Exploring the interrelationship between myopia, psychological resilience, and emotion regulation in adolescents using a network analysis

Psychological resilience and emotion regulation play essential roles in helping adolescents manage myopia-related psychological stress. However, existing research has focused predominantly on isolated associations among myopia and single psychological variables, neglecting the interactive networks among intrinsic dimensions of psychological resilience and emotion regulation strategies and potential gender-specific structural variations within these networks. We conducted a cross-sectional study of 1008 seventh-grade students in Shenzhen, China. Noncycloplegic autorefraction was used to assess myopia severity, whereas validated scales (RSCA and ERQ-CA) measured psychological resilience and emotion regulation. A Gaussian graphical model incorporating LASSO regularization and EBIC was employed to construct integrated networks encompassing myopia, five resilience dimensions, and two emotion regulation strategies. Centrality metrics and bridge centrality were calculated to identify pivotal nodes, and network comparison tests assessed gender-based structural differences. Network analysis demonstrated that interpersonal assistance exhibited a strong, direct association with myopia. Goal focus and interpersonal assistance emerged as the nodes with the highest centrality and bridge centrality. Nodes associated with interpersonal assistance and myopia showed greater expected influence in the female subgroup. This study elucidates the interrelationship of myopia, psychological resilience, and emotion regulation in Chinese adolescents and suggests targeted intervention strategies.