Patterns of lifestyle and their associations with anxiety symptoms among adolescents in Liaoning Province, China: a latent class analysis

Abstract

Objective: To explore the latent categories of adolescents’ lifestyles and analyze the relationship between these lifestyle categories and anxiety. Study design: A cross-sectional survey. Methods: The questionnaire was designed to assess demographic characteristics, lifestyle behaviors, and anxiety. Sleep quality was measured by The Pittsburgh Sleep Quality Index (PSQI), anxiety symptoms were assessed by the Generalized Anxiety Disorder 7 (GAD-7), and lifestyle behaviors were operationalized as dietary behavior, physical activity, and sedentary time. Data collection was conducted from January to March 2024, it was employed to select adolescents from 12 cities in Liaoning Province. The lifestyles were classified using Latent Class Analysis (LCA), and an unordered multinomial logistic regression was performed to analyze the impact of different types of adolescent lifestyles on anxiety. Results: A total of 11,449 students were analyzed, and the prevalence of anxiety symptoms among adolescents is 32.62%. The participants were classified into three categories, High Sleep Diet - Low Activity (54.79%), Low Sleep Diet - Low Activity (9.01%), and High Sleep Diet - High Activity (36.20%). The results of unordered multinomial logistic regression showed that Age, gender, school location and lifestyle categories are significant factors influencing adolescent anxiety. Conclusion: Adolescents exhibit high levels of anxiety. Adolescents’ lifestyles can be categorized into three distinct groups. Lifestyle plays an important role in influencing anxiety. Schools, families, and society collaborate to implement effective intervention strategies, promoting healthier lifestyles to prevent and alleviate anxiety.