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Background <p>Child anxiety and behavioral problems are significant global public health concerns. Traditional methods often fail to capture intricate symptom interactions. This study used network analysis to explore the relationship between anxiety and behavioral problems, focusing on gender differences in a large sample of Chinese children.</p> Methods <p>Data from 31,400 students (aged 9–16) were analyzed. Anxiety and behavioral problems were assessed using SCARED and PSQ. To control for developmental variance, symptom domains were residualized against chronological age prior to network estimation.</p> Results <p>Girls reported higher anxiety, while boys showed more behavioral problems. Generalized anxiety demonstrated the strongest independent association with behavioral problems, closely followed by school avoidance. Network analysis revealed significant gender differences in structure (M = 0.277, <i>p</i> &lt; 0.001) and global strength (S = 0.303, <i>p</i> &lt; 0.001). Boys exhibited higher global strength (Boys = 5.881, Girls = 5.578). Centrality stability was high (CS = 0.75), with Hyperkinesis and Generalized Anxiety acting as core domains for both genders.</p> Conclusions <p>Child psychopathology features distinct gender-specific network structures independent of age. These findings provide preliminary insights into the domain-level architecture of child psychopathology, which may inform the development of gender-sensitive screening and supportive strategies in school settings.</p> Trial registration <p>Clinical trial number: not applicable.</p>

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Gender differences in the association between anxiety and behavioral problems in 31,400 Chinese children: a cross-sectional regression and network analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月14日

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  • Shurui Chen,
  • Zheng Zhang,
  • Zhen Tao,
  • Jingyan Sun,
  • Xiaoping Wang,
  • Jiansong Zhou

摘要

Background

Child anxiety and behavioral problems are significant global public health concerns. Traditional methods often fail to capture intricate symptom interactions. This study used network analysis to explore the relationship between anxiety and behavioral problems, focusing on gender differences in a large sample of Chinese children.

Methods

Data from 31,400 students (aged 9–16) were analyzed. Anxiety and behavioral problems were assessed using SCARED and PSQ. To control for developmental variance, symptom domains were residualized against chronological age prior to network estimation.

Results

Girls reported higher anxiety, while boys showed more behavioral problems. Generalized anxiety demonstrated the strongest independent association with behavioral problems, closely followed by school avoidance. Network analysis revealed significant gender differences in structure (M = 0.277, p < 0.001) and global strength (S = 0.303, p < 0.001). Boys exhibited higher global strength (Boys = 5.881, Girls = 5.578). Centrality stability was high (CS = 0.75), with Hyperkinesis and Generalized Anxiety acting as core domains for both genders.

Conclusions

Child psychopathology features distinct gender-specific network structures independent of age. These findings provide preliminary insights into the domain-level architecture of child psychopathology, which may inform the development of gender-sensitive screening and supportive strategies in school settings.

Trial registration

Clinical trial number: not applicable.