COVID-19 risk perception moderates the relationships between health risk behaviors clustering and anxiety-depression comorbidity in adolescents
Abstract Background Mental health problems were certainly widespread during the COVID-19 pandemic. The study aimed to examine the associations between clustering patterns of health risk behaviors (HRBs) and anxiety-depression comorbidity among Chinese adolescents, and further explore the moderating...
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BMC
2025-06-01
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| Online Access: | https://doi.org/10.1186/s40359-025-02937-0 |
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| author | Shuman Tao Yang Qu Yi Zhang Hong Gan Xingyue Mou Panfeng Zhou Fangbiao Tao Xiaoyan Wu |
| author_facet | Shuman Tao Yang Qu Yi Zhang Hong Gan Xingyue Mou Panfeng Zhou Fangbiao Tao Xiaoyan Wu |
| author_sort | Shuman Tao |
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| description | Abstract Background Mental health problems were certainly widespread during the COVID-19 pandemic. The study aimed to examine the associations between clustering patterns of health risk behaviors (HRBs) and anxiety-depression comorbidity among Chinese adolescents, and further explore the moderating role of COVID-19 risk perception level in the associations. Methods A cross-sectional school-based study was conducted between April and May 2022 in Anhui Province, China. A self-administrated questionnaire was used to assess HRBs, anxiety-depression comorbidity, and COVID-19 risk perception. Latent Class Analysis was used to identify the clustering patterns of HRBs. The multinomial logistics regression models were used to explore the associations between clustering patterns of HRBs and anxiety-depression comorbidity. Furthermore, hierarchical multiple regression was used to analyze the moderating effect of COVID-19 risk perception level on the associations between the two. Results A total of 3 782 participants were analyzed. The prevalence of anxiety-depression comorbidity was 27.4%. HRBs clustering was grouped as category 1 (low-risk, 39.5%, n = 1 492), category 2 (unhealthy dietary patterns, 13.1%, n = 496), and category 3 (sleep insufficiency, 47.4%, n = 1 794). Unhealthy dietary patterns (OR = 2.10, 95%CI: 1.64–2.66) and sleep insufficiency (OR = 1.39, 95%CI: 1.17–1.66) were positively associated with anxiety-depression comorbidity. There was a positive moderating effect of COVID-19 risk perception on the relationships between clustering patterns of HRBs and anxiety-depression comorbidity (P<0.05). Conclusion COVID-19 risk perception enhances the positive association between clustering patterns of HRBs and anxiety-depression comorbidity symptoms in adolescents. Multidimensional risk factors should be warranted in the intervention programs for mental health among Chinese adolescents. |
| format | Article |
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| issn | 2050-7283 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | BMC |
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| series | BMC Psychology |
| spelling | doaj-art-37e642d4f50d455fa8c8a3d1e8fa6aac2025-08-20T02:31:00ZengBMCBMC Psychology2050-72832025-06-011311910.1186/s40359-025-02937-0COVID-19 risk perception moderates the relationships between health risk behaviors clustering and anxiety-depression comorbidity in adolescentsShuman Tao0Yang Qu1Yi Zhang2Hong Gan3Xingyue Mou4Panfeng Zhou5Fangbiao Tao6Xiaoyan Wu7Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical UniversityDepartment of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical UniversityDepartment of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical UniversityDepartment of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical UniversityDepartment of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical UniversityDepartment of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical UniversityMOE Key Laboratory of Population Health Across Life Cycle, Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical UniversityMOE Key Laboratory of Population Health Across Life Cycle, Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical UniversityAbstract Background Mental health problems were certainly widespread during the COVID-19 pandemic. The study aimed to examine the associations between clustering patterns of health risk behaviors (HRBs) and anxiety-depression comorbidity among Chinese adolescents, and further explore the moderating role of COVID-19 risk perception level in the associations. Methods A cross-sectional school-based study was conducted between April and May 2022 in Anhui Province, China. A self-administrated questionnaire was used to assess HRBs, anxiety-depression comorbidity, and COVID-19 risk perception. Latent Class Analysis was used to identify the clustering patterns of HRBs. The multinomial logistics regression models were used to explore the associations between clustering patterns of HRBs and anxiety-depression comorbidity. Furthermore, hierarchical multiple regression was used to analyze the moderating effect of COVID-19 risk perception level on the associations between the two. Results A total of 3 782 participants were analyzed. The prevalence of anxiety-depression comorbidity was 27.4%. HRBs clustering was grouped as category 1 (low-risk, 39.5%, n = 1 492), category 2 (unhealthy dietary patterns, 13.1%, n = 496), and category 3 (sleep insufficiency, 47.4%, n = 1 794). Unhealthy dietary patterns (OR = 2.10, 95%CI: 1.64–2.66) and sleep insufficiency (OR = 1.39, 95%CI: 1.17–1.66) were positively associated with anxiety-depression comorbidity. There was a positive moderating effect of COVID-19 risk perception on the relationships between clustering patterns of HRBs and anxiety-depression comorbidity (P<0.05). Conclusion COVID-19 risk perception enhances the positive association between clustering patterns of HRBs and anxiety-depression comorbidity symptoms in adolescents. Multidimensional risk factors should be warranted in the intervention programs for mental health among Chinese adolescents.https://doi.org/10.1186/s40359-025-02937-0Anxiety-depressionComorbidityAdolescentsCOVID-19Health riskBehaviors risk |
| spellingShingle | Shuman Tao Yang Qu Yi Zhang Hong Gan Xingyue Mou Panfeng Zhou Fangbiao Tao Xiaoyan Wu COVID-19 risk perception moderates the relationships between health risk behaviors clustering and anxiety-depression comorbidity in adolescents BMC Psychology Anxiety-depression Comorbidity Adolescents COVID-19 Health risk Behaviors risk |
| title | COVID-19 risk perception moderates the relationships between health risk behaviors clustering and anxiety-depression comorbidity in adolescents |
| title_full | COVID-19 risk perception moderates the relationships between health risk behaviors clustering and anxiety-depression comorbidity in adolescents |
| title_fullStr | COVID-19 risk perception moderates the relationships between health risk behaviors clustering and anxiety-depression comorbidity in adolescents |
| title_full_unstemmed | COVID-19 risk perception moderates the relationships between health risk behaviors clustering and anxiety-depression comorbidity in adolescents |
| title_short | COVID-19 risk perception moderates the relationships between health risk behaviors clustering and anxiety-depression comorbidity in adolescents |
| title_sort | covid 19 risk perception moderates the relationships between health risk behaviors clustering and anxiety depression comorbidity in adolescents |
| topic | Anxiety-depression Comorbidity Adolescents COVID-19 Health risk Behaviors risk |
| url | https://doi.org/10.1186/s40359-025-02937-0 |
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