The Relationship Between Social Anxiety Symptoms, Suicidal Ideation, and Loneliness: The Mediating Role of Dissociative Experiences

Abstract

Background: Suicidal ideation (SI) and loneliness are common among university students; yet, the role of social anxiety (SA) and its underlying mechanisms remains underexplored. Objectives: This study examined the mediating role of dissociative experiences (DE) in the relationship between SA, SI, and loneliness. Methods: This cross-sectional, correlational study was conducted in 2022 - 2023. A total of 312 students from Islamic Azad University, South Tehran Branch (107 men, 205 women; age range = 18 - 45 years, 21.16 ± 4.87) were included in the analysis based on a multi-stage cluster sampling method. Data were collected using the Depressive Symptom Index - Suicidality Subscale, the University of California (UCLA) Loneliness Scale III, the Social Phobia Inventory, and the Dissociative Experiences Scale II (DES-II). The data were analyzed using path analysis with SPSS-22 and Lisrel 8.8. Results: The model showed an excellent fit [ϰ2 ⁄ df = 2.87, Goodness of Fit Index (GFI) = 0.98, Root Mean Square Error of Approximation (RMSEA) = 0.074]. All paths were significant except the direct path from SA to SI. The results of the path analysis test supported the mediating role of DE in the relationship between SA and SI, as well as SA and loneliness. Higher SA was associated with greater DE [β = 0.22, P < 0.05, confidence interval (CI) = 0.08 - 0.34] and higher loneliness, both directly (β = 0.45, P < 0.01, CI = 0.40 - 0.56) and indirectly through DE (β = 0.042, P < 0.01, CI = 0.01 - 0.07). The SA explained 11% of the variance in DE, 28% in loneliness, and 9% in SI, while DE accounted for 21% of the variance in SI and 18% in loneliness. Although SA did not have a significant direct effect on SI, a significant indirect effect was observed through DE (β = 0.062, P < 0.01, CI = 0.02 - 0.1). Conclusions: The findings highlight DE as a key mechanism linking SA to loneliness and SI. These results emphasize the need for preventive interventions that focus on DE and promote adaptive coping strategies in individuals with SA. Despite the non-clinical sample, the findings offer important clinical insights from a dimensional psychological perspective.