with medical students ( N = 97) at a U. S. medical school. Validated measures assessed PCEs, adaptive ER, and loneliness. Mediation was tested using bootstrapped regression models with 5,000 resamples. Results Higher PCEs were significantly associated with greater use of adaptive ER strategies ( β  = 0.21, p  < 0.001), which in turn were associated with lower loneliness ( β  = −0.19, p  < 0.01). The indirect effect of PCEs on loneliness via adaptive ER was significant [indirect β  = −0.039, 95% CI (−0.073, −0.013)], supporting the hypothesized mediation model. Conclusion The findings support a theoretically grounded model linking developmental experiences to current wellbeing in medical students, with adaptive ER identified as a potential mechanism. However, given the cross-sectional design, causal inferences cannot be drawn. Results highlight adaptive ER as a modifiable intervention target for reducing loneliness, while PCEs highlight the importance of primary prevention efforts targeting children and families. Replication with larger, multi-site, and longitudinal studies is warranted.