Objective To analyze the relationships of familial affective expression with anxiety and depression in adolescents, and to explore the related factors influencing familial affective expression among adolescents.

Methods This cross-sectional study employed a multi-stage stratified cluster random sampling method to select 2, 216 middle school students in Hefei from January 2 to 15, 2024, for an online questionnaire survey. The Adolescent Affective Expression Scale, the Screen for Child Anxiety Related Emotional Disorders (SCARED), and the Depression Self-Rating Scale for Children (DSRSC) were used to assess the level of familial affective expression and the status of anxiety and depression among adolescents. The familial affective expression of adolescents with different demographic characteristics was compared; the Pearson correlation analysis was used to explore the correlations of familial affective expression with anxiety and depression; the multiple linear regression analysis was conducted to identify the influencing factors of familial affective expression among adolescents.

Results A total of 2, 216 questionnaires were distributed, and 2, 017 valid questionnaires were returned, yielding a response rate of 91.02%. The total score on the Adolescent Affective Expression Scale was (24.91±7.98), with a detection rate of 17.06% for high familial affective expression. The correlation analysis revealed positive correlations of the total score on the Adolescent Affective Expression Scale with the scores on the SCARED and DSRSC (P < 0.05). The results of multiple linear regression analysis indicated that male (B=-2.321, 95%CI, -2.587 to -2.106), living in an urban environment (B=-1.196, 95%CI, -1.636 to 0.154), having a harmonious parent-child relationship without frequent arguments (B=-2.348, 95%CI, -2.631 to -1.759), experiencing marital conflict (B=3.615, 95%CI, 3.015 to 4.123), adopting negative coping strategies (B=0.107, 95%CI, 0.033 to 0.196), and having lower psychological flexibility (B=0.212, 95%CI, 0.115 to 0.289) were influencing factors of familial affective expression among adolescents (P < 0.05).

Conclusion Familial affective expression is associated with anxiety and depression in adolescents. Gender, living environment, parent-child relationship, marital relationship, coping styles, and psychological flexibility may have certain impacts on familial affective expression among adolescents.