Researchers in Kerala found a significant association between low self-esteem and social anxiety among undergraduate medical students.

A new Indian study has found a significant link between low self-esteem and social anxiety among undergraduate medical students, highlighting a psychological burden that may affect future doctors both personally and professionally.
The cross-sectional study surveyed 507 medical students at a college in Kerala using validated questionnaires that assessed social anxiety and self-esteem. Researchers found that 201 students, or 39.64%, screened positive for social anxiety, while 158 students, or 31.16%, had low self-esteem. Students with low self-esteem were significantly more likely to show symptoms of social anxiety.
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Nearly Four in Ten Students Screened Positive
The findings suggest that social anxiety may affect a substantial proportion of medical students, despite the communication-intensive nature of their education and future profession.
Female students reported social anxiety slightly more often than male students, but the difference was not statistically significant. Students from nuclear families and those in the earlier years of medical school also showed relatively higher rates, although these patterns were not statistically conclusive.
Importantly, screening positive on a questionnaire does not confirm a clinical diagnosis. A diagnosis of social anxiety disorder requires a detailed evaluation by a qualified mental-health professional.
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When Fear of Judgement Follows Students into the Classroom
Social anxiety disorder involves an intense and persistent fear of situations in which a person may be watched, evaluated, criticised or embarrassed. It may appear during classroom presentations, group discussions, oral examinations, interactions with unfamiliar people or situations requiring public performance.(1✔ ✔Trusted Source
Prevalence of Social Anxiety and Its Association With Low Self-Esteem Among Medical Students: A Cross-Sectional Study From Kerala, India
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Students may experience sweating, trembling, a rapid heartbeat, difficulty making eye contact, their mind going blank or a strong urge to avoid social situations.
For medical students, these difficulties may interfere with:
- Answering questions during classes or ward rounds
- Communicating confidently with patients
- Participating in practical training
- Working effectively in clinical teams
- Delivering case presentations
- Seeking help from teachers or classmates
Anxiety symptoms can interfere with schoolwork, relationships and routine activities when they become persistent or severe.
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How Low Self-Esteem Can Deepen the Anxiety Cycle
Self-esteem refers to a person’s overall sense of self-worth and confidence in their abilities. Students with low self-esteem may be more sensitive to criticism, doubt their performance and expect others to judge them negatively.
These thought patterns can increase anxiety during social or performance situations. In turn, avoiding such situations may reduce opportunities to develop confidence, potentially reinforcing both low self-esteem and social anxiety.
However, the study does not prove that low self-esteem directly causes social anxiety. Because the researchers assessed students at one point in time, it is also possible that social anxiety lowers self-esteem or that both are influenced by academic stress, personality, family experiences or other psychological factors. (1✔ ✔Trusted Source
Prevalence of Social Anxiety and Its Association With Low Self-Esteem Among Medical Students: A Cross-Sectional Study From Kerala, India
Other student research has similarly reported an inverse relationship between self-esteem and social anxiety.
Medical Colleges Must Look Beyond Academic Performance
Social anxiety can remain hidden because affected students may avoid speaking up, asking for support or participating in activities that draw attention to them.
The researchers’ findings support the need for confidential counselling, early psychological screening, peer-support programmes, mentoring and communication-skills training within medical colleges.
Support should focus on building confidence and coping skills rather than labelling students. Those experiencing persistent fear, avoidance, panic-like symptoms or difficulty participating in academic and social activities should be encouraged to speak with a counsellor, psychologist or psychiatrist.
The study was conducted at a single medical college and relied on self-reported questionnaires, so its findings may not represent every medical student in India.
Larger, multicentre and longitudinal studies are needed to determine how self-esteem and social anxiety change throughout medical training.
Reference:
- Prevalence of Social Anxiety and Its Association With Low Self-Esteem Among Medical Students: A Cross-Sectional Study From Kerala, India
– (https://www.cureus.com/articles/507377-prevalence-of-social-anxiety-and-its-association-with-low-self-esteem-among-medical-students-a-cross-sectional-study-from-kerala-india?utm_source=chatgpt.com#!/)
Source-Medindia
