Daily diary study links ‘lying flat’ withdrawal to anxiety and depression in Chinese students

A 10-day daily diary study of Chinese university students has found that a culturally specific form of withdrawal, known as negative lying flat, shows short-lag reciprocal associations with both anxiety and depressive symptoms in daily life.

Negative lying flat, or NLF, is described by the researchers as a culturally salient form of withdrawal among Chinese youth. In the study it was operationalized as diminished goal pursuit and reduced willingness to expend effort.

The research enrolled 201 Chinese university students, of whom 34.8 percent were male, with a mean age of 21.04 years and a standard deviation of 1.40. Participants provided 1,863 valid observations across 10 scheduled weekday assessments spread over two weeks. Weekend days were treated as systematically missing within a 12-day calendar in sensitivity analyses that used calendar-day estimates.

The researchers fitted three models: one examining NLF and experiential avoidance together, one modeling anxiety with both withdrawal constructs, and one modeling depressive symptoms with both constructs. Between-person components were adjusted for age and gender.

The first model addressed whether daily NLF is distinguishable from experiential avoidance. It found no reliable within-person cross-lagged associations between the two constructs. The path from NLF to avoidance was estimated at a standardized coefficient of 0.030, with a 95 percent credible interval from -0.046 to 0.099, and the reverse path from avoidance to NLF was 0.053, with a credible interval from -0.010 to 0.115. Because both intervals included zero, the data did not establish directional daily influence between the constructs.

The joint emotional-distress models produced the study’s central results. Anxiety predicted subsequent NLF with a coefficient of 0.113 and a 95 percent credible interval of 0.050 to 0.184, while NLF in turn predicted subsequent anxiety at 0.082, with an interval of 0.023 to 0.153. Depressive symptoms showed the same bidirectional pattern: symptoms predicted subsequent NLF at 0.085, with an interval of 0.015 to 0.152, and NLF predicted subsequent depressive symptoms at 0.075, with an interval of 0.006 to 0.134.

The corresponding paths for experiential avoidance told a different story. In the same models, the avoidance paths with anxiety and depressive symptoms all included zero in their credible intervals, meaning no reliable short-lag associations were detected for that construct. Posterior contrasts, which directly compared corresponding NLF and avoidance paths statistically, did not establish differences between them, so the authors caution that the findings support continued investigation of NLF without establishing stronger effects than avoidance.

Sensitivity analyses using calendar-day estimates, which represented the two weekend days as systematically missing within a 12-day calendar, produced results similar in direction and magnitude. However, the credible intervals for the paths from NLF to anxiety and from NLF to depressive symptoms marginally included zero in these analyses.

The authors conclude that the primary models identified reciprocal short-lag associations between negative lying flat and emotional distress that were not observed for experiential avoidance. Taken together, they write, the findings support continued investigation of NLF as a goal-and-effort withdrawal process in daily emotional adjustment. As an observational diary study of a single sample of university students, the work identifies temporal associations rather than proven causal effects, and the authors frame the results as a basis for further research rather than a definitive characterization of the phenomenon.

Subject of Research: Daily temporal associations between negative lying flat withdrawal and emotional distress in Chinese university students

Article Title: Beyond avoidance: negative lying flat and emotional distress among Chinese youth in a 10-day daily diary study

Article References: Li, H., Zhang, B., Luo, Y., Zou, J., Chen, M., Li, F., Zhang, Z., & Sun, J. (2026). Beyond avoidance: negative lying flat and emotional distress among Chinese youth in a 10-day daily diary study. BMC Psychology, 14(1), Article 1498. https://doi.org/10.1186/s40359-026-05590-3

Image Credits: AI Generated

DOI: 10.1186/s40359-026-05590-3

Keywords: negative lying flat, experiential avoidance, anxiety, depressive symptoms, daily diary study, Chinese university students, DSEM, withdrawal, goal pursuit, mental health, BMC Psychology, longitudinal