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

Background Psychosomatic symptoms are common among females, which reflect complex interactions among biological, psychological, and cognitive processes. Although biological mechanisms have been well established, they offer limited guidance for psychological interventions. This study focuses on self-focused attention (SFA), rumination, and perceived stress to reveal the cognitive pathways contributing to female psychosomatic symptoms. Methods This cross-sectional study was conducted in China in 2024, recruiting 839 women with a mean age of 26.50 ± 6.08 years. Standardized questionnaires were used to collect data on somatic symptoms, anxiety symptoms, self-focused attention, rumination, and perceived stress. Data analysis employed IBM SPSS 29.0 and AMOS 30.0 software, with a significance level set at p < 0.05. Analytical methods used included descriptive statistics, correlation, hierarchical regression analyses, and structural equation modeling (SEM). Results Perceived stress (r = .696, p < .01), rumination (r = .759, p < .01), and SFA (r = .132, p < .01) were significantly positively correlated with female psychosomatic symptoms. SFA (r = .265, p < .01) and perceived stress (r = .706, p < .01) were also significantly positively correlated with rumination. Only SFA and perceived stress showed no significant association. SEM analysis indicated that rumination and perceived stress fully mediated the relationship between self-focus attention and psychosomatic symptoms. The model fit indicators showed that the final model fit was acceptable (χ²[71] = 461.159, χ²/df = 6.495, CFI = .963, IFI = .963, TLI = .953, RMR = .039). Conclusions This study indicated that when developing interventions to reduce psychosomatic symptoms in females, all these variables should be comprehensively considered.