In recent years, anxiety among college students has become increasingly prevalent, drawing significant societal concern due to its associated mental health issues.An epidemiological survey conducted by the World Health Organization across 21 countries found that anxiety disorders are the most prevalent mental health issue, with a prevalence rate between 11.7% and 14.7% [1]. Chinese college students, in particular, face unique pressures distinct from other demographics. These challenges include mastering academic knowledge and skills, developing intimate relationships, avoiding loneliness, experiencing love and fulfillment, and adapting to college life [2]. Given the unique causes of anxiety in this group, this study focuses on examining the current anxiety levels among Chinese college students.
Physical exercise is considered crucial in managing mild to moderate mental health conditions, particularly depression and anxiety [3]. It is important to differentiate between physical exercise and physical activity. As noted by C.J. Caspersen, physical exercise encompasses any movement generated by skeletal muscles that leads to energy expenditure, whereas exercise specifically refers to a subset of physical activity that is intentional, organized, and repeated to enhance or sustain physical health[4]. This study focuses on physical self-esteem, which relates to body image evaluation, and therefore uses the term "physical exercise." Numerous studies have demonstrated that physical exercise significantly reduces anxiety. For instance, Peter Salmon found that physical exercise has antidepressant and anxiolytic effects, preventing stress-related negative outcomes [5]. Participants engaging in less physical exercise reported higher levels of depressive symptoms and anxiety disorders [6], and those inactive had significantly higher anxiety levels compared to regular exercisers. Engaging in physical exercise correlates with reduced incidences of anxiety and depression[7]. The World Health Survey indicated that low physical exercise levels correlate with increased anxiety prevalence [8]. Interventions promoting physical exercise and enhancing self-esteem have been effective in reducing student anxiety [9]. High physical exercise levels were significantly linked to lower anxiety [10]. The pandemic has seen heightened anxiety among college students, with decreased physical exercise contributing to negative emotions[11].
According to Dr. Junmin Yang, physical self-esteem pertains to an individual's emotional assessment of their own body or appearance[12]. Physical self-esteem, a distinct element of overall self-esteem, significantly impacts emotional and mental health [13]. Both definitions highlight that physical self-esteem involves self-assessment related to one's body. However, terms like physical self-esteem and body dissatisfaction are often used interchangeably. The main difference lies in survey tools: the Body Dissatisfaction Scale measures satisfaction with different body parts, while the Physical Self-esteem Scale focuses on positive or negative feelings about specific body parts [14].Numerous studies indicate physical exercise positively impacts physical self-esteem. Exercise improves self-esteem and physical awareness [15]. A survey of Chilean schoolchildren found a negative correlation between BMI(Body Mass Index) and factors such as maximal oxygen consumption, jumping ability, physical activity, and self-esteem, while self-esteem showed a positive correlation with physical activity[16]. Physical exercise positively affects adolescents by increasing and promoting self-esteem [17]. After exercise, positive impact, self-esteem, and anxiety levels significantly improve for up to four hours [18]. Physical exercise not only supports adolescents' physical self-esteem but may also reduce the risk of depression [19].Jinling's research highlights the relationship between physical exercise and physical self-esteem, noting that college students who regularly exercise have significantly higher levels of physical self-esteem, athletic ability, physical attractiveness, and perceived physical value than those who do not exercise regularly, with notable sex differences [20]. Tao et al. found that a single 90-minute exercise session is more effective in improving physical self-esteem than a 30-minute session, and a 16-week intervention is more effective than a 10-week one [21].Physical self-esteem also plays a vital role in anxiety. Domestic research emphasizes the influence of physical self-esteem on social anxiety. For example, Li found a significant negative correlation between physical self-esteem and social anxiety among female college students after a 16-week exercise intervention[22]. Other studies suggest a link between physical exercise, physical self-esteem and anxiety relief [23]. Fu et al. found that physical activity is inversely correlated with levels of anxiety and depression, and positively correlated with levels of self-esteem[24].
This study also examined gender as a moderating variable due to significant differences observed. Physical self-esteem exhibit greater motivation for physical exercise, whereas girls often face more obstacles in engaging in physical exercise [25]. Research has shown that generally report higher levels of social physical anxiety and lower physical self-esteem compared to men, and this pattern persists across different age groups [26]. In contrast, boys generally report lower concerns about thinness and physical anxiety, while placing greater emphasis on muscularity and self-esteem [27].Body mass index (BMI) was found to predict perceived physical attractiveness, social anxiety related to physical fitness, body image satisfaction, and self-esteem among adolescent females[28]. Physical self-esteem is a multifaceted construct where men and women differ significantly. Men's physical self-esteem dimensions typically include physical attractiveness, upper body strength, and overall physical condition. In contrast, women's dimensions often encompass sexual attractiveness, weight concerns, and overall physical condition. Men tend to have higher correlations among these dimensions compared to women, suggesting that women's physical self-esteem varies to a greater extent [29].
In summary, this study introduces a moderated mediation model (Fig. 1), wherein physical self-esteem serves as a mediator between physical exercise and anxiety among college students, while gender moderates the relationship between physical exercise and anxiety levels in this demographic.