Trend of Chinese adolescent anxiety symptoms before and after COVID-19: A cross-temporal meta-analysis with segmented regression

Adolescent anxiety symptoms are a global concern, and studying their trends and influencing factors in China is essential due to unique cultural and social dynamics impacting mental health. This study presents a cross-temporal meta-analysis of research employing the GAD-7 to assess anxiety symptoms among Chinese adolescents. Systematic searches were conducted across databases including CNKI, Wanfang, VIP, Web of Science, PubMed, Scopus, ProQuest, and Wiley, resulting in the inclusion of 66 articles (67 studies) spanning data collection from 2016 to 2023. The findings revealed that: (1) Anxiety symptoms among Chinese adolescents showed a slight decrease from 2016 to 2020, which was not statistically significant, but then experienced a significant increase from 2021 to 2023. (2) Throughout the period, female adolescents had significantly higher increases in anxiety symptoms compared to males. Clinically anxious adolescents had a slightly more pronounced decline in anxiety symptoms from 2016 to 2020 compared to those with subclinical anxiety, but this difference was not significant from 2021 to 2023. (3) Social change factors including social connectedness, socioeconomic conditions, and social threats did not significantly impact adolescent anxiety symptoms in China from 2016 to 2020, and this pattern continued from 2021 to 2023. This research advances the understanding of the mechanisms driving adolescent anxiety symptoms in China and offers a foundation for targeted prevention and intervention strategies, emphasizing the importance of addressing emerging stressors in mental health policies.