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Gender differences in the association between anxiety and behavioral problems in 31,400 Chinese children: a

Shurui Chen1, Zheng Zhang2,3, Zhen Tao4

  • 1Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China.

BMC Psychiatry
|July 15, 2026
PubMed

Insights

Child anxiety and behavioral issues show distinct gender-specific patterns. Network analysis reveals differences in how these problems are structured and interact in boys and girls, informing targeted interventions.

Area of Science:

  • Child and adolescent psychology
  • Network analysis in psychopathology
  • Gender differences in mental health

Background:

  • Child anxiety and behavioral problems are significant global public health concerns.
  • Traditional assessment methods may not fully capture complex symptom interactions.
  • This study addresses these limitations by examining gender differences in symptom networks.

Purpose of the Study:

  • To investigate the network structure of anxiety and behavioral problems in a large sample of Chinese children.
  • To identify gender-specific differences in the relationships between these symptoms.
  • To explore the core domains within child psychopathology.

Main Methods:

  • Utilized network analysis on data from 31,400 students (aged 9-16).
  • Assessed anxiety and behavioral problems using the Screen for Child Anxiety Related Emotional Disorders (SCARED) and the Psychometric Properties Questionnaire (PSQ).
  • Controlled for age by residualizing symptom domains against chronological age before network estimation.

Main Results:

  • Girls reported higher anxiety, while boys exhibited more behavioral problems.
  • Generalized anxiety and school avoidance were strongly associated with behavioral problems.
  • Significant gender differences were found in network structure and global strength, with boys showing higher global strength.

Conclusions:

  • Child psychopathology presents distinct, age-independent, gender-specific network structures.
  • Findings offer preliminary insights into the domain-level architecture of child psychopathology.
  • Results may inform the development of gender-sensitive screening and support strategies in schools.
Abstract

Keywords:
AnxietyBehavioral problemsGender differencesPsychopathology

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