Abstract :
Digital platforms have become a primary source of health information for young adults in low- and middle-income countries, yet the psychological consequences of this shift remain poorly characterised outside high-income settings. This study examined the relationship between digital health literacy and psychological distress among university students in Pakistan, testing cyberchondria as a mediating mechanism and financial anxiety and proactive coping as moderators, within the theoretical framework of the Health Belief Model. A cross-sectional survey of 307 university students (62.2% female) from Islamabad and Rawalpindi was conducted using validated self-report measures. Data were analysed using bivariate correlation, hierarchical multiple regression, and PROCESS-based moderation and mediation analysis. Contrary to the hypothesised direction, digital health literacy was significantly and negatively associated with both cyberchondria (? = -.28, p < .001) and psychological distress (? = -.18, p = .002). Cyberchondria was significantly and positively associated with psychological distress (? = .80, p < .001) and partially mediated the relationship between digital health literacy and distress (indirect effect = -.22, 95% CI [-.32, -.12]). Financial anxiety significantly strengthened the association between cyberchondria and psychological distress (b = .14, p = .002), whereas proactive coping significantly attenuated it (b = -.19, p = .026). These findings indicate that digital health literacy functioned as a protective, rather than a risk-amplifying, factor in this population, and that its effect on psychological distress operated in part through reduced cyberchondriac behaviour. Implications for digital health literacy interventions and directions for future research are discussed.