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Observational Study
Copyright: ©Author(s) 2026.
World J Psychiatry. Oct 19, 2026; 16(10): 121800
Published online Oct 19, 2026. doi: 10.5498/wjp.121800
Table 1 Demographic characteristics of participants (n = 708)
Characteristic
Category
Frequency (n)
Percentage (%)
SexMen34048.0
Women36852.0
Age (years)mean ± SD21.5 ± 1.9-
17-2028039.5
21-2335550.1
24+7310.3
University typePublic42560.0
Private28340.0
Academic levelUndergraduate (years 1-2)29041.0
Undergraduate (years 3-4)31244.1
Graduate (Masters/PhD)10615.0
Field of studyNatural/health sciences23032.5
Social sciences/humanities25536.0
Engineering & IT13519.1
Business & law8812.4
Table 2 Psychometric properties of measurement scales
Scale
Number of items
Cronbach’s alpha
CFI
RMSEA
Example item
IPAQ-SF7(Test-Retest r = 0.84)--“During the last 7 days, on how many days did you do vigorous physical activities?”
DASS-21 (total)210.940.930.05“I felt that I had nothing to look forward to.” (depression)
GSES100.890.950.04“I can always manage to solve difficult problems if I try hard enough.”
PSQI190.820.910.06“During the past month, how would you rate your sleep quality overall?”
MSPSS (total)120.920.940.05“I get the emotional help and support I need from my family.”
Table 3 Measurement model, discriminant validity, and common method bias assessment
Construct
Item
Loading
α
CR
AVE
Fornell-larcker: √AVE & correlations
HTMT



Construct A (e.g., satisfaction)A10.820.880.890.670.821
A20.79
A30.85
A40.88
Construct B (e.g., burnout)B10.80.860.870.620.45 → 0.7910.52
B20.76
B30.84
B40.81
Construct C (e.g., intention)C10.770.830.840.640.380.42 → 0.8010.44
C20.83
C30.79
Construct D (e.g., support)D10.860.890.90.690.520.480.35 → 0.8310.56
D20.82
D30.79
D40.85
Construct E (e.g., performance)E10.840.870.880.710.610.550.410.44 → 0.8410.69
E20.81
E30.87
Table 4 Descriptive statistics and inter-correlations of study variables (n = 708)
Variable
mean ± SD
1
2
3
4
5
6
PA (MET-minute/week)2580 ± 2110-
Depression (DASS)12.1 ± 4.5-0.46b-
Anxiety (DASS)11.5 ± 4.2-0.41b0.78b-
Stress (DASS)13.8 ± 4.8-0.51b0.82b0.75b-
Self-efficacy (GSES)28.5 ± 5.10.52b-0.58b-0.50b-0.60b-
Sleep quality (PSQI)6.8 ± 2.9-0.38b0.55b0.49b0.57b-0.48b-
Social support (MSPSS)65.2 ± 11.30.45b-0.50b-0.44b-0.52b0.54b-0.41b
Table 5 Standardized direct and indirect relationships in the structural equation modeling model
Pathway
Standardized estimate (β)
P value
95%CI
Direct relationship
PA → psychological distress-0.28< 0.001-0.37 to -0.19
PA → self-efficacy0.48< 0.0010.40-0.56
PA → sleep quality-0.35< 0.001-0.43 to -0.27
PA → social support0.42< 0.0010.34-0.50
Self-efficacy → distress-0.33< 0.001-0.41 to -0.25
Sleep quality → distress0.26< 0.0010.18-0.34
Social support → distress-0.210.001-0.29 to -0.13
Sex-specific direct relationship
PA → distress (male)-0.31< 0.001-0.42 to -0.20
PA → distress (female)-0.24< 0.001-0.34 to -0.14
Institution type-specific direct relationship
PA → distress (public university)-0.25< 0.001-0.35 to -0.15
PA → distress (private university)-0.33< 0.001-0.44 to -0.22
Indirect relationship
PA → self-efficacy → distress-0.16< 0.001-0.21 to -0.11
PA → sleep quality → distress-0.12< 0.001-0.16 to -0.08
PA → social support → distress-0.090.002-0.13 to -0.05
Total indirect relationship-0.37< 0.001-0.45 to -0.29
Total relationship (direct + indirect)-0.65< 0.001-0.73 to -0.57
Table 6 Comparison of alternative model structures
Model structure
χ2 (df)
χ2/df
CFI
RMSEA (90%CI)
AIC
BIC
Conclusion
Parallel mediation model (original)48.32 (24)2.010.960.058 (0.035- 0.080)248.50312.20Good fit; preferred for parsimony
Serial mediation model (PA → SE → sleep → MH)52.17 (23)2.270.940.067 (0.045-0.089)254.30320.10Comparable fit but slightly worse
Single-mediator models (average of three)------Inferior to parallel model (by Δχ2)
Null model (no mediation)156.80 (30)5.230.500.142 (0.120-0.164)--Poor fit


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