Psychological Pain and Its Associations with Autistic Traits, Anger Rumination, and Tolerance for Mental Pain Among Medical Students

This study aimed to examine the relationships among autistic traits, psychological pain, anger rumination, and tolerance for psychological pain in medical students. This single-center, cross-sectional study included 544 medical students at Kırıkkale University Faculty of Medicine, Türkiye (mean age: 22.40 ± 1.91 years; 55.3% women). Participants completed the Autism Spectrum Quotient (AQ), Orbach and Mikulincer Mental Pain Scale-8 (OMMP-8), Tolerance for Mental Pain Scale-10 (TMPS-10), and Anger Rumination Scale (ARS). Higher autistic traits were associated with greater psychological pain and anger rumination and lower tolerance for psychological pain. Students with AQ scores ≥26 had significantly higher psychological pain and anger rumination and lower tolerance for psychological pain than those with AQ scores <26. In multivariable analysis, autistic traits, anger rumination, and tolerance for psychological pain were independently associated with psychological pain. Cross-sectional indirect-effect analyses showed significant indirect effects through anger rumination (b = 0.112, 95% CI [0.066, 0.162]) and tolerance for psychological pain (b = 0.185, 95% CI [0.127, 0.243]), while the corresponding direct effects remained significant. These findings highlight the relationships among autistic traits, anger rumination, tolerance for psychological pain, and psychological pain in medical students.