Gender-specific network analysis of parenting styles, depressive symptoms, and anxiety symptoms among 5157 Chinese adolescents

Background: In this study, we aimed to use network analyses to explore the gender-specific interactions between individual items of depressive symptoms, anxiety symptoms, and parenting styles in Chinese adolescents. Methods: We conducted a cross-sectional study with a total of 5157 adolescents in 5 primary schools, 8 junior high schools, and 2 senior high schools in Shandong province, China. Male and female adolescents' networks were assessed in all grades using the Egna Minnen Betraffande Uppfostran (EMBU), the 9-item Patient Health Questionnaire (PHQ-9), and the 7-item Generalized Anxiety Disorder Assessment (GAD-7). Network differences by gender and educational stages were further assessed stratified. Network analysis was used to identify central items and edges with important associations between depressive symptoms, anxiety symptoms, and parenting styles. All analyses in this study were performed using the R program (version 4.3.2). Results: Parenting styles can influence the overall depressive network by acting on PHQ9 (Suicidal thoughts) through EMBU1 (Punishment denial) and EMBU2 (Emotional warmth) in adolescents. Parenting styles had displayed gender-specific emotional impacts on adolescents. EMBU1 (Punishment denial) affected the anxiety network in senior high school male adolescents by increasing GAD6 (Easily annoyed/Irritable) and impacting their depression network by reducing the PHQ6 (Failure). However, none of these effects were found in senior high school female adolescents. Conclusions: The mood disorder and anxiety in male students were susceptible to the influence of the manner of upbringing. Depressive and anxiety symptom-specific issues related to parenting styles may be important in the development and maintenance of mood disorders in adolescents. Punishment rejection and emotional warmth might be the strong influencing factors.