Association between Mental Distress and Weight-Related Self-Stigma via Problematic Social Media and Smartphone Use among Malaysian University Students: An Application of the Interaction of Person-Affect-Cognition- Execution (I-PACE) Model

Wan Ying Gan^1,#,*, Wei-Leng Chin^2,3,#, Shih-Wei Huang^4,5, Serene En Hui Tung⁶, Ling Jun Lee¹, Wai Chuen Poon⁷, Yan Li Siaw⁸, Kerry S. O’Brien⁹, Iqbal Pramukti¹⁰, Kamolthip Ruckwongpatr¹¹, Jung-Sheng Chen¹², Mark D. Griffiths¹³, Chung-Ying Lin^{10,11,14,15,*}
1 Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, 43400, Malaysia
2 Department of Family Medicine, E-Da Hospital, I-Shou University, Kaohsiung, 82445, Taiwan
3 Bariatric and Metabolism International Surgery Center, E-Da Hospital, I-Shou University, Kaohsiung, 82445, Taiwan
4 Institute of Environmental Toxin and Emerging Contaminant, Cheng Shiu University, Kaohsiung, 83347, Taiwan
5 Center for Environmental Toxin and Emerging-Contaminant Research, Cheng Shiu University, Kaohsiung, 83347, Taiwan
6 Division of Nutrition, Dietetics and Food Science, School of Health Sciences, IMU University, Bukit Jalil, Kuala Lumpur, 57000, Malaysia
7 Sunway Business School, Sunway University, Selangor, 47500, Malaysia
8 Faculty of Education, Universiti Malaya, Kuala Lumpur, 50603, Malaysia
9 School of Social Sciences, Faculty of Arts, Monash University, Melbourne, VIC 3800, Australia
10 Department of Community Health Nursing, Faculty of Nursing, Universitas Padjadjaran, West Java, 45363, Indonesia
11 Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, 701401, Taiwan
12 Department of Medical Research, E-Da Hospital, I-Shou University, Kaohsiung, 82445, Taiwan
13 International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, NG1 4FQ, UK
14 Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, 701401, Taiwan
15 School of Nursing, College of Nursing, Kaohsiung Medical University, Kaohsiung, 807378, Taiwan
* Corresponding Author: Wan Ying Gan. Email: email ; Chung-Ying Lin. Email: email
# Both authors shared the equal contribution to the co-first authorship
(This article belongs to the Special Issue: Mattering in the Digital Era: Exploring Its Role in Internet Use Patterns and Mental Health Outcomes)

International Journal of Mental Health Promotion https://doi.org/10.32604/ijmhp.2025.060049

Received 22 October 2024; Accepted 08 February 2025; Published online 13 March 2025

Abstract

Background: Weight-related self-stigma (WRSS) is prevalent among individuals with different types of weight status and is associated with a range of negative health outcomes. Social support and coping models explain how individuals may use different coping methods to deal with their mental health needs. Psychological distress (e.g., depression and stress) could lead to overuse of social media and smartphones. When using social media or smartphones, individuals are likely to be exposed to negative comments regarding weight/shape/size posted on the social media. Consequently, individuals who experience problematic social media use (PSMU) or problematic smartphone use (PSPU) may develop WRSS. Therefore, the present study examined the roles of PSMU and PSPU as mediators in the relationship between psychological distress and WRSS. Methods: Using convenience sampling via an online survey, 622 participants with a mean age of 23.70 years (SD = 4.33) completed questions assessing sociodemographic variables, psychological distress, PSMU, PSPU, WRSS, and self-reported weight and height. Results: The hierarchical regression models showed that sex (β = 0.08, p = 0.01), BMI (β = 0.39, p < 0.001), depression (β = 0.21, p = 0.001), stress (β = 0.18, p = 0.01), PSMU (β = 0.09, p = 0.045), and PSPU (β = 0.14, p = 0.001) were significant factors for WRSS. Conclusion: The mediation models showed that both PSMU and PSPU were significant mediators in the relationships between depression and stress with WRSS. The present findings provide some evidence for understanding WRSS and has important implications for developing interventions to reduce its negative impact on individuals’ health and well-being.