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The Role of Social Support as a Buffer for Imposter Phenomenon Among Medical Students: Exploring the Mediation and Moderation of Anxiety and Stress
Background: Impostor syndrome (IS) is marked by persistent self-doubt and feelings of intellectual fraudulence despite evident accomplishments. It is associated with significant psychological distress, including anxiety and stress. Among Pakistani medical students, the association between IS, psychological well-being, and social support remains inadequately studied. This study aimed to assess the prevalence of IS and examine its relationship with anxiety, stress, and social support.
Methods: A cross-sectional study was conducted from March to September 2024 at four Pakistani medical colleges: Fazaia Ruth Pfau Medical College, Baqai Medical University, Nishtar Medical University, and Bakhtawar Amin Medical College. MBBS students from first to final year were included. Participants (n=649) were recruited via stratified sampling. Inclusion criteria included current MBBS enrollment; students with known psychiatric diagnoses were excluded. The Clance Impostor Phenomenon Scale assessed IS, the Oslo Social Support Scale (OSSS-3) evaluated social support, and the Depression, Anxiety, and Stress Scale (DASS-21) measured anxiety and stress. Data were self-reported through anonymous questionnaires. The primary outcome was the IS score. Correlation, regression, mediation, and moderation analyses were performed using SPSS version 26.0.
Findings: Among 649 students (mean age 21.4 years; 58.7% female), the mean IS score was 61.23 (SD ±10.3). Mean anxiety and stress scores were 17.25 (SD ±5.7) and 19.45 (SD ±6.2), respectively, while the mean social support score was 8.63 (SD ±1.9). IS negatively correlated with social support (r = –0.141), anxiety (r = –0.130), and stress (r = –0.132). Regression showed that social support alone explained 2.0% of IS variance (R2 = 0.020), increasing to 37.6% with anxiety and stress included (ΔR2 = 0.356; p < 0.001). Mediation analysis revealed that social support indirectly reduced IS by lowering anxiety and stress. No significant moderation effects were found.
Interpretation: Social support may reduce IS among medical students by mitigating anxiety and stress. Interventions to enhance support systems and address psychological distress could help alleviate IS and improve student well-being.
Keywords: Imposter syndrome, Imposter Phenomenon, Social Support, Anxiety, Stress, Medical Students, Psychological Well-being, Prevalence, Pakistan, Mediation, Moderation
Fatima, Maryam and Qamar, Manahil and Irfan, Hira and Malik, Hurais and Batool, Faraheem and Shahzad, Jawaria and Alam, Muhammad Shoaib and Jamil, Muhammad Usama and Jamil, Alishba and Mohiuddin, Sumaira and Abdullah, Muhammad and Ahmed, Zuhair and Rehman, Abdul and Karam, Ayat ul and Mahmmoud Fadelallah Eljack, Mohammed, The Role of Social Support as a Buffer for Imposter Phenomenon Among Medical Students: Exploring the Mediation and Moderation of Anxiety and Stress. Available at SSRN: https://ssrn.com/abstract=5216225 or http://dx.doi.org/10.2139/ssrn.5216225
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