Unique longitudinal relationships between symptoms of psychopathology in youth: A cross-lagged panel network analysis in the ABCD study

Unraveling the core symptoms across distinct trajectories of problematic Internet use among 27,577 adolescents: Cross-lagged panel network analyses

Problematic Internet Use (PIU) often begins in adolescence and develops along diverse trajectories. Understanding the interaction between PIU symptoms and identifying the core PIU symptoms that drive distinct trajectories among adolescents are crucial. We employed cross-lagged panel network analyses to examine temporal relationships of PIU symptoms among Chinese adolescents across four developmental trajectories over two time points. A total of 27,577 adolescents (Mean age = 13.8, SD = 1.5) participated in this study. Demographic variables and PIU symptoms were collected from December 17 to 26, 2021 (T1) and from May 17 to June 5, 2022 (T2). The symptom "Reluctant to stop" in the resilient group and "Uncontrollable checking" in the alleviating group at T1 were most predictive of remission of other symptoms at T2, while "Empty life" in the deteriorating group and "Feeling of missing" in the persistent dysfunction group were most strongly associated with worsening of other PIU symptoms. Improving self-control is likely to promote healthy and beneficial Internet use among adolescents, while enhancing social connection and fostering exercise habits may help mitigate negative emotions and reduce the emergence of additional PIU symptoms among adolescents who have developed PIU.

Associations among screen time, depressive symptoms and sleep in early adolescents: A sex-disaggregated cross-lagged network analysis

BACKGROUND

Prior research has established associations among screen time, depressive symptoms, and sleep. However, the nuances of these associations, particularly regarding directionality and sex-specific differences among early adolescents, remain insufficiently understood. This study aimed to investigate sex differences in the longitudinal associations among screen time, depressive symptoms, and sleep at the symptom level during early adolescence.

METHODS

Our cohort consisted of 2987 students (1451 boys at T1; Mage = 10.52 years), who were assessed twice over six-month intervals. Sex-stratified analyses in the network associations among screen time, depressive symptoms, and sleep were examined via a cross-lagged panel network modeling approach.

RESULTS

The results revealed that depressive symptoms such as "feeling unloved" for boys and "sadness" for girls were the most central symptoms with the greatest influence on other symptoms. Furthermore, depressive symptoms such as "crying" and "loneliness" for boys and "self-hatred" and "loneliness" for girls may act as bridge symptoms, significantly forecasting excessive screen time after six months.

CONCLUSIONS

Our findings bolster the compensatory internet use theory by suggesting that screen time may function as a coping mechanism for managing depressive symptoms and sleep problems. These findings advance our comprehension of the evolving dynamics among screen time, depressive symptoms, and sleep across sexes over time. The development of targeted prevention and intervention strategies that accommodate these sex differences could be instrumental in curtailing the onset or intensification of problematic screen use among early adolescents.

Unraveling the onset and continuity of depressive symptoms from early pregnancy to six weeks postpartum: A longitudinal network analysis

BACKGROUND

Perinatal depression is a major global public health problem, but the onset and progression of symptoms that give rise to perinatal depression are less clear in the scientific literature.

METHODS

This study followed 1210 Chinese pregnant women who completed the Edinburgh Postnatal Depression Scale at five time points: 13, 24, and 37 weeks of gestation (G13, G24, G37), and 1 and 6 weeks postpartum (W1, W6). Cross-lagged panel networks were used to analyze and compare networks from first to second trimester (G13 → G24), second to third trimester (G24 → G37), and one week to six weeks postpartum (W1 → W6).

RESULTS

Results showed that network structure did not differ significantly between the three networks, demonstrating continuity of depressive symptoms over the course of pregnancy and postpartum. Across the three periods, self-reported panic was identified as the symptom that had the largest influence on other symptoms at a following assessment, and self-reported worry was the symptom that was most strongly influenced by depressive symptoms at previous timepoints. Moreover, thoughts of self-harm showed a distinct feature where it could only trigger other symptoms in the postnatal, but not prenatal period.

LIMITATIONS

Self-reported questionnaires used in this study may be susceptible to bias. Items of perinatal depressive symptoms included in the network analysis are also not exhaustive.

CONCLUSIONS

Findings from this symptom-oriented psychopathology network shed light upon the developmental course of perinatal depressive symptoms, providing insights for tailored preventative intervention programs.

Distinct roles of specific metacognitive beliefs in adolescent problematic mobile phone use: A Cross-Lagged panel network analysis

Problematic mobile phone use (PMPU) among adolescents is increasingly recognized as a significant behavioral health concern. Previous studies have found general metacognitive beliefs can positively predict PMPU. However, the longitudinal relationship between specific metacognitive beliefs and addictive behaviors has not been fully explored. This study aimed to explore the longitudinal relationship between metacognitions about mobile phone use, metacognitions about desire thinking, and PMPU among adolescents using cross-lagged panel network analysis. A sample of 993 adolescents were surveyed at two points over six months. Findings indicated that negative metacognitions about mobile phone use and positive metacognitions about desire thinking emerged as two prominent bridge nodes. Negative metacognitions about mobile phone use were strongly associated with withdrawal and relapse symptoms, while positive metacognitions about desire thinking correlated with tolerance and relapse. These results suggest that interventions aimed at addressing PMPU should consider the distinct impacts of different metacognitive beliefs and tailor their approaches accordingly.

Which should be targeted first? The comorbidity of sleep disturbances and anxiety symptoms among adolescents: Cross-sectional and longitudinal network analyses

BACKGROUND

The comorbidity of sleep disturbances and anxiety is well-established, but which symptoms to prioritize for intervention remains unclear. Academic stress, a key factor worsening both, is common among adolescents facing growing academic demands. Understanding how it affects both comorbidities from a symptomatology perspective is crucial for developing targeted interventions.

METHODS

The longitudinal survey of 34,494 adolescents was conducted twice (Mage = 12.89 [1.76] years). Adolescents were categorized into three groups based on academic stress scores' mean ± 1 standard deviation. Then, we examined the moderating effect of academic stress on the relationship between sleep disturbances and anxiety symptoms longitudinally by comparing groups' network structures, where nodes represent symptoms, and edge thickness reflects the associations' strength.

RESULTS

In the cross-sectional network, at both time points, the key bridge symptom is "sleep quality" (bridge Expected Influence (bEI) at T1 = 0.21; bEI at T2 = 0.20). In the longitudinal network, "irritability" (bEI = 0.21) and "sleep quality" (bEI = 0.21) are key bridge symptoms in the whole sample, with "sleep quality" (bEI = 0.36) most prominent in the high stress group. In the low stress group, it's "difficulty initiating sleep" (bEI = 0.14). Additionally, compared to the low group, adolescents with high academic stress possess more tightly connected relationships (edge weights ≥0.05) not only within single disorder symptom networks but also between two disorder symptom networks (number of edges: 2 vs 34).

CONCLUSION

These findings highlight the moderating role of academic stress, offering insights for targeted interventions to improve adolescent mental health.

A network analysis of alcohol-related harms: An exploratory study in United Kingdom adolescents

BACKGROUND

This study applied a network analysis approach to the study of individual self-reported alcohol-related harms (ARHs) across four waves of data.

METHODS

Data were from a large clustered randomised control trial (N = 12,738) involving 105 schools. Data were collected at 4 time points over 4 academic years (mean age 12.5 [Time 0], 13.5 [T1], 14.5 [T2], and 15.3 years [Time 3]). Data were gathered on the experience of 16 separate ARHs experienced during the previous six months, and these were dichotomised (yes/no). We estimated cross-lagged panel networks for the 16 ARHs, capturing both the auto-regressive relationships (a harm predicting itself at follow up) and the cross-lagged relationships (a harm predicting another harm at follow-up) across the study (T0 → T1; T1 → T2; T2 →T3).

RESULTS

Exposure to all ARHs increased with age. However, the most serious ARHs (e.g., getting in trouble with the police because of your drinking) remained relatively rare, even at age 15. Actively planning to get drunk, coupled with an inability to control levels of intoxication (drinking more than planned) appeared central to each network, facilitating the emergence of all other ARHs. While the prevalence of ARHs increased with age, network complexity declined, and networks becoming more stable.

CONCLUSIONS

Interventions aimed at improving the capacity to self-regulate alcohol consumption, and actively challenging the planning of drunken episodes, may be pivotal in reducing the emergence of both acute and chronic ARHs in adolescence.

The Intrinsic Association of Posttraumatic Stress Symptoms Among Chinese Police Officers During COVID-19: Evidence From Network Perspective

BACKGROUND

The current study aimed to identify the core posttraumatic stress symptoms (PTSS) and to explore the longitudinal predictive relationships of these symptoms among Chinese police officers during COVID-19. Identifying the important symptoms of PTSS could help with informing future research to alleviate police officers' psychological problems.

METHODS

In this study, a two-wave on-line investigation (4 months interval; T1 and T2) was conducted with a sample of 891 Chinese police officers who completed the Chinese version of PTSD Checklist for DSM-5 (PCL-5). Cross-sectional network and cross-lagged panel network (CLPN) analyses were adopted.

RESULTS

The results showed that: (1) The most central nodes all belonged to the hyper-arousal and the negative cognition and emotion alteration clusters in both T1 and T2. (2) The strongest positive predictive paths were apparent from symptoms in hyper-arousal cluster to symptoms in negative cognition and emotion alteration cluster and intrusions cluster.

CONCLUSIONS

Hyperarousal is the core symptom cluster among police officers during COVID-19, and it positively predict negative cognition and emotion alteration symptoms and intrusions symptoms over time. Future research could focus more on these symptoms and examine their role in the onset and development of PTSS in police officers following traumatic events.

Longitudinal Network Associations Between Symptoms of Problematic Gaming and Generalized and Social Anxiety Among Adolescents

Problematic gaming has emerged as a significant problem among adolescents today, yet there is still an ongoing debate over the validity and relevance of its diagnostic criteria. Some critical steps have been recommended, including examining the structure of problematic gaming and exploring its comorbidity with generalized and social anxiety. To address these research aims, this study used network analysis, both cross-sectionally and longitudinally, to identify the most central symptoms of problematic gaming and elucidate the mechanisms underlying its co-occurrence with generalized and social anxiety in adolescents. A sample of 1893 Chinese adolescents (52.85% boys, 47.15% girls; Mage = 15.42 years, SD = 0.52) participated in a two-wave longitudinal study with a 12-month interval. The findings showed that giving up other activities, loss of control, tolerance, and continuation were the most central problematic gaming symptoms for both waves, as revealed by cross-sectional analyses. Moreover, the social anxiety symptom of social avoidance and distress-general was the most prominent in bridging different constructs across cross-sectional and longitudinal networks. The longitudinal findings further revealed that the generalized anxiety symptom of restlessness was closely connected to problematic gaming symptoms, indicating its influential role as a harmful mechanism underlying problematic gaming. Our results underscore the necessity to reconsider the criteria of problematic gaming. In addition, the symptoms of social avoidance and distress-general and restlessness can be prioritized as targets for preventing and treating problematic gaming in adolescents.

Depressive symptoms changes in the new-onset stroke patients: A cross-lagged panel network analysis

BACKGROUND

Each year, there are approximately 10.3 million new stroke cases worldwide, with 2 million occurring in China. Post-stroke depression (PSD) is a common complication that negatively affects rehabilitation outcomes and increases long-term mortality.

OBJECTIVE

This study used network analysis to investigate the cross-sectional and longitudinal networks between depressive symptoms in new-onset stroke patients with PSD, aiming to identify the key symptoms and predictive relationships among distinct symptoms during the acute phase and 6 months after the stroke.

METHODS

This longitudinal descriptive study collected data from October 2022 to December 2023, including eligible new-onset stroke patients. Depressive symptoms were assessed using the CES-D scale, and network analysis was used to analyze the interactions between symptoms.

RESULTS

613 participants completed the data collection. The study found that D3 (Felt sadness) emerged as the central depressive symptom at both baseline and follow-up (EI value = 1.215 and 1.168, respectively). In the longitudinal network analysis, D7 (Sleep quality) displayed the strongest out-Expected Influence (value = 1.728), while D4 (Everything was an effort) showed the strongest in-Expected Influence (value = 1.322).

LIMITATIONS

The self-report measure is adopted for all depressive symptoms in the study, and there may be some deviation.

CONCLUSION

These symptom-level associations at cross-sectional and longitudinal networks extend our understanding of PSD symptoms in new-onset stroke patients by pointing to specific key depressive symptoms that may aggravate PSD. Recognizing these symptoms is imperative for the development of targeted interventions and treatments aimed at addressing PSD in new-onset stroke patients.

The development of depressive symptoms in subthreshold depression adolescents with a history of childhood maltreatment: A longitudinal network analysis

BACKGROUND

Emerging evidence suggests that adolescents with subthreshold depression and a history of childhood maltreatment are at an elevated risk for developing depression and experiencing suboptimal treatment outcomes. Traditional studies often rely on sum scores to analyze depression, overlooking the intricate symptomatic relationships that can be revealed through the analysis of evolving depressive symptom networks.

METHODS

This study involved 5020 adolescents from four public schools in China, screened for a history of childhood maltreatment and subthreshold depression. A subset of 421 participants, identified with subthreshold depression and a history of childhood maltreatment, was selected. The longitudinal study comprised three assessment waves-baseline, T1, and T2-with follow-ups every six months over a year. Participants completed the CESD scale at each wave. Network analysis was employed for statistical analysis.

RESULTS

The results showed that central symptoms, including absence of positive affect, depressed affect and somatic symptoms, consistently emerged as central across time points, highlighting their critical roles within the network. Notably strong associations were observed between specific symptoms (e.g., interpersonal problems, depressed affect and absence of positive affect), along with significant temporal changes in an increasing relationship between somatic symptoms.

CONCLUSIONS

The findings reveal dynamic elements within the depressive symptom network, including strong symptom associations and significant changes in symptom connections over time. These insights suggest potential targets for focused therapeutic interventions, emphasizing the importance of understanding symptom interrelations in subthreshold depression among adolescents with a history of childhood maltreatment.

Unravelling early transdiagnostic dynamics of psychotic-like experiences in young adults: Results from a cross-lagged panel network analysis

BACKGROUND

Psychotic-like experiences (PLEs) are potential transdiagnostic markers of psychopathology. However, temporal patterns of associations between PLEs and other symptoms remain unclear. Moreover, it needs to be clarified as to whether PLEs might be primary targets for interventions. This study aimed to investigate longitudinal associations of PLEs with other psychopathological symptoms.

METHODS

A total of 1314 young adults (aged 29.3 ± 5.7, 49.2 % women) without a lifetime history of psychiatric treatment completed online assessments, measuring psychopathological symptoms, at baseline and after 6 months. A cross-lagged panel network was analyzed. Output (the sum of edge weights from a specific node to all other nodes) and input (the sum of edge weights to a specific node from all other nodes) centralities were estimated. Age, gender, education, employment, and place of residence were the covariates.

RESULTS

The highest output centrality was found for PLEs while the highest input centrality was observed for obsessive-compulsive symptoms. Centrality metrics of these symptom domains were significantly higher compared to centrality metrics of other psychopathological domains. PLEs showed cross-lagged associations with all other symptom domains. The strongest cross-lagged edge in the network led from PLEs to obsessive-compulsive symptoms (weight = 0.611). It was significantly stronger compared to all other cross-lagged edges in the network. The results were partially replicated in the network of specific symptoms.

CONCLUSIONS

The findings indicate that PLEs might precede the emergence of other domains of psychopathology. The highest output centrality of PLEs suggests their potential utility as primary targets for early interventions.

Exploring the longitudinal relationships between non-suicidal self-injury and depressive symptoms in adolescents: a cross-lagged panel network analysis

BACKGROUND

Non-suicidal self-injury (NSSI) and depressive symptoms are two major public health issues among adolescents. Moreover, they can often co-occur, which can lead to additional negative outcomes, such as suicidal behaviors. Therefore, this study aimed to explore the comorbidity patterns of NSSI and depressive symptoms and provide valuable insights for future interventions.

METHODS

This study examined the relationship between NSSI and depressive symptoms via a cross-lagged panel network (CLPN). A total of 866 Chinese junior high school students (39.80% girls, Mage = 12.73 years, SD = 0.43) completed measurements during three time points.

RESULTS

Comorbidity rates of NSSI and depressive symptoms ranged from 10.51 to 15.13% among the adolescents. Moreover, results of the CLPN indicated that somatic and retarded activity, depressive affect, and lack of positive affect were strongly and positively associated with multiple NSSI behaviors. Conversely, burning from the NSSI cluster could negatively predict somatic and retarded activity and depressive affect. In addition, somatic and retarded activity and depressed affect were bridge symptoms that linked the comorbidity between NSSI and depressive symptoms.

CONCLUSION

These results demonstrate a negative reinforcement feedback pathway between NSSI and depressive symptoms, which provides evidence for intrapersonal negative reinforcement of NSSI. Furthermore, these findings identify the core and bridge symptoms between NSSI and depressive symptoms, which can provide new ideas for subsequent intervention treatments.

A longitudinal network analysis of the relationship between love addiction, insecure attachment patterns, and interpersonal dependence

The present study employed a network analysis approach to explore interrelationships among love addiction, attachment anxiety, attachment avoidance, and interpersonal dependence. The sample included 80 couples (N = 160) in romantic relationships, assessed longitudinally through online self-reports at the study's initiation and three months later. The findings revealed that attachment anxiety correlated strongly with low self-confidence, attachment avoidance related to autonomy, and love addiction showed a positive association with emotional dependence but a negative association with attachment avoidance. These findings underscore the associations among love addiction, insecure attachment patterns, and dimensions of interpersonal dependence. Addressing the core link between love addiction and insecure attachment patterns may enhance the psychological well-being of both partners in a couple.

The Longitudinal Relationship Between the Symptoms of Depression and Perceived Stress Among Chinese University Students

Depression is one of the most common mental disorders. Perceived stress is a significant trigger and has adverse effects on depression. The complex longitudinal relationship between perceived stress and depression at the symptom level has significant implications for clinical intervention but is understudied. In our study, 823 students (67% female, median age 20.38, IQR 19.42-21.43) from a university in Tianjin were randomly sampled and completed measures of PHQ-9 and PSS-10, while 393 (65% female, median age 20.42, IQR 19.46-21.45) were followed up at three points, six months apart. The longitudinal relationships were estimated using cross-lagged modelling and cross-lagged panel network modelling. Among them, 49 students (59% female, median age 19.48, IQR 18.76-20.12) participated in resting-state functional magnetic resonance imaging (fMRI) scans. Cross-lagged analyses showed that depression and perceived stress predicted each other at the global level. At the dimensional level, depression and perceived helplessness were mutually predictive, while depression and perceived coping did not. In the cross-lagged panel network analyses, we identified symptoms in the top 20% of Bridge Expected Influence as bridging symptoms, specifically 'Guilt' (PHQ6) and 'Felt nervous and stressed' (PSS3). Notably, 'guilt' consistently demonstrated the highest Bridge Expected Influence across all time points and showed the strongest predictive power for perceived stress. We found that fALFF in the left superior frontal gyrus (SFG) mediated the association between "guilt" and perceived stress. Our findings elucidate the bidirectional relationship between symptoms of depression and perceived stress, identifying guilt is the most critical symptom of depression for the followed perceived stress, with SFG activity mediating this association.

Longitudinal associations of depressive symptoms in father-mother-child triads: A cross-lagged panel network analysis

BACKGROUND

The current study aimed to test symptom-level associations underlying the concordance of depressive symptoms in father-mother-child triads. We used network analysis to examine central and bridge symptoms in the contemporaneous depressive network of triads and additionally assessed prospective relationships in temporal depressive networks.

METHODS

We included 881 father-mother-child triads with children aged 10 to 14 years from the China Family Panel Studies. Depressive symptoms were assessed by the short version of the Center for Epidemiologic Studies Depression Scale (CESD) across three different time points from 2012 to 2018. Contemporaneous and temporal networks (2012 → 2016 and 2016 → 2018) were estimated to examine the cross-sectional and longitudinal relationships between symptoms.

RESULTS

Within the contemporaneous network, "feeling depressed" was the most central symptom. Parental "could not get going" was identified as the bridge symptom across almost all cross-sectional networks. In the temporal network (2012 → 2016), fathers' symptoms were likely to influence mothers' symptoms. Over time (2016 → 2018), offspring symptoms (such as "could not get going") began to affect their parents. Certain symptoms were more influential than others: for instance, fathers' "could not get going" significantly predicted mothers' "bad life" and feeling that "everything was an effort" in 2016. Fathers' "could not get going" in 2016 significantly predicted children's "bad life" and "lack of happiness" in 2018.

LIMITATIONS

A self-reported scale other than clinical diagnosis was used to assess depressive symptoms.

CONCLUSIONS

The current study demonstrates that family members mutually influence each other in specific depressive symptoms. Therefore, family-based treatments that combat depression in youth should also involve both parents and target core depressive symptoms to disrupt the cycle of depression within the family context.

Racial-Ethnic Discrimination and Early Adolescents' Behavioral Problems: The Protective Role of Parental Warmth

OBJECTIVE

The purpose of the study was to investigate the association between discrimination by multiple sources (ie, teachers, students, and other adults) and early adolescents' behavioral problems (ie, internalizing, externalizing, and attention problems), also considering the protective role of parental warmth in the association.

METHOD

Cross-sectional analyses were conducted with 3,245 early adolescents of color obtained from the Adolescent Brain Cognitive Development Study (ABCD Study) at year 1 follow-up (Y1), a large and diverse sample of children (mean age = 9.48 years) in the United States. Racially-ethnically minoritized adolescents reported sources of discrimination, parental warmth, and symptoms of psychopathology. Regression with interaction terms was conducted to investigate the associations among sources of discrimination, parental warmth, and behavioral problems among racially-ethnically minority adolescents. Sensitivity analyses were conducted to examine (1) race/ethnicity and sex/gender variations; (2) whether the associations between different sources of discrimination and behavioral problems were reliably different; and (3) effects of discrimination, parental warmth, and their interplay at Y1 in predicting adolescents' behavioral problems at year 2 follow-up.

RESULTS

Early adolescents experiencing interpersonal racial-ethnic discrimination by multiple sources, including teachers, students, and other adults, reported higher levels of attention, internalizing, and externalizing problems. Parental warmth was protective for the association between interpersonal racial-ethnic discrimination and early adolescents' behavioral problems.

CONCLUSION

Experiencing interpersonal racial-ethnic discrimination from teachers, peers, and other adults is related to heightened attention, internalizing, and externalizing problems among racially-ethnically minoritized early adolescents. Parental warmth may reduce the risk of developing behavioral problems among early adolescents who experience interpersonal racial-ethnic discrimination from students, teachers, and other adults outside of school.

PLAIN LANGUAGE SUMMARY

In this cross sectional analysis of 3,245 early adolescents of color obtained from the Adolescent Brain Cognitive Development (ABCD) Study, the authors found that early adolescents experiencing interpersonal racial-ethnic discrimination from multiple sources, including teachers, students, and other adults, reported higher levels of behavioral problems (ie, internalizing, externalizing, and attention problems). Parental warmth was found to be protective for the association between interpersonal racial-ethnic discrimination and early adolescents' behavioral problems. These findings emphasize the importance of assessing experiences of interpersonal racial-ethnic discrimination among racially-ethnically minoritized early adolescents and contribute to the understanding of parental warmth as a protective factor for early adolescents to cope with such experiences.

DIVERSITY & INCLUSION STATEMENT

We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. One or more of the authors of this paper received support from a program designed to increase minority representation in science. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list. We actively worked to promote sex and gender balance in our author group. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list.

The associations between interparental conflict and adolescent adjustment: a cross-lagged panel network analysis

Extensively studied in interparental relationship literature suggests interparental conflict is a risk factor for adolescent adjustment, but the specific, dimension level relationships between interparental conflict and adolescent adjustment remain unclear. This study explored the interactions between the various dimensions of interparental conflict and adolescent adjustment in Chinese adolescents. A total of 1870 Chinese adolescents (42.27% males; Mage = 16.18, SD = 0.43, range = 15-18) completed a survey at two time points spaced three months apart. Data was analyzed using both cross-sectional and longitudinal network analysis. The cross-sectional network analysis found that resolution has the greatest connections with the dimensions of adolescent adjustment, suggesting that adolescents reporting high resolution are more prone to experience concurrent poor adjustment and therefore should be a primary focus of attention. The longitudinal network analysis revealed that, in general, previous hyperactivity-inattention is a significant and strong predictor of future interparental conflict, underscoring a child-driven effect. Meanwhile, prosocial behavior contributes to decreases in both interparental conflict and adjustment problems over time. These findings highlight the importance of addressing hyperactivity-inattention and cultivating prosocial behavior in adolescents as key intervention points-these can help resolve conflicts between parents and reduce adjustment problems for adolescents.

Dynamic interactions among schizotypal traits, affective and prodromal symptoms, social functioning in a large sample of college students: A cross-lagged panel network analysis

OBJECTIVE

Previous studies suggested that schizotypal traits are closely related with affective symptoms and social dysfunction in general population. However, the dynamic interactions among these variables across time remain unclear. This study aimed to investigate this issue using cross-sectional and longitudinal network analysis.

METHODS

A total of 9136 college students completed self-report scales measuring schizotypal traits, anxiety, depression, prodromal risk, and social functioning at timepoint 1 (T1) and six months later. Classical contemporaneous network analysis was used to estimate the associations among all variables at T1, and the cross-lagged panel network analysis was performed to estimate the predictive effects at follow-up. In addition, prodromal high-risk and low-risk subgroups at T1 were identified using Prodromal Questionnaire (PQ-16) to investigate differences on network constructs and edge weights using Network Comparison Tests (NCT).

RESULTS

Contemporaneous network showed that negative dimension of schizotypal traits, anxiety, and depression interacted and were all negatively correlated with social functioning. Of all the nodes in the network, interpersonal features of schizotypal traits was the most centralized. The results of cross-lagged network analysis further verified the predictive effect of personality traits and emotions on social function. In addition, NCT revealed significant difference between prodromal high-risk and low-risk subgroups in network structure and strength of edges connecting schizotypal traits, affective symptoms with prodromal risk, but not in global strength.

CONCLUSIONS

Our findings suggest that schizotypal traits, affective symptoms, and prodromal risk relate to social functioning, both independently and through their dynamic interactions.

The Longitudinal Relationship between Adolescents' Prosocial Behavior and Well-Being: A Cross-Lagged Panel Network Analysis

Despite extensive research on the relationship between adolescents' prosocial behavior and well-being, few studies have examined the relationships between prosocial acts towards different targets (family, friends, and strangers) and both hedonic and eudaimonic well-being over time, especially within the cultural context of China, where relational closeness are highly emphasized. To address this research gap, the present study conducted a longitudinal investigation involving 514 Chinese adolescents (M = 13.75 years, SD = 1.46; 57.2% female) across three time points, each separated by six-month intervals. Cross-lagged panel network analyses revealed the reciprocal relationships between prosocial behavior and well-being, moderated by the relational closeness to the prosocial target. Specifically, the results showed a positive and reciprocal relationships between helping family members and both forms of well-being, as well as between helping friends and eudaimonic well-being. In contrast, while helping strangers did not exhibit a direct reciprocal relationship with well-being, both hedonic and eudaimonic well-being were predictive of prosocial behavior towards strangers. Furthermore, the mediation path analysis elucidated distinct mechanisms: helping family and strangers satisfied autonomy needs, contributing to well-being, whereas helping friends fulfilled relational needs. These findings highlight the mutual interplay between adolescents' prosocial behavior, particularly towards close relations, and their well-being.

Posttraumatic stress disorder symptoms in mothers and adolescents after the Wenchuan earthquake: A cross-sectional and longitudinal network analysis

OBJECTIVE

This study used network analysis to investigate the cross-sectional and longitudinal network between PTSD symptoms within mother-adolescent dyads at 12 and 18 months after the 2008 Wenchuan earthquake.

METHODS

The sample was from the Wenchuan Earthquake Adolescent Health Cohort. 399 mother-adolescent dyads completed the Posttraumatic Stress Disorder Self-Rating Scale at 12 and 18 months after the earthquake. We assessed central symptoms (those with the most significant influence on other symptoms) and bridge symptoms (symptoms connecting different communities) in contemporary networks (i.e., cross-sectional networks). Subsequently, cross-lagged panel network analyses (CLPN) were performed to estimate longitudinal relationships among symptoms between dyads.

RESULTS

In the contemporary networks, symptoms such as "intrusive thoughts" of both dyads and "flashbacks" of adolescents were central, indicating that they are crucial in maintaining the network of PTSD symptoms. Additional symptoms such as maternal "difficulty in concentration" and dyads' "pessimism and disappointment" should also be considered because of their central roles. Moreover, the temporary network did not directly replicate the contemporary networks, with adolescents' "nightmares" at 12 months having a high influence on other PTSD symptoms at 18 months.

LIMITATIONS

Self-reported tools other than clinical diagnoses were used to collect data.

CONCLUSIONS

These symptom-level associations at cross-sectional and longitudinal networks extend our understanding of PTSD symptoms among mother-adolescent dyads by pointing to specific key symptoms of PTSD that may drive the co-occurrence of PTSD among dyads. Recognizing these symptoms is imperative for the development of targeted interventions and treatments aimed at addressing comorbid PTSD in mother-adolescent dyads.

The prospective associations between problematic gaming and phubbing among Chinese adolescents: Insights from a cross-lagged panel network model

BACKGROUND AND AIMS

Previous studies are limited in addressing the directionality of temporal relationships between problematic gaming and phubbing symptoms by exploring cross-sectional studies. Therefore, we estimated the longitudinal relationships between individual behavioral addictive symptoms including problematic gaming and phubbing in adolescence, and explored potential sex differences in these relationships.

METHODS

This study included 3296 participants in Shandong Province, China. Data were collected from November 2021 (mean [SD] age: 15.17 [1.44] years) to May 2023 (mean [SD] age: 17.50 [1.18] years), with females comprising 54.5 % of the sample. Problematic gaming and phubbing were assessed using validated scales at each wave. We construct cross-sectional networks and cross-lagged panel networks (CLPN) to explore the contemptuous and temporal relationships between problematic gaming and phubbing.

RESULTS

Contemporaneous networks revealed significant differences in problematic gaming and phubbing networks between males and females. Additionally, temporal network analyses indicated that among male adolescents, feeling anxious when unable to play games was the most influential predictor of subsequent behavioral addictive symptoms. For female adolescents, fantasizing about gaming had the most significant associations with future addictive behaviors. The strongest bridge symptom linking problematic gaming and phubbing for both sexes was focusing on phones rather than engaging in conversation.

DISCUSSION AND CONCLUSIONS

The study applied network modeling to panel data from a large, population-based cohort of adolescents, identifying unique longitudinal relationships between problematic gaming and phubbing across symptom domains. It provides valuable insights into the characterization of behavioral addictive symptoms among adolescents and the potential predictive relationships among these symptoms among different sexes, guiding sex-specific targeted interventions for adolescents.

Unveiling relationships of human instinctive behaviors and blood pressure in Chinese adults: A network analysis

OBJECTIVES

Human behaviors and blood pressure (BP) are closely intertwined, affecting health. However, few studies have demonstrated their complex relationships. Using network analysis, we aimed to untangle the intricate and potential causal relationships between BP and human instinctive behaviors, identifying potential action points for hypertension prevention and control.

STUDY DESIGN

Cohort study.

METHODS

This study is based on two-wave data from 11,277 Chinese adults in the China Multi-Ethnic Cohort (CMEC) and an independent validation cohort of 21,947 adults from the Chinese Cohort of Working Adults (CCWA). We conducted a cross-sectional network analysis to estimate the interrelationships between measured BP and self-reported physical activity (PA), diet, and sleep. The centrality of each variable within the network was estimated using strength centrality index. Additionally, we performed a longitudinal network analysis to infer the potential causal relationships between BP and human instinctive behaviors in participants with normal or above-normal BP.

RESULTS

The network models suggested that BP exhibited negative associations with the dietary score (edge weight: -0.09) and sleep duration (-0.05). Non-sedentary behavior and dietary score were the most central variables, strongly connecting BP and other lifestyles. Higher BP predicted a poorer dietary score (β = -0.21) in participants with above-normal BP. The effect of BP on dietary score was replicated in the validation cohort and validated by linear regression analysis.

CONCLUSIONS

Non-sedentary behaviors and dietary behaviors may be the potential action points in promoting healthy behaviors and contributing to BP management. It is essential to manage individuals' BP status, non-sedentary behaviors, and dietary behaviors to disrupt malignant cycles.

Seeing adolescents grow from many angles using a multilevel approach: A tribute to the contributions of Dante Cicchetti to the field of developmental psychopathology

Dante Cicchetti propelled forward the field of developmental psychopathology by advancing this framework and championing new methods, including emphasizing the central role that multilevel analysis holds for explicating pathways of risk and resilience. His work continues to change the face of existing science. It has also paved the way for the formation of new projects, like the Research Domain Criteria initiative. This paper uses our laboratory's work on multilevel approaches to studying adolescent depression, non-suicidal self-injury, and suicidal thoughts and behaviors to shine a spotlight on Dr Cicchetti's contributions. In addition, we review recent developments, ongoing challenges, and promising future directions within developmental psychopathology as we endeavor to carry on the tradition of growth in the field.

Longitudinal Associations Between Anxiety and Depressive Symptoms in Adolescence, Early Adulthood, and Old Age: Cross-Lagged Panel Network Analyses

Background: Depression and anxiety are among the most prevalent psychiatric disorders worldwide, affecting individuals of all ages. The co-occurrence of these disorders often exacerbates their negative health impacts, underscoring the necessity of understanding their comorbid mechanisms. Methods: This study employed cross-lagged panel networks (CLPNs) to explore the longitudinal associations between depression and anxiety symptoms across three age groups and to compare the respective symptom networks. CLPNs were constructed through cross-temporal associations between different symptoms, reflecting both the pattern of interaction and the significance of specific symptoms in comorbidity. The sample consisted of 1258 adolescents (aged 13-19 years, M = 15.98), 1118 college students (aged 17-24 years, M = 19.94), and 548 older adults (aged 60-101 years, M = 85.19) from China. Depression and anxiety symptoms were assessed using the subscales of the Depression, Anxiety, and Stress Scale Short Version (DASS-21) at two time points over a 6-month period during 2020-2021. Results: The findings revealed that the prevalence of depression and anxiety in adolescents, college students, and older adults was 25.9%/46.6%, 53.7%/61.5%, and 7.2%/22.5%, respectively. The network structure varied across age groups: adolescents and college students exhibiting a tight interconnection between depression and anxiety symptoms, while older adults showed stronger small-world network characteristics. A key finding across all age groups was the central role of irrational fear. In addition, somatic anxiety symptoms frequently emerged as outcomes of other psychological symptoms. Conclusion: Depression and anxiety are more pronounced in college students compared to adolescents and older adults. Comparisons of the overall network structure provide insights into the lifelong trajectories of depression and anxiety symptom networks. The centrality of irrational fears and somatization symptoms is emphasized. These results offer guidance for more targeted clinical interventions.

A longitudinal network of psychotic-like experiences, depressive and anxiety symptoms, and adverse life events: a cohort study of 3,358 college students

AIMS

Psychotic-like experiences (PLEs), especially for persistent PLEs, are highly predictive of subsequent mental health problems. Hence, it is crucial to explore the psychopathological associations underlying the occurrence and persistence of PLEs. This study aimed to explore the above issues through a longitudinal dynamic network approach among PLEs and psychological and psychosocial factors.

METHODS

A total of 3,358 college students completed two waves of online survey (from Oct 2021 to Oct 2022). Socio-demographic information was collected at baseline, and PLEs, depressive and anxiety symptoms, and adverse life events were assessed in both waves. Cross-lagged panel network analyses were used to establish networks among individuals with baseline PLEs as well as those without.

RESULTS

At baseline, 455(13.5%) students were screened positive for PLEs. Distinct dynamic network structures were revealed among participants with baseline PLEs and those without. While 'psychomotor disturbance' had the strongest connection with PLEs in participants with baseline PLEs, 'suicide/self-harm' was most associated with PLEs in those without. Among all three subtypes of PLEs, bizarre experiences and persecutory ideation were the most affected nodes by other constructs in participants with baseline PLEs and those without, respectively. Additionally, wide interconnections within the PLEs construct existed only among participants without baseline PLEs.

CONCLUSIONS

The study provides time-variant associations between PLEs and depressive symptoms, anxiety symptoms, and adverse life events using network structures. These findings help to reveal the crucial markers of the occurrence and persistence of PLEs, and shed high light on future intervention aimed to prevent and relieve PLEs.

A panel network approach of internalizing and externalizing problems in early childhood: Evidence from American and Chinese preschoolers

Internalizing and externalizing problems tend to co-occur beginning in early childhood. However, the dynamic interplay of symptom-level internalizing and externalizing problems that may drive their co-occurrence is poorly understood. Within the frameworks of the Network Approaches to Psychopathology and the Developmental Cascade Perspective, this study used a panel network approach to examine how symptoms of internalizing and externalizing problems are related in early childhood both concurrently and longitudinally and whether the pattern may differ in American (N = 1,202) and Chinese (N = 180) preschoolers. Internalizing and externalizing problems were rated by mothers in two waves. Results from cross-sectional networks showed that the bridge symptoms underlying the co-occurrence of internalizing and externalizing problems were largely consistent in American and Chinese preschoolers (e.g., withdrawal, aggressive behavior, anxiety and depressive moods). Results from cross-lagged panel networks further showed that the co-occurrence was manifested by unidirectional relations from internalizing to subsequent externalizing symptoms in both American and Chinese preschoolers. The findings contribute needed cross-cultural evidence to better understand the co-occurrence of internalizing and externalizing problems and highlight the temporal heterogeneity of the symptom networks of internalizing and externalizing problems in early childhood.

Which comes first? Comorbidity of depression and anxiety symptoms: A cross-lagged network analysis

Depression and anxiety significantly impact college students, leading to various negative outcomes. While numerous studies have investigated the relationship between these two conditions, their temporal sequence remains unresolved. Many previous studies have concentrated on broad latent variables, often neglecting the nuanced symptomatology perspective, which may offer deeper insight into the clinical characteristics of these disorders. In this study, we collected questionnaire data from a college in South China using a cluster random sampling method. Data collection occurred over two time points, with the first round completed in November 2022 and May 2023, with a six-month interval. A total of 689 participants successfully completed the questionnaires during both rounds. Employing cross-lagged network analysis from a symptom-focused perspective, this research examines the interactions and predictive relationships between symptoms of depression and anxiety. The findings identified key symptoms-specifically "Irritability", "Guilty" and "Sad mood"- as critical bridging nodes of connection within the depression and anxiety symptom network. Our analysis revealed both bidirectional predictive relationships between certain symptoms nodes of depression and anxiety, as well as unidirectional ones. By highlighting these core nodes and their directional relationships, this study offers valuable insights that can inform targeted intervention and treatment strategies for enhancing mental health among college students.

Dynamics of symptom network in patients with first-episode schizophrenia: Insight from the CNFEST project

BACKGROUND

Schizophrenia is a heterogeneous psychotic disorder. Recent theories have emphasized the importance of interactions among psychiatric symptoms in understanding the pathological mechanisms of schizophrenia. In the current study, we examined the symptom network in patients with first-episode schizophrenia (FES) at four time points during a six-month follow-up period.

METHODS

In total, 565 patients with FES were recruited from the Chinese First-Episode Schizophrenia Trial (CNFEST) project. Clinical symptoms were measured using the Positive and Negative Syndrome Scale (PANSS) at baseline and follow-up (514 patients at one month, 429 at three months, and 392 at six months). We used a network analysis approach to estimate symptom networks with individual symptoms as nodes and partial correlation coefficients between symptoms as edges. A cross-lagged panel network (CLPN) model was used to identify predictive pathways for clinical symptoms.

RESULTS

We found stable and strongly connected edges in patients across the time points, such as links between delusions and suspiciousness/persecution (P1:P6), and emotional withdrawal and passive/apathetic social withdrawal (N2:N4). Emotional withdrawal (N2), poor rapport (N3), and passive/apathetic social withdrawal (N4) had high centrality estimates across all four time points. CLPN analysis showed that negative symptoms, including emotional withdrawal (N2), poor rapport (N3), and passive/apathetic social withdrawal (N4), and stereotyped thinking (N7) may have predictive effects for negative and general symptoms at follow-ups.

CONCLUSIONS

The symptom network of schizophrenia may be dynamic as treatment progresses. Negative symptoms remain the central and stable symptoms of schizophrenia. Negative symptoms may be potential therapeutic targets that predict other symptoms.

Maternal Depressive Symptoms and Offspring Internalizing Problems: A Cross-Lagged Panel Network Analysis in Late Childhood and Early Adolescence

The present study investigated the relations between maternal depressive symptoms and internalizing problems in offspring during late childhood and early adolescence, examining sex differences using symptom network analysis. A total of 885 Chinese youths in late childhood (n = 497, 38.6% girls; age = 9.58 years, SD = 0.24) and early adolescence (n = 388, 48.5% girls; age = 11.30 years, SD = 0.24) and their mothers (Mage = 37.34 years, SD = 5.42) were recruited. Cross-lagged panel network (CLPN) analysis was used to explore bridge symptoms (i.e., symptoms connecting two or more mental disorders) and identify transmission pathways between maternal depressive symptoms and offspring's internalizing problems at these two developmental stages. The CLPN results revealed that in late childhood, the bridge connections in the network model were boys feeling worried to mothers feeling distractible, and girls feeling worried to mothers feeling powerless. In early adolescence, the bridge connections were boys experiencing depressed mood to mothers feeling powerless, and mothers feeling bad to girls experiencing depressed mood. These findings highlight the network-level relations between maternal depressive symptoms and offspring internalizing problems. They provide insights into the developmental differences and similarities in symptoms during these periods and suggest ways to break the vicious cycle of psychopathology between mothers and their children.

Depressive Symptoms and Cognitive Function in Older Adults: A Cross-Lagged Network Analysis

Background: Depressive symptoms commonly co-occur with cognitive decline in older adults. However, prospective interrelationships between different cognitive function domains and depressive symptoms are not well understood. This study evaluated prospective interrelationships between depressive symptoms and cognitive functioning components among individuals aged 50 years or older from a perspective of network analysis. Method: Longitudinal data from the English Longitudinal Study of Aging were analyzed. Depressive symptoms were measured with the eight-item Center for Epidemiologic Studies Short-Depression Scale. Cognitive functions assessed included memory, orientation, and executive function. Contemporaneous network analyses were conducted using mixed graphical model, while a temporal network model was assessed using cross-lagged panel network model. To identify important predictors and outcomes, centrality indices, including expected influence, out-expected influence, and in-expected influence, were calculated. Results: A total of 6,433 older adults were included in the network analysis. Baseline "Not enjoy life" (CESD-6) was negatively associated with executive function at the follow-up assessment. Moreover, improvements in "Everything was an effort" (CESD-2) and "Loneliness" (CESD-5) were related to less future decline of executive function and memory ability. Furthermore, analyses suggested targeting "Lack of happiness" (CESD-4) could be useful in reducing the co-occurrence of depression and cognitive decline among older adults. Conclusions: This network analysis study highlighted dynamic interrelationships between depressive symptoms and cognitive decline in older adults. Findings suggest that interventions targeting specific depressive symptoms may have the potential to alleviate declines in executive function and memory for this population.

Adolescent anxiety and depression: perspectives of network analysis and longitudinal network analysis

BACKGROUND

Anxiety and depression often co-occur, exhibiting high comorbidity, with their trends evolving over time. However, the specific pathways through which comorbid symptoms of anxiety and depression evolve and interact remain unclear. To investigate these questions, this study employed Network Analysis (NA) and Longitudinal Network Analysis (LNA) to explore the central symptoms of anxiety and depression, as well as the temporal evolution of these central symptoms.

METHODS

The study focused on 606 high school students who were not in their final year in Shandong of China, with assessments conducted from March to September 2022. The bootnet package in R was used for establishing NA and LNA models, as well as for conducting accuracy analysis and node stability analysis.

RESULTS

The results of the NA indicated that adolescent highly susceptible to anxiety and depression. And uncontrollable worry was a common central symptom, while irritability emerged as a central bridging symptom across all three NAs. The LNA results revealed that suicidal ideation and worthlessness were key central symptoms in the LNA. Furthermore, worthlessness played a pivotal role in the developmental pathway of "suicidal ideation → worthlessness → anxiety and uncontrollable worry." A reduction in suicidal ideation was associated with decreased severity in other symptoms.

CONCLUSIONS

The findings suggest that adolescent anxiety and depression are in a state of vulnerability, and that irritability, worthlessness, and suicidal ideation are potential targets for interventions to address adolescent anxiety and depression.

The comorbidity mechanism of problematic internet use and depression among Chinese college students: A cross-lagged panel network analysis

Problematic internet use (PIU) and depression usually co-occur and are common among college students. According to network theory, it may be attributed to the interplay of symptoms that connect these two mental health problems. However, most studies have failed to examine complex and subtle connections at the symptom level and have not clarified how PIU and depression symptoms are intercorrelated, which symptoms serve as the source of comorbidity (i.e., the central symptoms), and whether such a comorbidity mechanism would change with higher grades. To explore these questions, this study examined four contemporaneous networks and three cross-lagged panel networks, visualizing the symptoms as nodes and the connections between symptoms as edges. A total of 2,420 college students (Mage = 18.35, SD = 0.84; 67.98 % girls) completed four annual surveys. Overall, the results of contemporaneous networks and cross-lagged panel networks indicated that (a) PIU and depression symptoms are intercorrelated; (b) the core symptoms responsible for comorbidity mostly belonged to PIU, and (c) the comorbidity mechanism would change with time. These findings explain the dynamic relation between PIU and depression and identify possible primary symptoms that comorbidity programs can mitigate at different stages of the college years.

Temporal Dynamics of Positive and Negative Affect in Adolescents: Associations with Depressive Disorders and Risk

Alterations in dynamic affective processes are associated with dysregulated affect and depression. Although depression is often associated with heightened inertia (i.e., greater moment-to-moment correlation) and variability (i.e., larger departures from typical levels) of affect in adults, less is known about whether altered affect dynamics are present in youth at risk for depression. This study investigated the association of clinical depression and depression risk with the inertia and variability of positive and negative affect in a sample of youth at varying risk for depression. Our sample included 147 adolescents aged 14 to 17, categorized into three groups: never-depressed lower-risk, never-depressed higher-risk (based on maternal history of depression), and currently depressed adolescents. Adolescents completed ecological momentary assessments of positive and negative affect up to seven times per day for a week. Multilevel models and ANOVAs were used to examine associations of affective inertia and variability with adolescent depression and risk based on maternal history, controlling for average affect. Depressed adolescents showed more inert and diminished positive affect, and more variable and elevated negative affect compared to lower- and higher-risk youth, though associations attenuated after controlling for average affect. No differences were identified between never-depressed higher-risk and lower-risk youth. Additional longitudinal studies are needed to evaluate whether altered affect dynamics in daily life precede depression onset to understand their utility for developing preventive interventions.

Cross-Lagged Panel Networks of Sleep Inertia Across Its Distinct Change Patterns Among Intern Nurses with Shift Work in China

Purpose

Although experimental psychopathology using PET, EEG, and fMRI is at the forefront of understanding the underlying mechanisms of sleep inertia, many questions concerning causality remain unanswerable due to ethical constraints and the use of small and heterogeneous samples in experimental methods. There is a pressing need for a novel perspective in a large and relatively homogeneous population to fully capture and elucidate longitudinal processes and dynamic causality that culminate in episodes of sleep inertia over time. Therefore, this study aimed to reveal the causal relationships between symptoms of sleep inertia across its distinct patterns.

Patients and Methods

A total of 1636 intern nurses participated in the first survey (94.1% validity rate), then 1277 intern nurses were followed up (82.9% tracing rate). Symptoms of sleep inertia were self-reported using the Sleep Inertia Questionnaire. The cross-lagged panel network models were used to examine unique longitudinal relationships between symptoms of sleep inertia across distinct trajectories.

Results

Four distinct trajectories of sleep inertia were established. Additionally, we found differences in those symptoms with the highest influence on other symptoms at the subsequent point across the networks of four trajectories, particularly, "Difficulty in concentrating" in the persistent-high group and "Feeling tense" in the deteriorating groups.

Conclusion

The current study highlights changes in sleep inertia based on the long-term course over time. Notably, symptoms of "Difficulty in concentrating" and "Feeling tense" are imperative to address these specific symptoms within subpopulations.

The association between online learning, perceived parental relationship, anxiety, and depression symptoms among secondary school students: insight from symptom network and cross-lagged panel network approach

INTRODUCTION

Anxiety and depression often co-occur in adolescents, with factors from family and school playing a significant role in the comorbidity. However, network analysis has not examined and clarified the detailed bridge and central symptoms of this comorbidity caused by online learning and perceived parental relationships across different COVID-19 times.

METHODS

Over four months, 2,356 secondary school students completed the Patient Health Questionnaire-9 and Generalized Anxiety Disorder Scale-7. Participants were divided into harmonious and disharmonious groups based on their answers to a question about parental conflicts.

RESULTS

The results indicated that adolescents perceiving more parental conflicts showed a denser comorbidity network after four months of online learning. Significant bridge symptoms decreased from three to two across two waves in the harmonious group, while in the disharmonious group, they increased from two to three. The number of central symptoms increased from one in wave 1 to three in wave 2 for the harmonious group, while four in wave 1 decreased to two in wave 2 for the disharmonious group. Furthermore, the CLPN analysis revealed that the strongest positive cross-lagged edge intensity between symptoms was anhedonia-energy in the harmonious group, with anhedonia being the most trigger symptom. In contrast, for the disharmonious group, guilt-suicide and trouble relaxing-excessive worry were the strongest cross-lagged edge, and trouble relaxing was the most trigger symptom.

CONCLUSION

These findings may have implications for interventions designed to promote adolescent mental health in the context of online learning and parental conflicts.

The Associations Between Parental Phubbing, Adolescent Phubbing, and Adolescents' Adjustments: A Cross-Lagged Panel Network Analysis

A growing body of research indicates that phubbing can negatively influence adolescent development, it is not clear how perceived parental phubbing, adolescent phubbing, and adolescents' adjustment problems concurrently relate to each other at the dimension level. This study conducted the contemporaneous network analyses and cross-lagged network analysis to examine the distinct relationships between the various dimensions of perceived father phubbing, perceived mother phubbing, adolescent phubbing and adolescent's adjustment problems. A total of 1447 Chinese students (60.5% females; Mean age = 16.15, SD = 0.65) completed a survey at two-time points. The results of the contemporaneous network analyses indicated that perceived father/mother ignorance have the strongest links with the dimensions of adolescent phubbing and adolescents' adjustment problems, suggesting that adolescents who reported high levels of perceived father/mother ignorance are more likely to concurrently face other issues and thus should be a primary focus of concern. The cross-lagged panel network analysis revealed that academic burnout is the primary catalyst in this dynamic network, which underscores a child-driven effect within the network. This emphasizes the importance of addressing adolescent academic burnout as a pivotal intervention point, both to alleviate phubbing in parent-adolescent interactions and to tackle adolescents' adjustment problems.

Contemporaneous and temporal network analysis of complex Posttraumatic stress disorder among Chinese college students with Childhood adversity: A longitudinal study

OBJECTIVE

To enhance understanding of the longitudinal progression of complex posttraumatic stress disorder (CPTSD) symptoms, this longitudinal study examined how CPTSD symptoms interact over time in Chinese college students with childhood trauma.

METHODS

From 18,933 college students who took part in two surveys 12 months apart, 4,006 participants who reported adverse childhood experiences were screened. Cross-sectional network comparisons and cross-lagged panel network (CLPN) analysis characterized interactions among CPTSD symptoms.

RESULTS

In the cross-sectional networks, feeling like a failure and avoid activities reminiscent of the trauma were the central symptoms. Takes long time to calm down and exaggerated startle are important bridge symptoms in the two networks respectively. The comparison of cross-sectional networks indicates that the global network strength was stable. The findings of the CLPN model reveal that feel worthless and feel like a failure had the highest "out" expected influence; exaggerated startle and avoid thoughts and feelings about the trauma had the highest "in" expected influence.

CONCLUSIONS

By conducting cross-sectional network analyses, the study illuminated the attributes of CPTSD networks across various time points. Additionally, the CLPN analysis uncovered the longitudinal patterns of CPTSD symptoms.

Executive Functioning, Internalizing and Externalizing Symptoms: Understanding Developmental Dynamics Through Panel Network Approaches

Objective

Early adolescence is a transition period during which many mental health disorders emerge. The interplay between different internalizing and externalizing mental health problems in adolescence is poorly understood at the within-person level. Executive functioning (EF) in early adolescence has been shown to constitute a transdiagnostic risk factor, but the specificity of the associations between different domains of EF and mental health problems remains unclear.

Method

Network dynamics (ie, temporal effects) of different internalizing and externalizing symptoms were investigated leveraging data from the Tracking Adolescents' Individual Lives Survey (TRAILS), a large longitudinal panel study of adolescents (>1,641 participants) assessed at ages 11, 13, and 15. Two novel methodological panel network approaches were used: cross-lagged panel network models and graphical vector autoregressive models. Hierarchical regression models were used to investigate prospective associations between different measures of EF and broadband transdiagnostic dimensions.

Results

Depressive problems predicted a range of other internalizing symptoms (ie, panic, somatic problems, separation anxiety, general anxiety, social phobia) over time, particularly during early adolescence. Important feedback loops with reciprocal associations between different anxiety symptoms were identified. Different facets of EF assessed at age 11, particularly sustained attention, showed weak but significant prospective associations with internalizing and externalizing symptoms at age 13.

Conclusion

The present findings emphasize the importance of targeting depressive problems in early adolescence to prevent a spiral of different internalizing symptoms from arising later on.

Physical and mental health in adolescence: novel insights from a transdiagnostic examination of FitBit data in the ABCD study

Adolescence is among the most vulnerable period for the emergence of serious mental illnesses. Addressing this vulnerability has generated interest in identifying markers of risk for symptoms and opportunities for early intervention. Physical fitness has been linked to psychopathology and may be a useful risk marker and target for early intervention. New wearable technology has made assessing fitness behavior more practical while avoiding recall and self-report bias. Still, questions remain regarding the clinical utility of physical fitness metrics for mental health, both transdiagnostically and along specific symptom dimensions. The current study includes 5007 adolescents (ages 10-13) who participated in the Adolescent Brain Cognitive Development (ABCD) study and additional sub-study that collected fitness data from wearable technology and clinical symptom measures. Physical fitness metrics included resting heart rate (RHR- an index of cardiovascular health), time spent sedentary (associated with increased inflammation and cardiovascular disease), and time spent in moderate physical activity (associated with increased neurogenesis, neuroplasticity, and healthy neurodevelopment). Self-report clinical symptoms included measures of psychosis-like experiences (PLE), internalizing symptoms, and externalizing symptoms. Increased RHR- lower cardiovascular fitness- related only to greater internalizing symptoms (t = 3.63). More sedentary behavior related to elevated PLE severity (t = 5.49). More moderate activity related to lower PLE (t = -2.69) and internalizing (t = -6.29) symptom severity. Wearable technology fitness metrics linked physical health to specific mental health dimensions, which emphasizes the utility of detailed digital health data as a marker for risk and the need for precision in targeting physical health behaviors to benefit symptoms of psychopathology.

The dynamics of psychological attributes and symptomatic comorbidity of depression in children and adolescents

PURPOSE

This investigation aimed to explore attribute dynamics and symptomatic comorbidity of depression with internalizing, externalizing, and other personal-contextual problems in children and adolescents from a network analysis.

METHODS

We tested an attribute network of regularized partial correlations, standard and alternative centrality measures, and comorbidity bridge symptoms according to centrality bridge measures.

RESULTS

Regularized partial correlation network and a centrality measures graph shown the prominent position of social problems and anxiety-depression. Minimum spanning tree (MST) found a hierarchical dynamics between attributes where mixed anxiety-depression was identified as the core and the other attributes were hierarchically connected to it by being positioned in six branches that are differentiated according to their theoretical contents. The most central connections are established with the attributes of their own community or theoretical groups, and 37 bridge symptoms were identified in all networks.

CONCLUSIONS

A significant role of mixed anxiety depression as an activator and intermediary of psychopathologies was supported as a central attribute of internalizing problems. Aggressive behavior as part of the broad externalizing dimension was one of the constructs that most intensively activate the network, and social problems were also distinguished as a relevant factor not only in terms of connections and central attributes but also in terms of bridge symptoms and comorbidity. This framework extends to the study of symptomatic "comorbidity."

Longitudinal Association Between Posttraumatic Stress Symptoms and Depression Symptoms Among Chinese Adolescents During COVID-19: Evidence from Network Perspective

Although there are an increasing number of studies that have explored the mental health consequences of COVID-19 focusing on revealing risk factors, the longitudinal research examining the potential mechanism of the co-occurrence of posttraumatic stress symptoms (PTSS) and depression symptoms among adolescents were scarce. The present study identified the important comorbidity symptoms and explored longitudinal relationship of PTSS and depression symptoms from the network perspective. A two-wave investigation (4 months interval; T1 and T2) was conducted with a sample of 1225 Chinese adolescents. Cross-sectional network and cross-lagged panel network (CLPN) analyses were adopted. Results showed that comorbidity symptoms consisted of both overlapping and non-overlapping symptoms, including "Future foreshortening" at T1 and T2 from PTSS, and "Hard to get started" at T1 and "Not sleep well" at T2 from depression symptoms. Strong longitudinal pathways appeared from all PTSS to depression symptoms, among which the pathway from "Difficulty concentrating" to "Hard to get started" was the strongest. These findings suggest that the possible comorbidity between PTSS and depression symptoms is caused by their independent and related structures, and their longitudinal association. Clinical intervention for these symptoms may alleviate adolescents' psychological problems in the aftermath of traumatic events.

Exploring the dynamics of perioperative symptom networks in colorectal cancer patients: a cross-lagged panel network analysis

BACKGROUND

Colorectal cancer incidence is on the rise, necessitating precise symptom management. However, causal relationships among symptoms have been challenging to establish due to reliance on cross-sectional data. Cross-lagged panel network (CLPN) analysis offers a solution, leveraging longitudinal data for insight.

OBJECTIVE

We employed CLPN analysis to construct symptom networks in colorectal cancer patients at three perioperative time points, aiming to identify predictive relationships and intervention opportunities.

METHODS

We evaluated the prevalence and severity of symptoms throughout the perioperative period, encompassing T1 the first day of admission, T2 2-3 days postoperatively, and T3 discharge, utilizing the M. D. Anderson Symptom Inventory Gastrointestinal Cancer Module (MDASI-GI). To identify crucial nodes in the network and explore predictive and interactive effects among symptoms, CLPNs were constructed from longitudinal data in R.

RESULTS

The analysis revealed a stable network, with disturbed sleep exhibiting the highest out-EI (outgoing expected influence) during T1. Distress had a sustained impact throughout the perioperative. Disturbed sleep at T1 predicted T2 bloating, fatigue, distress, and pain. T1 distress predicted T2 sadness severity. T2 distress primarily predicted T3 fatigue, disturbed sleep, changes in taste, and bloating. T2 shortness of breath predicted T3 changes in taste and loss of appetite. Furthermore, biochemical markers like RBC and ALB had notable influence on symptom clusters during T1→T2 and T2→T3, respectively.

CONCLUSION

Prioritizing disturbed sleep during T1 and addressing distress throughout the perioperative phase is recommended. Effective symptom management not only breaks the chain of symptom progression, enhancing healthcare impact, but also eases patient symptom burdens.

The Predictive Role of Tolerance and Health Problems in Problem Gambling: A Cross-Sectional and Cross-Lagged Network Analyses

The existing symptomatic networks of problem gambling are all based on cross-sectional data. Thus, there is a need to explore longitudinal symptom networks of problem gambling. Moreover, the replicability of cross-sectional symptom networks can be limited; therefore, further research should assess the convergence between cross-sectional networks of problem gambling symptoms. The present study aimed (i) to examine cross-sectional networks of problem gambling symptoms and evaluate their replicability and (ii) to examine a longitudinal cross-lagged network of problem gambling symptoms. The study included a representative sample of young adult gamblers (born between 1984 and 2000) from the first two waves of the Budapest Longitudinal Study (original sample: N = 2777; final sample: N = 335). The Problem Gambling Severity Index was used to assess symptoms of problem gambling. Cross-sectional symptom networks showed differences in the centrality of nodes. Correlations between the two cross-sectional networks were low in the presence vs. absence of edges, rank order of edge weights, and centrality estimates. However, network invariance tests indicated non-significant differences between them. The cross-lagged network revealed that the symptoms of tolerance and health problems could predict the subsequent presence of multiple problem gambling symptoms. Overall, limited evidence demonstrated the replicability of cross-sectional symptom networks of problem gambling. Future research needs to explore the utility of cross-sectional networks of problem gambling and assess more precisely causal relationships between problem gambling symptoms by distinguishing within- and between-subject effects.

Associations of screen use with physical activity and social capital amid the COVID-19 pandemic: A network analysis of youths in China

Inconsistent correlations of screen use with physical activity (PA) and social capital (SC) in youths have been observed in existing cross-sectional studies. This study aimed to elucidate associations among variables in screen use, PA, and SC domains during COVID-19, to improve the prediction and prevention of suboptimal health status in youths. An online survey based on the nationwide COVID-19 Impact on Lifestyle Change Survey (COINLICS) was conducted in China, and 10,082 youths reported their screen use, PA, and SC in the months immediately before, during, and after the COVID-19 lockdown. Cross-sectional and longitudinal network models were used to identify associations of variables in domains of screen use with PA and SC. Effect modifications of bridges and predictors in the associations were examined. The network models suggested that individual SC was a bridge that strongly connected other types of SC, and domains of screen use and PA before lockdown, while phone use became such a bridge during and after lockdown. More PC/TV use before lockdown predicted less household-related PA during lockdown (β = -0.142); more phone use during lockdown was a predictor for higher levels of household-related PA (β = 0.106), active transport (β = 0.096), and individual SC (β = 0.072) after lockdown. Phone use was negatively associated with PA through PC/TV use in the more phone use subgroup. Relationships among screen use, PA, and SC dynamically changed during COVID-19, and phone use that was identified as a bridge and a predictor may be the potential action point for health intervention in youths during lockdown.

Understanding the protective effect of social support on depression symptomatology from a longitudinal network perspective

BACKGROUND

Higher social support protects people from developing mental disorders. Limited evidence is available on the mechanism through which social support plays this protective role.

OBJECTIVE

To investigate the stress-buffering process of social support on depressive symptoms using a novel longitudinal dynamic symptom network approach.

METHODS

A total of 4242 adult participants who completed the first two waves (from May to October 2020) of the International Covid Mental Health Survey were included in the study. Cross-lagged panel network modelling was used to estimate a longitudinal network of self-reported social support, loneliness and depressive symptoms. Standardised regression coefficients from regularised cross-lagged regressions were estimated as edge weights of the network.

FINDINGS

The results support a unidirectional protective effect of social support on key depressive symptoms, partly mediated through loneliness: A higher number of close confidants and accessible practical help was associated with decreased anhedonia (weight=-0.033) and negative self-appraisal symptoms (weight=-0.038). Support from others was also negatively associated with loneliness, which in turn associated with decreased depressed mood (weight=0.086) and negative self-appraisal (weight=0.077). We identified a greater number of direct relationships from social support to depressive symptoms among men compared with women. Also, the edge weights from social support to depression were generally stronger in the men's network.

CONCLUSIONS

Reductions in negative self-appraisal might function as a bridge between social support and other depressive symptoms, and, thus, it may have amplified the protective effect of social support. Men appear to benefit more from social support than women.

CLINICAL IMPLICATIONS

Building community-based support networks to deliver practical support, and loneliness reduction components are critical for depression prevention interventions after stressful experiences.

The unique role of smartphone addiction and related factors among university students: a model based on cross-sectional and cross-lagged network analyses

Smartphone addiction is a global problem affecting university students. Previous studies have explored smartphone addiction and related factors using latent variables. In contrast, this study examines the role of smartphone addiction and related factors among university students using a cross-sectional and cross-lagged panel network analysis model at the level of manifest variables. A questionnaire method was used to investigate smartphone addiction and related factors twice with nearly six-month intervals among 1564 first-year university students (M = 19.14, SD = 0.66). The study found that procrastination behavior, academic burnout, self-control, fear of missing out, social anxiety, and self-esteem directly influenced smartphone addiction. Additionally, smartphone addiction predicted the level of self-control, academic burnout, social anxiety, and perceived social support among university students. Self-control exhibited the strongest predictive relationship with smartphone addiction. Overall, self-control, self-esteem, perceived social support, and academic burnout were identified as key factors influencing smartphone addiction among university students. Developing prevention and intervention programs that target these core influencing factors would be more cost-effective.

The development of depressive symptoms in older adults from a network perspective in the English Longitudinal Study of Ageing

An increased understanding of the interrelations between depressive symptoms among older populations could help improve interventions. However, studies often use sum scores to understand depression in older populations, neglecting important symptom dynamics that can be elucidated in evolving depressive symptom networks. We computed Cross-Lagged Panel Network Models (CLPN) of depression symptoms in 11,391 adults from the English Longitudinal Study of Ageing. Adults aged 50 and above (mean age 65) were followed over 16 years throughout this nine-wave representative population study. Using the eight-item Center for Epidemiological Studies Depression Scale, we computed eight CLPNs covering each consecutive wave. Across waves, networks were consistent with respect to the strength of lagged associations (edge weights) and the degree of interrelationships among symptoms (centrality indices). Everything was an effort and could not get going displayed the strongest reciprocal cross-lagged associations across waves. These two symptoms and loneliness were core symptoms as reflected in strong incoming and outgoing connections. Feeling depressed was strongly predicted by other symptoms only (incoming but not strong outgoing connections were observed) and thus was not related to new symptom onset. Restless sleep had outgoing connections only and thus was a precursor to other depression symptoms. Being happy and enjoying life were the least central symptoms. This research underscores the relevance of somatic symptoms in evolving depression networks among older populations. Findings suggest the central symptoms from the present study (everything was an effort, could not get going, loneliness) may be potential key intervention targets to mitigate depression in older adults.

The longitudinal relationship between bullying victimization and depressive symptoms for middle school students: A cross-lagged panel network analysis

BACKGROUND

Previous research about the relationship between bullying victimization and adolescent depressive symptoms was mostly based on latent variable modeling. This study, instead, applied item-level analysis to explore the cross-sectional relationship and longitudinal development between bullying victimization and adolescent depressive symptoms with network models.

METHODS

This study used Olweus Bully/Victim Questionnaire and Children's Depression Inventory to collect data. A total of 1911 middle school students (55.2 % female; Mage = 12.98 ± 0.60 at T1) completed measures on four occasions at 6-month intervals. Nine network analysis models were employed to better understand the relationship between variables.

RESULTS

(1) "Being threatened or intimidated" was the most influential bullying behavior within bullying victimization items; (2) "being excluded", "being spoken ill of" and "negative mood" were the bridge items between bullying victimization and adolescent depressive symptoms; (3) the most influential bullying victimization item on adolescent depressive symptoms was "being robbed or blackmailed" for short-term development and "being excluded" for long-term development. While the most affected depressive symptom by bullying victimization was "anhedonia" for short-term development and "negative mood" for long-term development.

LIMITATIONS

Self-report measure is adopted for all variables in the study, and there may be some deviation. Due to the questionnaires, the items of bullying behaviors and depressive symptoms included in the network analysis are limited.

CONCLUSIONS

From the item level, this study found more specific relationships between bullying victimization and adolescent depressive symptoms. These findings highlight depressed mood and anhedonia are depressive symptoms that should be more paid attention to in clinical intervention for bullying victims.

Comorbidity Patterns of Posttraumatic Stress Disorder and Depression Symptoms: Cross-Validation in Two Postearthquake Child and Adolescent Samples

Background

Children and adolescents who have been exposed to a major natural disaster are more likely to suffer from posttraumatic stress disorder (PTSD) and depression. However, only a few studies have examined comorbidity patterns at the symptom level. Furthermore, researchers should validate their findings using multiple samples to address the psychological reproducibility challenge.

Methods

The Child PTSD Symptom Scale (CPSS) and Center for Epidemiological Studies Depression Scale for Children (CES-DC) were administered to two postearthquake child and adolescent samples (Wenchuan earthquake, N = 1506; Ya'an earthquake, N = 720). Each sample was followed up twice. Comorbidity patterns were characterized by cross-lagged panel network analysis (CLPN), and communities were determined by bootstrap exploratory graphical analysis (bootEGA).

Results

Except for having difficulty remembering important aspects of the trauma, the remaining dysphoria symptoms could be considered bridge symptoms between PTSD and depression. Most often, intrusive and avoidant symptoms clustered together, whereas dysphoria symptoms tended to cluster with depressive symptoms. The relationship between PTSD and depression was reciprocal; within PTSD, intrusive symptoms often triggered avoidance symptoms. The correlation coefficient between the two networks was 0.70, and the correlation coefficient of node centrality was 0.55. Findings. The association between dysphoria symptoms and depression was strong, and intrusive symptoms constituted the core symptoms of PTSD. Depression and PTSD were causally related, explaining the high comorbidity rates. Two sample networks had similar global characteristics but different local characteristics. The conclusions can be generalized to some extent.