Skip to main content
Key Specialties
Anesthesiology Cardiology Dermatology Diabetology Endocrinology Gastroenterology General Medicine Geriatrics Hematology Infectious Diseases Internal Medicine Nephrology Neurology Obstetrics and Gynecology Oncology Pediatrics Psychiatry Radiology Respiratory Medicine Rheumatology Surgery Urology
Congress Coverage
2024 ESMO Congress 2024 ERS Congress 2024 EASD Congress 2024 ESC Congress 2024 EAN Congress 2024 ASCO Annual Meeting 2024 ACC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote series | Spotlight on menopause

Menopause can have a significant impact on the body, with effects ranging beyond the endocrine and reproductive systems. Learn about the systemic effects of menopause, so you can help patients in your clinics through the transition.

Launching: Thursday 12th December 2024
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in:

Open Access 01-12-2024 | Research

The association between chronotype and social anxiety among Chinese university students: a moderated mediation analysis of loneliness and perceived social support

Authors: Yingying Zhu, Junling Liu, Fulin Chen, Qian Wang, Kunxia Cao, Jiahao Huang, He Wang, Qiang Wang, Xue Luo

Published in: BMC Public Health | Issue 1/2024

Login to get access

Abstract

Background

Social anxiety has been a burning problem among contemporary college students in China. Increasing evidence suggests that individual circadian typology–chronotype may play an important role in the development of social anxiety. However, little research has focused directly on examining the association between chronotype and social anxiety, and less is known about the mediating and moderating mechanisms underlying this relationship. The aim of the present study was to investigate the link between chronotype and social anxiety among Chinese college students, and to explore the mediating effect of loneliness and the moderating effect of perceived social support in the association between chronotype and social anxiety.

Methods

A cross-sectional design was conducted among 1616 college students (16–29 years old) from several public universities in Northern China, including 1172 females (72.52%) and 444 males (27.48%), with an average age of 19.68 years old (SD = 1.49). All participants completed the standardized self-report questionnaires including the Social Avoidance and Distress Scale, Morningness-Eveningness Questionnaire, UCLA Loneliness Scale, and the Perceived Social Support Scale. Common method bias was performed using Harman’s single-factor test. The mediation and moderation effects were analyzed using SPSS software and PROCESS macros.

Results

Chronotype had a negative predictive effect on social anxiety in college students. Specifically, the greater the inclination of individuals' chronotypes toward evening preference, the more pronounced their symptoms of social anxiety would be. Loneliness served as a partial mediator in the relationship between chronotype and social anxiety, accounting for 30.0% of the total effect. In addition, perceived social support, particularly from friends and significant others, was found to play a moderating role in the process of loneliness affecting social anxiety among college students, while support from family did not. Interestingly, the perceived social support displayed a limited protective effect when college students suffered from higher levels of loneliness.

Conclusion

These findings deepened our understanding of how and when (or for “whom”) chronotype is related to social anxiety, offering a theoretical foundation and practical insights for preventing and addressing social anxiety risk in young adult university students, particularly those with evening chronotypes.
Literature
1.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders, Fifth Edition. Arlington, VA: American Psychiatric Association; 2013.
2.
Morrison AS, Heimberg RG. Social anxiety and social anxiety disorder. Annu Rev Clin Psychol. 2013;9:249–74.PubMedCrossRef
3.
Xu SP. Interpretation bias and social anxiety (doctoral dissertation). Shanghai: East China Normal University; 2010.
4.
Meng T, He Y, Zhang Q, Yu F, Zhao L, Zhang S, et al. Analysis of features of social anxiety and exploring the relationship between childhood major adverse experiences and social anxiety in early adulthood among Chinese college students. J Affect Disord. 2021;292:614–22.PubMedCrossRef
5.
Kraft JD, Grant DM, White EJ, Taylor DL, Frosio KE. Cognitive mechanisms influence the relationship between social anxiety and depression among college students. J Am Coll Health. 2021;69(3):245–51.PubMedCrossRef
6.
Weidman JC, DeAngelo L, Bethea KA. Understanding student identity from a socialization perspective. New Dir High Educ. 2014;166:43–51.CrossRef
7.
Jiang Y, Lin L, Hu R. Parental phubbing and academic burnout in adolescents: The role of social anxiety and self-control. Front Psychol. 2023;14:1157209.PubMedPubMedCentralCrossRef
8.
Brook CA, Willoughby T. The social ties that bind: Social anxiety and academic achievement across the university years. J Youth Adolesc. 2015;44:1139–52.PubMedCrossRef
9.
Hiller TS, Steffens MC, Ritter V, Stangier U. On the context dependency of implicit self-esteem in social anxiety. Disorder J Behav Ther Exp Psychiatry. 2017;57:118–25.PubMedCrossRef
10.
Li Z, Wang T, Liang Y, Wang M. The relationship between Mobile phone addiction and subjective well–being in college students: The mediating effect of social anxiety. Stud Psychol Behav. 2017;15(04):562–8.
11.
Leigh E, Chiu K, Ballard ED. Social anxiety and suicidality in youth: A systematic review and meta-analysis. Res Child Adolesc Psychopathol. 2023;51(4):441–54.PubMedCrossRef
12.
Buckner JD, Lemke AW, Jeffries ER, Shah SM. Social anxiety and suicidal ideation: Test of the utility of the interpersonal-psychological theory of suicide. J Affect Disord. 2017;45:60–3.
13.
Au J, Reece J. The relationship between chronotype and depressive symptoms: A meta-analysis. J Affect Disord. 2017;218:93–104.PubMedCrossRef
14.
Taylor BJ, Hasler BP. Chronotype and mental health: Recent advances. Curr Psychiatry Rep. 2018;20:1–10.CrossRef
15.
Merikanto I, Partonen T. Eveningness increases risks for depressive and anxiety symptoms and hospital treatments mediated by insufficient sleep in a populationbased study of 18,039 adults. Depress Anxiety. 2021;38(10):1066–77.PubMedCrossRef
16.
Adan A, Archer SN, Hidalgo MP, Di Milia L, Natale V, Randler C. Circadian typology: A comprehensive review. Chronobiol Int. 2012;29(9):1153–75.PubMedCrossRef
17.
Maierova L, Borisuit A, Scartezzini JL, Jaeggi SM, Schmidt C, Münch M, et al. Diurnal variations of hormonal secretion, alertness and cognition in extreme chronotypes under different lighting conditions. Sci Rep. 2016;6:33591.PubMedPubMedCentralCrossRef
18.
Dijk DJ, Lockley SW. Invited Review: Integration of human sleep-wake regulation and circadian rhythmicity. J Appl Physiol. 2002;92(2):852–62.PubMedCrossRef
19.
Höller Y, Gudjónsdottir BE, Valgeirsdóttir SK, Heimisson GT. The effect of age and chronotype on seasonality, sleep problems, and mood. Psychiatry Res. 2021;297: 113722.PubMedCrossRef
20.
Choi HJ, Lee YJ, Yoo YJ, Cho YW, Moon HJ. The effects of chronotype and social jetlag on medical students. Sleep Biol Rhythms. 2019;17(3):269–76.CrossRef
21.
Gau SSF, Shang CY, Merikangas KR, Chiu YN, Soong WT, Cheng ATA. Association between morningness-eveningness and behavioral/emotional problems among adolescents. J Biol Rhythms. 2007;22(3):268–74.PubMedCrossRef
22.
Randler C, Vollmer C. Aggression in young adults-a matter of short sleep and social jetlag? Psychol Rep. 2013;113(3):754–65.PubMedCrossRef
23.
Azad-Marzabadi E, Amiri S. Morningness–eveningness and emotion dysregulation incremental validity in predicting social anxiety dimensions. Int J Gen Med. 2017;10:275–9.PubMedPubMedCentralCrossRef
24.
Markarian SA, Gildner DJ, Pickett SM, Warnke AS. Morningness-eveningness and social anxiety symptoms: The influence of depression symptoms on the indirect effect through punishment sensitivity and experiential avoidance. Chronobiol Int. 2019;36(2):214–24.PubMedCrossRef
25.
Mecacci L, Rocchetti G. Morning and evening types: Stress-related personality aspects. Pers Individ Dif. 1998;25(3):537–42.CrossRef
26.
Van den Berg JF, Kivelä L, Antypa N. Chronotype and depressive symptoms in students: An investigation of possible mechanisms. Chronobiol Int. 2018;35:1248–61.PubMedCrossRef
27.
Singh R, Singh B, Mahato S, Hambour VK. Social support, emotion regulation and mindfulness: A linkage towards social anxiety among adolescents attending secondary schools in Birgunj. Nepal PloS One. 2020;15(4): e0230991.PubMedCrossRef
28.
Peplau L, Perlman D. Perspectives on loneliness: A sourcebook of current theory, research and therapy. New York: Wiley; 1982. p. 1–20.
29.
Cavanaugh AM, Buehler C. Adolescent loneliness and social anxiety: The role of multiple sources of support. J Soc Pers Relat. 2016;33(2):149–70.CrossRef
30.
Huan VS, Ang RP, Chye S. Loneliness and shyness in adolescent problematic internet users: The role of social anxiety. Child Youth Care Forum. 2014;43(5):539–51.CrossRef
31.
Käll A, Jagholm S, Hesser H, Andersson F, Mathaldi A, Norkvist BT, Shafran R, Andersson G. Internet-based cognitive behavior therapy for loneliness: A pilot randomized controlled trial. Behav Ther. 2020;51(1):54–68.PubMedCrossRef
32.
Hawkley LC, Cacioppo JT. Loneliness matters: A theoretical and empirical review of consequences and mechanisms. Ann Behav Med. 2010;40(2):218–27.PubMedCrossRef
33.
Mahaffey BL, Wheaton MG, Fabricant LE, Berman NC, Abramowitz JS. The contribution of experiential avoidance and social cognitions in the prediction of social anxiety. Biol Rev Camb Philos Soc. 2013;41:52–65.
34.
Lim MH, Rodebaugh TL, Zyphur MJ, Gleeson JFM. Loneliness over time: The crucial role of social anxiety. J Abnorm Psychol. 2016;125(5):620–30.PubMedCrossRef
35.
Wittmann M, Dinich J, Merrow M, Roenneberg T. Social jetlag: Misalignment of biological and social time. Chronobiol Int. 2006;23(1–2):497–509.PubMedCrossRef
36.
Kivelä L, Riese H, Fakkel TG, Verkuil B, Penninx BWJH, Lamers F, Antypa N. Chronotype, daily affect and social contact: An ecological momentary assessment study. Psychiatry Res. 2022;309: 114386.PubMedCrossRef
37.
Wills C, Ghani S, Tubbs A, Fernandez FX, Athey A, Turner R, et al. Chronotype and social support among student athletes: Impact on depressive symptoms. Chronobiol Int. 2021;38(9):1319–29.PubMedCrossRef
38.
39.
40.
Wethington E, Kessler RC. Perceived support, received support, and adjustment to stressful life events. J Health Soc Behav. 1986;27(1):78–89.PubMedCrossRef
41.
Eagle DE, Hybels CF, Proeschold-Bell RJ. Perceived social support, received social support, and depression among clergy. J Soc Pers Relat. 2019;36(7):2055–73.CrossRef
42.
Liu Y, Aungsuroch Y. Work stress, perceived social support, self-efficacy and burnout among Chinese registered nurses. J Nurs Manag. 2019;27(7):1445–53.PubMedCrossRef
43.
Uchino BN, Cacioppo JT, Kiecolt-Glaser JK. The relationship between social support and physiological processes: A review with emphasis on underlying mechanisms and implications for health. Psychol Bull. 1996;119(3):488–531.PubMedCrossRef
44.
Pineda CN, Naz MP, Ortiz A, et al. Resilience, social support, loneliness and quality of life during COVID-19 pandemic: A structural equation model. Nurse Educ Pract. 2022;64: 103419.PubMedPubMedCentralCrossRef
45.
Calsyn RJ, Winter JP, Burger GK. The relationship between social anxiety and social support in adolescents: a test of competing causal models. Adolescence. 2005;40(157):103.PubMed
46.
Xiao S, Shi L, Dong F, Zheng X, Xue Y, Zhang J, et al. The impact of chronic diseases on psychological distress among the older adults: The mediating and moderating role of activities of daily living and perceived social support. Aging Ment Health. 2022;26(9):1798–804.PubMedCrossRef
47.
Busack A. The influence of after-school activity participation and perceived social support on the emotional and social competence, and school engagement of adolescents (doctoral dissertation). New York: Pace University; 2013.
48.
Chang JJ, Zhu HD, Zhang XY, Li CX. Effect of social support on adolescents’ prosocial behavior: Mediating effect of social anxiety and depression. Mod Prev Med. 2021;48:2210–3.
49.
Hickin N, Käll A, Shafran R, Sutcliffe S, Manzotti G, Langan D. The effectiveness of psychological interventions for loneliness: A systematic review and meta-analysis. Clin Psychol Rev. 2021;88: 102066.PubMedCrossRef
50.
Harrison V, Moulds ML, Jones K. Perceived social support and prenatal wellbeing; The mediating effects of loneliness and repetitive negative thinking on anxiety and depression during the COVID-19 pandemic. Women Birth. 2022;35(3):232–41.PubMedCrossRef
51.
Horne JA, Ostberg O. A self-assessment questionnaire to determine morningness-eveningness in human circadian rhythms. Int J Chronobiol. 1976;4(2):97–110.PubMed
52.
Zhu YY, Huang JH, Yang MQ. Association between chronotype and sleep quality among Chinese college students: The role of bedtime procrastination and sleep hygiene awareness. Int J Environ Res Public Health. 2022;20(1):197.PubMedPubMedCentralCrossRef
53.
Watson D, Friend R. Measurement of social-evaluative anxiety. Consult Clin Psychol. 1969;33(4):448.CrossRef
54.
Liang Z, Kang D, Zhang M, et al. The impact of the COVID-19 pandemic on Chinese postgraduate students’ mental health. Int J Environ Res Public Health. 2021;18(21):11542.PubMedPubMedCentralCrossRef
55.
56.
Shi X, Wang A, Zhu Y. Longitudinal associations among smartphone addiction, loneliness, and depressive symptoms in college students: disentangling between–and within–person associations. Addict Behav. 2023;142: 107676.PubMedCrossRef
57.
Zimet GD, Dahlem NW, Zimet SG, Farley GK. The multidimensional scale of perceived social support. J Pers Assess. 1988;52(1):30–41.CrossRef
58.
Jiang QJ. Perceived Social Support Scale (PSSS). In: Wang XD, Wang XL, Ma H, editors. Rating scales for mental health. Beijing: China Mental Health Journal Press; 1999. p. 131–3.
59.
Preacher KJ, Hayes AF. Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behav Res Methods. 2008;40(3):879–91.PubMedCrossRef
60.
Erol O, Cirak NS. Exploring the loneliness and internet addiction level of college students based on demographic variables. Contemp Educ Technol. 2019;10(2):156–72.CrossRef
61.
Lin YP, Fan ZP. The relationship between rejection sensitivity and social anxiety among Chinese college students: The mediating roles of loneliness and self-esteem. Curr Psychol. 2023;42:12439–48.CrossRef
62.
Podsakoff PM, MacKenzie SB, Lee JY, Podsakoff NP. Common method biases in behavioral research: A critical review of the literature and recommended remedies. J Appl Psychol. 2003;88:879.PubMedCrossRef
63.
Horne CM, Norbury R. Altered resting-state connectivity within default mode network associated with late chronotype. J Psychiatr Res. 2018;102:223–9.PubMedCrossRef
64.
Werner KH, Goldin PR, Ball TM, Heimberg RG, Gross JJ. Assessing emotion regulation in social anxiety disorder: The emotion regulation interview. J Psychopathol Behav Assess. 2011;33(3):346–54.CrossRef
65.
Watts AL, Norbury R. Reduced effective emotion regulation in night owls. J Biol Rhythms. 2017;32(4):369–75.PubMedCrossRef
66.
Schafer JÖ, Naumann E, Holmes EA, Tuschen-Caffier B, Samson AC. Emotion regulation strategies in depressive and anxiety symptoms in youth: A meta-analytic review. J Youth Adolesc. 2017;46(2):261–76.PubMedCrossRef
67.
El-Jaziz A, Lotfi S. Effect of circadian preferences and personality traits on academic achievement in active students. Chronobiol Med. 2023;5(2):87–92.CrossRef
68.
69.
Gopalakrishnan P, Simiyon M, Mani M, Thilakan P. Do chronotypes influence problematic mobile phone use and sleep quality among the doctors? – A cross-sectional study from india. BJPsych Open. 2022;8(S1):S73–S73.PubMedCentralCrossRef
70.
Schimmenti A, Musetti A, Costanzo A, Terrone G, Maganuco NR, Aglieri Rinella C, Gervasi AM. The unfabulous four: Maladaptive personality functioning, insecure attachment, dissociative experiences, and problematic internet use among young adults. Int J Ment Health Addict. 2021;19:447–61.CrossRef
71.
Thomée S, Härenstam A, Hagberg M. Mobile phone use and stress, sleep disturbances, and symptoms of depression among young adults-a prospective cohort study. BMC Public Health. 2011;11(1):66.PubMedPubMedCentralCrossRef
72.
73.
Knowles ML, Lucas GM, Baumeister RF, Gardner WL. Choking under social pressure: Social monitoring among the lonely. Pers Soc Psychol Bull. 2015;41(6):805–21.PubMedCrossRef
74.
Hou XL, Elhai JD, Hu TQ, She Z, Xi JZ. Anxiety symptoms and problematic smartphone use severity among Chinese college students: The moderating role of social support. Curr Psychol. 2023;42:2841–9.CrossRef
75.
Reid GM, Holt MK, Bowman CE, Espelage DL, Green JG. Perceived social support and mental health among first-year college students with histories of bullying victimization. J Child Fam Stud. 2016;25(11):3331–41.CrossRef
76.
Spence SH, March S, Donovan CL. Social support as a predictor of treatment adherence and response in an open-access, self-help, internet-delivered cognitive behavior therapy program for child and adolescent anxiety. Internet Interv. 2019;18: 100268.PubMedPubMedCentralCrossRef
77.
Maeda U, Shen BJ, Schwarz ER, Farrell KA, Mallon S. Self-Efficacy Mediates the Associations of Social Support and Depression with Treatment Adherence in Heart Failure Patients. Int J Behav Med. 2013;20:88–96.PubMedCrossRef
78.
Akbari M, Seydavi M, Rowhani NS, Nouri N. Psychological predictors of treatment adherence among patients with diabetes (types I and II): Modified information–motivation–behavioural skills model. Clin Psychol Psychother. 2022;29:1854–66.PubMedCrossRef
79.
Atefi GL, Koh WQ, Kohl G, Seydavi M, Swift JK, Akbari M, de Vugt ME. Adherence to Online Interventions for Family Caregivers of People With Dementia: A Meta-Analysis and Systematic Review. Am J Geriatr Psychiatry. 2024;32(10):1271–91.PubMedCrossRef
80.
Rueger SY, Malecki CK, Pyun Y, Aycock C, Coyle S. A meta-analytic review of the association between perceived social support and depression in childhood and adolescence. Psychol Bull. 2016;142(10):1017.PubMedCrossRef
81.
Arnett JJ. Socialization in emerging adulthood: From the family to the wilder world, from socialization to self-socialization. In: Grusec JE, Hastings PD, editors. Handbook of socialization: Theory and research. 2nd ed. New York: The Guilford Press; 2015. p. 85–108.
82.
Parra LA, Bell TS, Benibgui M, Helm JL, Hastings PD. The buffering effect of peer support on the links between family rejection and psychosocial adjustment in LGB emerging adults. J Soc Pers Relat. 2018;35(6):854–71.CrossRef
83.
Lamis DA, Ballard ED, May AM. Depressive symptoms and suicidal ideation in college students: The mediating and moderating roles of hopelessness, alcohol problems, and social support. J Clin Psychol. 2016;72:919–32.PubMedCrossRef
Metadata
Title
The association between chronotype and social anxiety among Chinese university students: a moderated mediation analysis of loneliness and perceived social support
Authors
Yingying Zhu
Junling Liu
Fulin Chen
Qian Wang
Kunxia Cao
Jiahao Huang
He Wang
Qiang Wang
Xue Luo
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2024
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-024-20811-3

Other articles of this Issue 1/2024

Functional disability and its associated factors among community- dweller older adults living in Gondar Town, Ethiopia: a community-based cross-sectional study

Psychometric assessment of the Runyankole-translated Marlowe-Crowne Social Desirability Scale among persons with HIV in Uganda

Assessing urban family physician program challenges in Iran: the insurance organizations’ perspective(2021)

  • Open Access
  • Research

Prevalence, risks factors, and control of hypertension in Guinean older adults in 2021: a cross-sectional survey

Association between weight-adjusted waist index and testosterone deficiency in adult American men: findings from the national health and nutrition examination survey 2013–2016

#Bartender: portrayals of popular alcohol influencer’s videos on TikTok©

  • Open Access
  • Research