Examining the interplay between physical activity, problematic internet use and the negative emotional state of depression, anxiety and stress: insights from a moderated mediation path model in university students

Background The aim of this study was to investigate the relationship between Problematic Internet Use (PIU), emotional states of stress, anxiety and depression, and the practice of physical activity among Tunisian students. Methods Cross-sectional data were collected from 976 university students aged 20.76 +/- 1.63 years (46.8% female). They filled out an online survey comprised of a socio-demographic questionnaire, the depression, anxiety and stress scale- 21 items (DASS-21), the international physical activity questionnaire (IPAQ) and the compulsive internet use scale (CIUS). Students were divided, based on their economic levels, into three groups: low (n = 256, 26.23%), medium (n = 523, 53.59%) and high (n = 197, 20.18%). Results Mediation analysis: Indirect effects of IPAQ and gender on DASS-21 were highlighted: beta= -0.18 (p < 0.01) and beta= -0.04, P < 0.01) respectively. In addition, a significant and negative effect of IPAQ on CIUS was demonstrated (beta = -0.45, P < 0.01). In addition, the effect of CIUS on DASS-21 was significant (beta = 0.39, P < 0.01). Also, the effect of gender on CIUS was significant (beta=-0.10, P < 0.01) However, its effect on DASS-21 was not significant (beta = 0.05, p = 0.078). The total effect of IPAQ on DASS21 was significant (beta= -0.52, p < 0.01) but the effect of Gender on DASS-21 was not significant (beta = 0.01, p = 0.817). Moderation analysis: the results showed a significant moderation effect of the interaction between IPAQ and Gender on CIUS (beta = 0.07, p < 0.01). However, it was not significant between Gender and CIUS on DASS-21 (beta = 0.09, p = 0.390) and between IPAQ and Gender on DASS21 (beta = 0.01, p = 0.736) Also, the interaction between IPAQ and CIUS did not have a significant moderation effect on DASS-21 (beta = 0.15, p = 0.115). Conclusions Findings suggest that relationships between PIU and negative emotional state of depression, anxiety and stress are mediated via physical exercise. These results underscore the importance of the physical activity factor in the studies analyzing longitudinal effects of PIU on mental health outcomes.