Characterizing heterogeneity in emotional and behavioral problems: Latent class analysis with 507,188 children and adolescents and associations with mobile gaming addiction behavior.

BACKGROUND

While mobile gaming addiction (MGA) behavior is increasingly prevalent among children and adolescents, the role of specific emotional-behavioral profiles - particularly their latent patterns - in associating with MGA behavior remains poorly understood. This study aimed to examine these associations and age-related variations.

METHODS

Data were analyzed from 507,188 participants aged 6-18 years in the Children's Growth Environment, Lifestyle, and Physical and Mental Health Development Project, conducted in Guangzhou, China, in 2020. Latent class analysis was performed on parent-reported Strengths and Difficulties Questionnaire (SDQ) data to identify subgroups with distinct emotional and behavioral problems. Associations between SDQ dimensions, latent classes, and MGA behavior were examined using logistic regression analysis.

RESULTS

Five latent classes were identified: 'Low symptom' (82.2%), 'Internalizing' (0.8%), 'Peer and prosocial issues' (4.3%), 'High difficulties' (5.0%), and 'Hyperactive' (7.6%). Compared to the 'Low symptom' class, all other latent classes showed significantly higher risks for MGA, with the strongest association observed in the 'Internalizing' class (adjusted odds ratio [AOR]: 2.84; 95% confidence interval [95% CI]: 2.67-3.02). Among SDQ subscales, conduct problems presented the highest association (AOR: 2.08; 95% CI: 2.04-2.12), though all SDQ subdimensions were significantly positively correlated with MGA behavior (all p < 0.05). Notably, these associations were consistently stronger in adolescents (aged 13-18 years) than in children (aged 6-12 years).

CONCLUSIONS

This study identifies specific SDQ-based risk characteristics for MGA behavior, with adolescents (aged 13-18 years) being the most vulnerable. Future longitudinal studies should verify these associations, and clinicians may prioritize early screening for internalizing and conduct-related difficulties.