Family environment, health risk behaviors, and mental health among chinese five-year vocational education students: a cross-sectional network analysis

Background Adolescent mental health problems, particularly depression and anxiety, pose a global public health challenge. Family environment and health risk behaviors are key influencing factors, yet their complex interrelationships with psychological symptoms remain unclear. This study employed network analysis to investigate these associations, aiming to identify core symptoms and potential gender differences. Methods A total of 1,601 students were recruited from two higher vocational colleges in Nanning, Guangxi, using a cluster random sampling method. Adolescents' family environment, health risk behaviors, and mental health status were assessed using the Family Environment Scale, the Student Health Status and Influencing Factors Questionnaire, and the Mental Health Scale for Middle School Students, respectively. The EBICglasso method was used to estimate networks and derive centrality indices, followed by the Network Comparison Test to evaluate gender differences. Results "Depression" and "Anxiety" exhibited the highest strength centrality as core symptoms. Family "Cohesion" and "Conflict" served as key bridge nodes connecting health risk behaviors to mental health. The strongest association was observed between "Sleep deprivation" and "Depression." No significant gender differences were found in network structure. Conclusion Depression and anxiety are central to adolescent mental health problems, with family cohesion and sleep deprivation representing important intervention targets. Family-based emotional communication training and sleep health promotion may hold preventive value.