Associations of generalized and social anxiety with somatic symptoms in Japanese university students

Somatic symptoms are common among young adults and are strongly shaped by psychological factors. However, the distinct contributions of anxiety subtypes to somatic symptom burden remain unclear. This study examined how generalized anxiety and social anxiety are differentially associated with somatic symptom burden among university students.

A cross-sectional survey was conducted at a large Japanese university. Participants were 1452 students who completed the Somatic Symptom Scale-8 (SSS-8) and the Counseling Center Assessment of Psychological Symptoms-Japanese version (CCAPS-J). Multiple linear regression analyses were performed to estimate the associations of generalized anxiety and social anxiety with somatic symptom burden, adjusting for sex and academic grade.

Moderate-to-severe somatic symptom burden (SSS-8 ≥ 16) was observed in 37.4% of students. Generalized anxiety showed the strongest positive association with somatic symptoms (β = 0.475, p < .001). In contrast, social anxiety demonstrated a significant negative association (β = -0.121, p < .001). Depression and academic distress also showed positive associations with somatic symptom burden. These patterns persisted after adjustment for covariates.

Generalized and social anxiety exhibit contrasting associations with somatic symptom burden in young adults. The strong positive link between generalized anxiety and somatic symptoms highlights a key mental health assessment factor, whereas the inverse association with social anxiety may reflect suppression of symptom expression or underreporting. These findings highlight the importance of considering anxiety subtypes when interpreting somatic symptom reports among young adults and may inform symptom assessment in university mental health settings.