Abstract
This study aimed to investigate the impact of low self-esteem on social media addiction among medical students, as well as the underlying mechanisms involving academic involution and anxiety. A cross-sectional survey was conducted among 1055 medical students from two universities in China. Subjective data regarding self-esteem, academic involution, anxiety, and social media addiction were collected. Correlation analyses were performed, and a mediation model was constructed to examine the relationships. The results indicated that: (1) self-esteem, academic involution, anxiety, and social media addiction were significantly correlated with each other; (2) self-esteem significantly negatively predicted social media addiction; (3) in the relationship between self-esteem and social media addiction, anxiety and academic involution played both independent mediating roles and a sequential mediating role. Specifically, self-esteem not only directly influenced social media addiction but also exerted an indirect effect through the chain mediation of academic involution and anxiety. These findings provide new insights into the mechanisms underlying social media addiction among medical students and suggest potential targets for prevention and intervention.