Associations of academic stress with anxiety and depressive symptoms: the mediating role of emotional eating

Background Academic stress is a prominent stressor during adolescence. This study aimed to examine the multidimensional associations of academic stress with anxiety and depressive symptoms, as well as the potential mediating role of emotional eating. Methods A cross-sectional survey was conducted among 608 adolescents and young adults (mean age: 18.78 years, girl: 66.61%) in southern China between July and September 2025. Academic stress was assessed using a validated multidimensional scale covering parental, self-imposed, teacher, and social pressure. Logistic regression, restricted cubic spline models, and structural equation modeling were used to evaluate associations, dose–response relationships, and potential mediation effects. Results The prevalence of anxiety and depressive symptoms was 24.18% and 34.38%. An approximately linear dose–response association was observed between academic stress and both outcomes. Compared with participants in the lowest stress quartile, those in the highest quartile had higher odds of anxiety (OR = 8.52, 95% CI: 4.04–18.29, P < 0.001) and depressive symptoms (OR = 5.64, 95% CI: 3.32–9.92, P < 0.001). All four academic stress dimensions were independently associated with both outcomes, with social pressure showing the strongest associations. Emotional eating was identified as a potential behavior-related factor partly involved in these associations, accounting for 9.98% of the association with anxiety and 4.79% with depressive symptoms. Across stress dimensions, the indirect associations involving emotional eating were more pronounced for teacher and parental pressures. Conclusions Academic stress was positively associated with anxiety and depressive symptoms. Emotional eating may represent a potential behavior-related correlate involved in these associations.