Influence of physical education on anxiety, depression, and self-esteem among college students

Abstract

Background: Physical education is pivotal in our country's education reform. Urban schools have notably enhanced the intensity of physical education in recent years. However, the effects of physical education on students' anxiety, depression, and self-esteem levels, as well as their interrelations, remain unexplored.

Aim: To analyze the influence of physical education on students' anxiety, depression, and self-esteem.

Methods: This study employed a cross-sectional design. A stratified cluster sampling method was used to select 478 first-year university students. Self-administered questionnaires were used to investigate the physical education status and basic information of college students. We used the Physical Activity Rank Scale-3 (PARS-3), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and Self-Esteem Scale (SES) to assess the level of exercise, anxiety, depression, and self-esteem. Multiple Logistic regression was used to analyze the factors influencing anxiety, depression, and low self-esteem. The receiver operating characteristic curve and area under the curve (AUC) were used to evaluate the predictive ability of PARS-3 scores for anxiety, depression, and low self-esteem. Spearman's correlation was used to analyze the correlations among the PARS-3, SAS, SDS, and SES.

Results: Compared with the domestic norms, SAS and SDS scores were higher, and SES scores were lower (P < 0.05). Among the participants, 210 (43.93%) had PARS-3 scores below 20, 94 (19.67%) had scores of 20-42, and 174 (36.40%) had scores above 42. After adjusting for daily sleep time, gender, being an only child, major, father's educational background, mother's educational background, and family residence, PARS-3 scores were independent influencing factors for anxiety, depression, and low self-esteem (P < 0.05). The AUC of PARS-3 scores predicting anxiety, depression, and low self-esteem were 0.805 (0.760-0.849), 0.799 (0.755-0.843), and 0.831 (0.788-0.874), respectively. The sensitivities were 0.799, 0.801, and 0.748, and the specificities were 0.743, 0.716, and 0.814, respectively. PARS-3 was negatively correlated with SAS and SDS scores (r = -0.566, -0.621, both P < 0.001) and positively correlated with SES scores (r = -0.621, P < 0.001). SES scores were negatively correlated with SAS and SDS scores (r = -0.508, r = -0.518, both P < 0.001).

Conclusion: The amount of physical activity is negatively correlated with anxiety and depression degree and positively correlated with self-esteem degree.

Keywords: Anxiety; Depression; Influence; Physical education; Self-esteem; Student.

Figure 1

Receiver operating characteristic curve of Physical Activity Rank Scale-3 scores predicting anxiety, depression, and low self-esteem. A: Physical Activity Rank Scale-3 (PARS-3) scores predicting anxiety; B: PARS-3 scores predicting depression; C: PARS-3 scores predicting low self-esteem.

Figure 2

Scatter plot of correlation between Physical Activity Rank Scale-3 scores and Self-Rating Anxiety Scale, Self-Rating Depression Scale, and the Self-Esteem Scale scores. A: The correlation between Self-Rating Anxiety Scale and Physical Activity Rank Scale-3 (PARS-3); B: The correlation between Self-Rating Depression Scale and PARS-3; C: The correlation between the Self-Esteem Scale and PARS-3. SAS: Self-Rating Anxiety Scale; SDS: Self-Rating Depression Scale; SES: the Self-Esteem Scale; PARS-3: Physical Activity Rank Scale-3.