{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:23:11Z","timestamp":1790209391325,"version":"4.1.0"},"reference-count":65,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,9,23]],"date-time":"2022-09-23T00:00:00Z","timestamp":1663891200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Due to tremendous academic pressure, Chinese high school students suffer from severe depression, anxiety, and sleep disturbances. Moreover, senior high school students commonly face more serious mental health problems than junior high school students. However, the co-occurrence and internal relationships of depression, anxiety, and sleep disturbances clusters are scarcely examined among high students. Therefore, the current study inspected relationships between depression, anxiety, and sleep disturbance symptoms through network analysis and identified key symptoms bolstering the correlation and intensifying the syndromes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A total of 13,999 junior high school students (\n                      <jats:italic>M<\/jats:italic>\n                      <jats:sub>age<\/jats:sub>\n                      = 13.42 years,\n                      <jats:italic>SD<\/jats:italic>\n                      <jats:sub>age<\/jats:sub>\n                      = 1.35, 50% females) and 12,550 senior high school students (\n                      <jats:italic>M<\/jats:italic>\n                      <jats:sub>age<\/jats:sub>\n                      = 16.93 years,\n                      <jats:italic>SD<\/jats:italic>\n                      <jats:sub>age<\/jats:sub>\n                      = 1.67, 47% females) were recruited in Harbin. We constructed networks for all students, junior high group, and senior high group, including data from the Youth Self-rating Insomnia Scale-3 (YSIS-3), the Generalized Anxiety Disorder-2 (GAD-2), and the Patient Health Questionnaire-2 (PHQ-2). The indices of \u201cstrength\u201d was used to identify symptoms' centrality, and \u201cbridge strength\u201d was used to find specific nodes that could bridge anxiety, depression, and sleep disturbance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The networks of all students, junior high and senior high students, were stable and accurate. Among all networks, \u201cNervousness\u201d (GAD1) had the highest strength, and \u201cNervousness\u201d\u2013\u201cExcessive worry\u201d (GAD1-GAD2) had the strongest correlation. \u201cNervousness\u201d (GAD1) also functioned as the bridge symptom among junior high students, while \u201cSad mood\u201d (PHQ2) among senior high students. Senior high students scored higher than junior high students on all items and had a tighter network structure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In networks consisting of anxiety, depression, and sleep disturbance, anxiety plays a conspicuous role in comorbidity among junior high school students, which transforms into depression among senior high school students. Treatments or interventions should be focused on these critical symptoms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2022.1015166","type":"journal-article","created":{"date-parts":[[2022,9,23]],"date-time":"2022-09-23T07:19:06Z","timestamp":1663917546000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":37,"title":["Mapping network connection among symptoms of anxiety, depression, and sleep disturbance in Chinese high school 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