Exploring and comparing central mental health problems between rural primary and secondary school teachers—insight from a large sample symptom network analysis

Identifying and alleviating influential mental health symptoms among rural school teachers may improve their well-being, especially considering grade and gender, leaving a research gap that focuses on a symptom-level perspective. This study aimed to explore and compare the central mental health symptoms between rural primary and secondary school teachers using a symptom network approach. The symptom network analysis was conducted to estimate network structures, and network stability and accuracy were also assessed. Epidemiological results show that a total of 3,712 (17.96%) of 20,672 rural primary and secondary school teachers with mental health problems were screened by the Symptom Checklist-90. For the edge (i.e., the association between symptoms) within the network structure, interpersonal sensitivity – paranoid ideation, and anxiety – depression were the strongest positive edges in both primary and secondary school teachers. Somatization –interpersonal sensitivity was the strongest negative edge in both groups. Anxiety was the most central symptom (Z score of ExpectedInfluence (EI) was above 1) among both primary and secondary school teachers, as well as across genders. The network comparison test indicates that female secondary school teachers had higher EI centrality for depression (p = .006) than female primary school teachers. Among primary schools, female teachers had higher EI centrality for anxiety and phobia (p = .046; p = .017) than male teachers. Implementing targeted interventions for anxiety in primary and secondary school teachers, as well as for depression in female secondary school teachers and psychoticism in male primary school teachers, may help alleviate their mental health problems.