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Introduction: Childhood anxiety is a growing concern in Indian school settings, yet the behavioral and coping mechanisms that shape anxiety outcomes remain insufficiently understood. This study examined how coping patterns, behavioral tendencies, prosocial characteristics, and socioeconomic factors predict anxiety among school-going children in Sikkim. Methods: A cross-sectional survey was conducted among 1,001 children aged 7 to 10 years in Sikkim. Standardized instruments were used, including the Revised Children's Manifest Anxiety Scale-2 (RCMAS-2), the Strengths and Difficulties Questionnaire (SDQ-P), the Coping Strategies Inventory (CSI-SF), and the 2020 Kuppuswamy Socioeconomic Scale. Analyses included descriptive statistics, Chi-square tests, correlations, regression models, and structural equation modelling. Result: Based on established RCMAS-2 thresholds, 22.5% of children screened positive for clinically elevated anxiety (21.0% moderate; 1.5% severe). In the structural model, maladaptive coping showed the strongest association with anxiety (β = 0.18, p < 0.001). Adaptive coping (β = -0.08, p = 0.057) and prosocial behavior (β =-0.11, p = 0.035) showed small protective effects. Internalizing and externalizing behavior showed weak direct associations with anxiety and minimal indirect effects through maladaptive coping. Overall, behavioral and coping variables exhibited low intercorrelations, indicating that anxiety symptoms were associated with coping patterns rather than broad behavioral difficulties. Conclusion: A substantial proportion of primary-school children in Sikkim exhibit clinically elevated anxiety symptoms. Coping style, particularly maladaptive coping, emerged as the most salient factor associated with anxiety, whereas behavioral difficulties contributed minimally. Strengthening adaptive coping and encouraging prosocial engagement within school mental health programs may help reduce anxiety risk during early schooling years.
Chhetri et al. (Fri,) studied this question.