The Potential Pathway Among Self-Focused Attention, Rumination, Perceived Stress and Female Psychosomatic Symptoms

Psychosomatic symptoms are common among females and involve complex psychological and cognitive processes. This study examined the relationships among self-focused attention (SFA), rumination, perceived stress, and psychosomatic symptoms. A cross-sectional survey was conducted in China among 839 women (mean age = 26.50 ± 6.08 years). Standardized questionnaires assessed SFA, rumination, perceived stress, anxiety symptoms, and somatic symptoms. Correlation, hierarchical regression, and structural equation modeling (SEM) analyses were performed. Psychosomatic symptoms were positively correlated with perceived stress, rumination, and SFA. SFA was positively correlated with rumination but not with perceived stress. SEM indicated a full mediation pattern in which rumination and perceived stress mediated the relationship between SFA and psychosomatic symptoms. The indirect path through rumination alone was not significant, whereas the indirect path through perceived stress alone and the chained indirect path through rumination and perceived stress were significant. The final SEM fit indices were (χ² [70] = 441.460, χ²/df = 6.307, CFI = 0.965, IFI = 0.965, TLI = 0.954, RMSEA = 0.080 [0.073-0.087], SRMR = 0.079, RMR = 0.037). The findings suggest that SFA may be associated with psychosomatic symptoms through different pathways. Given the online convenience sampling and the relatively limited age distribution, the findings should be generalized cautiously to broader female populations.