Association of health locus of control with anxiety and depression and mediating roles of health risk behaviors among college students

We aimed to assess the association of health locus of control with anxiety and depression, and explore the mediating effects of health risk behaviors. A multi-stage cluster random sampling method was used among Chinese college students. Logistic regression models were used to explore the associations of health locus of control with anxiety and depression. Structural equation models were used to explore the mediation roles of health risk behaviors in the associations of health locus of control with anxiety and depression. A total of 3,951 college students were included in this study. Internality was associated with lower prevalence of depression (OR = 0.94, 95% CI, 0.91-0.97), powerful others externality was also associated with lower prevalence of anxiety and depression (0.92, 0.88-0.96; 0.93, 0.89-0.96), while chance externality was associated with higher risk of anxiety and depression (1.13, 1.08-1.18; 1.24, 1.20-1.28). The mediated proportion of health risk behaviors in associations of internality, powerful others externality, chance externality with anxiety was 7.55%, 2.37% and 2.18%, respectively. The mediated proportion of health risk behaviors in associations of powerful others externality, chance externality with depression was 10.48% and 2.14%, respectively. Health locus of control is associated with anxiety and depression that are mediated by health risk behaviors.