Socially Prescribed Perfectionism, Resilience, and Internet Gaming Disorder in Adolescents: 3-Wave Longitudinal Study

Background: Internet gaming disorder (IGD) is increasingly prevalent among adolescents. Although socially prescribed perfectionism (SPP) and resilience are both related to IGD, longitudinal evidence on their temporal relationships and underlying mechanisms remains limited. Objective: This study aimed to examine the longitudinal associations among SPP, resilience, and IGD in Chinese adolescents; test the mediating role of resilience; and explore potential sex differences. Methods: A 3-wave prospective longitudinal study was conducted among students from 4 middle schools in Zhejiang Province, China. Adolescents who had played online games in the past 12 months were recruited using convenience sampling. Data were collected at 6-month intervals: time 1 (T1; March 2024), time 2 (T2; September 2024), and time 3 (T3; March 2025). A total of 1332 Chinese adolescents (875/1332, 65.7% male; mean age 13.61, SD 0.70 years) participated in the baseline survey. SPP, resilience, and IGD were assessed using the Hewitt-Flett Multidimensional Perfectionism Scale-Short Form, the 10-item Connor-Davidson Resilience Scale, and the 9-item Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) IGD Checklist, respectively. Cross-lagged panel model (CLPM) and multigroup analyses across sex were conducted. Results: All statistical tests were 2-tailed with α=.05. The CLPM demonstrated good fit to the data (χ²38=163.34; comparative fit index [CFI]=0.945; Tucker-Lewis index [TLI]=0.932; root mean square error of approximation [RMSEA]=0.054; standardized root mean square residual [SRMR]=0.047). Higher SPP predicted later IGD (T1→T2: β=0.10, 95% CI 0.04 to 0.16, P<.001; T2→T3: β=0.09, 95% CI 0.03 to 0.15, P=.004) and lower resilience (T1→T2: β=-0.09, 95% CI -0.16 to -0.02, P=.007; T2→T3: β=-0.12, 95% CI -0.18 to -0.06, P<.001). In contrast, SPP was not significantly predicted by prior IGD nor resilience. Higher resilience predicted lower subsequent IGD (T1→T2: β=-0.09, 95% CI -0.15 to -0.03, P=.001; T2→T3: β=-0.09, 95% CI -0.15 to -0.03, P=.001), whereas higher IGD predicted lower subsequent resilience (T1→T2: β=-0.19, 95% CI -0.27 to -0.11, P<.001; T2→T3: β=-0.09, 95% CI -0.15 to -0.03, P=.003). Bootstrapped mediation analysis showed a significant indirect effect of SPP at T1 on IGD at T3 via resilience at T2 (β=0.008, 95% CI 0.004 to 0.012, P=.005). However, multigroup analyses revealed no significant sex differences. Conclusions: This study provides novel insights into the longitudinal associations among SPP, resilience, and IGD in adolescents. Unlike previous research based mainly on cross-sectional data, this 3-wave CLPM study clarifies the temporal relationships among these variables and shows that resilience mediates the association between SPP and subsequent IGD. These findings advance the field by identifying a temporal psychological pathway underlying adolescent IGD. They also have practical implications for early screening and for developing resilience-focused interventions for adolescents at risk of IGD.