The chain mediating role of emotion regulation and stress perception in physical activity alleviating college students’ health anxiety

Under the background of increasing social competition pressure and health awareness, health anxiety among college students is becoming more and more prominent, which seriously affects their physical and mental health and quality of life. This study aimed to explore the relationship between physical activity, emotion regulation, stress perception, and health anxiety among college students, and to examine the mediating roles of emotion regulation and stress perception in the process of physical activity affecting health anxiety, to provide a theoretical basis for interventions targeting college students' physical activity behaviors. In this study, a cross-sectional design was used to administer questionnaires to 518 academics from Ningxia University using four questionnaires, namely, Physical Activity Rating Scale, Emotional Regulation Scale, Stress Perception Scale, and Health Anxiety Scale. SPSS 27.0 was used for descriptive statistics, reliability analysis, correlation analysis, and regression analysis, and PROCESS 4.1 plug-in was used for chained mediation effect model analysis and testing. Physical activity was negatively associated with stress perception and health anxiety and positively associated with emotion regulation. Emotion regulation and stress perception acted as chain mediators in the process of physical exercise affecting health anxiety. The indirect effect value of the path PA→PSS→SHAI accounted for 56.87% of the total effect value, indicating that physical exercise is one of the key paths to reducing the health anxiety level of college students by regulating stress perception and then alleviating health anxiety. This study reveals for the first time the intermediary mechanism of "emotion regulation → stress perception" of physical exercise to alleviate college students' health anxiety. At the theoretical level, a multilevel framework of physiological activation, cognitive regulation, and stress reconstruction was constructed; at the practical level, it provides a scientific basis for mental health intervention programs in colleges and universities and suggests that techniques such as Positive Mindfulness Exercise and Cognitive Behavioral Training can be integrated into physical exercise, which can effectively alleviate college students' health anxiety and promote their physical and mental health development by enhancing their emotion regulation ability and lowering the level of stress perception.