Sex differences in social anxiety: A longitudinal serial mediation via perceived stress and resilience among adolescents in China.

Background: Adolescent social anxiety is consequential. There is a substantial sex difference in the prevalence. Yet, the underlying mechanisms are almost unknown; no longitudinal studies have investigated this topic. Inspired by the gender role theory, this longitudinal study tested whether resilience and perceived stress would mediate between sex and social anxiety.

Methods: A longitudinal study surveyed middle school students from March 2022 to March 2023 in Taizhou City, China at baseline (T1), Month 6 (T2), and Month 12 (T3). Data from 2144 students completing the three surveys were analyzed. Validated scales were used to assess social anxiety, resilience, and perceived stress. Path analysis was performed.

Results: Females showed significantly stronger social anxiety and perceived stress but lower resilience than males. Perceived stress and resilience were positively and negatively correlated with social anxiety, respectively. The mediation paths via resilience and perceived stress (sex → resilience (T1) → social anxiety (T3) and sex → perceived stress (T2) → social anxiety (T3)) were statistically significant; the mediation effect sizes were 11 % and 7 %, respectively, A serial path (sex → resilience (T1)→ perceived stress (T2)→ social anxiety (T3)) was significant; the mediation effect size was only 1 %. The direct effect from sex to social anxiety at T3 was statistically significant (β = 0.081).

Conclusion: Female adolescents showed stronger social anxiety than male adolescents, partially because they have lower resilience and stronger perceived stress. Future longitudinal studies involving other mediators are warranted to advance understanding on the mechanisms. Efforts are needed to reduce the sex difference.