Appearance-ideal internalization and appearance-related physical activity avoidance among female university students in Sichuan, China: the role of social physique anxiety and body surveillance

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Physical activity and sport can become appearance-evaluative settings when the body is visible, compared, or judged. This cross-sectional study examined whether thin/low body fat internalization (TLB) and muscular/athletic internalization (MA) were associated with appearance-related avoidance of physical activity and sport (APAS) in a convenience sample of 1,687 female university students recruited from 16 universities in Sichuan Province, China. Social physique anxiety (SPA) and body surveillance (BS) were examined as parallel intermediate variables. The primary latent-variable model was estimated with robust maximum likelihood, allowed TLB and MA to covary, and allowed the residuals of SPA and BS to covary. Bias-corrected confidence intervals for indirect associations were obtained from 5,000 bootstrap resamples. The primary model yielded robust χ 2 (550) = 600.111, CFI = 0.998, TLI = 0.998, RMSEA = 0.007, 90% CI [0.000, 0.011], and SRMR = 0.017. TLB and MA each showed positive direct associations with APAS (standardized β = 0.198 and 0.160), SPA (0.231 and 0.219), and BS (0.289 and 0.228); SPA and BS were also positively associated with APAS (0.193 and 0.207), all p < 0.001. Four specific indirect associations were statistically significant: TLB-SPA-APAS, B = 0.042, 95% bias-corrected CI [0.028, 0.061]; TLB-BS-APAS, B = 0.057, CI [0.039, 0.077]; MA-SPA-APAS, B = 0.050, CI [0.032, 0.073]; and MA-BS-APAS, B = 0.056, CI [0.037, 0.079]. Bootstrap contrasts did not indicate unequal contributions from SPA and BS. Directionally specified serial alternatives were statistically equivalent in fit and did not identify temporal ordering. Targeted sensitivity analyses supported the principal pattern across covariate, subgroup, university-cluster, item, and ordinal-estimation checks. Higher APAS scores were concurrently associated with lower self-reported activity frequency and shorter session duration. The findings describe positive direct and specific indirect associations in this Sichuan university sample; they do not establish causal or temporal processes.

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