Longitudinal association between problematic social media use and school refusal among adolescents: a random intercept cross-lagged panel model.

Introduction: Problematic social media use (PSMU) and school refusal have become increasingly prevalent during adolescence. However, the longitudinal association between these two constructs remains insufficiently understood, particularly with respect to potential sex differences. Methods: Using three-wave longitudinal data, this study applied a Random Intercept Cross-Lagged Panel Model (RI-CLPM) to disentangle within-person reciprocal associations between school refusal and PSMU. The sample comprised 1,216 Chinese adolescents (49.5% females; Results: RI-CLPM analyses revealed bidirectional within-person effects, such that elevations in school refusal were associated with subsequent increases in PSMU, and vice versa. Multi-group comparisons further demonstrated sex-specific patterns. Specifically, the prospective effect of school refusal on PSMU was more pronounced among females, whereas the predictive effect of PSMU on later school refusal was stronger among males. Conclusion: These findings underscore the mutually reinforcing nature of school refusal and PSMU during early adolescence and point to the importance of incorporating sex-sensitive components in prevention and intervention efforts.