{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T00:33:11Z","timestamp":1792801991263,"version":"4.5.0"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"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>Adolescent idiopathic scoliosis (AIS) patients frequently experience appearance-related anxiety and psychological distress. However, previous studies largely focused on variable-centered analyses, failing to capture the complex interplay among these symptoms and protective factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To construct an integrated network of appearance anxiety, fear of negative evaluation, psychological distress, and psychosocial protective factors in AIS patients, identifying core symptoms and key bridge nodes connecting risk and protective communities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional study included 349 AIS patients (aged 10\u201318 years, 64.76% female) recruited from a tertiary general hospital in Northeast China. Participants completed measures of appearance anxiety (SAAS), fear of negative evaluation (BFNES), psychological distress (K10), perceived social support (PSSS), and resilience (RSCA). A Gaussian Graphical Model estimated a 30-node network. Centrality and bridge centrality analyses identified core symptoms and key connectors, with network stability tested across sex and disease severity using Network Comparison Tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Node S6 (\u201cFear of lacking attractiveness due to appearance\u201d) exhibited the highest strength (1.14) and expected influence (1.01). \u201cEmotional Control\u201d demonstrated the strongest bridge strength (0.47), exceeding other protective factors (Positive Cognition = 0.29). Network structure was robust (CS-coefficient = 0.673) and invariant across sex (\n                      <jats:italic>M<\/jats:italic>\n                      = 0.22,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.687) and severity subgroups (\n                      <jats:italic>M<\/jats:italic>\n                      = 0.24,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.445).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Appearance-related attractiveness concerns are the most central symptom, while emotional control is the key bridge node linking risk and protective factors in AIS patients. These findings highlight precise cognitive and emotion regulation targets for psychosomatic interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1823055","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T04:25:44Z","timestamp":1781497544000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["A cross-sectional network analysis of appearance-related anxiety and psychosocial protective factors in adolescent idiopathic scoliosis patients: core symptoms and bridging analysis"],"prefix":"10.3389","volume":"14","author":[{"given":"Yujie","family":"Guan","sequence":"first","affiliation":[{"name":"The Second Clinical College, Heilongjiang University of Chinese Medicine","place":["Harbin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baocheng","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Soft Tissue Injury, Shenzhen Traditional Chinese Medicine Hospital","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haozhe","family":"Wang","sequence":"additional","affiliation":[{"name":"China University of Mining and Technology","place":["Xuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Musculoskeletal Pain, The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine","place":["Harbin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuhuang","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Sanya Hospital of Traditional Chinese Medicine (Hainan Hospital, Guangzhou University of Chinese Medicine)","place":["Sanya, 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