Investigating the Relationship Between Perceived Stress and Addiction Readiness Among Students of Zahedan University of Medical Sciences, 2023 - 2024

Abstract

Background: University students face substantial academic and psychosocial pressures that may increase their vulnerability to risky behaviors. Objectives: This study examined the association between perceived stress and addiction readiness among students at Zahedan University of Medical Sciences (ZaUMS) during the 2023 - 2024 academic year. Methods: In this cross-sectional study, 612 students completed the 14-item Perceived Stress Scale (PSS-14) and the Iranian Addiction Potential Scale (IAPS). Sampling was conducted using a stratified proportional framework across six faculties. Students were recruited from classrooms, dormitories, and clinical training settings until the recruitment quota for each faculty was reached. Questionnaires with extensive missing responses were excluded, and limited item-level missingness was handled using prespecified prorated scoring. Pearson correlations (overall and sex-stratified) and multivariable linear regression with HC3 robust standard errors were used to assess the association between stress and addiction readiness after adjustment for sociodemographic factors and self-reported substance use. Analyses were conducted using IBM SPSS Statistics version 26. Results: The mean age was 21.46 ± 1.44 years, and 73.5% of participants were male. The mean PSS-14 and IAPS scores were 25.34 ± 5.58 and 55.04 ± 34.93, respectively. Perceived stress was positively correlated with addiction readiness (r = 0.38, P < 0.001), with a stronger correlation among females (r = 0.58) than among males (r = 0.26). In adjusted models, perceived stress remained independently associated with higher IAPS scores (fully adjusted model: b = 2.20 per 1-point increase in PSS score; P < 0.001). In the sex-interaction model, the perceived stress × male interaction coefficient was negative and statistically significant (b = -2.32; 95% CI, -3.14 to -1.51; P < 0.001). Conclusions: Higher perceived stress was significantly associated with greater addiction readiness among medical sciences students. Given the cross-sectional design, the findings should be interpreted as associations rather than causal effects. Longitudinal and interventional studies are warranted to determine whether stress-focused interventions can reduce addiction-related vulnerability in university settings.