The correlation between phubbing and depression anxiety stress of first-year medical students: the mediating role of sedentary behavior

Background Freshmen often experience challenges when adjusting from high school to college, which may elevate levels of depression, anxiety, and stress. This phenomenon is particularly pronounced in medical schools, where the overall academic atmosphere is widely regarded as exceptionally demanding and stressful. Objectives To examine the indirect effect of sedentary behavior on the relationship between phubbing and depression anxiety stress of first-year medical students. Methods This study conducted a cross-sectional survey with 795 first-year medical students from Soochow University in China from October 2024 to November 2024 by using electronic questionnaire. The instruments were Depression Anxiety Stress Scale-21 (DASS-21), Generic Scale of Phubbing (GSP), and Adolescent Sedentary Activity Questionnaire (ASAQ). Results The findings indicate that first-year medical students’ phubbing and sedentary behavior positively affects their depression anxiety stress (r = 0.120 ~ 0.815, both p 0.01), and phubbing positively impacts medical students’ sedentary behavior (r = 0.128, p 0.01). Additionally, sedentary behavior acts as a significant mediator between phubbing and depression, anxiety, and stress. The indirect effect contributes to 1.9%~2.5% of the total effect. Conclusion These findings indicate that reducing depression anxiety stress in first-year medical students can be achieved not only through direct improvements in phubbing but also through the indirect effects of reducing sedentary behavior.