Sense of coherence and resilience as predictors of psychological well-being: a longitudinal study of medical students in Pakistan

Background Although psychological well-being (PWB), sense of coherence (SoC), and resilience have been widely studied, longitudinal evidence regarding their reciprocal relationships among medical students remains limited. This study examined the bidirectional longitudinal relationships among these psychological resources using a two-wave cross-lagged panel design.Methods A two-wave longitudinal study was conducted among medical students from seven medical colleges in Islamabad, Pakistan. A total of 722 students participated at baseline (August–September 2022) and 465 at the six-month follow-up (March–April 2023), with 401 participants successfully matched across both waves. Cross-lagged panel modeling (CLPM) was used to examine reciprocal longitudinal relationships while controlling for age, gender, and socioeconomic status.Results Significant autoregressive effects were observed for PWB, SoC, and resilience across the two measurement occasions. Significant reciprocal cross-lagged associations were identified between PWB and both SoC and resilience. Higher baseline SoC and resilience predicted subsequent PWB, whereas higher baseline PWB predicted subsequent levels of SoC and resilience. In contrast, the reciprocal associations between SoC and resilience were weaker and not consistently significant.Conclusion The findings suggest that psychological well-being, sense of coherence, and resilience function as dynamically interconnected psychological resources among medical students. Strengthening psychological well-being alongside resilience and sense of coherence may therefore represent an important strategy for supporting student mental health in demanding educational environments. Further longitudinal studies with additional measurement waves are warranted to confirm these developmental relationships.