ArticleCureus2026
Prevalence of Social Anxiety and Its Association With Low Self-Esteem Among Medical Students: A Cross-Sectional Study From Kerala, India.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundSocial anxiety is common among medical students because of academic pressure and frequent evaluations. Low self-esteem may contribute to the development of social anxiety. This study assessed the prevalence of social anxiety and low self-esteem and examined their association among medical students.
objectivesThis study aimed to determine the prevalence of social anxiety and low self-esteem among medical students and to evaluate the association between social anxiety and low self-esteem, as well as their relationship with gender.
methodsA cross-sectional analytical study was conducted among MBBS students at Believers Church Medical College Hospital, Thiruvalla, Kerala, India, between 2019 and 2021. All MBBS students from the 2016-2021 admission batches were invited to participate through a self-administered online questionnaire (Google Forms, Google LLC, California, USA). Of 600 eligible students, 507 responded (84.5%). Social anxiety was assessed using the Social Interaction Anxiety Scale (SIAS) and self-esteem using the Rosenberg Self-Esteem Scale (RSES). Social anxiety was defined as an SIAS score ≥35 and low self-esteem as an RSES score <20. Data were analyzed using IBM SPSS Statistics for Windows, version 25 (IBM Corp., Armonk, NY, USA). Chi-square tests, odds ratios (ORs), Pearson correlation, and multivariable logistic regression were performed.
resultsSocial anxiety was identified in 201 (39.64%) participants, while low self-esteem was present in 134 (26.43%). Low self-esteem was significantly associated with social anxiety (χ² = 67.41, p < 0.001; OR =5 .57, 95% confidence interval (CI): 3.62-8.56). Female participants had significantly higher odds of low self-esteem (OR = 2.31, p < 0.001), whereas gender was not independently associated with social anxiety. SIAS and RSES scores showed a significant negative correlation (r = -0.595, p < 0.001). Low self-esteem remained an independent predictor of social anxiety after adjustment for gender (adjusted OR = 5.76, 95% CI: 3.71-8.93; p < 0.001). Most participants reported symptom onset between 15 and 19 years.
conclusionsSocial anxiety and low self-esteem are highly prevalent among medical students. Low self-esteem is independently associated with social anxiety, highlighting the importance of early screening and interventions aimed at improving psychological well-being in this population.
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