Pakistani students’ physical activity and psychological well-being: A structural equation modeling approach

doi:10.5498/wjp.121800

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World Journal of Psychiatry

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2220-3206

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Observational Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Psychiatry. Oct 19, 2026; 16(10): 121800
Published online Oct 19, 2026. doi: 10.5498/wjp.121800

Pakistani students’ physical activity and psychological well-being: A structural equation modeling approach

Rizwan A Laar, He-Xuan Xiang, Qi Zhang, Rong-Rong Liu

Rizwan A Laar, College of Physical Education, Hubei Normal University, Huangshi 435002, Hubei Province, China

He-Xuan Xiang, Bijie Vocational and Technical College, Jeonbuk National University, Jeonju 561-756, Jeonbuk, South Korea

Qi Zhang, School of Physical Education, Yanshan University, Qinhuangdao 066004, Hebei Province, China

Rong-Rong Liu, College of Foreign Studies, Hubei Normal University, Huangshi 435002, Hubei Province, China

Author contributions: Laar RA performed the majority of the writing, prepared the figures and tables; Xiang HX, Zhang Q, and Liu RR designed the outline and coordinated the writing of the paper.

AI contribution statement: AI tools Grammarly (Premium) (Grammarly, Inc., San Francisco, CA, United States, https://app.grammarly.com) were used solely for linguistic refinement and formatting assistance. No AI tool was involved in the generation of research data, interpretation of results, or formulation of conclusions. All AI-generated outputs were critically reviewed and revised by the authors.

Supported by Youth Fund Project for Humanities and Social Sciences Research of the Ministry of Education of China, No. 25YJC890054.

Institutional review board statement: This study adhered to the ethical guidelines outlined in the Declaration of Helsinki, and the protocol of this study was approved by the Institutional Review Board of the Cholistan University of Veterinary and Animal Sciences, Pakistan. The ethical approval number was No. FAPT/PS/897.

Informed consent statement: Written informed consent for publication and participation was obtained from all participants before participating in any study procedure. The participants were assured that their personal identities will not be disclosed in subsequent research reports.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.

Data sharing statement: The data generated and/or analyzed in the current study are not publicly available because ethics approval was granted on the basis that only researchers involved in the survey could access the de-identified data. The minimum retention period was five years from publication. Supporting documents are available upon reasonable request from the corresponding authors.

Corresponding author: Qi Zhang, Lecturer, School of Physical Education, Yanshan University, No. 438 Hebei Street, Qinhuangdao 066004, Hebei Province, China. qzhang0115@ysu.edu.cn

Received: April 7, 2026
Revised: May 12, 2026
Accepted: July 10, 2026
Published online: October 19, 2026
Processing time: 191 Days and 7.6 Hours

Abstract

BACKGROUND

University students in Pakistan are silently experiencing psychological distress due to economic instability, academic pressure, and a lack of mental health services. In this context, physical activity (PA) has been proposed as an evidence-based, cost-effective, non-stigmatizing, and accessible adjunctive behavioral intervention. However, our understanding of its mechanism of action within Pakistan’s unique socio-cultural context remains limited. Factors such as gender norms, religious beliefs, family expectations, and institutional constraints may significantly shape how PA influences mental health outcomes among Pakistani students. Without context-specific research, the potential of PA as a feasible mental health strategy cannot be fully realized or appropriately implemented.

AIM

To examine the association of PA with depression, anxiety, and stress and to test a comprehensive theoretical model in which self-efficacy, sleep quality, and social support serve as parallel mediators in the relationship between PA and psychological well-being.

METHODS

A cross-sectional survey was conducted with 708 students from six public and private universities in three provinces of Pakistan using multistage cluster sampling. The participants completed validated scales, including the Depression Anxiety Stress Scale, International Physical Activity Questionnaire, General Self-Efficacy Scale, Multidimensional Perceived Social Support Scale, and Pittsburgh Sleep Quality Index. Descriptive statistics, Pearson’s correlation coefficient, and structural equation modeling (SEM) were used to analyze the data.

RESULTS

SEM analysis shows that the model fits well (comparative fit index = 0.95, root mean square error of approximation = 0.04). PA has a significant direct negative impact on psychological distress (β = -0.28, P < 0.001). The indirect effects generated through the medium are also significant: Self-efficacy (β = -0.16, P < 0.001), sleep quality (β = -0.12, P < 0.001), and social support (β = -0.09, P = 0.002), accounting for a large part of the total impact.

CONCLUSION

PA may alleviate psychological distress by improving self-efficacy, sleep quality, and social support. These findings support the inclusion of structured PA, sleep hygiene, and supportive campuses in Pakistan’s student mental health strategy.

Keywords: Psychological well-being; Mental health; Physical activity; Pakistani students; Structural equation model; Health psychiatry

Core Tip: This study had two main goals. First, it aimed to directly investigate how physical activity (PA) affects levels of depression, anxiety, and stress. Second, it sought to test a detailed theoretical model to understand how PA leads to better psychological well-being.