Associations of traditional social support and dazi socializing with social anxiety in medical students: the mediating role of psychological resilience

Abstract

This study investigated associations of traditional social support (family and friend support) and dazi socializing with social anxiety among medical students, and examined the mediating role of psychological resilience, addressing gaps in integrating the stress-buffering model and conservation of resources theory. Convenience sampling was used to recruit undergraduate students majoring in clinical medicine from the first to fifth years at a university in Zhejiang Province. Participants completed online questionnaires including the Self-developed Questionnaire on Experiences of dazi Socializing, Chinese Version of the Perceived Social Support Scale, Interaction Anxiousness Scale and the Connor-Davidson Resilience Scale. Data cleaning and statistical analyses were performed using Python 3.11. ANCOVA was conducted to control for gender, academic year, and student leadership. The mediating effect of psychological resilience was examined using model 4 of Hayes's PROCESS macro and Bootstrap method based on 5,000 resampling iterations. Pearson correlation, hierarchical regression, and independent-samples t tests were applied for intra-group analyses among participants with dazi experiences. After controlling for covariates, the dazi group scored higher than non- dazi users in friend support ( F (1,677) = 27.18, p < 0.001), family support ( F (1,677) = 8.45, p = 0.004), and psychological resilience ( F (1,677) = 18.80, p < 0.001). Meanwhile, the dazi group reported lower social anxiety than non- dazi users ( F (1,677) = 22.23, p < 0.001). Mediation analysis showed that psychological resilience fully mediated friend support (indirect effect = −0.0211, 95% CI [−0.0433, −0.0021], 23.4%) and family support (indirect effect = −0.0159, 95% CI [−0.0340, −0.0017], 33.1%) on social anxiety. It partially mediated dazi socializing (direct effect = −1.2215, 95% CI [−1.8773, −0.5439]; indirect effect = −0.0812, 95% CI [−0.1951, −0.0033], 6.2%). Within the dazi group, higher social anxiety was indirectly associated with greater “Safety/Trust concerns”; emotional dazi scored lower on resilience than functional dazi , with the difference approaching significance ( t = −1.94, p = 0.054). Both traditional social support and dazi experiences are associated with social anxiety levels among medical students. The relationship between traditional social support and social anxiety is entirely indirect through psychological resilience, whereas the association between dazi experiences and social anxiety is achieved through both direct and indirect pathways via psychological resilience.