Reciprocal association and bridge symptoms in the comorbidity between social anxiety and problematic internet use: A...

This study aimed to examine the reciprocal association between social anxiety and PIU across four time points among Chinese rural adolescents, and to explore the bridge symptoms underlying their comorbidity over time.

Chinese rural adolescents (42.67 % boys; M_age = 15.64 years, SD = 1.42 years) participated in four waves of data collection (T1: September 2022, T2: March 2023, T3: September 2023, and T4: March 2024), and completed the Chinese Version of the Adolescent Social Anxiety Scale (SAS-A) and Problematic Internet Use Questionnaire Short Form (PIUQ-SF). Random intercept cross-lagged panel model (RI-CLPM) and cross-lagged panel network (CLPN) were employed for data analysis.

Results of RI-CLPM showed that social anxiety was positively associated with PIU at the between-person level. At the within-person level, consistent reciprocal relationships between social anxiety and PIU at all waves were found, with medium to large lagged effects. Results of CLPN showed that "obsession" and "neglect" symptoms from the PIU subnetwork, and "fear of negative evaluation" symptoms from the social anxiety subnetwork were the central bridge symptoms underlying the comorbidity between social anxiety and PIU.

The findings provide novel and indicative evidence for the comorbidity between social anxiety and PIU and the underlying mechanism among marginalized rural adolescents. The central bridge symptoms may serve as potential intervention targets to help prevent the progression of social anxiety and PIU comorbidity in rural schools, potentially leading to better mental health outcomes.