Gender differences in mental health among late adolescents: A cross-lagged panel network analysis

Mental health symptoms are highly prevalent among late adolescents, particularly among girls, highlighting the need for early identification and targeted interventions. This study aims to identify initiating symptoms and temporal pathways in adolescent mental health symptoms networks to inform prevention efforts.

A total of 7367 adolescents (47.14 % female; M_age = 17.66) from Eastern China were assessed twice over one year (2024-2025) using the Symptom Checklist-90 (SCL-90). Cross-lagged panel network (CLPN) models were estimated for the full sample, as well as for male and female subgroups, to identify central symptoms and their temporal associations.

Controlling for demographic variables, CLPN models showed that psychoticism was the strongest predictor of subsequent symptoms, followed by depression, which was also the most influenced by prior symptoms. Anxiety and interpersonal sensitivity were also key subsequent symptoms. Gender-stratified analyses revealed that psychoticism and somatization were initial symptoms in females, while paranoid ideation and obsessive-compulsive symptoms played this role in males. Symptom interconnections were stronger in females than in males.

The limited number of assessment waves restricted the ability to distinguish between-person and within-person symptom dynamics.

Psychoticism and depression should be prioritized in interventions, with gender-specific strategies recommended.