Comorbidity of loneliness and social anxiety in adolescents: Bridge symptoms and peer relationships

Previous research investigating the comorbidity of loneliness and social anxiety symptoms in population samples has relied on latent variable modeling in which averaged scores representing dimensions were derived from observed symptoms. Studies have not examined how loneliness and social anxiety co-occur at the symptom level or their relations with peer relationships.This study examined the comorbidity of loneliness and social anxiety and the role of peer relationships (i.e., the number of reciprocated friends, friendship quality, and bullying victimization) in adolescents' co-occurring network using a large sample of Chinese adolescents.We performed a network analysis in a sample of Chinese adolescents (N = 2601, 51.6% male, M age = 13.9 years, SD = 0.60). Participants completed self-report measures of loneliness, social anxiety, bullying victimization, and friendship quality as well as peer nomination measures of the number of reciprocated friends.Network analysis revealed that feeling ridiculed, fear of being rejected, having difficulty asking others to do things together, and feeling left out at school were essential bridge symptoms in the co-occurrence of loneliness and social anxiety. Bullying victimization had more positive associations with symptoms of social anxiety, and friendship quality had more negative associations with symptoms of loneliness.The findings provide preliminary evidence for the comorbidity of loneliness and social anxiety symptoms in adolescents. The results also highlight the potential importance of targeting peer relationships in the prevention and intervention of loneliness and social anxiety symptoms. The combination of longitudinal networks and interventions on bridge symptoms may provide further insight into the development of the links between peer relationships, loneliness, and social anxiety symptoms.