Association between anxiety and aggression among students at a medical college in China: a cross-sectional analysis of indirect associations involving physical activity motivation and self-regulatory fatigue.

Background: Anxiety and aggression are important concerns for college students' mental health and campus adjustment. However, motivational and self-regulatory correlates of this association remain insufficiently examined. Objective: This study examined the anxiety-aggression association among students at one medical college in China, tested separate and serial statistical indirect associations involving physical activity motivation (PAM) and self-regulatory fatigue (SRF), and examined the reverse ordering of PAM and SRF. Methods: A cross-sectional questionnaire survey was conducted among 1,773 students at Shangqiu Medical College, Henan Province, China. Measures included a GAD-7-derived anxiety item set with five-point agreement responses and no two-week recall period, a BAQ-derived aggression item set with five rather than seven response categories, and PAM and SRF scales. Pearson correlations, regression analyses, and PROCESS Model 6 with 5,000 percentile bootstrap samples were used. Gender and three age-group indicator variables were included as covariates; reverse-order and outlier sensitivity analyses were also conducted. Results: Anxiety showed modest correlations with aggression ( Conclusion: Among students at one medical college, anxiety, lower PAM, higher SRF, and aggression formed modest cross-sectional covariance patterns. Because both PAM-SRF orderings were compatible with the data and the serial association was small, the findings are hypothesis-generating and do not establish temporal or causal mechanisms.