Associations Between Physical Activity, Generalized Anxiety Disorder, And Social Physique Anxiety Among Young Adults

Abstract

Social Physique Anxiety (SPA) has been associated with physical activity (PA) behaviors and anxiety disorder symptoms. However, little is known about the potential influence of SPA on associations between PA and Generalized Anxiety Disorder (GAD). PURPOSE: This study quantified associations between PA, GAD and SPA among young adults (N=470, 23.2±4.8y; 63.4% female) and explored SPA as a mediator of the association between PA and GAD. METHODS: Seven-day PA Recall determined estimated expenditure (kcal/wk) and classified inactive, moderately active, and highly active PA dose categories. The Psychiatric Diagnostic Screening Questionnaire GAD subscale assessed GAD symptom severity; a score of ≥6 indicated analogue GAD (AGAD) status. The Social Physique Anxiety Scale assessed SPA. Independent t-tests examined baseline differences based on gender and AGAD status. Cohen’s d quantified the magnitude of difference. Logistic regression quantified odds of AGAD based on PA dose, adjusting for age, gender, and smoking status. Simple mediation analyses examined mediation of the continuous PA-GAD symptom association by SPA. RESULTS: Females reported less PA (p≤0.002, d=0.31) and greater SPA (p≤0.001, d=-0.63) and GAD symptom severity (p≤0.001, d=-0.51). AGAD reported greater SPA (p≤0.001, d=0.92). Compared to inactive, odds of AGAD were 28.3% (OR=0.72, 95%CI: [0.43, 1.20], p≥0.21) and 42.5% (OR=0.58, [0.35, 0.94], p≤0.03) lower among moderately active and highly active, respectively. In adjusted models, compared to inactive, odds were 29.3% (OR= 0.71, [0.42, 1.20], p≥0.21) and 36.9% (OR=0.63, [0.38, 1.06], p≥0.08) lower among moderately active and highly active, respectively. Regression models of PA on GAD symptoms (β=-0.01, p≤0.04), SPA on PA (β=-0.02, p≤0.03), and SPA on GAD symptoms (β=0.14, p≤0.001) were significant. When regressed together, SPA was (β=0.14, p≤0.001), but PA was not (β=-0.003, p≤0.27), statistically significant, supporting mediation. CONCLUSION: PA may lower odds of GAD, but findings were not significant after adjusting for covariates. SPA, a modifiable factor that was higher among females and those with AGAD, mediated the association between PA and GAD. Future research should examine these relationships longitudinally and explore SPA experimentally.