The Impact of Reading Trauma Literature on Chinese Undergraduates’ PTSD: The Mediating Roles of Social Support and Empathy

The Impact of Reading Trauma Literature on Chinese Undergraduates’ PTSD: The Mediating Roles of Social Support and Empathy | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The Impact of Reading Trauma Literature on Chinese Undergraduates’ PTSD: The Mediating Roles of Social Support and Empathy Ruikai Yuan, Fengjun Qi, Jingxian Zhou, Qi Zhu, Qin Liu, Yuanqing Wang, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6446529/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 01 Sep, 2025 Read the published version in BMC Psychology → Version 1 posted 10 You are reading this latest preprint version Abstract Trauma literature has emerged as a powerful medium for exploring collective and individual psychological experiences. However, it’s the potential psychological risks—particularly its association with PTSD symptoms among students—have not been thoroughly examined, especially in the context of Chinese undergraduates who face unique academic and social pressures. This study investigates the impact of trauma literature on PTSD symptoms, with a focus on the mediating roles of social support and empathy. Our findings demonstrate that trauma literature can alleviate psychological distress, while also highlighting the critical moderating roles of social support and empathy in mitigating potential adverse effects. The study underscores the need for trauma-informed pedagogical approaches to balance literary education with mental health considerations, offering practical implications for educators and policymakers. trauma literature Chinese undergraduates social support empathy PTSD Figures Figure 1 1. Introduction As a significant genre within modern literature, trauma literature provides a literary and expressive framework for traumatic experiences through the depiction of extreme human events such as war, disaster, violence, and persecution (Balaev, 2014 ; Whitehead, 2004 ). In recent years, trauma literature has gained increasing prominence in higher education curricula (Gladden et al., 2023 ). Trauma literature not only documents collective trauma but also explores the representation and healing processes of individual psychological trauma (Reis, 2019 ; Clark, 2016 ). However, close engagement with traumatic narratives may also entail psychological consequences, as the distressing experiences depicted in these texts can evoke emotional resonance, psychological distress, or even vicarious trauma in readers (Figley, 2002 ; Newell et al., 2016 ). Research indicates that childhood maltreatment is prevalent in China (Chen et al., 2021 ), and trauma-exposed individuals may exhibit concurrent negative and positive posttraumatic psychological responses after they grow up (Liu et al., 2025 ). Traumatic literature provides a mirror effect and psychological compensation mechanism (Brooks et al., 2024 ; Velasco et al., 2023 ). Besides, evidence suggests that even without direct exposure to traumatic events, intense engagement with traumatic content through literature can lead to secondary traumatic stress (Jacob & Lambert, 2021 ). In this context, understanding the psychological mechanisms that mediate the relationship between trauma literature reading and PTSD symptoms becomes crucial. There remains a relative scarcity of empirical studies examining how trauma literature reading relates to PTSD symptoms with consideration of the interactive roles of social support and empathy, particularly in the Chinese educational context. This study aims to address this gap by investigating the impact of reading trauma literature on Chinese undergraduates’ PTSD symptoms, with specific attention to the mediating roles of social support and empathy. By exploring these relationships, this research seeks to contribute to the development of “trauma-informed pedagogy” and provide insights for educational practices that maximize the benefits of trauma literature while minimizing potential psychological harm to students. 2. Literature Review PTSD affects an individual’s emotional state and cognitive functioning and also lead to impaired social functioning, poor academic performance, and other difficulties (Svenaeus, 2014; Friedman et al., 2011 ; Forkus et al., 2023 ). The core symptoms of PTSD include intrusive memories of traumatic events, nightmares, flashbacks, avoidance of trauma-related stimuli, negative alterations in cognition and mood, and marked changes in arousal and reactivity (Wampold et al., 2010 ). University students are in a critical period of cognitive and emotional development, and face ongoing challenges such as academic pressure, interpersonal adaptation, and identity formation, rendering them relatively more psychologically vulnerable (Arnett, 2016 ; Ferrari et al., 2022 ; Hamza et al., 2021 ). Research indicates that the prevalence of PTSD among Chinese university students is significantly higher than that of the general population, reaching as high as 6.4% in some studies (Li et al., 2024 ). Furthermore, PTSD symptoms in university students may be exacerbated by factors such as academic stress, life transitions, and identity struggles, which can subsequently impair cognitive functioning, learning abilities, and social interactions (Leow et al., 2013; Boyraz et al., 2016 ). Implicitly, evidence from both literary and psychological studies suggests that even without direct exposure to traumatic events, intense engagement with traumatic content through literature, media, or other narratives can lead to secondary traumatic stress” (Bride, 2007 ; Leung et al., 2023 ). This phenomenon is particularly pronounced among individuals who are emotionally sensitive or have a history of similar traumatic experiences (Ludick & Figley, 2017 ; Waegemakers & Lane, 2019). Research has found that university students may exhibit PTSD-like symptoms, such as emotional fluctuations, heightened anxiety, and intrusive thoughts, after reading literary works depicting war, violence, or catastrophic events (Kross & Ayduk, 2017 ; Cole et al., 2024 ). These findings have sparked discussions about the necessity of implementing mental health safeguards in the teaching of trauma literature. Social support and empathy are critical components of individual psychological resources, play a pivotal role in the process of trauma coping and recovery. Social support refers to the resources individuals obtain from family, friends, colleagues, and communities, including emotional care, material assistance, informational guidance, and a sense of belonging (Cobb, 1976 ; Wang et al., 2023 ; Lee et al., 2024 ). Perceived social support, in particular, has been shown to have a more stable predictive effect on mental health (Marroquín et al., 2020 ; Oh et al., 2023 ). Ample social support has been widely demonstrated to alleviate stress responses and reduce the severity and duration of PTSD symptoms (Cohen & Wills, 1985 ; Diamond & Alley, 2023; Carmassi et al., 2020 ). Especially for university students, social support from family, friends, and educational institutions constitutes a vital protective network against psychological stress (Deng et al., 2021 ; Acoba, 2024 ). Research indicates that high levels of social support not only reduce the incidence of PTSD symptoms among university students but also facilitate positive cognitive reappraisal and foster post-traumatic growth (Waters, 2022; Ye et al., 2020 ). Empathy is defined as the ability to understand and share the emotional states of others, compassing two dimensions: cognitive empathy and affective empathy (Fultz & Bernieri, 2022 ; Nair et al., 2024 ). Cognitive empathy refers to the capacity to adopt another’s perspective and understand their thoughts and feelings, while affective empathy involves the emotional resonance with another’s emotional state (Decety & Jackson, 2004 ; Aldrup et al., 2022 ). Empathy plays a complex role in shaping an individual’s emotional responses and psychological processing of traumatic narratives, potentially serving as both a protective factor and a risk factor (Eisenberg & Fabes, 1990; Babik & Gardner, 2021 ). Adaptive empathy facilitates a nuanced understanding of the multifaceted dimensions of traumatic experiences and promotes emotional regulation and healing (Lamothe et al., 2014 ; Siegel, 2019 ). However, excessive affective empathy, particularly in the absence of appropriate emotional boundaries, may lead to empathy fatigue and vicarious trauma (Leiberg et al., 2011 ; Stevens & Taber, 2021 ; Donald et al., 2019 ). Research indicates that individuals with high empathy may be more susceptible to intrusive thoughts and emotional fluctuations following trauma exposure, but they are also more likely to actively seek social support and professional assistance (Warren, 2018 ; Weisz, E., & Cikara, 2021 ). However, there is a relative scarcity of studies examining the relationship between trauma literature reading and PTSD symptoms condisering interactive roles of social support and empathy. Therefore, this study proposes the following hypotheses: H1 Trauma literature reading is associated with PTSD symptoms among university students. H2 Social support mediates the relationship between trauma literature reading and PTSD symptoms. H3 Empathy mediates the relationship between trauma literature reading and PTSD symptoms. H4 Trauma literature reading has a significant impact on university students’ PTSD symptoms through the mediating roles of social support and empathy. 2. Method 2.1 Participants This study investigates 589 undergraduate students as participants from five universities in Jiangsu, China. The participants ranged in age from 18 to 22 and above, with 297 females (50.42%) and 292 males (49.58%). Participants were drawn from different academic years (freshmen to seniors) and various disciplines (humanities, sciences, engineering, etc.). The inclusion criteria were full-time undergraduate students currently enrolled at the university, while the exclusion criteria included individuals with a history of severe psychological disorders or those currently undergoing psychological treatment. Participants were recruited through random sampling conducted by 10 students from the university’s psychology department. The researchers asked if the participants had the experience of trauma and reading trauma literature. If student’s answer was yes, she/he was asked to fill out the questionnaire. The study is in accordance with the Declaration of Helsinki and was approved by the ethics committee of Jiangsu Second Normal University [20250410001], and all participants provided informed consent prior to participation, ensuring they understood the purpose and procedures of the study and that their involvement was voluntary. Data collection took place from December 2024 to February 2025. 3.2 Measures 3.2.1 Reading self-efficacy To measure individuals’ confidence in their ability to understand and appreciate novels, the study adopted a reading self-efficacy scale. Reading self-efficacy was assessed via a four-item scale specifically developed for this study, based on two general self-efficacy measures (Engeser, 2005; Beierlein et al., 2012). The internal consistency of this scale was acceptable (McDonald’s ω = 0.62). Reading self-efficacy was assessed using single items on five-point Likert scales (ranging from “very strongly disagree” (= 1) to “very strongly agree” (= 5) (Thissen et al., 2018 ). 3.2.2 Social Support This study used a simplified version of the Chinese version of the Perceived Social Support Scale (PSSS-A6) to assess the subjects’ perceived social support level. The scale was obtained by Wu et al. ( 2025 ) based on the original PSSS-12, using the Ant Colony Optimization (ACO) algorithm to screen items. It is more suitable for large sample research scenarios and takes into account both measurement validity and practicality. PSSS-A6 contains three dimensions (family support, friend support, and important others support), each of which consists of two questions, for a total of 6 items. The internal consistency index of this simplified version in the mainland Chinese sample is relatively high, and the Cronbach’s α in both data sets reached 0.91. At the same time, the reliability of each sub-dimension is also relatively ideal. Therefore, in research situations where both questionnaire response speed and measurement accuracy are required, the use of this 6-item version of the scale can not only save time to fill in the questionnaire, but also maintain a more accurate assessment of the individual’s perceived social support level. 3.2.3 Empathy Empathy was assessed using the Emotional Empathic Drive Short Scale (EED), a five-item instrument grounded in Zaki’s (2014) theoretical framework of motivated empathy (Karlstetter, 2017 ). The EED measures individuals’ dispositional drive to share others’ emotions, capturing affective components of empathy rather than cognitive ones. Unlike traditional agree–disagree scales, this scale employs a frequency-based response format adapted from Spreng et al. (2009), which asks participants how often they feel or behave in ways described by each item. Each item is scored on a scale from 0 to 4, producing a total sum score ranging from 0 to 20, with higher scores indicating stronger emotional empathic drive. This response format helps mitigate social desirability bias by focusing on the regularity of empathic experiences rather than levels of agreement, a concern raised in previous survey research (Karlstetter, 2014). It also helps preserve the multidimensionality of empathy more effectively than standard Likert scales (Marcus et al., 2006). The EED has been validated in cross-cultural samples from Canada and Germany and is particularly suited for use in psychology, neuroscience, and social science contexts. In this study, the scale was administered in its Chinese version to undergraduate students aged 18 and older. 3.2.3 PTSD In this study, PTSD symptoms were assessed using the Short PTSD Rating Interview (SPRINT) developed by Connor and Davidson ( 2001 ). The SPRINT is a brief and psychometrically validated tool designed to measure global PTSD symptom severity efficiently. It consists of 8 items, including four that correspond directly to the core PTSD symptom clusters—intrusion, avoidance, numbing, and hyperarousal—as defined by DSM-IV. The other four items assess somatic distress, stress vulnerability, and impairments in work/daily functioning and social relationships. Each item is rated on a 5-point Likert scale from 0 (not at all) to 4 (very much), with a total score ranging from 0 to 32, where higher scores indicate greater PTSD severity. The SPRINT has demonstrated a good internal consistency (Cronbach’s α = 0.77–0.88), excellent inter-rater reliability (ICC up to 0.998), and high diagnostic efficiency, with scores between 14–17 offering up to 96% diagnostic accuracy in general populations. Its brevity (5–10 minutes) and comprehensive symptom coverage make it particularly well-suited for both clinical and research contexts where time efficiency is essential. 3.3 Data Analysis Descriptive statistics were computed to summarize the demographic information and central tendencies of the key variables, including reading self-efficacy, perceived social support, emotional empathy, and PTSD symptoms. Normality tests and missing data checks were also conducted to ensure data quality. Internal consistency of all scales was evaluated using Cronbach’s alpha coefficients, with values above 0.70 considered acceptable. Confirmatory Factor Analysis (CFA) was conducted to assess the construct validity, including convergent validity (standardized factor loadings > 0.5, AVE > 0.5, CR > 0.7) and discriminant validity (inter-construct correlations lower than the square root of AVEs). Normally, AVE value should be at least 0.50 or above, however, AVE value of more than 0.40 is acceptable if the composite reliability CR value is adequate (Lam, 2012 ; Murtagh & Heck, 2012 ). Model fit was assessed using the following indices: RMSEA ( 0.90), TLI (> 0.90), GFI (> 0.90), and SRMR (< 0.08) (Feng et al., 2017). To examine the hypothesized relationships among variables, a structural equation model (SEM) was constructed and tested using maximum likelihood estimation in AMOS. This included the direct effect of trauma literature reading self-efficacy (RS) on PTSD symptoms, as well as the indirect effects mediated by social support (SS) and empathy (EP). The model tested the following hypothesized relationships: a. direct effect of RS on PTSD symptoms; b. indirect effect of RS on PTSD via SS; c: indirect effect of RS on PTSD via EP; a′. Chain mediation from RS → SS → EP → PTSD. All path coefficients were estimated using maximum likelihood estimation, and the significance of indirect effects was tested via bootstrapping (5,000 samples, 95% confidence interval). Path significance was determined using standardized regression weights (β) and critical ratios (C.R.), with C.R. > 1.96 indicating statistical significance (p < .05) (Hazra, 2017 ). 4. Results 4.1 Descriptive Data Table 1 presents demographic characteristics and psychological measures from a sample of 589 college students. The gender distribution is nearly equal, with females comprising 50.42% and males 49.58% of participants. Students are distributed fairly evenly across four grade levels, with first-year students representing 26.32%, second-year students 23.26%, third-year students 27.33%, and fourth-year students 23.09% of the sample. The age profile indicates most participants are between 19 and 21 years old, collectively accounting for 81.66% of the sample. Specifically, 13.24% are 18 years old, 24.45% are 19 years old, 30.22% are 20 years old, 26.99% are 21 years old, and only 5.09% are 22 years or older. This age distribution aligns with typical undergraduate populations. Reading habits among participants show considerable variation. Only a small percentage (5.09%) report reading daily, while approximately one-quarter read weekly (24.96%), monthly (25.47%), or quarterly (25.98%). A notable portion (18.51%) indicates they read only yearly, suggesting limited regular reading engagement among a significant subset of the sample. The dataset also includes mean scores for several psychological constructs measured on standardized scales. Reading Engagement shows a mean score of 3.46 (SD = 0.62), suggesting moderate to high levels of engagement with reading materials. Social Support and Empathy demonstrate similar moderate levels with means of 3.04 (SD = 0.55) and 3.06 (SD = 0.59), respectively. PTSD scores are notably higher with a mean of 3.81 (SD = 0.52), though without knowing the specific measurement scales used, interpretation of these values must be approached with caution. Table 1 Descriptive data of participants. Variable Mean (SD)/N(%) Demographical characteristics Sex Female 297 (50.42) Male 292 (49.58) Grade 1 155 (26.32) 2 137 (23.26) 3 161(27.33) 4 136 (23.09) Age 18 78 (13.24) 19 144 (24.45) 20 178 (30.22) 21 159 (26.99) ≥ 22 30 (5.09) Reading frequency Daily 30 (5.09) Weekly 147 (24.96) Monthly 150 (25.47) Quarterly 153 (25.98) Yearly 109 (18.51) Reading Engagement M (SD) 3.46 (0.62) Social Support M (SD) 3.04 (0.55) Empathy M (SD) 3.06 (0.59) PTSD M (SD) 3.81 (0.52) 4.2 Reliability and Validity The degree to which a measurement item is seen consistently by the same individuals under the same circumstances is known as reliability. Cronbach’s alphas and reliability coefficients would be used to assess the internal consistency of the questionnaire’s measurement items. Table 2 displays the survey’s Cronbach’s alpha results. Every construct was higher above the criterion of 0.70 (Mugge & Schoormans, 2012 ). Furthermore, the column’s competitive reliability (C.R.) is likewise above the cutoff. Consequently, the survey’s measurement items are regarded as trustworthy. Table 2 Reliability and Unidimensionality. Construct Cronbach’s Alpha Variable Standardized Factor Loading C.R. (t-value) SMC AVE Composite Reliability Reading Self-efficacy 0.83 RS1 0.64 12.8 0.41 0.533 0.819 RS2 0.78 15.6 0.608 RS3 0.79 15.8 0.624 RS4 0.70 14.0 0.49 Social support 0.85 SS1 0.70 14.0 0.49 0.561 0.884 SS2 0.66 13.2 0.436 SS3 0.76 15.2 0.578 SS4 0.72 14.4 0.518 SS5 0.84 16.8 0.706 SS6 0.80 16.0 0.64 Empathy 0.74 EP1 0.65 13.0 0.423 0.421 0.782 EP2 0.73 14.6 0.533 EP3 0.56 11.2 0.314 EP4 0.73 14.6 0.533 EP5 0.65 11.0 0.303 PTSD 0.78 P1 0.63 12.6 0.397 0.458 0.871 P2 0.68 13.6 0.462 P3 0.74 14.8 0.548 P4 0.63 12.6 0.397 P5 0.62 12.4 0.384 P6 0.69 13.8 0.476 P7 0.75 15.0 0.562 P8 0.66 13.2 0.436 Construct validity is the degree of agreement between a construct and its operationalisation. To ascertain the construct validity of our study framework, we may assess (1) unidimensionality, (2) convergent validity, (3) discriminant validity, and (4) nomological validity (Mugge & Schoormans, 2012 ). Confirmatory factor analysis was used to examine the study framework’s unidimensionality (CFA). CFA was created to examine if a construct’s measures align with the researcher's understanding of the construct's (or factor’s) nature. A measurement scale is said to be unidimensional if it only has one dimension. Convergent validity, then, is the degree to which two measures of constructs that theoretically should be connected are related to each other. The threshold of convergent validity is evaluated individually using critical ratios (CR, value are 2 or above), standardised factor loadings (value are 0.5 or above), and averaged variances expected (AVEs, value above 0.5 or more than 0.4 if CR value is over 0.6) (Evanschitzky et al., 2006 ). The least standardised factor loading (= 0.56) was over the “0.5” barrier, the minimum AVE calculated was within the acceptable range in our study paradigm, and the minimum CR (= 11.0) was noticeably higher than the “2” threshold. Thus, convergent validity is thought to be suitable for the study design. Discriminant validity examines the relationship between ideas or measurements that should not be related. We determined our study framework’s correlation coefficients displayed in Table 3 . Table 3 Correlation on the key variables Construct RS SS EP PTSD RS 1 SS 0.279*** 1 EP 0.246*** 0.247*** 1 PTSD -0.375*** -0.355*** -0.284*** 1 Note: *p < 0.1; **p < 0.05; ***p < 0.01 Table 4 presents the findings of an evaluation of the research framework’s goodness of fit through absolute fit and incremental fit indices. Specifically, the subsequent metrics adhered to their respective thresholds: RMSEA (root mean square error of approximation), NFI (normed fit index), IFI (incremental fit index), TLI (Tucker–Lewis index), CFI (comparative fit index), SRMR (standardised root mean square residual), and GFI & AGFI (goodness-of-fit index). Consequently, the research framework was deemed suitable for the collected data. Table 4 Goodness of fit test Category Measure Acceptable Values Value Absolute fit indices Chi-square 192.34 d,f. 97.0 Chi-square/d.f. 1–5 1.98 GFI 0.9 or above 0.952 AGFI 0.9 or above 0.928 SRMR 0.08 or below 0.041 RMSEA 0.05–0.08 0.046 Incremental fit indices NFI 0.9 or above 0.941 IFI 0.9 or above 0.968 TLI 0.9 or above 0.955 CFI 0.9 or above 0.967 4.3 Path analysis The aim of this study is to explore the impact of trauma literature reading on PTSD with the mediating role of social support and empathy. In order to analyze the relationships within the research framework, we conducted a path analysis based on the SEM. Figure 1 shows the results of this analysis, and Table 5 shows the standardized coefficients of each path and the derivation of the hypotheses. The direct pathway from reading self-efficacy to PTSD symptoms (path a) shows a significant negative relationship (β = -0.23, p < 0.001, C.R. = -6.57), indicating that students with higher confidence in their ability to engage with trauma literature report fewer PTSD symptoms. The indirect path from reading self-efficacy through social support to PTSD symptoms (path b) demonstrated a significant negative relationship (β = -0.15, p < 0.001, C.R. = -3.75). Similarly, the indirect pathway through empathy (path c) showed a significant negative relationship (β = -0.11, p < 0.05, C.R. = -2.44). The sequential mediation pathway (path a′), examining the influence of reading self-efficacy on PTSD symptoms through both social support and empathy in sequence, yielded a marginally significant negative effect (β = -0.08, p < 0.1, C.R. = -1.78). Table 5 Hypothesis Testing Hypothesis Path Standardized Coefficient Standard Error C.R.(t-Value) Result H1 a (RS → PTSD) -0.23 0.035 -6.57 Accepted H2 b (RS → SS → PTSD) -0.15 0.040 -3.75 Accepted H3 C (RS → EP → PTSD) -0.11 0.045 -2.44 Accepted H4 a’ (RS → SS → EP→PTSD) -0.08 0.045 -1.78 Accepted 5. Discussion The findings from this study suggest a significant relationship between trauma literature reading self-efficacy and PTSD symptoms among Chinese undergraduate students, with important mediating roles played by social support and empathy. These results align with previous theoretical frameworks that propose engagement with traumatic narratives can evoke psychological reactions in readers, even without direct traumatic exposure (Brooks, 2024). Our finding that reading self-efficacy has a negative direct effect on PTSD symptoms supports H1 and suggests that students with higher confidence in their ability to process trauma literature may experience fewer adverse psychological effects when engaging with distressing content. The mediating role of social support confirmed in H2 corresponds with established literature demonstrating the protective function of social support against psychological distress (Ozbay, 2007; Acoba, 2024 ). This finding extends previous research by specifically applying it to the context of trauma literature engagement, suggesting that students with higher reading self-efficacy may perceive and utilize social support resources more effectively, thereby reducing their vulnerability to PTSD symptoms. These results are consistent with studies showing that social support can buffer stress responses and facilitate recovery from traumatic experiences (Calhoun et al., 2022 ), and highlight its particular importance in educational settings where students encounter potentially distressing content. Our third hypothesis concerning empathy as a mediator was also supported, revealing a complex relationship whereby reading self-efficacy positively influences empathy, which in turn reduces PTSD symptoms. This finding presents an interesting nuance to previous literature describing empathy’s dual role as both protective and potentially harmful in trauma contexts (Shamai-Leshem et al., 2025 ). While excessive affective empathy without appropriate boundaries can increase vulnerability to vicarious trauma, our results suggest that when empathy develops alongside reading self-efficacy, it may function as a protective factor. This aligns with research indicating that adaptive empathy can facilitate healthier processing of traumatic content (Adonis et al., 2025 ; Nina et al., 2022). The chain mediation effect (RS → SS → EP → PTSD) yielded a marginally significant result, indicating that reading self-efficacy may influence PTSD symptoms through a sequential pathway involving both social support and empathy. This finding extends beyond previous research by proposing an integrated mechanism through which reading self-efficacy may operate. Specifically, students with higher reading self-efficacy may perceive greater social support, which enhances their capacity for adaptive empathy, ultimately reducing vulnerability to PTSD symptoms when engaging with trauma literature. This sequential relationship has not been extensively explored in previous studies and represents a novel contribution to understanding how these psychological resources interact in educational contexts. 6. Conclusion The overall findings suggest that trauma literature, while valuable for educational purposes, requires thoughtful implementation in university curricula. The negative relationship between reading self-efficacy and PTSD symptoms underscores the importance of cultivating students’ confidence and competence in engaging with challenging texts. This advocates for “trauma-informed teaching” that acknowledges the potential psychological impact of educational content (Crosby, 2015 ). Moreover, the significant mediating roles of social support and empathy highlight the importance of addressing not only students’ academic skills but also their psychological resources and social environment when introducing trauma literature in educational settings. Our findings should be considered within the cultural context of Chinese higher education, where academic pressure is often intense and mental health concerns among university students have received increasing attention. The protective factors identified in this study—reading self-efficacy, social support, and adaptive empathy—may be particularly important resources for Chinese students navigating both academic and psychological challenges. These results offer important implications for educational practice, suggesting that enhancing students’ reading self-efficacy, strengthening social support networks, and promoting adaptive empathy could mitigate potential adverse effects of engaging with trauma literature. Faculty members who incorporate trauma literature into their courses should consider implementing strategies to build these protective resources among students. These might include scaffolded reading approaches to build confidence, creating supportive classroom communities that encourage discussion and emotional processing, and explicit instruction in empathic engagement that maintains appropriate boundaries. Such pedagogical considerations align with calls for more psychologically informed approaches to teaching sensitive content in higher education. 7. Limitations and Future Implications Few limitations should be acknowledged. The cross-sectional design prevents us from establishing causal relationships between the variables. While our path analysis suggests directional relationships, longitudinal studies are needed to confirm the temporal sequence and causality between trauma literature reading, mediating factors, and PTSD symptoms. Besides, the study’s reliance on self-report measures may introduce social desirability bias, particularly for sensitive topics like empathy and psychological distress. Future research could benefit from incorporating physiological measures, behavioral observations, or experimental designs to complement self-report data. Declarations Ethics approval and consent to participate The study involving human participants was reviewed and approved by the Ethics Committee of Jiangsu Second Normal University. Informed consent to participate in the study was obtained from all participants. Consent for publication Not applicable. Availability of data and materials The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation. Competing interests The authors have no competing interests. Author Contribution declaration Yuan conceptualized the idea and wrote the main manuscript. Qi and Zhou conducted the computing. Zhu and Zhang prepared figures and tables. Qin edited the manuscript. Wang did the supervision. All authors reviewed the manuscript. Funding N/A Acknowledgements The authors thank. References Acoba, E. F. (2024). Social support and mental health: the mediating role of perceived stress. Frontiers in Psychology , 15 , 1330720. 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Social support and resilience to stress: from neurobiology to clinical practice. Psychiatry (edgmont) , 4 (5), 35. Reis, B. E., & Bollas, C. (2019). Creative repetition and intersubjectivity: Contemporary Freudian explorations of trauma, memory, and clinical process . Routledge. Siegel, D. J. (2019). The mind in psychotherapy: An interpersonal neurobiology framework for understanding and cultivating mental health. Psychology and Psychotherapy: Theory, Research and Practice , 92 (2), 224-237. Shamai-Leshem, D., Porat-Butman, S., Levy-Gigi, E., & Shamay-Tsoory, S. (2025). The dual nature of empathy: Exploring its role in PTSD symptoms among psychotherapists following a mass casualty event. Psychological Trauma: Theory, Research, Practice, and Policy . Stevens, F., & Taber, K. (2021). The neuroscience of empathy and compassion in pro-social behavior. Neuropsychologia , 159 , 107925. Svenaeus, F. (2014). Diagnosing mental disorders and saving the normal: American Psychiatric Association, 2013. Diagnostic and statistical manual of mental disorders, American Psychiatric Publishing: Washington, DC. 991 pp., ISBN: 978-0890425558. Price: $122.70. Medicine, Health Care and Philosophy , 17 , 241-244. Thissen, B. A., Menninghaus, W., & Schlotz, W. (2018). Measuring optimal reading experiences: The reading flow short scale. Frontiers in Psychology , 9 , 2542. Waegemakers Schiff, J., & Lane, A. M. (2019). PTSD symptoms, vicarious traumatization, and burnout in front line workers in the homeless sector. Community mental health journal , 55 , 454-462. Wampold, B. E., Imel, Z. E., Laska, K. M., Benish, S., Miller, S. D., Flűckiger, C., ... & Budge, S. (2010). Determining what works in the treatment of PTSD. Clinical psychology review , 30 (8), 923-933. Wang, F., Gao, Y., Han, Z., Yu, Y., Long, Z., Jiang, X., ... & Zhao, Y. (2023). A systematic review and meta-analysis of 90 cohort studies of social isolation, loneliness and mortality. Nature human behaviour , 7 (8), 1307-1319. Warren, C. A. (2018). Empathy, teacher dispositions, and preparation for culturally responsive pedagogy. Journal of Teacher Education , 69 (2), 169-183. Waters, L., Algoe, S. B., Dutton, J., Emmons, R., Fredrickson, B. L., Heaphy, E., ... & Steger, M. (2022). Positive psychology in a pandemic: Buffering, bolstering, and building mental health. The journal of positive psychology , 17 (3), 303-323. Weisz, E., & Cikara, M. (2021). Strategic regulation of empathy. Trends in cognitive sciences , 25 (3), 213-227. Whitehead, A. (2004). Trauma fiction . Edinburgh University Press. Wu, Y., Tang, J., Du, Z., Chen, K., Wang, F., Sun, X., ... & Wu, Y. (2025). Development of a short version of the perceived social support scale: based on classical test theory and ant colony optimization. BMC Public Health , 25 (1), 232. Velasco, J., Sanmartín, F. J., Gálvez-Lara, M., Cuadrado, F., & Moriana, J. A. (2023). Psychological effects of professional exposure to trauma and human suffering: systematic review and meta-analysis. Trauma, Violence, & Abuse , 24 (3), 1656-1676. Ye, Z., Yang, X., Zeng, C., Wang, Y., Shen, Z., Li, X., & Lin, D. (2020). Resilience, social support, and coping as mediators between COVID‐19‐related stressful experiences and acute stress disorder among college students in China. Applied Psychology: Health and Well‐Being , 12 (4), 1074-1094. Additional Declarations No competing interests reported. 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Introduction","content":"\u003cp\u003eAs a significant genre within modern literature, trauma literature provides a literary and expressive framework for traumatic experiences through the depiction of extreme human events such as war, disaster, violence, and persecution (Balaev, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2014\u003c/span\u003e; Whitehead, \u003cspan citationid=\"CR66\" class=\"CitationRef\"\u003e2004\u003c/span\u003e). In recent years, trauma literature has gained increasing prominence in higher education curricula (Gladden et al., \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Trauma literature not only documents collective trauma but also explores the representation and healing processes of individual psychological trauma (Reis, \u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Clark, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2016\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eHowever, close engagement with traumatic narratives may also entail psychological consequences, as the distressing experiences depicted in these texts can evoke emotional resonance, psychological distress, or even vicarious trauma in readers (Figley, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2002\u003c/span\u003e; Newell et al., \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). Research indicates that childhood maltreatment is prevalent in China (Chen et al., \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2021\u003c/span\u003e), and trauma-exposed individuals may exhibit concurrent negative and positive posttraumatic psychological responses after they grow up (Liu et al., \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e2025\u003c/span\u003e). Traumatic literature provides a mirror effect and psychological compensation mechanism (Brooks et al., \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Velasco et al., \u003cspan citationid=\"CR68\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Besides, evidence suggests that even without direct exposure to traumatic events, intense engagement with traumatic content through literature can lead to secondary traumatic stress (Jacob \u0026amp; Lambert, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn this context, understanding the psychological mechanisms that mediate the relationship between trauma literature reading and PTSD symptoms becomes crucial. There remains a relative scarcity of empirical studies examining how trauma literature reading relates to PTSD symptoms with consideration of the interactive roles of social support and empathy, particularly in the Chinese educational context. This study aims to address this gap by investigating the impact of reading trauma literature on Chinese undergraduates\u0026rsquo; PTSD symptoms, with specific attention to the mediating roles of social support and empathy. By exploring these relationships, this research seeks to contribute to the development of \u0026ldquo;trauma-informed pedagogy\u0026rdquo; and provide insights for educational practices that maximize the benefits of trauma literature while minimizing potential psychological harm to students.\u003c/p\u003e"},{"header":"2. Literature Review","content":"\u003cp\u003ePTSD affects an individual\u0026rsquo;s emotional state and cognitive functioning and also lead to impaired social functioning, poor academic performance, and other difficulties (Svenaeus, 2014; Friedman et al., \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2011\u003c/span\u003e; Forkus et al., \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). The core symptoms of PTSD include intrusive memories of traumatic events, nightmares, flashbacks, avoidance of trauma-related stimuli, negative alterations in cognition and mood, and marked changes in arousal and reactivity (Wampold et al., \u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e2010\u003c/span\u003e). University students are in a critical period of cognitive and emotional development, and face ongoing challenges such as academic pressure, interpersonal adaptation, and identity formation, rendering them relatively more psychologically vulnerable (Arnett, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2016\u003c/span\u003e; Ferrari et al., \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Hamza et al., \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Research indicates that the prevalence of PTSD among Chinese university students is significantly higher than that of the general population, reaching as high as 6.4% in some studies (Li et al., \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Furthermore, PTSD symptoms in university students may be exacerbated by factors such as academic stress, life transitions, and identity struggles, which can subsequently impair cognitive functioning, learning abilities, and social interactions (Leow et al., 2013; Boyraz et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2016\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eImplicitly, evidence from both literary and psychological studies suggests that even without direct exposure to traumatic events, intense engagement with traumatic content through literature, media, or other narratives can lead to secondary traumatic stress\u0026rdquo; (Bride, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2007\u003c/span\u003e; Leung et al., \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). This phenomenon is particularly pronounced among individuals who are emotionally sensitive or have a history of similar traumatic experiences (Ludick \u0026amp; Figley, \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e2017\u003c/span\u003e; Waegemakers \u0026amp; Lane, 2019). Research has found that university students may exhibit PTSD-like symptoms, such as emotional fluctuations, heightened anxiety, and intrusive thoughts, after reading literary works depicting war, violence, or catastrophic events (Kross \u0026amp; Ayduk, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e2017\u003c/span\u003e; Cole et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). These findings have sparked discussions about the necessity of implementing mental health safeguards in the teaching of trauma literature.\u003c/p\u003e \u003cp\u003eSocial support and empathy are critical components of individual psychological resources, play a pivotal role in the process of trauma coping and recovery. Social support refers to the resources individuals obtain from family, friends, colleagues, and communities, including emotional care, material assistance, informational guidance, and a sense of belonging (Cobb, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e1976\u003c/span\u003e; Wang et al., \u003cspan citationid=\"CR62\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Lee et al., \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Perceived social support, in particular, has been shown to have a more stable predictive effect on mental health (Marroqu\u0026iacute;n et al., \u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Oh et al., \u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Ample social support has been widely demonstrated to alleviate stress responses and reduce the severity and duration of PTSD symptoms (Cohen \u0026amp; Wills, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e1985\u003c/span\u003e; Diamond \u0026amp; Alley, 2023; Carmassi et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Especially for university students, social support from family, friends, and educational institutions constitutes a vital protective network against psychological stress (Deng et al., \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Acoba, \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Research indicates that high levels of social support not only reduce the incidence of PTSD symptoms among university students but also facilitate positive cognitive reappraisal and foster post-traumatic growth (Waters, 2022; Ye et al., \u003cspan citationid=\"CR69\" class=\"CitationRef\"\u003e2020\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eEmpathy is defined as the ability to understand and share the emotional states of others, compassing two dimensions: cognitive empathy and affective empathy (Fultz \u0026amp; Bernieri, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Nair et al., \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Cognitive empathy refers to the capacity to adopt another\u0026rsquo;s perspective and understand their thoughts and feelings, while affective empathy involves the emotional resonance with another\u0026rsquo;s emotional state (Decety \u0026amp; Jackson, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2004\u003c/span\u003e; Aldrup et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). Empathy plays a complex role in shaping an individual\u0026rsquo;s emotional responses and psychological processing of traumatic narratives, potentially serving as both a protective factor and a risk factor (Eisenberg \u0026amp; Fabes, 1990; Babik \u0026amp; Gardner, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Adaptive empathy facilitates a nuanced understanding of the multifaceted dimensions of traumatic experiences and promotes emotional regulation and healing (Lamothe et al., \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e2014\u003c/span\u003e; Siegel, \u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). However, excessive affective empathy, particularly in the absence of appropriate emotional boundaries, may lead to empathy fatigue and vicarious trauma (Leiberg et al., \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e2011\u003c/span\u003e; Stevens \u0026amp; Taber, \u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Donald et al., \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). Research indicates that individuals with high empathy may be more susceptible to intrusive thoughts and emotional fluctuations following trauma exposure, but they are also more likely to actively seek social support and professional assistance (Warren, \u003cspan citationid=\"CR63\" class=\"CitationRef\"\u003e2018\u003c/span\u003e; Weisz, E., \u0026amp; Cikara, \u003cspan citationid=\"CR65\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). However, there is a relative scarcity of studies examining the relationship between trauma literature reading and PTSD symptoms condisering interactive roles of social support and empathy. Therefore, this study proposes the following hypotheses:\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eH1\u003c/strong\u003e \u003cp\u003eTrauma literature reading is associated with PTSD symptoms among university students.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eH2\u003c/strong\u003e \u003cp\u003eSocial support mediates the relationship between trauma literature reading and PTSD symptoms.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eH3\u003c/strong\u003e \u003cp\u003eEmpathy mediates the relationship between trauma literature reading and PTSD symptoms.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eH4\u003c/strong\u003e \u003cp\u003eTrauma literature reading has a significant impact on university students\u0026rsquo; PTSD symptoms through the mediating roles of social support and empathy.\u003c/p\u003e \u003c/p\u003e"},{"header":"2. Method","content":"\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Participants\u003c/h2\u003e \u003cp\u003e This study investigates 589 undergraduate students as participants from five universities in Jiangsu, China. The participants ranged in age from 18 to 22 and above, with 297 females (50.42%) and 292 males (49.58%). Participants were drawn from different academic years (freshmen to seniors) and various disciplines (humanities, sciences, engineering, etc.). The inclusion criteria were full-time undergraduate students currently enrolled at the university, while the exclusion criteria included individuals with a history of severe psychological disorders or those currently undergoing psychological treatment. Participants were recruited through random sampling conducted by 10 students from the university\u0026rsquo;s psychology department. The researchers asked if the participants had the experience of trauma and reading trauma literature. If student\u0026rsquo;s answer was yes, she/he was asked to fill out the questionnaire. The study is in accordance with the Declaration of Helsinki and was approved by the ethics committee of Jiangsu Second Normal University [20250410001], and all participants provided informed consent prior to participation, ensuring they understood the purpose and procedures of the study and that their involvement was voluntary. Data collection took place from December 2024 to February 2025.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e3.2 Measures\u003c/h2\u003e \u003cdiv id=\"Sec6\" class=\"Section3\"\u003e \u003ch2\u003e3.2.1 Reading self-efficacy\u003c/h2\u003e \u003cp\u003eTo measure individuals\u0026rsquo; confidence in their ability to understand and appreciate novels, the study adopted a reading self-efficacy scale. Reading self-efficacy was assessed via a four-item scale specifically developed for this study, based on two general self-efficacy measures (Engeser, 2005; Beierlein et al., 2012). The internal consistency of this scale was acceptable (McDonald\u0026rsquo;s ω\u0026thinsp;=\u0026thinsp;0.62). Reading self-efficacy was assessed using single items on five-point Likert scales (ranging from \u0026ldquo;very strongly disagree\u0026rdquo; (=\u0026thinsp;1) to \u0026ldquo;very strongly agree\u0026rdquo; (=\u0026thinsp;5) (Thissen et al., \u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e2018\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section3\"\u003e \u003ch2\u003e3.2.2 Social Support\u003c/h2\u003e \u003cp\u003eThis study used a simplified version of the Chinese version of the Perceived Social Support Scale (PSSS-A6) to assess the subjects\u0026rsquo; perceived social support level. The scale was obtained by Wu et al. (\u003cspan citationid=\"CR67\" class=\"CitationRef\"\u003e2025\u003c/span\u003e) based on the original PSSS-12, using the Ant Colony Optimization (ACO) algorithm to screen items. It is more suitable for large sample research scenarios and takes into account both measurement validity and practicality. PSSS-A6 contains three dimensions (family support, friend support, and important others support), each of which consists of two questions, for a total of 6 items.\u003c/p\u003e \u003cp\u003eThe internal consistency index of this simplified version in the mainland Chinese sample is relatively high, and the Cronbach\u0026rsquo;s α in both data sets reached 0.91. At the same time, the reliability of each sub-dimension is also relatively ideal. Therefore, in research situations where both questionnaire response speed and measurement accuracy are required, the use of this 6-item version of the scale can not only save time to fill in the questionnaire, but also maintain a more accurate assessment of the individual\u0026rsquo;s perceived social support level.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section3\"\u003e \u003ch2\u003e3.2.3 Empathy\u003c/h2\u003e \u003cp\u003eEmpathy was assessed using the Emotional Empathic Drive Short Scale (EED), a five-item instrument grounded in Zaki\u0026rsquo;s (2014) theoretical framework of motivated empathy (Karlstetter, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). The EED measures individuals\u0026rsquo; dispositional drive to share others\u0026rsquo; emotions, capturing affective components of empathy rather than cognitive ones. Unlike traditional agree\u0026ndash;disagree scales, this scale employs a frequency-based response format adapted from Spreng et al. (2009), which asks participants how often they feel or behave in ways described by each item. Each item is scored on a scale from 0 to 4, producing a total sum score ranging from 0 to 20, with higher scores indicating stronger emotional empathic drive.\u003c/p\u003e \u003cp\u003eThis response format helps mitigate social desirability bias by focusing on the regularity of empathic experiences rather than levels of agreement, a concern raised in previous survey research (Karlstetter, 2014). It also helps preserve the multidimensionality of empathy more effectively than standard Likert scales (Marcus et al., 2006). The EED has been validated in cross-cultural samples from Canada and Germany and is particularly suited for use in psychology, neuroscience, and social science contexts. In this study, the scale was administered in its Chinese version to undergraduate students aged 18 and older.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section3\"\u003e \u003ch2\u003e3.2.3 PTSD\u003c/h2\u003e \u003cp\u003eIn this study, PTSD symptoms were assessed using the Short PTSD Rating Interview (SPRINT) developed by Connor and Davidson (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2001\u003c/span\u003e). The SPRINT is a brief and psychometrically validated tool designed to measure global PTSD symptom severity efficiently. It consists of 8 items, including four that correspond directly to the core PTSD symptom clusters\u0026mdash;intrusion, avoidance, numbing, and hyperarousal\u0026mdash;as defined by DSM-IV. The other four items assess somatic distress, stress vulnerability, and impairments in work/daily functioning and social relationships.\u003c/p\u003e \u003cp\u003eEach item is rated on a 5-point Likert scale from 0 (not at all) to 4 (very much), with a total score ranging from 0 to 32, where higher scores indicate greater PTSD severity. The SPRINT has demonstrated a good internal consistency (Cronbach\u0026rsquo;s α\u0026thinsp;=\u0026thinsp;0.77\u0026ndash;0.88), excellent inter-rater reliability (ICC up to 0.998), and high diagnostic efficiency, with scores between 14\u0026ndash;17 offering up to 96% diagnostic accuracy in general populations. Its brevity (5\u0026ndash;10 minutes) and comprehensive symptom coverage make it particularly well-suited for both clinical and research contexts where time efficiency is essential.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003e3.3 Data Analysis\u003c/h2\u003e \u003cp\u003eDescriptive statistics were computed to summarize the demographic information and central tendencies of the key variables, including reading self-efficacy, perceived social support, emotional empathy, and PTSD symptoms. Normality tests and missing data checks were also conducted to ensure data quality.\u003c/p\u003e \u003cp\u003eInternal consistency of all scales was evaluated using Cronbach\u0026rsquo;s alpha coefficients, with values above 0.70 considered acceptable. Confirmatory Factor Analysis (CFA) was conducted to assess the construct validity, including convergent validity (standardized factor loadings\u0026thinsp;\u0026gt;\u0026thinsp;0.5, AVE\u0026thinsp;\u0026gt;\u0026thinsp;0.5, CR\u0026thinsp;\u0026gt;\u0026thinsp;0.7) and discriminant validity (inter-construct correlations lower than the square root of AVEs). Normally, AVE value should be at least 0.50 or above, however, AVE value of more than 0.40 is acceptable if the composite reliability CR value is adequate (Lam, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e2012\u003c/span\u003e; Murtagh \u0026amp; Heck, \u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e2012\u003c/span\u003e). Model fit was assessed using the following indices: RMSEA (\u0026lt;\u0026thinsp;0.08), CFI (\u0026gt;\u0026thinsp;0.90), TLI (\u0026gt;\u0026thinsp;0.90), GFI (\u0026gt;\u0026thinsp;0.90), and SRMR (\u0026lt;\u0026thinsp;0.08) (Feng et al., 2017).\u003c/p\u003e \u003cp\u003eTo examine the hypothesized relationships among variables, a structural equation model (SEM) was constructed and tested using maximum likelihood estimation in AMOS. This included the direct effect of trauma literature reading self-efficacy (RS) on PTSD symptoms, as well as the indirect effects mediated by social support (SS) and empathy (EP). The model tested the following hypothesized relationships: a. direct effect of RS on PTSD symptoms; b. indirect effect of RS on PTSD via SS; c: indirect effect of RS on PTSD via EP; a\u0026prime;. Chain mediation from RS \u0026rarr; SS \u0026rarr; EP \u0026rarr; PTSD.\u003c/p\u003e \u003cp\u003eAll path coefficients were estimated using maximum likelihood estimation, and the significance of indirect effects was tested via bootstrapping (5,000 samples, 95% confidence interval). Path significance was determined using standardized regression weights (β) and critical ratios (C.R.), with C.R. \u0026gt; 1.96 indicating statistical significance (p\u0026thinsp;\u0026lt;\u0026thinsp;.05) (Hazra, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2017\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e"},{"header":"4. Results","content":"\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003e4.1 Descriptive Data\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e presents demographic characteristics and psychological measures from a sample of 589 college students. The gender distribution is nearly equal, with females comprising 50.42% and males 49.58% of participants. Students are distributed fairly evenly across four grade levels, with first-year students representing 26.32%, second-year students 23.26%, third-year students 27.33%, and fourth-year students 23.09% of the sample. The age profile indicates most participants are between 19 and 21 years old, collectively accounting for 81.66% of the sample. Specifically, 13.24% are 18 years old, 24.45% are 19 years old, 30.22% are 20 years old, 26.99% are 21 years old, and only 5.09% are 22 years or older. This age distribution aligns with typical undergraduate populations.\u003c/p\u003e \u003cp\u003eReading habits among participants show considerable variation. Only a small percentage (5.09%) report reading daily, while approximately one-quarter read weekly (24.96%), monthly (25.47%), or quarterly (25.98%). A notable portion (18.51%) indicates they read only yearly, suggesting limited regular reading engagement among a significant subset of the sample. The dataset also includes mean scores for several psychological constructs measured on standardized scales. Reading Engagement shows a mean score of 3.46 (SD\u0026thinsp;=\u0026thinsp;0.62), suggesting moderate to high levels of engagement with reading materials. Social Support and Empathy demonstrate similar moderate levels with means of 3.04 (SD\u0026thinsp;=\u0026thinsp;0.55) and 3.06 (SD\u0026thinsp;=\u0026thinsp;0.59), respectively. PTSD scores are notably higher with a mean of 3.81 (SD\u0026thinsp;=\u0026thinsp;0.52), though without knowing the specific measurement scales used, interpretation of these values must be approached with caution.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDescriptive data of participants.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMean (SD)/N(%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eDemographical characteristics\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e297 (50.42)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e292 (49.58)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eGrade\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e155 (26.32)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e137 (23.26)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e161(27.33)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e136 (23.09)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e78 (13.24)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e144 (24.45)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e178 (30.22)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e159 (26.99)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e30 (5.09)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eReading frequency\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDaily\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e30 (5.09)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWeekly\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e147 (24.96)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMonthly\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e150 (25.47)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eQuarterly\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e153 (25.98)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYearly\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e109 (18.51)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReading Engagement\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eM (SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.46 (0.62)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSocial Support\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eM (SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.04 (0.55)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmpathy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eM (SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.06 (0.59)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePTSD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eM (SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.81 (0.52)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003e4.2 Reliability and Validity\u003c/h2\u003e \u003cp\u003eThe degree to which a measurement item is seen consistently by the same individuals under the same circumstances is known as reliability. Cronbach\u0026rsquo;s alphas and reliability coefficients would be used to assess the internal consistency of the questionnaire\u0026rsquo;s measurement items. Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e displays the survey\u0026rsquo;s Cronbach\u0026rsquo;s alpha results. Every construct was higher above the criterion of 0.70 (Mugge \u0026amp; Schoormans, \u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e2012\u003c/span\u003e). Furthermore, the column\u0026rsquo;s competitive reliability (C.R.) is likewise above the cutoff. Consequently, the survey\u0026rsquo;s measurement items are regarded as trustworthy.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eReliability and Unidimensionality.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConstruct\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCronbach\u0026rsquo;s Alpha\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eStandardized Factor Loading\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eC.R.\u003c/p\u003e \u003cp\u003e(t-value)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eSMC\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eAVE\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eComposite Reliability\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eReading Self-efficacy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRS1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e12.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.533\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.819\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRS2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e15.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.608\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRS3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e15.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.624\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRS4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e14.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.49\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003eSocial support\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003e0.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSS1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e14.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003e0.561\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003e0.884\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSS2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e13.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.436\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSS3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e15.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.578\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSS4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e14.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.518\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSS5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e16.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.706\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSS6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e16.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.64\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eEmpathy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003e0.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eEP1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e13.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.423\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003e0.421\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003e0.782\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eEP2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e14.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.533\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eEP3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e11.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.314\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eEP4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e14.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.533\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eEP5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e11.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.303\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"7\" rowspan=\"8\"\u003e \u003cp\u003ePTSD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\" morerows=\"7\" rowspan=\"8\"\u003e \u003cp\u003e0.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eP1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e12.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.397\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\" morerows=\"7\" rowspan=\"8\"\u003e \u003cp\u003e0.458\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"7\" rowspan=\"8\"\u003e \u003cp\u003e0.871\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eP2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e13.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.462\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eP3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e14.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.548\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eP4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e12.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.397\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eP5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e12.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.384\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eP6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e13.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.476\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eP7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e15.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.562\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eP8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e13.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.436\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eConstruct validity is the degree of agreement between a construct and its operationalisation. To ascertain the construct validity of our study framework, we may assess (1) unidimensionality, (2) convergent validity, (3) discriminant validity, and (4) nomological validity (Mugge \u0026amp; Schoormans, \u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e2012\u003c/span\u003e). Confirmatory factor analysis was used to examine the study framework\u0026rsquo;s unidimensionality (CFA). CFA was created to examine if a construct\u0026rsquo;s measures align with the researcher's understanding of the construct's (or factor\u0026rsquo;s) nature. A measurement scale is said to be unidimensional if it only has one dimension.\u003c/p\u003e \u003cp\u003eConvergent validity, then, is the degree to which two measures of constructs that theoretically should be connected are related to each other. The threshold of convergent validity is evaluated individually using critical ratios (CR, value are 2 or above), standardised factor loadings (value are 0.5 or above), and averaged variances expected (AVEs, value above 0.5 or more than 0.4 if CR value is over 0.6) (Evanschitzky et al., \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2006\u003c/span\u003e). The least standardised factor loading (=\u0026thinsp;0.56) was over the \u0026ldquo;0.5\u0026rdquo; barrier, the minimum AVE calculated was within the acceptable range in our study paradigm, and the minimum CR (=\u0026thinsp;11.0) was noticeably higher than the \u0026ldquo;2\u0026rdquo; threshold. Thus, convergent validity is thought to be suitable for the study design.\u003c/p\u003e \u003cp\u003eDiscriminant validity examines the relationship between ideas or measurements that should not be related. We determined our study framework\u0026rsquo;s correlation coefficients displayed in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCorrelation on the key variables\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConstruct\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRS\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSS\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eEP\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePTSD\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.279***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.246***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.247***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePTSD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.375***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.355***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.284***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003eNote: *p\u0026thinsp;\u0026lt;\u0026thinsp;0.1; **p\u0026thinsp;\u0026lt;\u0026thinsp;0.05; ***p\u0026thinsp;\u0026lt;\u0026thinsp;0.01\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e presents the findings of an evaluation of the research framework\u0026rsquo;s goodness of fit through absolute fit and incremental fit indices. Specifically, the subsequent metrics adhered to their respective thresholds: RMSEA (root mean square error of approximation), NFI (normed fit index), IFI (incremental fit index), TLI (Tucker\u0026ndash;Lewis index), CFI (comparative fit index), SRMR (standardised root mean square residual), and GFI \u0026amp; AGFI (goodness-of-fit index). Consequently, the research framework was deemed suitable for the collected data.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eGoodness of fit test\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMeasure\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAcceptable Values\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eValue\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAbsolute fit indices\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eChi-square\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e192.34\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ed,f.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e97.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eChi-square/d.f.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u0026ndash;5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.98\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGFI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.9 or above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.952\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAGFI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.9 or above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.928\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSRMR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.08 or below\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.041\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRMSEA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.05\u0026ndash;0.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.046\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIncremental fit indices\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNFI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.9 or above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.941\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIFI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.9 or above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.968\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTLI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.9 or above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.955\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCFI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.9 or above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.967\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003e4.3 Path analysis\u003c/h2\u003e \u003cp\u003eThe aim of this study is to explore the impact of trauma literature reading on PTSD with the mediating role of social support and empathy. In order to analyze the relationships within the research framework, we conducted a path analysis based on the SEM. Figure\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e shows the results of this analysis, and Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e shows the standardized coefficients of each path and the derivation of the hypotheses.\u003c/p\u003e \u003cp\u003eThe direct pathway from reading self-efficacy to PTSD symptoms (path a) shows a significant negative relationship (β = -0.23, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001, C.R. = -6.57), indicating that students with higher confidence in their ability to engage with trauma literature report fewer PTSD symptoms. The indirect path from reading self-efficacy through social support to PTSD symptoms (path b) demonstrated a significant negative relationship (β = -0.15, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001, C.R. = -3.75). Similarly, the indirect pathway through empathy (path c) showed a significant negative relationship (β = -0.11, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05, C.R. = -2.44). The sequential mediation pathway (path a\u0026prime;), examining the influence of reading self-efficacy on PTSD symptoms through both social support and empathy in sequence, yielded a marginally significant negative effect (β = -0.08, p\u0026thinsp;\u0026lt;\u0026thinsp;0.1, C.R. = -1.78).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eHypothesis Testing\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHypothesis\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePath\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eStandardized Coefficient\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eStandard Error\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eC.R.(t-Value)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eResult\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eH1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ea (RS \u0026rarr; PTSD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-0.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.035\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e-6.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eAccepted\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eH2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eb (RS \u0026rarr; SS \u0026rarr; PTSD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-0.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.040\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e-3.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eAccepted\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eH3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eC (RS \u0026rarr; EP \u0026rarr; PTSD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-0.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.045\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e-2.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eAccepted\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eH4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ea\u0026rsquo; (RS \u0026rarr; SS \u0026rarr; EP\u0026rarr;PTSD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-0.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.045\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e-1.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eAccepted\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"5. Discussion","content":"\u003cp\u003eThe findings from this study suggest a significant relationship between trauma literature reading self-efficacy and PTSD symptoms among Chinese undergraduate students, with important mediating roles played by social support and empathy. These results align with previous theoretical frameworks that propose engagement with traumatic narratives can evoke psychological reactions in readers, even without direct traumatic exposure (Brooks, 2024). Our finding that reading self-efficacy has a negative direct effect on PTSD symptoms supports H1 and suggests that students with higher confidence in their ability to process trauma literature may experience fewer adverse psychological effects when engaging with distressing content.\u003c/p\u003e \u003cp\u003eThe mediating role of social support confirmed in H2 corresponds with established literature demonstrating the protective function of social support against psychological distress (Ozbay, 2007; Acoba, \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). This finding extends previous research by specifically applying it to the context of trauma literature engagement, suggesting that students with higher reading self-efficacy may perceive and utilize social support resources more effectively, thereby reducing their vulnerability to PTSD symptoms. These results are consistent with studies showing that social support can buffer stress responses and facilitate recovery from traumatic experiences (Calhoun et al., \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2022\u003c/span\u003e), and highlight its particular importance in educational settings where students encounter potentially distressing content.\u003c/p\u003e \u003cp\u003eOur third hypothesis concerning empathy as a mediator was also supported, revealing a complex relationship whereby reading self-efficacy positively influences empathy, which in turn reduces PTSD symptoms. This finding presents an interesting nuance to previous literature describing empathy\u0026rsquo;s dual role as both protective and potentially harmful in trauma contexts (Shamai-Leshem et al., \u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e2025\u003c/span\u003e). While excessive affective empathy without appropriate boundaries can increase vulnerability to vicarious trauma, our results suggest that when empathy develops alongside reading self-efficacy, it may function as a protective factor. This aligns with research indicating that adaptive empathy can facilitate healthier processing of traumatic content (Adonis et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2025\u003c/span\u003e; Nina et al., 2022).\u003c/p\u003e \u003cp\u003eThe chain mediation effect (RS \u0026rarr; SS \u0026rarr; EP \u0026rarr; PTSD) yielded a marginally significant result, indicating that reading self-efficacy may influence PTSD symptoms through a sequential pathway involving both social support and empathy. This finding extends beyond previous research by proposing an integrated mechanism through which reading self-efficacy may operate. Specifically, students with higher reading self-efficacy may perceive greater social support, which enhances their capacity for adaptive empathy, ultimately reducing vulnerability to PTSD symptoms when engaging with trauma literature. This sequential relationship has not been extensively explored in previous studies and represents a novel contribution to understanding how these psychological resources interact in educational contexts.\u003c/p\u003e"},{"header":"6. Conclusion","content":"\u003cp\u003eThe overall findings suggest that trauma literature, while valuable for educational purposes, requires thoughtful implementation in university curricula. The negative relationship between reading self-efficacy and PTSD symptoms underscores the importance of cultivating students\u0026rsquo; confidence and competence in engaging with challenging texts. This advocates for \u0026ldquo;trauma-informed teaching\u0026rdquo; that acknowledges the potential psychological impact of educational content (Crosby, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). Moreover, the significant mediating roles of social support and empathy highlight the importance of addressing not only students\u0026rsquo; academic skills but also their psychological resources and social environment when introducing trauma literature in educational settings.\u003c/p\u003e \u003cp\u003eOur findings should be considered within the cultural context of Chinese higher education, where academic pressure is often intense and mental health concerns among university students have received increasing attention. The protective factors identified in this study\u0026mdash;reading self-efficacy, social support, and adaptive empathy\u0026mdash;may be particularly important resources for Chinese students navigating both academic and psychological challenges.\u003c/p\u003e \u003cp\u003eThese results offer important implications for educational practice, suggesting that enhancing students\u0026rsquo; reading self-efficacy, strengthening social support networks, and promoting adaptive empathy could mitigate potential adverse effects of engaging with trauma literature. Faculty members who incorporate trauma literature into their courses should consider implementing strategies to build these protective resources among students. These might include scaffolded reading approaches to build confidence, creating supportive classroom communities that encourage discussion and emotional processing, and explicit instruction in empathic engagement that maintains appropriate boundaries. Such pedagogical considerations align with calls for more psychologically informed approaches to teaching sensitive content in higher education.\u003c/p\u003e"},{"header":"7. Limitations and Future Implications","content":"\u003cp\u003eFew limitations should be acknowledged. The cross-sectional design prevents us from establishing causal relationships between the variables. While our path analysis suggests directional relationships, longitudinal studies are needed to confirm the temporal sequence and causality between trauma literature reading, mediating factors, and PTSD symptoms. Besides, the study\u0026rsquo;s reliance on self-report measures may introduce social desirability bias, particularly for sensitive topics like empathy and psychological distress. Future research could benefit from incorporating physiological measures, behavioral observations, or experimental designs to complement self-report data.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study involving human participants was reviewed and approved by the Ethics Committee of Jiangsu Second Normal University. Informed consent to participate in the study was obtained from all participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contribution declaration\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eYuan conceptualized the idea and wrote the main manuscript. Qi and Zhou conducted the computing. Zhu and Zhang prepared figures and tables. Qin edited the manuscript. Wang did the supervision. \u0026nbsp;All authors reviewed the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eN/A\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors thank.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eAcoba, E. F. (2024). Social support and mental health: the mediating role of perceived stress. \u003cem\u003eFrontiers in Psychology\u003c/em\u003e, \u003cem\u003e15\u003c/em\u003e, 1330720.\u003c/li\u003e\n \u003cli\u003eAdonis, M., Loucaides, M., Sullman, M. J., \u0026amp; Lajunen, T. (2025). The protective role of self compassion in trauma recovery and its moderating impact on post traumatic symptoms and post traumatic growth. \u003cem\u003eScientific Reports\u003c/em\u003e, \u003cem\u003e15\u003c/em\u003e(1), 8145.\u003c/li\u003e\n \u003cli\u003eAldrup, K., Carstensen, B., \u0026amp; Klusmann, U. 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Resilience, social support, and coping as mediators between COVID‐19‐related stressful experiences and acute stress disorder among college students in China. \u003cem\u003eApplied Psychology: Health and Well‐Being\u003c/em\u003e, \u003cem\u003e12\u003c/em\u003e(4), 1074-1094.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-psychology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"psyo","sideBox":"Learn more about [BMC Psychology](http://bmcpsychology.biomedcentral.com/)","snPcode":"","submissionUrl":"","title":"BMC Psychology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"trauma literature, Chinese undergraduates, social support, empathy, PTSD","lastPublishedDoi":"10.21203/rs.3.rs-6446529/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6446529/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eTrauma literature has emerged as a powerful medium for exploring collective and individual psychological experiences. However, it\u0026rsquo;s the potential psychological risks\u0026mdash;particularly its association with PTSD symptoms among students\u0026mdash;have not been thoroughly examined, especially in the context of Chinese undergraduates who face unique academic and social pressures. This study investigates the impact of trauma literature on PTSD symptoms, with a focus on the mediating roles of social support and empathy. Our findings demonstrate that trauma literature can alleviate psychological distress, while also highlighting the critical moderating roles of social support and empathy in mitigating potential adverse effects. The study underscores the need for trauma-informed pedagogical approaches to balance literary education with mental health considerations, offering practical implications for educators and policymakers.\u003c/p\u003e","manuscriptTitle":"The Impact of Reading Trauma Literature on Chinese Undergraduates’ PTSD: The Mediating Roles of Social Support and Empathy","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-14 11:47:27","doi":"10.21203/rs.3.rs-6446529/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-06-30T07:27:19+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-06-28T21:54:54+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-06-24T06:45:51+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"27448559149197015253155710049454751712","date":"2025-06-14T07:48:31+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"15337994194457751061558274247136167128","date":"2025-05-31T18:25:04+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-05-09T11:57:23+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-05-09T08:09:45+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-04-25T14:34:20+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-04-24T03:51:23+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Psychology","date":"2025-04-24T03:50:19+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-psychology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"psyo","sideBox":"Learn more about [BMC Psychology](http://bmcpsychology.biomedcentral.com/)","snPcode":"","submissionUrl":"","title":"BMC Psychology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"f79c0bbe-8463-4a7a-94df-2a410615eee8","owner":[],"postedDate":"May 14th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-09-08T15:58:52+00:00","versionOfRecord":{"articleIdentity":"rs-6446529","link":"https://doi.org/10.1186/s40359-025-03356-x","journal":{"identity":"bmc-psychology","isVorOnly":false,"title":"BMC Psychology"},"publishedOn":"2025-09-01 15:57:06","publishedOnDateReadable":"September 1st, 2025"},"versionCreatedAt":"2025-05-14 11:47:27","video":"","vorDoi":"10.1186/s40359-025-03356-x","vorDoiUrl":"https://doi.org/10.1186/s40359-025-03356-x","workflowStages":[]},"version":"v1","identity":"rs-6446529","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6446529","identity":"rs-6446529","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}