The Algorithm of Anguish: Examining Doomscrolling and Gen-Z Mental Health

Noreena Kausar1 & Areej Arshad

Department of Psychology, University of Gujrat, Gujrat, Pakistan

The study measures the relationship among appearance anxiety, subjective happiness and mental health issues in university students. Using Cross-sectional survey research design, a total of 616 students were included in the study through stratified sampling. Data were collected through Appearance Anxiety Inventory (AAI), Subjective Happiness Scale (SHS) and Depression Anxiety Stress Scale (DASS-21). Using SPSS-24, results indicated a negative relationship between appearance anxiety and subjective happiness and a positive relationship between appearance anxiety and mental health issue (r = .526). Correlation analysis also revealed that there is a significant negative relationship between subjective happiness and mental health issues (r = -.13) among university students. Regression analysis revealed that appearance anxiety is a significant predictor of mental health issues in university students. Through the findings, the role of body image in students’ overall well-being is highlighted. Further, it also sheds light on the importance of mental health related services in the universities for the promotion of mental well-being of students. The significant relationship among appearance anxiety, subjective happiness and mental health issues suggests that providing counseling and intervention services for appearance anxiety not only enhances overall well-being, but also reduces the mental health issues among students.

Keywords: appearance anxiety; subjective happiness; mental health issues; university students

In Pakistan, mental health of university students is being studied more and more concerning appearance anxiety, body image issues, subjective happiness and overall psychological well-being. Research results have indicated that body image dissatisfaction is a big problem among students of Pakistani universities, where negative views of one’s own appearance are associated with anxiety and lower self-esteem. As an illustration, a correlational study conducted among students from The University of Lahore and the University of Sargodha found that body image dissatisfaction was a positive predictor of social physique anxiety and a negative predictor of self-esteem, suggesting that students discontented with their bodies are more likely to be anxious about the way others see their physical selves and have less self-confidence (Aysha et al., 2024). In the same fashion, a recent cross-sectional survey of Pakistani university students found that social media addiction was a significant factor and health issue in relation to body image distress mostly seen among females in the age group of 18–24 and it was reported that the exposure to idealized images and online comparisons adds significantly in boosting appearance anxiety and pregnant distress (Munir et al., 2025).Moreover, the extensive study of psychosocial factors influencing students’ well-being has shown that subjective happiness has a strong inverse correlation with psychological distress and poor mental health. In this regard, lower level of happiness and perceived social support were major predictors of high depression, anxiety, stress, and even suicidal thoughts among the University students of Pakistan (Siyal et al., 2025). All these studies taken together indicate a trend where social and cultural pressures, the influence of media, and the acceptance of beauty standards as one’s own lead to the development of appearance anxiety and body dissatisfaction, which are eventually associated with low subjective well-being and increased mental health issues among university students in Pakistan.

Investigations carried out on university students in Pakistan have found a strong correlation between body image issues and anxiety about physical appearance with psychological distress and lack of self-worth.In a cross-sectional survey encompassing 561 undergrads studying at two universities in Pakistan, higher body consciousness and fear of negative social appearances were positively related to body shame and social appearance anxiety and were negatively related to self-esteem and confidence, more in female students than in male students (Shahid et al., 2024). These findings indicated that appearance-related anxiety is very common and measurable, causing an adverse impact on the psychological well-being of students.

Recent empirical data suggests that 30% to 40% of college students are suffering from major psychological conditions and dysfunctions including depression and anxiety (Auerbach et al., 2018). Appearance anxiety concerns are more prevalent nowadays and these concerns have emerged as the main drives of stress and anxiety related to one’s appearance conclusively affecting overall psychological well-being. Appearance anxiety is defined as persistent concern and uneasiness with one’s physical appearance, how one looks or how other people perceive individuals (Warren, 2017). It also involves perceiving flaws in their own appearance and fixed beliefs that other people can see their flaws (Mastro, et al. 2016).

Researchers have conducted new studies which put forth the claim that subjective happiness is a protective factor against mental health problems even stronger than before. A study done in 2025 on psychological distress among university students in Pakistan found that those who had low subjective happiness and were lacking in social support reported much higher levels of depression, anxiety, and stress, as well as suicidal thoughts. The aforementioned results point to the importance of subjective well-being in lessening the negatively impacting psychological effects of academic, social, and appearance-related stressors in university students (Siyal et al., 2025). University students are more susceptible to face appearance anxiety due to their evolving beliefs and mental schemas, changes in social ideas and social identity with excessive use of media and unrealistic beauty standards in society– they are more vulnerable to fall victim to appearance anxiety (Muhammad, 2017; Zheng, 2025). This is because they have to frequently navigate social settings involving interactions with a large number of people on a daily basis including both male and female- this makes them conscious about their appearance. More and more research suggests that appearance anxiety has a significant connection to poor mental health. It may also result in low self-esteem, low confidence and strain in interpersonal relationships (Liao et al., 2023). Hence, appearance anxiety affects individuals’ satisfaction and comfort level and their feeling of happiness may start reducing. Concerns about appearance have grown in importance among the many stressors that students deal with. Increasing data from cross-sectional and qualitative studies also indicates that college and university students in Pakistan have high prevalence of mental health issues, and there are significant gaps in knowledge, help-seeking, and campus mental health facilities (Shah et al., 2024).

It appears that social appearance concern is also a local issue rather than just a Western one, as recent research from Pakistan (such as studies on body image & acne) shows that it predicts lower self-esteem and quality of life among teenagers and college students (Shakir et al., 2024). Appearance anxiety in Pakistanis students is also related to self-objectification and body shame thus adding burdens psychologically. In a study conducted on self-objectification among students from Rawalpindi and Islamabad, significant positive relationships were found between self-objectification, body shame, and appearance anxiety (Naqi et al., 2022). It is thus inferred that they infer that the internalization of the cultural appearance standards activates a sense of heightened appearance apprehensions which may turn into higher levels of anxiety and dissatisfaction with the body among young adults, in educational settings.

With the onset of larger, stressful contexts such as the COVID-19 pandemic, students having psychological distress seemed to express reduced life satisfaction, suggesting that in Pakistan, poorer mental health marked by heightened stress and anxiety was associated with lower subjective well-being (Sher et al., 2023). Although it pertains to pandemic settings, this study adds to knowledge about how psychological distress negates subjective fulfillment –a key determinant of subjective happiness is in universities.

Recent Pakistani research highlighted that appearance anxiety and body image distress have become main university students’ mental-health issues, especially due to the influence of social media, as the latter was found to be the biggest factor affecting body image distress among the youth (aged 18–24 years), especially among females. The researchers also pointed out that exposure to online content focusing on appearance is the cause of anxiety about looks and thus students’ psyches are negatively affected in general (Munir et al., 2025).

Although excessive worry about one's looks among college students can result in eating disorders, depression, and other negative reactions to mental health and quality of life, appearance anxiety is a serious societal problem that has an impact on students' mental and physical health (Liu et al., 2024).

Recent research demonstrates that increased appearance anxiety enhances maladaptive coping strategies including social disengagement and body-checking behaviours and predicts worse mental-health indicators (higher anxiety & depressive symptoms, lower life satisfaction) (Wang et al., 2025). Subjective happiness has emerged as a significant psychological trait. It is the self-perception related to ones’ own happiness, emotions and mood. It is one’s own idea about life and circumstances. Subjective happiness refers to the individuals' comprehensive evaluation of life satisfaction and inclination towards positive feelings (Veenhoven, 2011). Happy and content students are better prepared to manage stress, maintain healthy social relationships, and protect their mental health from common challenges of student life (Martínez et al., 2024). Crucially, the subjective happiness can affect positively or negatively both the appearance anxiety and mental health issues, thus also affecting the relationship between the two. This tells us that overall feeling of happiness directly affects an individual’s well-being can counter negative mental health related easily. The link between happiness and mental health isn't always about a disease or absence of disease. It also involves identifying the role of positive feelings and negative feelings in a person's life. This involves a holistic concept including commitment in life, purpose, satisfaction and so on. According to a 2025 study, in higher-education populations, lower levels of anxiety, sadness, and perceived stress were linked to higher subjective well-being. In other words, pupils who express higher subjective enjoyment are more resilient, have stronger coping mechanisms, and have fewer symptoms. Happiness is often treated as an outcome in research, but more studies are modelling positive psychological qualities as moderators or mediators which alter the way stressors result in psychopathology. This theoretical shift encourages the investigation of subjective happiness as a mechanism for explaining the relationship between appearance anxiety and outcomes related to mental health (Putri et al., 2025).

The idea that provides the foundation for mediating role of happiness between appearance anxiety and mental health issues is – that appearance concerns can reduce a person’s mood, and emotion, also affecting a person’s sense of fulfillment all these things collectively exacerbating the physical and psychological discomfort (Park, 2007). On the other hand, people who are happier are considered to be more resilient and efficient in coping with difficult anxiety inducing situations about their perceptions- this leads to a determinable affect on emotional and behavioral wellbeing (El-Etreby et al., 2025). From a conceptual standpoint, this suggests an indirect pathway: anxiety regarding one’s appearance can influence the mental health by impacting subjective happiness. The present study seeks to measure the relationship among appearance anxiety, subjective happiness and mental health issues among university students. Further, it also seeks to measure the mediating role of subjective happiness in the relationship of appearance anxiety and mental health issues among university students.

The significance of the study lies in the theoretical model of this research that appearance anxiety or appearance related concerns can affect the mental wellbeing of an individual. This study aims to expand existing literature of research on students’ mental health especially on students’ appearance related concerns.

The research is important since it provides an understanding of the role of appearance anxiety in the subjective happiness and mental health issues of university students, a topic that very few studies have investigated so far in Pakistan. It also points out the protective function of subjective happiness, thereby increasing the understanding of the factors that might bring about the reduction of anxiety, stress, and other mental health problems among students. The findings can lead to provision of mental health and counseling interventions in universities that will not only help to promote psychological well-being,but it would also be a supportive step for reducing the mental health related issues among students.

Appearance anxiety as a predictor of mental health issues suggests an important concern in determining students’ wellbeing. This study establishes its primary focus on appearance related concern as the major factor for discomfort in students’ life, and addresses the issues for more management techniques and interventions to improve students’ wellbeing.

Method

Cross-sectional survey research design was used to study appearance anxiety, subjective happiness and mental health issues among students at the University of Gujrat, Pakitsan. This research was quantitative in nature.

p>Participants

The targeted population for this study was undergraduate students of the BS program enrolled in Faculty of Science and Faculty of Social Science, University of Gujrat. By using multistage stratified sampling technique, the sample was selected in four stages. First Stage comprised two faculties, Faculty of Social Sciences and Faculty of Sciences. In the second step, the faculties were divided into their respective departments. In the third stage, each department was further divided into semesters and then finally a sample was selected according to their gender- male and female. This resulted in a total sample of 614 participants (136 male & 478 female) aged between 17 to 28 years.

Majority of the students were female (77.9%) as compared to male students (22.1%) in the sample. Similarly, the majority of the participants belong to a nuclear family system (66.4%) as compared to students living in joint (33.6%) family system. In the sample, students having the birth order of middle were 37.8, youngest were 34.4% and eldest had the lowest number with 27.9%.

Measures and Procedure

Data was collected using three self-report measures including Appearance Anxiety Inventory (Veale et al., 2014), Subjective Happiness Scale (Lyubomirsky & Lepper, 1999) and Depression, Anxiety, and Stress Scale (Lovibond & Lovibond, 1995). Demographic variables included age, gender, academic group, family characteristics including mother father living status, socio-economic status, marital status and number of siblings etc. Prior permission was obtained from departments and university authorities to conduct research on their undergraduate students. A consent form was provided with topic, purpose of research, right of withdrawal and confidentiality related statements. Data was analyzed using SPSS version 21 applying descriptive analysis, correlation analysis, regression and mediation analysis.

Results

Data collected from university students are meticulously examined to uncover patterns, correlations, and significant relationships among variables using IBM statistics SPSS.

Table 2 demonstrates statistically significant negative relationship between appearance anxiety and subjective happiness (r = -0.060), statistically significant positive relationship between appearance anxiety and mental health issues. Whereas, table depicts a statistically significant negative relationship between subjective happiness and mental health.

The regression model predicting mental health Issues from appearance anxiety which is statistically significant, F (1, 61) =234.066, p<0.001. The model explained 27.7% of the variance in total DASS (R2=0.27). The predictor appearance anxiety was a significant predictor of mental health issues, B=0.901, p<0.001.

The regression model predicting total subjective happiness (SH) from total appearance anxiety (AA) was not statistically significant, F (1, 61) =2.214, p=0.14. The model explained 0.4% of the variance in total SH (R2=0.004). The total AA was not a significant predictor of total SH, B=0.042, p=0.137.

According to above table, appearance anxiety has no significant predictive ability for subjective happiness (Path A). Specifically, for parameters of Path A, the observed B value is -0.042, with an associated SE of 0.028; so, t was calculated as -1.49. Thus, the p-value was 0.137, the 95% confidence interval was [-0.098, 0.013], which indicates that as people experience greater levels of anxiety regarding their appearance, there is no corresponding increase or decrease in subjective feelings of happiness.

Contrary to this result, subjective happiness is a significant predictor of mental health problems after controlling for appearance anxiety (Path B). The results for Path B indicate that for Path B, the parameters of B= -0.247 with an associated SE=0.083. Therefore, Path B has a t score of -2.96 (p < .001); 95% confidence interval = [-0.411, -0.083]. The conclusion that can be drawn from the previous discussion about the predictive ability of Path B is that subjective feelings of happiness and mental health are inversely related; higher levels of subjective happiness correspond to lower levels of the presence of mental health concerns.

With respect to the total effects of appearance anxiety on mental health, Path C has a significant total effect on mental health issues in that Path C indicates a calculated B value of 0.901 with an associated SE=0.059. So, Path C has a t score of 15.30 with a statistically significant p-value; that is, p <0.001 (95% confidence interval = [0.785, 1.017]). Thus, it can be concluded that greater levels of appearance anxiety are related to greater levels of mental health problems.

When considering Path C', once subjective happiness is included in the overall model, we find that the direct effect of appearance anxiety on mental health remains a significant predictor of mental health problems. The parameters of Path C' indicate that B=0.890, SE=0.059; thus, Path C' produces a t score of 15.19 and, therefore, has a statistically significant p-value; so p <0.001 (with a 95% confidence interval of [0.775, 1.006]). Therefore, it can be concluded that although subjective happiness could be a partial mediator of the effect of appearance anxiety on mental health, it does not substantially weaken the relationship between appearance anxiety and mental health problems.

Table displays the bootstrapped indirect effects of appearance anxiety on mental health. The results indicate that the bootstrapped indirect effects of appearance anxiety on mental health are nonsignificant; specifically, B=0.010 with Boot SE=0.009 and the associated 95% bootstrapped confidence interval of the indirect effects is inclusive of zero, or [-0.002, 0.032]. Therefore, it can be concluded that subjective happiness does not mediate the relationship between appearance anxiety and mental health problems.

Following I have included two diagrams showing the framework and pathway of mediation analysis. Both are almost same but structurally different. You can add which one is to your liking.

Descriptive statistics in table 7 revealed that the mean score for males was slightly higher than females. Thus, the t-test results indicated a non-significant difference in AA scores across genders. Similarly, the descriptive statistics for SH revealed a very small difference in the mean scores for males and female students indicating a significant difference in SHS scores between genders. Further, the descriptive statistics for DASS also revealed a non-significant difference in DASS scores across the genders of the participants.

Discussion

The current study was conducted with the aim to examine the relationship among appearance anxiety, subjective happiness and mental health issues among university students. Findings indicate a statistically significant negative relationship between appearance anxiety and subjective happiness, statistically significant positive relationship between appearance anxiety and mental health issues, whereas, there is a statistically significant negative relationship between subjective happiness and mental health issues among university students.

In the current era of social media, appearance concerns become prominent in students almost at all levels of education. Among university students, appearance related concerns have been reported by different studies. Such concerns may have a relationship with the emotional and behavioral issues among students. Xian et al.2024 indicate that students in a medical university in China experience appearance anxiety, further, they reported that it has a significant effect on students’ depression. Celik, and Tolan (2021) reported a statistically significant and positive relationship in social appearance anxiety, stress and automatic thoughts among emerging adults between age ranges of 18 years to 35 years. Similarly, Milic, et al. (2024) studied 2137 health sciences students in Croatia and reported that when students were in their early years of studies, they are experienced more mental health issues such as depression, and anxiety and low level of subjective happiness. Hence, finding empirical evidence of students who have social appearance anxiety, one can also experience mental health issues and interrupted subjective happiness, current study measured social appearance anxiety, subjective happiness and mental health issues among students.

Findings indicate that there is a negative relationship between appearance anxiety and subjective happiness, whereas is a positive relationship of appearance anxiety with mental health issues among university students. According to the first hypothesis, a negative relationship between appearance anxiety and subjective happiness among university students is not significant. Table 2 indicates that there is a significant negative correlation between appearance anxiety and subjective happiness, and a statistically significant relationship between appearance anxiety and mental health. Jarman et al. (2021) supports the findings by concluding that higher levels of social appearance anxiety are associated with lower subjective happiness. The study of Duyan et al., 2022 also supports the findings as it suggests that social appearance anxiety has an overall negative impact on psychological well-being and is negatively correlated to psychological wellbeing. Table 4 states that appearance anxiety is a significant predictor of mental health issues in university students. These findings are also supported by Wu et al. (2024), that appearance anxiety, exacerbated by social media use, is closely linked to various mental health problems, including anxiety and depression.

Furthermore, a significant positive relationship between appearance anxiety and mental health issues among university students is also found. Xian, et al. (2024) confirmed the findings by studying the 724 medical college students. They found that appearance anxiety directly affects the depression among students. Appearance anxiety was found to have a negative relationship with mental health for both male and female students, but this relationship is more pronounced in males as compared to females. This finding supports the body of literature indicating that appearance-related stress can lead to mental health issues such as depression, anxiety, and low self-esteem (Grogan, 2016). Aslan and Tolan (2022) reported a positive relationship between appearance anxiety and automatic thoughts among students. This further indicates that appearance anxiety has a negative relationship with psychological well-being.

A statistically significant negative correlation was observed between subjective happiness and mental health issues. This indicates that higher score in subjective happiness is related to lower scores in mental health issues. It is also reported that a higher level of happiness has better mental health outcomes providing a link between universal nature of happiness and mental wellbeing. Previous studies have demonstrated that subjective happiness is a strong predictor of mental health, with happier individuals experiencing fewer psychological issues (Lyubomirsky et al., 2005). It also reveals that subjective happiness partially mediates the relationship between appearance anxiety and mental health issues. The negative relationship of overall happiness and psychological well-being with the mental health issues indicates that if students are experiencing the coherent psychological feelings, feelings of happiness and have a sense of well-being inversely, there would be less mental health issues. Göbel et al. (2023) reported that social appearance anxiety is inversely related to self-esteem among women. Hence, indicating that social appearance anxiety has a negative impact on positive elements of personality.

Table 7 indicates a non-significant difference between gender for appearance anxiety, and mental health issues. Çetin and Ece (2021) also reported similar social appearance anxiety in university students. Erick et al. (2022) reported a non-significant gender difference in the mental states of graduate students. Malik and Saida (2013) reported an insignificant difference in the level of happiness among male and female university students. However, in the current study, results are contrary, as there is a significant difference in subjective happiness in relation to the gender of the participants. The difference in subjective feelings of the happiness of male and female participants may be due to cultural practices. As males showed the greater mean in subjective feelings of happiness as compared to females. Male are more expressive and assertive comparatively, in Pakistani culture as compared to female. Female are considered less assertive due to which they may experience reduced feelings of overall happiness.

Strengths, Limitations and Future Recommendations

One of the strengths of the current study is that it measures the appearance anxiety and mental health issues among university students. On account of exposure to social media and competitive environment, students in educational institutes especially in universities not only face appearance anxiety but also experience many other mental health related issues. The current study is designed to measure the relationship between appearance anxiety and mental health issues in students from University of Gujrat. Further, the research investigates role of subjective happiness in relation to social appearance anxiety and mental health issues. Following the findings of the current study, counseling programs can be provided to the concerned students. However, the limitation of the study is that it is only conducted in one university, hence findings cannot be generalized to students from other universities of Pakistan. Future studies should increase the results’ generalizability, by increasing the sample size from other universities of different cities of Pakistan.

Conclusion

In conclusion, this study suggests the importance of subjective happiness as mediator between appearance anxiety and mental health issues. These findings underscore the importance and development of counseling based strategies to improve students’ mental health issues. Strategies should also be used to promote overall happiness and create a more supportive environment for university students. It further highlighted the need for targeted interventions to address appearance-related concerns or anxieties and to promote overall happiness and mental health for students of both genders. By understanding and addressing these issues, universities can create a more supportive and healthier environment for their students.

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