The Temporal Relationships Between Non-Suicidal Self-Injury and Social Anxiety: A Cross-Lagged Panel Study

Abstract

Empirical evidence increasingly supports an association between non-suicidal self-injury (NSSI) and social anxiety symptoms among Chinese adolescents, although their temporal relationship remains inadequately established. To address this gap, the present study employed a cross-lagged panel design to examine the longitudinal relationships between NSSI and social anxiety symptoms. The final analytic sample consisted of 614 Chinese adolescents aged 13–18 years (53.09% girls), who completed three waves of assessments at six-month intervals using standardized self-report measures of NSSI, social anxiety, and rejection sensitivity. Longitudinal analyses controlling for prior symptom levels and gender showed that social anxiety at Time 1 significantly predicted subsequent NSSI at Time 2. A reciprocal relationship between social anxiety and NSSI was also observed across subsequent measurement waves. Furthermore, rejection sensitivity showed a significant indirect effect in the longitudinal association between social anxiety and subsequent NSSI. These findings highlight the longitudinal and reciprocal associations between social anxiety and NSSI among Chinese adolescents and suggest that rejection sensitivity may represent an important psychological pathway linking social anxiety to subsequent NSSI. Intervention strategies targeting NSSI may therefore benefit from considering co-occurring social anxiety symptoms and rejection sensitivity.