Social anxiety is the uneasiness, nervousness, or fear experienced in the presence of others (Schlenker & Leary, 1982). It is a common human experience that exists on a continuum (McNeil, 2001), with severe impairment of social functioning developing into social anxiety disorder (Morrison & Heimberg, 2013). Social anxiety can lead to serious consequences, such as suicide and self-injury (Buckner et al., 2017; Holt-Lunstad et al., 2015). For example, a large-scale survey of 20,130 adults found that individuals with generalized anxiety disorder and social anxiety disorder are more likely to engage in NSSI and suicide attempts compared to those with other anxiety disorders (Chartrand et al., 2012). Moreover, research by Zou et al. (2024) indicates that social anxiety among college students is linked to NSSI, and a study by Tatnell et al. (2024) shows that reductions in social anxiety are associated with decreases in NSSI.

Loneliness is an emotional state in which individuals feel disconnected from others due to unmet personal needs (Copel, 1988). Loneliness is different from social isolation. Loneliness refers to the subjective perception of lacking a desired social network or companionship, whereas social isolation is the objective lack or paucity of social contacts and interactions with other persons (Valtorta & Hanratty, 2012). Loneliness is strongly associated with social anxiety (Maes et al., 2019). The experience of loneliness is unpleasant and painful (Younger, 1995), and it is linked to an increased risk of depression, anxiety, suicide, and even mortality (Moeller & Seehuus, 2019; McClelland et al., 2020; Holt-Lunstad et al., 2015). Interestingly, a recent five-year longitudinal study found that while social anxiety predicts loneliness, loneliness does not significantly predict social anxiety (Reinwarth et al., 2024), suggesting a need for further studies. Loneliness has also been identified as a potential risk factor for NSSI (Costa et al., 2021; Tang et al., 2018). Social anxiety represents an interpersonal vulnerability factor, while loneliness is a highly aversive intrapersonal emotion. However, how these two factors jointly influence NSSI among college students remains unclear.

Coping styles refer to the actions individuals take to manage stressful events and maintain well-being (Folkman & Lazarus, 1986). Positive coping can effectively reduce social anxiety (Li, 2020) and lessen feelings of loneliness (Dong et al., 2023), which may, in turn, reduce the risk of NSSI (Castro & Kirchner, 2018; Wu & Liu, 2019).

However, the role of positive coping in relation to NSSI remains inconclusive. One study of Chinese college students suggested that positive coping acts as a protective factor against NSSI (Wu & Liu, 2019). In contrast, another study found no significant difference in the use of positive coping between adolescents with and without a history of NSSI, although those with a history of NSSI were more likely to use negative coping (Giordano et al., 2022). Surprisingly, a study of American college students found that those who engaged in NSSI reported using more positive coping than those who did not (Trepal et al., 2015). However, little is known about whether positive coping can buffer the effects of social anxiety (an interpersonal vulnerability factor) and loneliness (an intrapersonal aversive emotion) on NSSI among college students.

According to Nock’s integrated theoretical model of NSSI (Nock, 2009), interpersonal vulnerability factors—such as poor communication skills and inadequate social problem-solving—can lead to NSSI. Social anxiety falls within this category of interpersonal vulnerability factors. The integrated theoretical model of NSSI (Nock, 2009) would lead to the expectation that high aversive emotions and interpersonal vulnerabilities, combined with an inability to cope or the use of poor coping styles, may lead individuals to engage in NSSI as a temporary means of stress regulation. These theoretical propositions warrant examination in collectivist cultural contexts.

Chinese society is characterized by collectivist values and Confucian principles that emphasize interpersonal harmony (Huang, 2024). However, rapid modernization has prompted a shift toward individualization, creating a context of cultural dissonance for contemporary college students (Yan, 2010). This unique socio-cultural context is associated with heightened psychological challenges. Research indicates that collectivist orientations may intensify the impact of loneliness on adverse health outcomes (Lee et al., 2021), while cultural dimensions also moderate the relationship between loneliness and social anxiety among adolescents (Wang et al., 2024).

Structural factors such as the urban-rural divide and the legacy of the One-Child Policy (OCP) further compound these challenges. Urban areas have a significantly higher proportion of only-child families (64.95%) compared to rural regions (9.80%) (Lee, 2012). While only children often receive more familial support, they may lack opportunities to develop coping skills for social adversity, increasing their vulnerability to social anxiety and NSSI (Cameron et al., 2013; Huang et al., 2022). Conversely, rural students often experience social defeat and struggle to adapt to urban college life, potentially exacerbating loneliness.

When facing these combined socio-cultural and psychological pressures—namely, social anxiety and loneliness—individual coping styles become crucial. However, the role of positive coping within the Chinese context appears complex and, at times, paradoxical. Although typically associated with better mental health (Meng et al., 2011) and reduced loneliness (Zhang et al., 2021), positive coping has paradoxically been linked to elevated NSSI risk among rural adolescents (Zhou et al., 2022), underscoring the need for context-specific investigations.

Given the high prevalence of NSSI among Chinese college students (11.8%; Qu et al., 2023), it is essential to examine, within the Chinese context, how social anxiety and loneliness influence NSSI and how positive coping may moderate these relationships.

A total of 1129 college students from three universities in China participated in the study. The participants’ ages ranged from 18 to 25 years (M = 20.00, SD = 1.61). Of the participants, 480 were female (42.52%); 414 were only children (36.67%), and 715 had siblings (63.33%). Regarding residence, 602 students were from rural areas (53.32%), and 527 were from urban areas (46.68%).

This study was approved by the Ethics Committee of Shanghai Normal University (Approval No. 2025-005). All participants provided informed consent, and confidentiality was strictly maintained. Participation was voluntary, and data were collected anonymously through an online survey platform (wjx.cn).

Data analysis was performed using IBM SPSS Statistics 26.0. First, Harman’s one-factor test was conducted to assess common method bias. The results revealed six factors with eigenvalues greater than 1, and the first factor accounted for 34.20% of the total variance, below the 40% threshold, indicating no serious common method bias. Next, multicollinearity was assessed. The variance inflation factor (VIF) values for all predictor variables ranged from 1.19 to 1.50, well below the threshold of 5, and tolerance values ranged from 0.67 to 0.85, above the 0.20 threshold, indicating no multicollinearity concerns.

Following Hayes (2013), the SPSS macro PROCESS (Model 4) was used to test the mediating role of loneliness in the relationship between social anxiety and NSSI, controlling for gender, age, only-child status, and residence. The mediation effect of loneliness was examined using a non-parametric percentile bootstrap method (N = 5000, 95% CI) and Model 4 of the PROCESS macro (Hayes, 2013). Also, using the SPSS macro program PROCESS (Model 7), the moderated mediating role of positive coping and loneliness was tested while controlling for gender, age, only-child status, and residence (Hayes, 2013).

Table 1 presents the statistical measures of the study’s correlated variables, including the means, standard deviations, and Pearson’s correlation coefficients. The results showed that social anxiety was significantly and positively correlated with NSSI (r = 0.46, p < 0.001) and loneliness (r = 0.53, p < 0.001), but significantly and negatively correlated with positive coping (r = −0.31, p < 0.001). Loneliness was also significantly and positively correlated with NSSI (r = 0.53, p < 0.001). Furthermore, positive coping was significantly and negatively correlated with both NSSI (r = −0.38, p < 0.001) and loneliness (r = −0.38, p < 0.001).

The regression analysis results are shown in Table 2. After controlling for gender, age, only-child status, and residence, social anxiety significantly and positively predicted NSSI (β = 0.21, p < 0.001), supporting Hypothesis 1.

The results revealed that social anxiety significantly and positively predicted loneliness (β = 0.41, p < 0.001, 95% CI [0.36, 0.45]). When both social anxiety and loneliness were entered into the regression equation, loneliness significantly and positively predicted NSSI (β = 0.17, p < 0.001, 95% CI [0.15, 0.20]), and social anxiety remained a significant predictor (β = 0.14, p < 0.001, 95% CI [0.11, 0.16]). These findings indicate a partial mediating effect. The indirect effect of social anxiety on NSSI through loneliness was β = 0.07, 95% CI [0.00, 0.11], accounting for 33.87% of the total effect. Therefore, Hypothesis 2 was supported.

The results showed that social anxiety positively predicted loneliness (β = 0.26, p < 0.001, 95% CI [0.21, 0.31]), and the interaction between positive coping and social anxiety was significant (β = −0.21, p < 0.001, 95% CI [−0.25, −0.17]). The main effect of loneliness on NSSI remained significant when all variables were included in the regression equation (β = 0.17, p < 0.001, 95% CI [0.15, 0.20]). These results suggest that positive coping moderates the first stage of the mediation pathway, influencing the strength of the relationship between social anxiety and loneliness. Thus, Hypothesis 3 was supported.

To further examine the moderating effect, a simple slopes analysis was conducted by dividing participants into high and low positive coping groups based on their positive coping scores. As shown in Figure 2, social anxiety significantly predicted loneliness among participants with low positive coping (β = 0.41, t = 17.18, p < 0.001). In contrast, for participants with high positive coping, this relationship was weaker but remained significant (β = 0.11, t = 3.56, p < 0.01).

As shown in Table 3, for the low positive coping group, social anxiety significantly influenced NSSI through loneliness (β = 0.07, 95% CI [0.05, 0.09]). For the high positive coping group, the indirect effect was smaller (β = 0.02, 95% CI [0.01, 0.03]). The difference in the indirect effects between the two groups was significant, with a difference coefficient of −0.04 (95% CI [−0.05, −0.02]), confirming the moderated mediation effect and further supporting Hypothesis 3.

Our study findings suggest a need for college mental health professionals to prioritize teaching positive coping to help alleviate the impact of negative emotions on NSSI. Specifically, College mental health education programs could focus on enhancing interpersonal skills as a starting point, enabling students to better manage social anxiety, reduce loneliness, and ultimately decrease NSSI. Moreover, college students should be recognized as a high-risk population for NSSI. NSSI serves both intrapersonal functions (e.g., emotion regulation, avoidance of aversive emotions, self-punishment) and interpersonal functions (e.g., communication pain, influencing others, or seeking support) (Nock & Prinstein, 2005; Klonsky & Glenn, 2009).

For students experiencing social anxiety, consciously increasing the use of positive coping can help reduce the loneliness associated with social anxiety, thereby weakening its impact on NSSI.

Social anxiety, loneliness, and NSSI exhibit dynamic changes over time. The cross-sectional design employed in this study limits the ability to assess these variables dynamically. Future research should employ longitudinal or diary study designs to assess these variables more dynamically and clarify their temporal relationships. Second, positive coping is multidimensional, and state social anxiety often varies across situations. While this study examined the overall effect, future research should differentiate between coping types (e.g., problem-focused vs. emotion-focused) to identify the most effective forms of intervention. Finally, although this study focused on loneliness as a highly aversive emotion, other emotional and interpersonal factors—such as depression or social self-efficacy—should be explored in future studies to provide a more comprehensive understanding of NSSI mechanisms among college students.