Association of fear of missing out and problematic social media use with multidimensional health outcomes among Iranian employed women

Employed Iranian women might face unique digital stressors due to their dual professional and domestic roles within a conservative sociocultural context. Their social media use is often purposeful, driven by time constraints and professional needs, rather than passive. According to the Uses and Gratifications Theory, such differentiated motivations may heighten vulnerability to Fear of Missing Out (FoMO) and problematic social media use (PSMU). Despite high digital engagement, few studies have explored how these stressors affect multidimensional health in this population. This study addresses that gap by examining psychological, physical, social, spiritual, and sexual wellbeing among employed Iranian women. This cross-sectional study surveyed 334 employed Iranian women (mean age = 35.59 ± 9.65 years) using validated measures of FoMO, PSMU, and health outcomes. Data were analyzed via Partial Least Squares Structural Equation Modeling (PLS-SEM) to examine direct and mediated pathways. FoMO was strongly associated with PSMU (β = 0.568, p < 0.001), which mediated 52.6% and 73.9% of FoMO’s effects on anxiety/insomnia (β = 0.091, p = 0.043) and depression (β = 0.099, p = 0.026), respectively. FoMO showed a strong negative relationship with spiritual wellbeing (β = − 0.415, p < 0.001), with minimal mediation by PSMU (3.2%). Surprisingly, FoMO and PSMU showed negligible associations with somatic symptoms (p = 0.064) and sexual wellbeing (p = 0.124). Social dysfunction scores were notably high (mean = 9.77 ± 3.46), suggesting digital engagement may impair real-world relationships. FoMO and PSMU were associated with poorer mental and spiritual wellbeing among employed Iranian women. These associations were stronger for psychological outcomes and minimally mediated by PSMU in the case of spiritual wellbeing. No significant relationships were observed for somatic symptoms or sexual wellbeing. These findings suggest that digital stress may be linked to specific dimensions of health in this population, warranting further investigation through longitudinal and culturally sensitive research.