Social anxiety among young adults in Switzerland: a cross-sectional study on associations with sports and social support

Abstract

Background

This cross-sectional study examined the relationship of sports and perceived social support with social anxiety in young adults. We aimed to find out whether participation in sports and good social support were associated with lower social anxiety symptoms in individuals aged 18–40 years in Switzerland.

Methods

Participants aged 18–40 years were recruited through an online panel, which included company data pools, mail/email invitations, and social media. The survey included validated instruments: the Social Phobia and Anxiety Inventory (SPAI) for social anxiety, the Physical Activity and Sports Questionnaire (BSA-F) for sports participation, and the German Questionnaire for Social Support (F-SozU). Sociodemographic data and sports duration were also collected, with sports classified by type and duration. We fitted linear regression models to explore associations between social anxiety, sports type, duration, and perceived social support. Analyses were adjusted for sociodemographic characteristics.

Results

A total of 104 participants (51% female; mean age = 30.2 years, SD = 6.2) completed the survey, with 65.4% reporting recent sports participation, averaging 4.5 h/week. Social anxiety scores did not differ significantly across no sport, individual sport, or group sport participants. However, longer sports duration was associated with lower social anxiety scores, even after adjusting for perceived social support and sociodemographic factors. Social support was independently and negatively associated with social anxiety, highlighting its protective role regardless of sport type or duration.

Conclusion

Our findings suggest that sports involvement and supportive social networks are associated with lower social anxiety. Sports and social support should be considered to treat social anxiety, along with primary treatments such as psychotherapy and pharmacotherapy.

Introduction

Social Anxiety Disorder (SAD) is a prevalent mental health condition characterized by avoidance of social situations due to fear of judgment and scrutiny [1]. This disorder significantly impacts individuals’ lives, causing distress and impairments in their quality of life [2, 3]. SAD affects approximately 3.6% of the global population and is among the leading contributors to disease burden worldwide [4]. The prevalence of SAD tends to be higher in women than men, with a lifetime occurrence rate of 12.1% in the general population [5, 6]. The COVID-19 pandemic has exacerbated social anxiety, particularly among women [7].

Symptoms and treatment

SAD is the fear of being observed and judged by others, for example, at work or in everyday situations [1]. Symptoms of social anxiety include physiological responses such as blushing, sweating, trembling, rapid heartbeat, abdominal discomfort, stiff body language, speaking softly, and avoiding eye contact with strangers [8]. Individuals with social anxiety struggle with self-consciousness and emotional expression, making it difficult for them to identify, name, express, and understand their emotions [9]. Cognitive behavioral therapy, psychotherapies, and pharmacotherapy are common treatments for SAD, with promising results also seen in mindfulness-based stress reduction (MBSR), meditation, and sports as complementary therapies [8, 10,11,12].

Impact of sports and social support

Sports have been found to have a buffering effect against anxiety and to alleviate existing symptoms [13]. Engaging in sports can improve self-esteem and self-confidence, indirectly contributing to coping with psychosomatic reactions associated with social anxiety [8, 14]. Participation in team sports promotes positive social experiences and integration [8, 15]. Social support, including emotional, instrumental, and companionship support, plays a crucial role in reducing social anxiety levels [16, 17]. Lower levels of social support are associated with higher social anxiety scores, highlighting the importance of social connections in managing anxiety [18]. Social support (from family, friends, or other social networks) can connect young adults with others and enhance their resources and coping strategies, increasing their sense of security and reducing anxiety [17].

Current study objectives

Given the rising prevalence of social anxiety, especially among young adults, exploring the impact of interventions like sports and social support is imperative [6]. We aimed to (1) compare social anxiety by type of sports and determine the association of sport duration with social anxiety, (2) determine the association of social support and social anxiety, and (3) describe how sports (type and duration) change this association.

Methods

Sample and procedure

Eligible participants were young adults aged between 18 and 40 years. Using a multi-channel recruitment strategy, participants were recruited through an online panel provided by a private survey research company (Intervista AG, Zurich, Switzerland). The company has an online panel of 120,000 respondents across the country. They use age-, sex-, and language region to ensure that respondents represent the Swiss population. Intervista performed extensive data quality checks and validation techniques following the inclusion criteria in the study. We decided to outsource participant enrollment to ensure the representativeness of the sample, the broader reach of the survey, and the minimization of self-selection and observer bias.

Participants were reached through email and social media platforms. Eligible participants were contacted between June 5 and 12, 2023. Individuals who met the eligibility criteria and agreed to participate were granted access to the online questionnaire. Prior to the study’s launch, the recruitment process was piloted to ensure feasibility, and the questionnaire was tested to ensure clarity and validity.

Measurements

All measures were self-reported. To measure social anxiety, we used the German adaptation of the Social Phobia and Anxiety Inventory (SPAI) [19]. The SPAI is designed to assess the cognitive, somatic, and behavioral dimensions of social anxiety. It consists of 22 items evaluated using a seven-point Likert scale (0 = never to 6 = always). The tool includes items such as “I feel insecure when I am the center of attention” or “Social situations make me so insecure that I avoid them.” For this analysis, we calculated a mean score for all items. In previous studies, the instrument has shown high internal consistency (Cronbach’s alpha = 0.93–0.96) and retest reliability for socially anxious adults and control groups [19, 20].

To assess sports participation, we used the Physical Activity and Sports Questionnaire (Bewegungs- und Sport-Aktivitäts-Fragebogen, BSA-F) [21]. The BSA-F provides validated measures of activity, exercise, and sports [22]. It has six items and assesses the type and frequency of sports activities. Participants are asked open-ended questions about their sports activities, including the duration of each session over the past four weeks and the frequency per week (e.g., reporting that running was done three times per week for 60 min). According to the BSA-F, such as climbing stairs and gardening, light physical activities were excluded because the study focused specifically on sports (and not on physical activity broadly). For the analysis, we categorized participants’ engagement in sports activity (yes/no). Participants who reported engaging in sports were asked whether they practiced sports individually, as part of a team, or both. Those who indicated participating in both individual and team sports were categorized as team sports for the analysis. The duration of sports activity was assessed as the total time spent in hours over the past month. We further categorized participants engaged in sports into short-duration and long-duration groups by dividing the total sample at the median, creating two equal subgroups. No information on the intensity of sports activities was collected.

The German Questionnaire for Social Support (F-SozU) assessed perceived social support [23]. Perceived social support was measured using 14 items on a 5-point Likert scale (0 = does do not apply − 4 = applies). The questionnaire used items such as “There are people who accept me as I am, without any restrictions” or “I know several people with whom I like to do things”. Next, a mean score of the perceived social support is computed, providing a single-dimensional representation of perceived support. The F-SozU demonstrated high internal consistency (Cronbach’s αlpha value = 0.94) [24].

Our questionnaire also covered sociodemographic characteristics such as gender (female, male), age, current living situation (alone, shared apartment, living with parents, living with a partner), highest educational achievement (high school, vocational training, or university education), current professional situation (unemployed, full-time job, part-time job, or studying/ in training).

Statistical analysis

To describe our population, we used mean and standard deviation for continuous data and proportions for categorical data. We tested the normality of distribution using the Shapiro-Wilk test. We summarized each participant’s overall responses on standardized questionnaires (F-SozU and SPAI) using mean scores; thus, no imputation was done in case of missing responses. Scatterplots and Q-Q plots were used to detect outliers.

Using regression, we compared the social anxiety mean scores according to sport type (Aim 1). Linear regression was fitted using the SPAI mean score as the dependent variable and sport type (no sport, individual sport, or group sport) as the independent variable. Covariate adjustments were made using age, gender, education, employment, and living situation. Additional adjustment by perceived social support (F-SozU) was also done. Marginal means were computed to describe the mean social anxiety scores across sport groups.

Furthermore, to determine the association between social anxiety and sports duration (Aim 1), we fitted another linear regression using the SPAI mean score as the dependent variable and sports duration (short duration and long duration, median cut) as the independent variable. Covariate adjustments were made using age, gender, education, employment, and living situation. Additional adjustment by perceived social support (F-SozU) was also done. Marginal means were computed to describe the mean social anxiety scores across the sport duration group. Similarly, sports duration was also fitted as a continuous independent variable.

To determine the association between social anxiety and social support (Aim 2), we fitted a linear regression using the SPAI mean score as the dependent variable and the F-SozU mean score as the independent variable. Covariate adjustments were made using age, gender, education, employment, and living situation.

Finally, to determine the effect of sports on the association of social anxiety and social support (Aim 3), we fitted a linear regression using SPAI mean score as the dependent variable and F-SozU mean score as the independent variable, with sports duration (hours/month) and sports type (individual vs. group).

We performed all statistical analyses using IBM SPSS Statistics version 29.0. All two-tailed statistical tests and p values < 0.05 were considered statistically significant.

Results

A total of N = 104 participants (n = 53 female, 51%) responded to the survey (Table 1). The mean age was 30.2 years (range 18–40; SD = 6.2 years). Most of the sample had a university degree (n = 56, 53.8%), and almost half reported working full-time (n = 48, 46.2%). Many respondents were living with a partner (n = 45, 43.3%). A majority reported doing sport in the last four weeks (65.4%), including 39 (37.5%) engaged in individual sports and 29 (27.9%) engaged in sports in a team/club (group sports). A total of 34.6% reported not engaging in any sports activity in the last four weeks (Table 1). Among participants who engaged in sports, the average reported activity was 17.9 h over the past four weeks (SD = 16.2, range = 2.3–74.0), equating to approximately 4.5 h per week.

Table 1 Characteristics of the study population (n = 104)

Comparing social anxiety in individuals doing different types of sport (Aim 1), there was no significant association in social anxiety across no sport, individual sport, and group sport (Fig. 1A; Table 2). Social anxiety mean scores (SPAI) were not different among the three groups in the crude model, adjusted model, and the model adjusted for perceived social support (F-SozU). (Fig. 1A).

Comparing the social anxiety in individuals according to sports duration (Aim 1), we found those with long sports duration have significantly lower social anxiety mean score (SPAI) compared to those with shorter duration of sports (Fig. 1B). This is consistent with the crude model, the adjusted model, and the model adjusted for perceived social support (F-SozU) (Fig. 1B). Furthermore, sports duration (in hours/month) was inversely associated with social anxiety mean score (SPAI) (adjusted model: coeff. = -0.02, p = 0.02; model adjusted for sociodemographic characteristics: coeff. = -0.01, p = 0.08) (Table 2).

Fig. 1

Social anxiety according to sport type (A) and sport duration (B)

Note: The data presented in A includes three groups (n = 39 no sport, n = 29 individual sport, n = 68 team) analyzed with respect to social anxiety. Comparison of means revealed no statistically significant difference among sport type. The data presented in B includes two groups (32 participants for each group). For participants engaged in sports, we categorized the group based on activity duration, dividing it by the median. A comparison of means shows lower social anxiety in long duration/longer hours of sports activities compared to those with short duration. Covariate adjustment on age, gender, education, employment, and living arrangements. In addition to adjustment on sociodemographic characteristics, we also did covariate adjustment on perceived social support (F-SozU). *** p-value < 0.001

We also determined the association of social support and social anxiety (Aim 2) and determined how sports affect this association (Aim 3). We found that social support is negatively associated with social anxiety, even if the type and duration of sport are accounted for (Table 2). Individuals with lower social support report higher levels of social anxiety, with coefficients ranging from − 0.57 (adjusted for sports duration) to -0.69 (adjusted by sociodemographic factors, sports type, and duration) (all p < 0.001).

Table 2 Association between social support (F-SozU) and social anxiety (SPAI), and changes when adjusted with sports (coefficients and 95% CI)

Discussion

In our study, we found that longer duration of sport and higher social support were associated with lower social anxiety. This supports a possible beneficial effect of both social support and sports activity on social anxiety, though causation cannot be inferred due to the study’s cross-sectional design.

Although SAD is common and often chronic, it frequently remains inadequately treated or entirely neglected, particularly at a subclinical level [25,26,27,28]. A meta-analysis have shown that sports and physical activity reduce anxiety [3]. However, similar to the heterogeneity observed in anxiety disorders, no single mechanism fully explains the anxiolytic effects of sports [3, 14, 29]. Sports are thought to influence various psychological and biological processes, warranting further investigation. In our study, no significant differences in social anxiety scores were observed across sport types, possibly due to heterogeneity in sports characteristics, such as contact level (contact vs. non-contact sports), frequency (e.g., daily vs. once per week), and other unmeasured factors. Nonetheless, prior research suggests that team sports may provide additional benefits for mental and social outcomes, including social anxiety [27, 29]. Notably, our findings show that longer sport duration was associated with lower social anxiety levels, both independently (crude model and adjusted model) and after adjusting for perceived social support. Thus, our findings support the literature and further highlight the need for a more detailed characterization of sports activities to understand their anxiolytic effects better.

We found that strong social support was significantly associated with lower social anxiety scores, which is supported by a previous study [30]. According to the social causation model, a lack of perceived social support leads to social anxiety [30]. Perceived social support refers to the social support individuals subjectively feel, closely related to their subjective, personal feelings [31]. Connecting with other people helps to regulate one’s own emotions [32]. Difficulties in emotion regulation in individuals with social anxiety have been demonstrated at both intrapersonal and interpersonal levels [33]. Social support and connectedness can help a person feel safe around others [32]. Consequently, under these circumstances, it is possible that the symptoms of the socially anxious person, such as an increased heart rate, are better regulated. Social connectedness offers safety signals that help down-regulate threatening defensive responses and promote accessibility [34]. Generally, when a person does not feel threatened or in danger and is healthy, they may be in a physiological state that favors behaviors of spontaneous social affiliation [8]. In this sense, it would be expected that people who experience good social support would have lower scores on social anxiety.

In a time of rising healthcare costs and the number of young adults with mental disorders increasing, these findings may be a small but valuable contribution to improving existing treatments [35]. There are now several treatment centers where sports and various group and social activities are well integrated into treating SAD [8]. Our findings should be incorporated into established forms of prevention and treatment of SAD, whether in psychoeducational sessions or involving various sports, group activities, or social skills training. It might also be beneficial and effective to find other forms of treatment (in addition to the classic ones such as psychotherapy and psychopharmacological treatment) to prevent and treat this prevalent disorder. Particularly in the general population or the subclinical setting, low-threshold forms of prevention and treatment appear to have an essential role in the future [8], including sports, good social networks, support, and mindfulness or meditation should be part of it [12]. Furthermore, it may be beneficial to support patients in therapy to build (better) social networks. However, SAD may also be the reason for needing better social support. If someone’s social support is low, it is thus crucial to find out about and address causes to help the individual increase their social support [36].

The results of this study underscore that social contact and the sense of security and belonging that comes with it can help individuals regulate their emotions [32]. When people have different experiences of dealing with symptoms, they learn to cope with these reactions (such as increased pulse, reduced sweating, and blushing) and emotions, and they can learn that they can cope with them [8]. COVID-19 has led to an increase in anxiety disorders of about 25% [31]. The results and insights may contribute to counteracting this increase and further optimize the various forms of prevention and treatment.

Strengths and limitations

Our study has several notable strengths. First, we ensured a gender-balanced sample, increasing our findings’ robustness by capturing diverse perspectives. In addition, we used widely accepted measures known for their high internal consistency and validity. As a result, our study’s methods are easily replicable and comparable with larger samples, different age groups, and educational backgrounds. In addition, the size of our sample allows for reliable descriptive analyses. Finally, this is one of the few studies in Switzerland that may have a different cultural context in terms of sports and social support compared to other countries [37, 38]. Thus, we provide generalizable findings in the country.

However, our study also has limitations that need to be considered. First, there was a degree of selection bias within the sample, especially evident in the high level of education of the participants. The 2023 Swiss Federal Statistical Office report showed that 41.3% of the Swiss general population’s young adults (20–34 years old) received a university education, which closely resembles our study sample [39]. Generalization to groups with lower education and other age groups might not be adequate.

Second, the cross-sectional study design limits causal interpretation. Self-report surveys are susceptible to bias, which could lead to either overestimating or underestimating results, or answers can be given that are socially desirable, especially in the indication of sport. Given the inherent study limitation, the results should be interpreted cautiously, and causal conclusions should be avoided. Instead, an associative approach was taken [3]. Nevertheless, our findings are supported by previous studies [3].

Third, another limitation is the lack of diversity in sports activities covered by the questionnaire. For example, horse riding differs considerably from triathlon in terms of intensity and demands, which may introduce potential biases. Some sports, such as running or cycling, are highly demanding in cardiac activity, while others, like climbing, require intense concentration. Furthermore, the item assessing participation in team or group sports encompasses a broad range of activities, making it less specific. We did not collect information about the intensity of the activity, whether practiced individually or in a group. This focus on quantity rather than intensity represents another study limitation.

Finally, we were unable to assess and control various external influences, such as stress, conflict, or personal issues among study participants, which could affect their emotional well-being, including levels of anxiety. Furthermore, protective factors, such as stable, supportive relationships, were not explicitly addressed, potentially introducing bias into the data.

Further research is needed to investigate other influences and the interaction of the various factors with each other. For future research, exploring combinations such as psychotherapy/pharmacotherapy alongside sports and social skills training could provide valuable insights into their interactive dynamics. Furthermore, a lack of understanding of the underlying mechanisms of different sports activities remains. Qualitative research could shed light on inter-individual differences and the nuanced benefits within the sport and mental well-being nexus [29]. It is important to emphasize that optimal psychotherapeutic approaches and supportive interventions, including participation in sports and strengthening social activities, could provide invaluable support to individuals. This emphasis is warranted because sports and social engagement are readily accessible and often economically feasible. This is particularly relevant given the heightened vulnerability to social anxiety among those with limited financial resources [40], so it can be crucial in reducing health inequalities and promoting recovery by better integrating social support into services and policies [41]. Increased empirical and longitudinal research is essential to elucidate the mechanisms underlying the mental health effects of sport [29]. Future investigations should seek to innovate alternative interventions and integrate them with established methods, particularly for individuals with suboptimal responses to conventional treatments [33]. Exploring and evaluating additional and complementary prevention and treatment modalities, such as sports groups or social skills training, holds promise, especially given the frequent co-occurrence of social anxiety with various comorbid conditions, including depression [6].

Conclusion

Our research suggests that participation in sports is associated with less social anxiety in young adults. The combination of sports and social support may serve as a viable, accessible prevention and treatment option for individuals with social anxiety disorder. It is essential for healthcare professionals to actively advocate for existing prevention and treatments and incorporate this understanding into their efforts to support individuals with social anxiety effectively. In addition, sports and social support initiatives are generally accessible and affordable, allowing individuals to actively participate in alleviating their symptoms. This involvement fosters a sense of personal responsibility, empowerment, and self-efficacy to improve overall well-being and health.