Psychological, Behavioral, and Socioeconomic Correlates of Stress in Bangladeshi Medical Students: A Cross-Sectional Study

Background: Academic stress is a widespread challenge among medical students, shaped by a complex interplay of sociodemographic, psychological, and behavioral factors. Although widely studied, limited research has explored how these factors influence academic stress among medical students in Southeast Asia. This study aims to explore how personal, psychological, and behavioral factors influence academic stress.Methods: A cross-sectional survey was conducted from October to December 2022 among 1,072 medical students from eight public colleges in Bangladesh, employing stratified random sampling. The Academic Stress Scale (ASS-40) was utilized to assess academic stress, while the Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder (GAD-7), Insomnia Severity Index (ISI), Internet Addiction Test (IAT), Stress Coping Style Inventory (SCSI), and Rosenberg Self-Esteem Scale (RSES) were employed to evaluate depression, anxiety, insomnia, internet addiction, coping strategies, and self-esteem, respectively. Chi-square tests, t-tests, and logistic regression were used to interpret associations.Results: The predictive model incorporated sociodemographic, psychological, and behavioral factors, demonstrating high accuracy in identifying students at risk for academic stress. The analysis also uncovered several key determinants contributing to academic stress. Notably, Hindu students reported significantly higher stress levels than their Muslim peers. The father’s education, urban residence, and living with family were associated with increased stress, whereas higher maternal education appeared to offer a protective effect. Among psychological factors, depression exhibited the strongest association with academic stress, followed closely by anxiety and insomnia. Behavioral influences also played a significant role, with internet addiction correlating strongly to elevated stress levels. Additionally, coping strategies significantly influenced stress outcomes, with passive emotional coping providing a modest protective effect.Conclusion: Academic stress among medical students is multifaceted and driven by sociocultural, psychological, and behavioral factors. To alleviate stress, targeted interventions such as mental health support programs, parental awareness initiatives, and training on coping strategies should be implemented.