The Relationship between Social Media Use and Appearance Anxiety of College students:The Serial Mediation of Psychological Flexibility and Rumination

The Relationship between Social Media Use and Appearance Anxiety of College students:The Serial Mediation of Psychological Flexibility and Rumination | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The Relationship between Social Media Use and Appearance Anxiety of College students:The Serial Mediation of Psychological Flexibility and Rumination Min Zhang, Zitin Zhao, Jing Lu, Yuhan Liu, Yang Li This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6972535/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objective: This study explored the psychological pathways of social media use affecting college students' appearance anxiety, focusing on the sequential mediating pathways between psychological flexibility and ruminant thinking. Method: Using the convenience sampling method, 781 college students were surveyed by digital stress scale, multidimensional psychological flexibility questionnaire, college students' appearance rumination scale and appearance anxiety scale. Result : Social media use, psychological flexibility, rumination and college students' appearance anxiety are significantly correlated; Social media use had a predictive effect on college students' appearance anxiety, with the chain mediating indirect effect by psychological flexibility and rumination. Conclusion : The empirical results show that psychological flexibility and rumination play a sequential mediating role in the effect of social media use on appearance anxiety among college students. Appearance anxiety social media use psychological flexibility rumination college students Figures Figure 1 1 Introduction In January 2025, the China Internet Network Information Center (CNNIC) released the latest "Statistical Report on the Development Status of China's Internet", showing that the current scale of social network users in our country has reached 1.101 billion, among them, college students are the main users of various media[ 1 ].With the application and extension of the internet and social media, using social media to obtain information, communicate, and express themselves has become an important part of college students' daily lives.However, while social media provides convenience to college students, value orientations related to appearance such as "panda face," "peach buttocks," and "swan neck" have become a single-dimensional "ideal beauty" and are rapidly pursued and imitated on social media platforms, thereby triggering psychological problems such as anxiety, depression, and obsessions. Therefore, exploring the impact of social media use on college students' appearance anxiety and its pathways has profound significance for psychological intervention of college students' appearance anxiety. 2 Literature Review and Research Hypotheses Appearance anxiety refers to a psychological state where an individual feels uneasy or worried about their own appearance, leading to emotional distress[ 2 ]. A survey by China Youth School Media found that nearly 60% of college students suffer from appearance anxiety, and the proportion of female students with appearance anxiety (59.67%) is significantly higher than that of male students (37.14%)[ 3 ].With the widespread use of social media, research has found that social media use can predict female appearance anxiety[ 4 ]. Excessive social media use of more than 3 hours per day has negative effects on women's bodies[ 5 ], and girls who frequently engage in appearance social comparison are more prone to appearance anxiety, have a stronger desire for plastic surgery, and are more likely to undergo plastic surgery[ 6 ].In addition, exposure to social media content such as celebrities and influencers, live streams, and beauty-related videos may trigger negative body image[ 7 ]and reduce body satisfaction[ 8 ].It is clear that social media usage shapes current aesthetic standards, while also creating a social comparison environment, leading to unrealistic expectations and cognitive biases about the real situation, which in turn results in appearance anxiety.Based on this, this study proposes hypothesis 1: Social media use positively predicts college students' appearance anxiety. Psychological flexibility refers to an individual's ability to flexibly and autonomously engage with the present moment, and to continue or adjust behavioral patterns under the guidance of personal value commitments[ 9 ].Research has found that psychological flexibility can negatively predict body shame experiences[ 10 ], body dissatisfaction[ 11 ], and negative body image[ 12 ].It is found that excessive use of social media can lead to a decrease in psychological flexibility and cause a decline in physical satisfaction[ 13 ].Women with low psychological flexibility are more prone to phenomena such as dissatisfaction with body fat, muscle dissatisfaction, and appearance dissatisfaction[ 14 ].It can be seen that psychological flexibility may play a mediating role in the pathway of social media use affecting appearance anxiety.Based on the above research, hypothesis 2 is proposed: psychological flexibility plays a mediating role in the pathway of social media use affecting appearance anxiety among college students. Rumination is a way of thinking that repeatedly focuses on one's negative emotions and the corresponding events[ 15 ]. The research found a positive correlation between rumination and body dissatisfaction[ 16 ].Experiments show that people induced to ruminate about themselves may be more dissatisfied with their bodies[ 17 ]. It is evident that frequent exposure to idealized images and information in the media may lead to more negative emotions and excessive thinking about appearance, thereby producing rumination[ 18 ].Therefore, individuals with higher rumination tendencies who continuously focus on social media related to appearance may perceive a gap between their reality and the ideal appearance on media, which may lead to body dissatisfaction[ 17 ], thus falling into appearance anxiety.Furthermore,this study proposes hypothesis 3: rumination thinking plays a mediating role in the path of social media use affecting college students' appearance anxiety. Research shows that external rumination is related to psychological flexibility[ 19 ]. Individuals with lower psychological flexibility often lack positive coping methods for negative emotions and difficulties, making them prone to negative thought and behavioral patterns[ 33 ].University students' life views and values have not yet matured[ 20 ], and when they use social media, they are prone to blend with the situation, producing maladaptive cognition,i.e.,reduced psychological flexibility[ 9 ],leading to strong dissatisfaction with their appearance, while rumination may further exacerbate university students' body dissatisfaction, ultimately resulting in appearance anxiety.In summary, social media use has a significant impact on college students' appearance anxiety, and psychological flexibility, rumination, and appearance anxiety are closely related, but their interaction relationship is yet to be clarified.Therefore, this study proposes hypothesis 4, that psychological flexibility and rumination play a chain mediating role in the pathway of social media use affecting college students' appearance anxiety. 3 Research design 3.1 Research Objects This study selected university students from a university in Heilongjiang as the research sample. Using the convenient sampling method, a total of 854 questionnaires were distributed through Wenjuanxing platform. After excluding invalid questionnaires of 73 such as those with abnormal response times, regular response patterns, and logical contradictions, the final number of valid questionnaires was 781, with an effective rate of 91.5%. There were a total of 781 valid subjects in this study, with an average age of (20.48±1.88) years. Among them, there were 142 males (18.18%) and 639 females (81.82%). Freshmen accounted for 158 (20.23%), sophomores for 253 (32.39%), juniors for 168 (21.51%), seniors for 120 (15.36%), and postgraduates or above for 82 (10.50%). There were 404 urban origin students (51.73%) and 377 countryside origin students (48.27%). The average daily internet usage was less than 1 hour for 66 (8.45%), 1-4 hours for 437 (55.95%), 5-8 hours for 184 (23.56%), and more than 8 hours for 94 (12.04%). See Table 1. As shown in Table 2, there were no significant differences in appearance anxiety among subjects of different genders, origins, grades, and average daily internet usage (P＞0.05). 3.2 Research Tools 3.2.1 Digital Stress Scale Adopting the scale developed by Hall et al.[21]and localized by Liu Qiuqi et al. [22], it consists of 31 items across 6 dimensions:Contact pressure, Recognition anxiety, social comparison,Missed anxiety, information overload, and Online alert. The scale uses a 5-point Likert scale, where 1 represents "never" and 5 represents "always." A higher total score indicates greater digital stress. In this study, the Cronbach’s α coefficients for each dimension are 0.859, 0.853, 0.818, 0.833, 0.864, and 0.865, respectively, and the Cronbach’s α coefficient for the total scale is 0.923. 3.2.2 Multidimensional Psychological Flexibility Questionnaire Developed by Rolffs et al. [23]and localized by Chinese scholars Liu Dandan et al.[24], the scale consists of 24 items, with 2 dimensions: psychological flexibility and psychological rigidity. The scale uses a 6-point scoring method, where 1 represents "never" and 6 represents "always." The scores of each item in the dimensions are summed, with higher scores indicating higher levels of psychological flexibility or greater degrees of psychological rigidity. In this study, the Cronbach's α coefficients for the two dimensions were 0.941 and 0.938, respectively, and the Cronbach's α coefficient for the total scale was 0.946. 3.2.3 College Students' Appearance Rumination Scale The scale developed by Shen Qi[25] in 2022 was adopted, consisting of 21 items and 2 dimensions: positive appearance rumination and negative appearance rumination. The scale uses a 4-point scoring method, where 1 represents "never" and 4 represents "always." A higher total score indicates higher negative rumination. In this study, the Cronbach’s α coefficient of this scale was 0.802. 3.2.4 Appearance Anxiety Scale The scale, developed by Hart et al.[26] and translated and revised by Kong Shanshan and Yang Hongfei [27] is used to measure individuals' overall excessive concern about appearance, consisting of 16 items. It uses a 5-point Likert scale, where "strongly disagree" corresponds to 1 point and "strongly agree" corresponds to 5 points. A higher total score indicates a higher level of excessive concern about appearance. In this study, the Cronbach’s α coefficient for this scale is 0.943. 3.3 Statistical Methods Descriptive statistical analysis, differential analysis, common method bias test, and Pearson correlation analysis were performed on the data using SPSS 27.0 software; Structural equation models were constructed and evaluated using Amos 28.0 software, and the mediating effects were tested using bias-corrected percentile bootstrap method (2000 resamples, 95% confidence interval). Differences with P < 0.05 were statistically significant. 4 Statistical Analysis and Results 4.1 Common Method Bias Test The Harman single-factor method was used to conduct a common method bias test. The results showed that there were 11 factors with eigenvalues greater than 1 Among them, the first common factor explained 19.102% of the variance, which is less than the critical standard of 40%. Therefore, it can be concluded that there is no severe common method variance. 4.2 Descriptive Statistics and Correlation Analysis Descriptive statistics and correlation analysis of social media use, psychological flexibility, rumination, and appearance anxiety are shown in Table 3, all reaching significant levels. Among them, social media use is significantly negatively correlated with psychological flexibility, psychological flexibility is significantly negatively correlated with rumination, and psychological flexibility is significantly negatively correlated with appearance anxiety ( r = -0.290, r = -0.408, r = -0.293, P < 0.01 ). While social media use is significantly positively correlated with appearance anxiety and rumination, and rumination is significantly positively correlated with appearance anxiety ( r = 0.288, r = 0.401, r = 0.460, P < 0.01 ). See Table 3 for details. 4.3 Mediation Model Evaluation In this study, 2 latent variables (social media use and psychological flexibility) and 2 observed variables (rumination and appearance anxiety) were involved. Based on this, a measurement model was constructed, and the model fit values are as follows: CMIN/df = 1.697 (P < 0.01), RMSEA = 0.030, IFI = 0.988, CFI = 0.988, RFI = 0.958 . As shown in Table 4, this indicates that all fit indices are within acceptable levels, and to some extent, it suggests that there are no significant multicollinearity issues in this study, and the analysis results are reference-worthy. 4.4 Analysis of Chain Mediating Effect Using structural equation modeling to verify the chain mediating effect of psychological flexibility and rumination on the relationship between social media use and college students' appearance anxiety. The analysis results are shown in Figure 1 (all standardized coefficients). The results indicate that social media use significantly positively predicts college students' appearance anxiety ( β=0.11, P<0.01 ); psychological flexibility significantly negatively predicts college students' appearance anxiety ( β=-0.14, P<0.01 ); and social media use positively predicts rumination ( β=0.30, P<0.001 ). Therefore, it can be concluded that social media use significantly reduces college students' psychological flexibility ( β=-0.40, P<0.001 ), which in turn, through rumination ( β=-0.38, P<0.001 ), ultimately leads to college students' appearance anxiety ( β=0.34, P<0.001 ) in the chain mediating effect. Finally, the Bootstrap method was used to test the significance of the mediating effect. As shown in Table 5, social media use affects college students' appearance anxiety through psychological flexibility [-0.089, -0.004], the mediating effect is significant, accounting for 11.72% of the mediating effect; social media use affects college students' appearance anxiety through rumination [-0.078, -0.011], the mediating effect is significant, accounting for 11.02% of the mediating effect; social media use affects college students' appearance anxiety through psychological flexibility and rumination [-0.043, -0.005], the chain mediating effect accounts for 6.09%; total mediating effect [-0.163, -0.054], effect ratio is 24.33%. 5 Discussion This study explains how social media use affects college students' appearance anxiety and its mechanisms. The results show that social media use not only directly affects college students' appearance anxiety but also influences it through the mediating effects of psychological flexibility and rumination, as well as the chain mediating effect of psychological flexibility and rumination. This provides a theoretical basis for subsequent prevention and intervention of college students' appearance anxiety. Undergraduates are in a critical developmental stage for forming their self-concepts, and their process of identity construction is particularly susceptible to external influences.At the same time, when facing real pressures such as job competition, building intimate relationships, and comparing achievements with peers, stereotypes like "beauty is justice" may reinforce their incorrect belief that appearance equates to value. Good looks may give college students more opportunities or a higher sense of achievement.This characteristic makes college students more susceptible to the influence of idealized beauty on social media, making them more inclined to engage in upward social appearance comparisons[ 28 , 29 ]。When they perceive the gap between the real image and the ideal appearance, they may internalize the cultural of social appearance imposed on individuals by the media. This process leads college students to form negative perceptions and denials of their own appearance, resulting in dissatisfaction with their bodies and appearance anxiety.Therefore, for the growth and development of college students, the“appearance determinism”should be broken, and this negative cognitive chain should be dispelled by reconstructing the self-worth evaluation system, and a healthy image and identity with inherent abilities as the core should be shaped. Psychological flexibility, as a key psychological resource for individual adaptation to the environment, may significantly affect cognitive processing patterns in college students when its level decreases. Research findings indicate that lower psychological flexibility is more likely to lead to upward social appearance comparisons, a pursuit of thin body shapes, increased risk of body dissatisfaction among female selfie behaviors, and a decline in body appreciation [ 30 , 31 , 32 ].When college students with low psychological flexibility are frequently exposed to carefully edited and processed appearance information from others, they are prone to integrate it with their values and excessively identify with media aesthetic standards, which can lead to excessive pressure and heightened appearance sensitivity.In this process, college students with high-level ruminative thinking are more likely to have passive thinking and excessive attention to their own appearance and image, forming a negative cycle of “comparison-dissatisfaction-rumination-more dissatisfaction”, thereby deepening the negative physical appearance experience and experience.Conversely, college students with high psychological flexibility and low rumination may employ cognitive dissociation strategies, viewing appearance information with a more flexible and objective perspective, actively exploring personal values, and avoiding body image anxiety caused by cognitive and value integration.Therefore, enhancing college students' psychological flexibility and reducing rumination can help develop a diverse range of perceptual and responsive abilities, thereby lowering levels of body image anxiety. At the same time, schools and professional teachers should establish comprehensive psychological support systems to help students develop a healthy body image centered on intrinsic self-acceptance and overall acceptance, effectively reducing students' body image anxiety. Finally, this study found that college students' social media use not only directly affects appearance anxiety but also exerts its effect through a chain of mediating mechanisms involving psychological flexibility and rumination. Psychological flexibility negatively predicts rumination. Social media use often exposes college students to high-quality information meticulously edited and processed by others. Individuals with low psychological flexibility tend to be easily influenced by these messages when browsing them, leading to negative emotions and thoughts, resulting in dissatisfaction and anxiety about appearance. Rumination leads individuals to be trapped in negative emotions and cognition, making it difficult to break free from repetitive thinking about negative information, exacerbating body dissatisfaction and further deepening the level of appearance anxiety. This study also has certain limitations: (1) the sample size is relatively small (n = 781) and the population consists of college students, which may affect the generalizability of the results; (2) all variables were measured using traditional self-report methods, which may introduce potential bias; (3) the cross-sectional study design makes it difficult to reveal the causal relationships between variables. In future research, it could be considered that (1) expanding the sample size and population diversity through multicenter collaboration to enhance the generalizability of the results; (2) adopting longitudinal or experimental study designs to capture the causal patterns. In summary, the findings of this study provide direction for subsequent interventions on appearance anxiety among college students, with a focus on how to change their inappropriate use of social media, adjust their self-perceptions and ways of thinking, i.e., psychological flexibility and rumination, thereby reducing appearance anxiety. Declarations 1.Ethics approval and consent to participate According to the Declaration of Helsinki of the World Medical Association , t he Ethical Review Procedures for Biomedical Research Involving Human Beings , and other relevant ethical norms at home and abroad，this study is approved by Ethics Committee of Harbin Medical University Daqing Campus(Ethical number:HMUDQ20250612002) . Inform consent was obtained from all individual participants included in the study. Participants signed informed consent regarding published their date. 2.Consent for publication We declare that this manuscript is original, has not been published before and is not currently being considered for publication elsewhere. We confirm that the manuscript has been read and approved by all named authors and that there are no other persons who satisfied the criteria for authorship but are not listed. We further confirm that the order of authors listed in the manuscript has been approved by all of us. We understand that the Corresponding Author is the sole contact for the Editorial process. She is responsible for communicating with the other authors about progress, submissions of revisions and final approval of proofs. 3.Availability of data and materials The datasets generated during and analyzed during the current study are not publicly available,but are available from the corresponding author on request. 4.Competing interests The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. 5.Funding No funding was received for conducting this study. 6.Authors' contributions Author 1(First Authors):Investigation;Data curation;Formal analysis;Writing-Original Draft Author 2:Investigation;Data curation;Validation Author 3:Resource;Investigation Author 4:Resource;Investigation Author 5(Corresponding Author):Supervision;Writing-Review & Editing 7.Acknowledgements We would like to thank all participants in this study. 8.Authors' information Author order Item Name Family name Email and Telephone Affiliation(s) The first author Zhang Min Min Zhang [email protected] 15848731762 Harbin Medical University (Daqing) , No.39 Xinyang Road , High-techZone , Daqing City , Heilongjiang Province , China. (Postal Code 163711) The second author Zhao Zitin Zitin Zhao [email protected] 15968719998 The third Author Lu Jing Jing Lu [email protected] 18245950444 The fourth Author Liu Yuhan Yuhan Liu [email protected] 17822210870 The fifth Author (Corresponding Author) Li Yang Yang Li [email protected] 13936785360 References The China Internet Network Information Center,2025.The 55 th statistical Report of China’s Internet Developmenthttps://cnnic.cn/n4/2025/0117/c88-11229.html /(accessed 15 February,2025).(in Chinese) Davis, C., Brewer, H., Weinstein, M., 1993. A study of appearance anxiety in young men. Soc. Behav. Pers.: Int. J. 21, 63–74. https://doi.org/10.2224/sbp.1993.21.1.63 Cheng Si, Luo Xi. 2021 .Nearly sixty percent of college students have appearance anxiety. Chinese youth Report.2021-02-25 Edition 07.https://zqb.cyol.com/html/2021-02/25/nw.D110000zgqnb_20210225_1-07.htm/(accessed 12 February,2025)(in Chinese) Üstündağ, A., Kanik, R., Çinar, Y.R., 2024. 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Exploring the reciprocal associations between body appreciation, body image flexibility, and body acceptance by others in the context of the COVID-19 pandemic in Germany: results from cross-lagged panel analyses among women and men. Body Image 46, 139. https://doi.org/10.1016/j.bodyim.2023.05.008 Malo, R., Acier, D., Bulteau, S., 2022. Psychological flexibility: toward a better understanding of a key concept. Trends Psychol. 32, 734–759. https://doi.org/10.1007/s43076-022-00188-1 Tables Table 1 Demographic Characteristics Items Category Number Percentage（%） Gender Male 142 18.18 Female 639 81.82 Grade Freshman 158 20.23 Sophomore 253 32.39 Junior 168 21.51 Senior 120 15.36 Graduate student and above 82 10.50 Residence Urban 404 51.73 Countryside 377 48.27 Average daily online time Less than 1 hour 66 8.45 1-4 hours 437 55.95 5-8 hours 184 23.56 More than 8 hours 94 12.04 Total 781 100.0 Table 2 Differences in Appearance Anxiety Across Demographic Variables Indicator M±SD t/F P-Value Appearance Anxiety Gender Male 51.61±12.02 0.646 0.518 Female 50.87±12.39 Residence Urban 50.99±12.01 -0.026 0.979 Countryside 51.01±12.66 Grade Freshman 49.19±12.70 1.365 0.244 Sophomore 50.94±12.31 Junior 51.38±12.20 Senior 52.26±14.47 Graduate student and above 52.07±11.42 Average daily online time Less than 1 hour 51.41±12.46 2.028 0.108 1-4 hours 50.74±12.39 5-8 hours 50.07±12.70 More than 8 hours 53.77±10.79 Table 3 Descriptive Statistics and Correlation Analysis (r) of Various Variables M±SD 1 2 3 4 5 6 7 8 9 10 11 12 1 Contact pressure 3.526±0.746 1 2 Recognition anxiety 3.541±0.795 .358** 1 3 Social comparison 3.541±0.804 .320** .381** 1 4 Missed anxiety 3.523±0.755 .392** .390** .314** 1 5 Information overload 3.501±0.818 .458** .376** .333** .356** 1 6 Online alert 3.535±0.765 .391** .420** .412** .413** .423** 1 7 Social media use 3.528±0.543 .692** .702** .665** .680** .711** .730** 1 8 Mentally flexible 2.970±0.912 -.198** -.228** -.173** -.195** -.234** -.141** -.280** 1 9 Psychological rigidity 2.928±0.897 -.106** -.155** -.177** -.160** -.157** -.162** -.220** .490** 1 10 Psychological flexibility 2.949±0.781 -.176** -.222** -.202** -.206** -.227** -.175** -.290** .866** .861** 1 11Rumination 2.472±0.394 .289** .275** .259** .267** .299** .289** .401** -.371** -.332** -.408** 1 12Appearance anxiety 3.189±0.770 .178** .174** .242** .173** .213** .221** .288** -.251** -.255** -.293** .460** 1 注：* p<0.05，** p0.8 >0.8 0.8 >0.8 >0.8 >0.8 <5 ＜0.08 Observed value 0.986 0.976 0.030 0.971 0.988 0.988 0.958 1.697 0.0234 Table 5 Mediation Effect Values and 95% Confidence Intervals for Psychological Flexibility and Rumination Path Effect value 95%CI Effect proportion（%） P-Value Lower limit Upper limit Social Media Use - Psychological Flexibility - Appearance Anxiety -0.045 -0.089 -0.004 11.72 0.032 Social Media Use - Rumination - Appearance anxiety -0.042 -0.078 -0.011 11.02 0.010 Social Media Use - Psychological Flexibility - Rumination - Appearance anxiety -0.022 -0.043 -0.005 6.09 0.011 Total Mediation Effect -0.109 -0.163 -0.054 24.33 0.001 Additional Declarations No competing interests reported. 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(Daqing)","correspondingAuthor":false,"prefix":"","firstName":"Zitin","middleName":"","lastName":"Zhao","suffix":""},{"id":485372510,"identity":"62a16d81-6748-4cab-9404-fb8eab901e41","order_by":2,"name":"Jing Lu","email":"","orcid":"","institution":"Harbin Medical University (Daqing)","correspondingAuthor":false,"prefix":"","firstName":"Jing","middleName":"","lastName":"Lu","suffix":""},{"id":485372511,"identity":"4fc2774c-4300-4e2f-8090-cb87cee422b8","order_by":3,"name":"Yuhan Liu","email":"","orcid":"","institution":"Harbin Medical University (Daqing)","correspondingAuthor":false,"prefix":"","firstName":"Yuhan","middleName":"","lastName":"Liu","suffix":""},{"id":485372512,"identity":"f77ff0e3-8e66-423f-afbd-57de5d239e1d","order_by":4,"name":"Yang Li","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABEUlEQVRIie3QMUvDQBTA8RcKF4cz89VK40e4EAiC0PpRLgTicopjBpFK4LKIcxb9GM4XDtol0rWgQ6Hg0gxxkQwinptLzo6C9x+P94P3DsBm+8shN6/WLSVj5BZyN+LheRKUl8ehh2u2GxkTHo1wm8UP5JQaJ+niSW3x1ctEkJQNS0rOBAEGXfbYT+qL9ATPXxOBN5LqW87F6EY6t/VzP5E8CjFSCXJTFpff5FCygSMMZNlo8qkJcKqwXgwRRs1kxcPNvlATtMeDXBP2Kxmumsi5v1MM6U929GKB0J9cmW7xljxsm3c19Yt80bUf175fFNW6y/rJkQR0gAHi2c9X2Tuv82cweOsApqYhm81m++d9AT6rXlrMt4YZAAAAAElFTkSuQmCC","orcid":"","institution":"Harbin Medical University (Daqing)","correspondingAuthor":true,"prefix":"","firstName":"Yang","middleName":"","lastName":"Li","suffix":""}],"badges":[],"createdAt":"2025-06-25 08:53:10","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6972535/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6972535/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":86844568,"identity":"ceaf7df1-1e09-4c10-b74b-aacf995f2b10","added_by":"auto","created_at":"2025-07-16 08:34:44","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":49184,"visible":true,"origin":"","legend":"\u003cp\u003eSee image above for figure legend.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-6972535/v1/b052df04181d2f715ddb595c.png"},{"id":94822121,"identity":"1a542e59-71ab-4752-8b50-9d7edb938e2d","added_by":"auto","created_at":"2025-10-31 06:23:34","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":716557,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6972535/v1/252ccec6-3514-48c5-a316-5e06961545d7.pdf"},{"id":86844572,"identity":"917e56df-4bee-4e0d-8431-c01d79bc2cb4","added_by":"auto","created_at":"2025-07-16 08:34:44","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":98673,"visible":true,"origin":"","legend":"","description":"","filename":"Graphicalabstract.docx","url":"https://assets-eu.researchsquare.com/files/rs-6972535/v1/8bf326b208e5f75ca85fb9b0.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"The Relationship between Social Media Use and Appearance Anxiety of College students:The Serial Mediation of Psychological Flexibility and Rumination","fulltext":[{"header":"1 Introduction","content":"\u003cp\u003eIn January 2025, the China Internet Network Information Center (CNNIC) released the latest \"Statistical Report on the Development Status of China's Internet\", showing that the current scale of social network users in our country has reached 1.101\u0026nbsp;billion, among them, college students are the main users of various media[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e].With the application and extension of the internet and social media, using social media to obtain information, communicate, and express themselves has become an important part of college students' daily lives.However, while social media provides convenience to college students, value orientations related to appearance such as \"panda face,\" \"peach buttocks,\" and \"swan neck\" have become a single-dimensional \"ideal beauty\" and are rapidly pursued and imitated on social media platforms, thereby triggering psychological problems such as anxiety, depression, and obsessions. Therefore, exploring the impact of social media use on college students' appearance anxiety and its pathways has profound significance for psychological intervention of college students' appearance anxiety.\u003c/p\u003e"},{"header":"2 Literature Review and Research Hypotheses","content":"\u003cp\u003eAppearance anxiety refers to a psychological state where an individual feels uneasy or worried about their own appearance, leading to emotional distress[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. A survey by China Youth School Media found that nearly 60% of college students suffer from appearance anxiety, and the proportion of female students with appearance anxiety (59.67%) is significantly higher than that of male students (37.14%)[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].With the widespread use of social media, research has found that social media use can predict female appearance anxiety[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Excessive social media use of more than 3 hours per day has negative effects on women's bodies[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e], and girls who frequently engage in appearance social comparison are more prone to appearance anxiety, have a stronger desire for plastic surgery, and are more likely to undergo plastic surgery[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].In addition, exposure to social media content such as celebrities and influencers, live streams, and beauty-related videos may trigger negative body image[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]and reduce body satisfaction[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].It is clear that social media usage shapes current aesthetic standards, while also creating a social comparison environment, leading to unrealistic expectations and cognitive biases about the real situation, which in turn results in appearance anxiety.Based on this, this study proposes hypothesis 1: Social media use positively predicts college students' appearance anxiety.\u003c/p\u003e\u003cp\u003ePsychological flexibility refers to an individual's ability to flexibly and autonomously engage with the present moment, and to continue or adjust behavioral patterns under the guidance of personal value commitments[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].Research has found that psychological flexibility can negatively predict body shame experiences[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e], body dissatisfaction[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e], and negative body image[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].It is found that excessive use of social media can lead to a decrease in psychological flexibility and cause a decline in physical satisfaction[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e].Women with low psychological flexibility are more prone to phenomena such as dissatisfaction with body fat, muscle dissatisfaction, and appearance dissatisfaction[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].It can be seen that psychological flexibility may play a mediating role in the pathway of social media use affecting appearance anxiety.Based on the above research, hypothesis 2 is proposed: psychological flexibility plays a mediating role in the pathway of social media use affecting appearance anxiety among college students.\u003c/p\u003e\u003cp\u003eRumination is a way of thinking that repeatedly focuses on one's negative emotions and the corresponding events[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. The research found a positive correlation between rumination and body dissatisfaction[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e].Experiments show that people induced to ruminate about themselves may be more dissatisfied with their bodies[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. It is evident that frequent exposure to idealized images and information in the media may lead to more negative emotions and excessive thinking about appearance, thereby producing rumination[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e].Therefore, individuals with higher rumination tendencies who continuously focus on social media related to appearance may perceive a gap between their reality and the ideal appearance on media, which may lead to body dissatisfaction[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e], thus falling into appearance anxiety.Furthermore,this study proposes hypothesis 3: rumination thinking plays a mediating role in the path of social media use affecting college students' appearance anxiety.\u003c/p\u003e\u003cp\u003eResearch shows that external rumination is related to psychological flexibility[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Individuals with lower psychological flexibility often lack positive coping methods for negative emotions and difficulties, making them prone to negative thought and behavioral patterns[\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e].University students' life views and values have not yet matured[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e], and when they use social media, they are prone to blend with the situation, producing maladaptive cognition,i.e.,reduced psychological flexibility[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e],leading to strong dissatisfaction with their appearance, while rumination may further exacerbate university students' body dissatisfaction, ultimately resulting in appearance anxiety.In summary, social media use has a significant impact on college students' appearance anxiety, and psychological flexibility, rumination, and appearance anxiety are closely related, but their interaction relationship is yet to be clarified.Therefore, this study proposes hypothesis 4, that psychological flexibility and rumination play a chain mediating role in the pathway of social media use affecting college students' appearance anxiety.\u003c/p\u003e"},{"header":"3 Research design","content":"\u003cp\u003e3.1 Research Objects\u003c/p\u003e\n\u003cp\u003eThis study selected university students from a university in Heilongjiang as the research sample. Using the convenient sampling method, a total of 854 questionnaires were distributed through Wenjuanxing platform. After excluding invalid questionnaires of 73 such as those with abnormal response times, regular response patterns, and logical contradictions, the final number of valid questionnaires was 781, with an effective rate of 91.5%. There were a total of 781 valid subjects in this study, with an average age of (20.48\u0026plusmn;1.88) years. Among them, there were 142 males (18.18%) and 639 females (81.82%). Freshmen accounted for 158 (20.23%), sophomores for 253 (32.39%), juniors for 168 (21.51%), seniors for 120 (15.36%), and postgraduates or above for 82 (10.50%). There were 404 urban origin students (51.73%) and 377 countryside origin students (48.27%). The average daily internet usage was less than 1 hour for 66 (8.45%), 1-4 hours for 437 (55.95%), 5-8 hours for 184 (23.56%), and more than 8 hours for 94 (12.04%). See Table 1. As shown in Table 2, there were no significant differences in appearance anxiety among subjects of different genders, origins, grades, and average daily internet usage (P＞0.05).\u003c/p\u003e\n\u003cp\u003e3.2 Research Tools\u003c/p\u003e\n\u003cp\u003e3.2.1 Digital Stress Scale\u003c/p\u003e\n\u003cp\u003eAdopting the scale developed by Hall et al.[21]and localized by Liu Qiuqi et al. [22], it consists of 31 items across 6 dimensions:Contact pressure, Recognition anxiety, social comparison,Missed anxiety, information overload, and Online alert. The scale uses a 5-point Likert scale, where 1 represents \u0026quot;never\u0026quot; and 5 represents \u0026quot;always.\u0026quot; A higher total score indicates greater digital stress. In this study, the Cronbach\u0026rsquo;s \u0026alpha; coefficients for each dimension are 0.859, 0.853, 0.818, 0.833, 0.864, and 0.865, respectively, and the Cronbach\u0026rsquo;s \u0026alpha; coefficient for the total scale is 0.923.\u003c/p\u003e\n\u003cp\u003e3.2.2 Multidimensional Psychological Flexibility Questionnaire\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eDeveloped by Rolffs et al. [23]and localized by Chinese scholars Liu Dandan et al.[24], the scale consists of 24 items, with 2 dimensions: psychological flexibility and psychological rigidity. The scale uses a 6-point scoring method, where 1 represents \u0026quot;never\u0026quot; and 6 represents \u0026quot;always.\u0026quot; The scores of each item in the dimensions are summed, with higher scores indicating higher levels of psychological flexibility or greater degrees of psychological rigidity. In this study, the Cronbach\u0026apos;s \u0026alpha; coefficients for the two dimensions were 0.941 and 0.938, respectively, and the Cronbach\u0026apos;s \u0026alpha; coefficient for the total scale was 0.946.\u003c/p\u003e\n\u003cp\u003e3.2.3 College Students\u0026apos; Appearance Rumination Scale\u003c/p\u003e\n\u003cp\u003eThe scale developed by Shen Qi[25] in 2022 was adopted, consisting of 21 items and 2 dimensions: positive appearance rumination and negative appearance rumination. The scale uses a 4-point scoring method, where 1 represents \u0026quot;never\u0026quot; and 4 represents \u0026quot;always.\u0026quot; A higher total score indicates higher negative rumination. In this study, the Cronbach\u0026rsquo;s \u0026alpha; coefficient of this scale was 0.802.\u003c/p\u003e\n\u003cp\u003e3.2.4 Appearance Anxiety Scale \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe scale, developed by Hart et al.[26] and translated and revised by Kong Shanshan and Yang Hongfei [27] is used to measure individuals\u0026apos; overall excessive concern about appearance, consisting of 16 items. It uses a 5-point Likert scale, where \u0026quot;strongly disagree\u0026quot; corresponds to 1 point and \u0026quot;strongly agree\u0026quot; corresponds to 5 points. A higher total score indicates a higher level of excessive concern about appearance. In this study, the Cronbach\u0026rsquo;s \u0026alpha; coefficient for this scale is 0.943.\u003c/p\u003e\n\u003cp\u003e3.3 Statistical Methods\u003c/p\u003e\n\u003cp\u003eDescriptive statistical analysis, differential analysis, common method bias test, and Pearson correlation analysis were performed on the data using SPSS 27.0 software; Structural equation models were constructed and evaluated using Amos 28.0 software, and the mediating effects were tested using bias-corrected percentile bootstrap method (2000 resamples, 95% confidence interval). Differences with P \u0026lt; 0.05 were statistically significant.\u003c/p\u003e"},{"header":"4 Statistical Analysis and Results","content":"\u003cp\u003e4.1 Common Method Bias Test\u003c/p\u003e\n\u003cp\u003eThe Harman single-factor method was used to conduct a common method bias test. The results showed that there were 11 factors with eigenvalues greater than 1 Among them, the first common factor explained 19.102% of the variance, which is less than the critical standard of 40%. Therefore, it can be concluded that there is no severe common method variance.\u003c/p\u003e\n\u003cp\u003e4.2 Descriptive Statistics and Correlation Analysis\u003c/p\u003e\n\u003cp\u003eDescriptive statistics and correlation analysis of social media use, psychological flexibility, rumination, and appearance anxiety are shown in Table 3, all reaching significant levels. Among them, social media use is significantly negatively correlated with psychological flexibility, psychological flexibility is significantly negatively correlated with rumination, and psychological flexibility is significantly negatively correlated with appearance anxiety (\u003cem\u003er = -0.290, r = -0.408, r = -0.293, P \u0026lt; 0.01\u003c/em\u003e). While social media use is significantly positively correlated with appearance anxiety and rumination, and rumination is significantly positively correlated with appearance anxiety (\u003cem\u003er = 0.288, r = 0.401, r = 0.460, P \u0026lt; 0.01\u003c/em\u003e). See Table 3 for details.\u003c/p\u003e\n\u003cp\u003e4.3 Mediation Model Evaluation\u003c/p\u003e\n\u003cp\u003eIn this study, 2 latent variables (social media use and psychological flexibility) and 2 observed variables (rumination and appearance anxiety) were involved. Based on this, a measurement model was constructed, and the model fit values are as follows: \u003cem\u003eCMIN/df = 1.697 (P \u0026lt; 0.01), RMSEA = 0.030, IFI = 0.988, CFI = 0.988, RFI = 0.958\u003c/em\u003e. As shown in Table 4, this indicates that all fit indices are within acceptable levels, and to some extent, it suggests that there are no significant multicollinearity issues in this study, and the analysis results are reference-worthy.\u003c/p\u003e\n\u003cp\u003e4.4 Analysis of Chain Mediating Effect\u003c/p\u003e\n\u003cp\u003eUsing structural equation modeling to verify the chain mediating effect of psychological flexibility and rumination on the relationship between social media use and college students\u0026apos; appearance anxiety. The analysis results are shown in Figure 1 (all standardized coefficients). The results indicate that social media use significantly positively predicts college students\u0026apos; appearance anxiety (\u003cem\u003e\u0026beta;=0.11, P\u0026lt;0.01\u003c/em\u003e); psychological flexibility significantly negatively predicts college students\u0026apos; appearance anxiety (\u003cem\u003e\u0026beta;=-0.14, P\u0026lt;0.01\u003c/em\u003e); and social media use positively predicts rumination (\u003cem\u003e\u0026beta;=0.30, P\u0026lt;0.001\u003c/em\u003e). Therefore, it can be concluded that social media use significantly reduces college students\u0026apos; psychological flexibility (\u003cem\u003e\u0026beta;=-0.40, P\u0026lt;0.001\u003c/em\u003e), which in turn, through rumination (\u003cem\u003e\u0026beta;=-0.38, P\u0026lt;0.001\u003c/em\u003e), ultimately leads to college students\u0026apos; appearance anxiety (\u003cem\u003e\u0026beta;=0.34, P\u0026lt;0.001\u003c/em\u003e) in the chain mediating effect.\u003c/p\u003e\n\u003cp\u003eFinally, the Bootstrap method was used to test the significance of the mediating effect. As shown in Table 5, social media use affects college students\u0026apos; appearance anxiety through psychological flexibility [-0.089, -0.004], the mediating effect is significant, accounting for 11.72% of the mediating effect; social media use affects college students\u0026apos; appearance anxiety through rumination [-0.078, -0.011], the mediating effect is significant, accounting for 11.02% of the mediating effect; social media use affects college students\u0026apos; appearance anxiety through psychological flexibility and rumination [-0.043, -0.005], the chain mediating effect accounts for 6.09%; total mediating effect [-0.163, -0.054], effect ratio is 24.33%.\u003c/p\u003e"},{"header":"5 Discussion","content":"\u003cp\u003eThis study explains how social media use affects college students' appearance anxiety and its mechanisms. The results show that social media use not only directly affects college students' appearance anxiety but also influences it through the mediating effects of psychological flexibility and rumination, as well as the chain mediating effect of psychological flexibility and rumination. This provides a theoretical basis for subsequent prevention and intervention of college students' appearance anxiety.\u003c/p\u003e\u003cp\u003eUndergraduates are in a critical developmental stage for forming their self-concepts, and their process of identity construction is particularly susceptible to external influences.At the same time, when facing real pressures such as job competition, building intimate relationships, and comparing achievements with peers, stereotypes like \"beauty is justice\" may reinforce their incorrect belief that appearance equates to value. Good looks may give college students more opportunities or a higher sense of achievement.This characteristic makes college students more susceptible to the influence of idealized beauty on social media, making them more inclined to engage in upward social appearance comparisons[\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]。When they perceive the gap between the real image and the ideal appearance, they may internalize the cultural of social appearance imposed on individuals by the media. This process leads college students to form negative perceptions and denials of their own appearance, resulting in dissatisfaction with their bodies and appearance anxiety.Therefore, for the growth and development of college students, the\u0026ldquo;appearance determinism\u0026rdquo;should be broken, and this negative cognitive chain should be dispelled by reconstructing the self-worth evaluation system, and a healthy image and identity with inherent abilities as the core should be shaped.\u003c/p\u003e\u003cp\u003ePsychological flexibility, as a key psychological resource for individual adaptation to the environment, may significantly affect cognitive processing patterns in college students when its level decreases. Research findings indicate that lower psychological flexibility is more likely to lead to upward social appearance comparisons, a pursuit of thin body shapes, increased risk of body dissatisfaction among female selfie behaviors, and a decline in body appreciation [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e].When college students with low psychological flexibility are frequently exposed to carefully edited and processed appearance information from others, they are prone to integrate it with their values and excessively identify with media aesthetic standards, which can lead to excessive pressure and heightened appearance sensitivity.In this process, college students with high-level ruminative thinking are more likely to have passive thinking and excessive attention to their own appearance and image, forming a negative cycle of \u0026ldquo;comparison-dissatisfaction-rumination-more dissatisfaction\u0026rdquo;, thereby deepening the negative physical appearance experience and experience.Conversely, college students with high psychological flexibility and low rumination may employ cognitive dissociation strategies, viewing appearance information with a more flexible and objective perspective, actively exploring personal values, and avoiding body image anxiety caused by cognitive and value integration.Therefore, enhancing college students' psychological flexibility and reducing rumination can help develop a diverse range of perceptual and responsive abilities, thereby lowering levels of body image anxiety. At the same time, schools and professional teachers should establish comprehensive psychological support systems to help students develop a healthy body image centered on intrinsic self-acceptance and overall acceptance, effectively reducing students' body image anxiety.\u003c/p\u003e\u003cp\u003eFinally, this study found that college students' social media use not only directly affects appearance anxiety but also exerts its effect through a chain of mediating mechanisms involving psychological flexibility and rumination. Psychological flexibility negatively predicts rumination. Social media use often exposes college students to high-quality information meticulously edited and processed by others. Individuals with low psychological flexibility tend to be easily influenced by these messages when browsing them, leading to negative emotions and thoughts, resulting in dissatisfaction and anxiety about appearance. Rumination leads individuals to be trapped in negative emotions and cognition, making it difficult to break free from repetitive thinking about negative information, exacerbating body dissatisfaction and further deepening the level of appearance anxiety.\u003c/p\u003e\u003cp\u003eThis study also has certain limitations: (1) the sample size is relatively small (n\u0026thinsp;=\u0026thinsp;781) and the population consists of college students, which may affect the generalizability of the results; (2) all variables were measured using traditional self-report methods, which may introduce potential bias; (3) the cross-sectional study design makes it difficult to reveal the causal relationships between variables. In future research, it could be considered that (1) expanding the sample size and population diversity through multicenter collaboration to enhance the generalizability of the results; (2) adopting longitudinal or experimental study designs to capture the causal patterns. In summary, the findings of this study provide direction for subsequent interventions on appearance anxiety among college students, with a focus on how to change their inappropriate use of social media, adjust their self-perceptions and ways of thinking, i.e., psychological flexibility and rumination, thereby reducing appearance anxiety.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003e1.Ethics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAccording to \u003cem\u003ethe Declaration of Helsinki of the World Medical Association\u003c/em\u003e, t\u003cem\u003ehe Ethical Review Procedures for Biomedical Research Involving Human Beings\u003c/em\u003e, and other relevant ethical norms at home and abroad，this study is approved by Ethics Committee of Harbin Medical University Daqing Campus(Ethical number:HMUDQ20250612002) .\u003c/p\u003e\n\u003cp\u003eInform consent was obtained from all individual participants included in the study. Participants signed informed consent regarding published their date.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.Consent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe declare that this manuscript is original, has not been published before and is not currently being considered for publication elsewhere.\u003c/p\u003e\n\u003cp\u003eWe confirm that the manuscript has been read and approved by all named authors and that there are no other persons who satisfied the criteria for authorship but are not listed. We further confirm that the order of authors listed in the manuscript has been approved by all of us.\u003c/p\u003e\n\u003cp\u003eWe understand that the Corresponding Author is the sole contact for the Editorial process. She is responsible for communicating with the other authors about progress, submissions of revisions and final approval of proofs.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.Availability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated during and analyzed during the current study are not publicly available,but are available from the corresponding author on request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4.Competing interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e5.Funding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo funding was received for conducting this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e6.Authors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAuthor 1(First Authors):Investigation;Data curation;Formal analysis;Writing-Original Draft\u003c/p\u003e\n\u003cp\u003eAuthor 2:Investigation;Data curation;Validation\u003c/p\u003e\n\u003cp\u003eAuthor 3:Resource;Investigation\u003c/p\u003e\n\u003cp\u003eAuthor 4:Resource;Investigation\u003c/p\u003e\n\u003cp\u003eAuthor 5(Corresponding Author):Supervision;Writing-Review \u0026amp; Editing\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e7.Acknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe would like to thank all participants in this study.\u003cbr\u003e\u003cstrong\u003e8.Authors\u0026apos; information\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"99%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003eAuthor\u0026nbsp;order\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003eItem\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003eName\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14px;\"\u003e\n \u003cp\u003eFamily name\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003eEmail and Telephone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23px;\"\u003e\n \u003cp\u003eAffiliation(s)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003eThe first author\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003eZhang Min\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003eMin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14px;\"\u003e\n \u003cp\u003eZhang\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\[email protected]\u003c/p\u003e\n \u003cp\u003e15848731762\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" style=\"width: 23px;\"\u003e\n \u003cp\u003eHarbin Medical University (Daqing) , No.39 Xinyang Road , High-techZone , Daqing City , Heilongjiang Province , China.\u003c/p\u003e\n \u003cp\u003e(Postal Code 163711)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003eThe second author\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003eZhao Zitin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003eZitin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14px;\"\u003e\n \u003cp\u003eZhao\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\[email protected]\u003c/p\u003e\n \u003cp\u003e15968719998\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003eThe third Author\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003eLu Jing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003eJing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14px;\"\u003e\n \u003cp\u003eLu\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\[email protected]\u003c/p\u003e\n \u003cp\u003e18245950444\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003eThe fourth Author\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003eLiu Yuhan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003eYuhan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14px;\"\u003e\n \u003cp\u003eLiu\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\[email protected]\u003c/p\u003e\n \u003cp\u003e17822210870\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 18px;\"\u003e\n \u003cp\u003eThe fifth Author\u003c/p\u003e\n \u003cp\u003e(Corresponding Author)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003eLi Yang\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003eYang\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14px;\"\u003e\n \u003cp\u003eLi\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\[email protected]\u003c/p\u003e\n \u003cp\u003e13936785360\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eThe China Internet Network Information Center,2025.The 55\u003csup\u003eth\u0026nbsp;\u003c/sup\u003estatistical Report of China\u0026rsquo;s Internet Developmenthttps://cnnic.cn/n4/2025/0117/c88-11229.html /(accessed 15 February,2025).(in Chinese)\u003c/li\u003e\n \u003cli\u003eDavis, C., Brewer, H., Weinstein, M., 1993. A study of appearance anxiety in young men. Soc. Behav. Pers.: Int. J. 21, 63\u0026ndash;74. https://doi.org/10.2224/sbp.1993.21.1.63\u003c/li\u003e\n \u003cli\u003eCheng Si, Luo Xi. 2021 .Nearly sixty percent of college students have appearance anxiety. Chinese youth Report.2021-02-25 Edition 07.https://zqb.cyol.com/html/2021-02/25/nw.D110000zgqnb_20210225_1-07.htm/(accessed 12 February,2025)(in Chinese)\u003c/li\u003e\n \u003cli\u003e\u0026Uuml;st\u0026uuml;ndağ, A., Kanik, R., \u0026Ccedil;inar, Y.R., 2024. The effect of Turkish Adolescents\u0026rsquo; social appearance anxiety on their appearance-related social media consciousness: A cross-sectional descriptive study. J Pediatr Nurs S0882-5963(24)00371\u0026ndash;3. https://doi.org/10.1016/j.pedn.2024.10.010\u003c/li\u003e\n \u003cli\u003eYang, H., Wang, J.J., Tng, G.Y.Q., Yang, S., 2020. Effects of Social Media and Smartphone Use on Body Esteem in Female Adolescents: Testing a Cognitive and Affective Model. 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Psychological flexibility as a fundamental aspect of health. Clinical Psychology Review 30, 865\u0026ndash;878. https://doi.org/10.1016/j.cpr.2010.03.001\u003c/li\u003e\n \u003cli\u003e20 Arnett, J.J., 1994. Are college students adults? Their conceptions of the transition to adulthood. J. Adult Dev. 1, 213\u0026ndash;224. https://doi.org/10.1007/BF02277582\u003c/li\u003e\n \u003cli\u003eHall, J.A., Steele, R.G., Christofferson, J.L., Mihailova, T., 2021. Development and initial evaluation of a multidimensional digital stress scale. Psychol. Assess. 33, 230\u0026ndash;242. https://doi.org/10.1037/pas0000979\u003c/li\u003e\n \u003cli\u003eLiu Qiuqi,Su Jiabao,Wei Shijuan,et al.Revision and Validation of the Digital Pressure Scale in Chinese College Students [J/OL]. Acta Scientiarum Naturalium Universitatis Pekinensis,2023, 59(6): 1025-1034. DOI:10.13209/j.0479-8023.2023.055.\u003c/li\u003e\n \u003cli\u003eRolffs, J.L., Rogge, R.D., Wilson, K.G., 2018. 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Assessment 15, 48\u0026ndash;59. https://doi.org/10.1177/1073191107306673\u003c/li\u003e\n \u003cli\u003eKong Shanshan,Yang Hongfei, 2009. Development of A College Female Student Appearance-management Behavior Scale. Chinese Journal of Clinical Psychology\u003c/li\u003e\n \u003cli\u003eWolfe, W.L., Yakabovits, L., 2024. I\u0026rsquo;ll see your beautified photo and raise you one: an experimental investigation of the effect of edited social media photo exposure. Psychol. Pop. Media 13, 249\u0026ndash;255. https://doi.org/10.1037/ppm0000443\u003c/li\u003e\n \u003cli\u003eZhang, Z., Zhou, M., 2024. The impact of social media information exposure on appearance anxiety in young acne patients: a moderated chain mediation model. Front. Psychol. 15, 1409980. https://doi.org/10.3389/fpsyg.2024.1409980\u003c/li\u003e\n \u003cli\u003eDe Valle, M.K., Wade, T.D., 2022. Targeting the link between social media and eating disorder risk: a randomized controlled pilot study. Int. J. Eat. Disord. 55, 1066\u0026ndash;1078. https://doi.org/10.1002/eat.23756\u003c/li\u003e\n \u003cli\u003eWu, L., Niu, G., Ni, X., Shao, X., Luo, Y., 2022. Body image flexibility moderates the association between photo-related activities on WeChat moments and the body dissatisfaction of female adolescents in China. Curr. Psychol. 41, 99\u0026ndash;104. https://doi.org/10.1007/s12144-019-00553-x\u003c/li\u003e\n \u003cli\u003eBehrend, N., Webb, J.B., Warschburger, P., 2023. Exploring the reciprocal associations between body appreciation, body image flexibility, and body acceptance by others in the context of the COVID-19 pandemic in Germany: results from cross-lagged panel analyses among women and men. Body Image 46, 139. https://doi.org/10.1016/j.bodyim.2023.05.008\u003c/li\u003e\n \u003cli\u003eMalo, R., Acier, D., Bulteau, S., 2022. Psychological flexibility: toward a better understanding of a key concept. Trends Psychol. 32, 734\u0026ndash;759. https://doi.org/10.1007/s43076-022-00188-1\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cdiv align=\"Left\"\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" style=\"width: 100px;\"\u003e\n \u003cp\u003eTable 1 Demographic Characteristics\u0026emsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 25px;\"\u003e\n \u003cp\u003eItems\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003eCategory\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003eNumber\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003ePercentage（%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 25px;\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e142\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e18.18\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e639\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e81.82\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" style=\"width: 25px;\"\u003e\n \u003cp\u003eGrade\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003eFreshman\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e158\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e20.23\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003eSophomore\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e253\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e32.39\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003eJunior\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e168\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e21.51\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\u0026nbsp;Senior\u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e15.36\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003eGraduate student and above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e10.50\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 25px;\"\u003e\n \u003cp\u003eResidence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003eUrban\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e404\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e51.73\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003eCountryside\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e377\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e48.27\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" style=\"width: 25px;\"\u003e\n \u003cp\u003eAverage daily online time\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003eLess than 1 hour\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e8.45\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e1-4 hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e437\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e55.95\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e5-8 hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e184\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e23.56\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003eMore than 8 hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e12.04\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 60px;\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e781\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" style=\"width: 100px;\"\u003e\n \u003cp\u003eTable 2 Differences in Appearance Anxiety Across Demographic Variables\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" style=\"width: 54px;\"\u003e\n \u003cp\u003eIndicator\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003e\u003cem\u003eM\u0026plusmn;SD\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12px;\"\u003e\n \u003cp\u003e\u003cem\u003et/F\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cem\u003eP-Value\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"13\" style=\"width: 15px;\"\u003e\n \u003cp\u003eAppearance Anxiety\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 16px;\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 209px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003e51.61\u0026plusmn;12.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 12px;\"\u003e\n \u003cp\u003e0.646\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 11px;\"\u003e\n \u003cp\u003e0.518\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 209px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003e50.87\u0026plusmn;12.39\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 16px;\"\u003e\n \u003cp\u003eResidence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 209px;\"\u003e\n \u003cp\u003eUrban\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003e50.99\u0026plusmn;12.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 12px;\"\u003e\n \u003cp\u003e-0.026\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 11px;\"\u003e\n \u003cp\u003e0.979\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 209px;\"\u003e\n \u003cp\u003eCountryside\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003e51.01\u0026plusmn;12.66\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" style=\"width: 16px;\"\u003e\n \u003cp\u003eGrade\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 209px;\"\u003e\n \u003cp\u003eFreshman\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003e49.19\u0026plusmn;12.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"5\" style=\"width: 12px;\"\u003e\n \u003cp\u003e1.365\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"5\" style=\"width: 11px;\"\u003e\n \u003cp\u003e0.244\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 209px;\"\u003e\n \u003cp\u003eSophomore\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003e50.94\u0026plusmn;12.31\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 209px;\"\u003e\n \u003cp\u003eJunior\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003e51.38\u0026plusmn;12.20\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 209px;\"\u003e\n \u003cp\u003e\u0026nbsp;Senior\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003e52.26\u0026plusmn;14.47\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 209px;\"\u003e\n \u003cp\u003eGraduate student and above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003e52.07\u0026plusmn;11.42\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" style=\"width: 16px;\"\u003e\n \u003cp\u003eAverage daily online time\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 209px;\"\u003e\n \u003cp\u003eLess than 1 hour\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003e51.41\u0026plusmn;12.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 12px;\"\u003e\n \u003cp\u003e2.028\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 11px;\"\u003e\n \u003cp\u003e0.108\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 209px;\"\u003e\n \u003cp\u003e1-4 hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003e50.74\u0026plusmn;12.39\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 209px;\"\u003e\n \u003cp\u003e5-8 hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003e50.07\u0026plusmn;12.70\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 209px;\"\u003e\n \u003cp\u003eMore than 8 hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22px;\"\u003e\n \u003cp\u003e53.77\u0026plusmn;10.79\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"14\" style=\"width: 100px;\"\u003e\n \u003cp\u003eTable 3 Descriptive Statistics and Correlation Analysis (r) of Various Variables\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003eM\u0026plusmn;SD\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e1 Contact pressure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e3.526\u0026plusmn;0.746\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e2 Recognition anxiety\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e3.541\u0026plusmn;0.795\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.358**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e3 Social comparison\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e3.541\u0026plusmn;0.804\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.320**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.381**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e4 Missed anxiety\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e3.523\u0026plusmn;0.755\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.392**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.390**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.314**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e5 Information overload\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e3.501\u0026plusmn;0.818\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.458**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.376**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.333**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.356**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e6 Online alert\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e3.535\u0026plusmn;0.765\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.391**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.420**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.412**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.413**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.423**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e7 Social media use\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e3.528\u0026plusmn;0.543\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.692**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.702**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.665**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.680**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.711**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.730**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e8 Mentally flexible\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e2.970\u0026plusmn;0.912\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.198**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.228**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.173**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.195**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.234**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.141**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.280**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e9 Psychological rigidity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e2.928\u0026plusmn;0.897\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.106**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.155**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.177**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.160**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.157**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.162**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.220**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.490**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e10 Psychological flexibility\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e2.949\u0026plusmn;0.781\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.176**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.222**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.202**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.206**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.227**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.175**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.290**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.866**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.861**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e11Rumination\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e2.472\u0026plusmn;0.394\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.289**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.275**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.259**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.267**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.299**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.289**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.401**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.371**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.332**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.408**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e12Appearance anxiety\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e3.189\u0026plusmn;0.770\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.178**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.174**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.242**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.173**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.213**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.221**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.288**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.251**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.255**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e-.293**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6px;\"\u003e\n \u003cp\u003e.460**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"14\" style=\"width: 100px;\"\u003e\n \u003cp\u003e注：* p\u0026lt;0.05，** p\u0026lt;0.01，下同\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"10\" style=\"width: 99px;\"\u003e\n \u003cp\u003eTable 4 Model Fit\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003eFitting index\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003eGFI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003eAGFI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003eRMSEA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003eNFI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003eIFI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003eCFI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003eRFI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003eCMIN/df\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 10px;\"\u003e\n \u003cp\u003eSRMR\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003eAcceptable range\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026gt;0.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026gt;0.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026lt;0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026gt;0.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026gt;0.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026gt;0.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026gt;0.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026lt;5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 10px;\"\u003e\n \u003cp\u003e＜0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003eObserved value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e0.986\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e0.976\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e0.030\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e0.971\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e0.988\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e0.988\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e0.958\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e1.697\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 10px;\"\u003e\n \u003cp\u003e0.0234\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\" class=\"fr-table-selection-hover\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"bottom\" style=\"width: 100px;\"\u003e\n \u003cp\u003eTable 5 Mediation Effect Values and 95% Confidence Intervals for Psychological Flexibility and Rumination\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"bottom\" style=\"width: 45px;\"\u003e\n \u003cp\u003ePath\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"bottom\" style=\"width: 10px;\"\u003e\n \u003cp\u003eEffect value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e95%CI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"bottom\" style=\"width: 15px;\"\u003e\n \u003cp\u003eEffect proportion（%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"bottom\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cem\u003eP-Value\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 9px;\"\u003e\n \u003cp\u003eLower limit\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 10px;\"\u003e\n \u003cp\u003eUpper limit\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 45px;\"\u003e\n \u003cp\u003eSocial Media Use - Psychological Flexibility - Appearance Anxiety\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e-0.045\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e-0.089\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e-0.004\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e11.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e0.032\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 45px;\"\u003e\n \u003cp\u003eSocial Media Use - Rumination - Appearance anxiety\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e-0.042\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e-0.078\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e-0.011\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e11.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e0.010\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 45px;\"\u003e\n \u003cp\u003eSocial Media Use - Psychological Flexibility - Rumination - Appearance anxiety\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e-0.022\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e-0.043\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e-0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e6.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e0.011\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 45px;\"\u003e\n \u003cp\u003eTotal Mediation Effect\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e-0.109\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e-0.163\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e-0.054\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e24.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Appearance anxiety, social media use, psychological flexibility, rumination, college students","lastPublishedDoi":"10.21203/rs.3.rs-6972535/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6972535/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjective:\u003c/strong\u003e This study explored the psychological pathways of social media use affecting college students' appearance anxiety, focusing on the sequential mediating pathways between psychological flexibility and ruminant thinking.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethod: \u003c/strong\u003eUsing the convenience sampling method, 781 college students were surveyed by digital stress scale, multidimensional psychological flexibility questionnaire, college students' appearance rumination scale and appearance anxiety scale.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResult\u003c/strong\u003e: Social media use, psychological flexibility, rumination and college students' appearance anxiety are significantly correlated; Social media use had a predictive effect on college students' appearance anxiety, with the chain mediating indirect effect by psychological flexibility and rumination.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e: The empirical results show that psychological flexibility and rumination play a sequential mediating role in the effect of social media use on appearance anxiety among college students.\u003c/p\u003e","manuscriptTitle":"The Relationship between Social Media Use and Appearance Anxiety of College students:The Serial Mediation of Psychological Flexibility and Rumination","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-16 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