Abstract: The prevalence of anxiety and depression has escalated, prompting the current study to investigate the antecedents and coping strategies for these conditions in an era of digital media. A theoretical framework grounded in affective events theory and social comparison theory is built to elucidate the relationships between social comparison and anxiety and depression, acknowledging that such relationships are contingent upon the influences of the social media environment. This review unveils that negative social comparison (upward comparison and downward assimilation comparison) exerts a deleterious impact on anxiety and depression, with social networking applications catalyzing these adverse effects. Conversely, emotional comparison (i.e., social comparison of emotions) and downward contrast comparison are positively associated with alleviated anxiety and depression, as online health communities fostered a supportive milieu for emotional comparison, thereby helping to mitigate these conditions. This study extends social comparison theory in the realm of emotion and identifies the affordance of online health communities for coping with anxiety and depression. The implications for the principles of design, management, and operation of such communities are further discussed.
Previous research on the relationship between social comparison and anxiety/depression has yielded divergent findings. Some studies have identified social comparison as a paramount factor in initiating, perpetuating, and exacerbating anxiety and depression. Conversely, others have demonstrated that emotional comparison may alleviate stress and anxiety. Unfavorable comparisons with others across various dimensions, such as interpersonal relationships, social status, abilities, accomplishments, careers, income, and appearance, can precipitate psychological disorders like anxiety and depression. However, emotional comparison contributes cognitive clarity, empathic comfort, prevention, and learning, proving to be a coping mechanism for individuals experiencing negative emotions like anxiety in threatening situations. By delineating the distinct subtypes of social comparison, this review elucidates, to some extent, the seemingly complex and contradictory findings in the extant literature on the relationship between social comparison and anxiety and depression, as well as the internal logic behind the dual impact of social comparison on anxiety and depression.
Previous studies have underscored the markedly distinct role of online media environments in shaping the relationship between social comparison and anxiety/depression. On one hand, social networking platforms have expanded the scope of comparisons, diversified the targets of comparison, and increased the accessibility of social comparison information; consequently, the frequency of social comparisons has substantially escalated. Moreover, the editability of information on social networking platforms, the selective presentation of users, and the positive bias of self-presentation (i.e., individuals showcasing their best selves, exaggerating their self-importance, overstating their accomplishments and enjoyment of life, blatantly exhibiting, and even selectively displaying or altering photographs to enhance their appearance) exacerbate the deleterious impact of upward social comparisons, which can provoke anxiety and depression. On the other hand, the characteristics of online health communities (i.e., anonymity, homogeneity, normative, social, and on-demand availability) provide a conducive environment for emotional communication and social comparison, thereby facilitating the amelioration of anxiety and depression.
The review delves into the intricate mechanisms of anxiety and depression within the within the digital media era. It elucidates the intrinsic link between anxiety/depression and social comparison as well as the affordances of online health communities. Furthermore, it conducts a comprehensive exploration of emotional comparison, which has the potential to advance social comparison theory within the emotional realm and broaden the scope of emotional comparison theory in the context of internet-based healthcare. The discussion of the bi-directional effects of social comparison on anxiety and depression underscores the self-reinforcing spiral of individual negative emotions, a notable consideration when addressing the emotional experiences of anxious and depressed groups.
Given the pervasive, disseminated, and developmental affective states, coupled with the distinctive social comparison proclivity exhibited by anxiety-depression cohorts, it is imperative to investigate the emotional adversities (emanating from social interactions) of stigmatized groups through the theoretical lens of intergroup emotions. The ubiquity of self-disclosure, extensive accessibility, and traceability of information facilitated by online communities present opportunities to ameliorate mental health outcomes or manage emotional preoccupations. Subsequent empirical inquiries should delve into the efficacy of online communities in the identification, diagnostic processes, and therapeutic modalities for anxiety and depressive disorders, with particular emphasis on the delineation of online and offline domains, as well as the trade-off between the dichotomous effects of social comparison in digital spheres.

Key words: social comparison, anxiety, depression, social networking platforms, online health communities