Network Parameters of Mental Health Concerns in Adolescents: An Examination of Age and Sex Differences.

Introduction: Adolescent mental health concerns are crucial for early intervention. This study examined networks of mental health concerns with the aim of identifying central issues and analyzing age and sex differences in these networks during adolescence.

Methods: A total of 3723 middle and high school students (aged 11-19 years; M = 14.39, SD = 1.38; 43.6% girls) were recruited for this cross-sectional study from May 8, 2023 to September 10, 2023, in Chongqing and Nanning, China. Loneliness, social anxiety, generalized anxiety, depression, suicidal behavior, Internet addiction, sleep quality, self-esteem, and self-efficacy were assessed using a questionnaire. Centrality indices were analyzed to identify the most central mental health concerns. A network comparison test was conducted to examine whether the network parameters varied by age and sex.

Results: Loneliness was the most central node regardless of age or sex. The associations between loneliness and social anxiety, as well as between suicidal behavior and sleep quality, weakened in girls as they matured. Loneliness was more strongly associated with Internet addiction in girls in middle school and with social anxiety in boys in high school.

Conclusions: Given its centrality, loneliness should be prioritized for prevention and intervention. Recognizing specific parameters of mental health concerns is essential for developing effective prevention and intervention programs for school-aged students.