Unveiling gender disparities in mental health among Chinese preschoolers: partial statistical mediation by parental overreactivity.

OBJECTIVES: This study aimed to examine whether parental overreactivity is associated with the relationship between child gender and mental health in preschool children, exploring potential pathways that may underlie observed gender-related disparities. METHODS: A total of 21,366 children aged 3-6 years were recruited through stratified cluster sampling from 189 kindergartens across 13 districts in western China. Child gender (boy/girl) was treated as the exposure variable. Parental overreactivity was assessed using the Arnold-O'Leary Parenting Scale, and child mental health was measured with the Strengths and Difficulties Questionnaire (SDQ), focusing on total difficulties and prosocial behavior. Multivariable logistic and linear regression models were applied, and mediation analysis was conducted to quantify indirect effects. RESULTS: Compared with boys, girls exhibited a 12% lower risk of total difficulties (OR = 0.88; 95% CI: 0.82-0.94; P = 0.0003) and a 21% higher likelihood of prosocial behavior (OR = 1.21; 95% CI: 1.14-1.28; P < 0.0001). Each one-point increase in parental overreactivity was associated with an 85% higher risk of total difficulties (OR = 1.85; 95% CI: 1.78-1.92; P < 0.0001) and a 34% reduction in prosocial behavior (OR = 0.66; 95% CI: 0.64-0.68; P < 0.0001). Girls experienced significantly lower levels of parental overreactivity (β = -0.04; 95% CI: -0.06 to -0.01; P = 0.0152). Mediation analysis showed that overreactivity statistically explained 16.22% of the gender effect on total difficulties and 7.49% on prosocial behavior. Subgroup analyses suggested stronger effects among families with lower socioeconomic status. CONCLUSIONS: Parental overreactivity was identified as a statistically significant indirect factor in the association between child gender and early mental health. Girls showed lower parental overreactivity, which was statistically associated with more favorable psychological profiles. These findings suggest that parental overreactivity may represent a potential intervention target, and highlight the value of gender-sensitive parenting approaches for narrowing early mental health disparities.