Li Xinger, Feng Xiuqiong, Li Lu, Luo Shengyu, Hu Wanting, Xu Dan, Li Jinghua, Chen Weiqing, Guo Vivian Yawei
Department of Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Second Road, Guangzhou, Guangdong, China.
Department of Public Health, Guangzhou Huangpu District Center for Disease Control and Prevention, Guangzhou, Guangdong, China.
J Affect Disord. 2025 Dec 1;390:119786. doi: 10.1016/j.jad.2025.119786. Epub 2025 Jul 1.
Maltreatment is a well-established risk factor for both depressive and anxiety symptoms. However, the symptom-level associations between these mental health issues in adolescents with and without a history of maltreatment remain underexplored. This study employed network analysis to compare depressive and anxiety symptom networks across these two groups.
This cross-sectional study involved 6618 Chinese adolescents. The Childhood Trauma Questionnaire-Short Form was used to assess maltreatment, while the 9-item Patient Health Questionnaire and the 7-item Generalized Anxiety Disorder scale were used to measure depressive and anxiety symptoms, respectively. Network analyses were conducted separately for adolescents with and without maltreatment, and compared using network comparison tests.
Of the adolescents included (mean age [standard deviation]: 14.5 [1.6] years; 52.2 % boys), 63.8 % reported experiencing maltreatment. Maltreated adolescents had more severe depressive and anxiety symptoms than their non-maltreated peers. Network analysis identified "Uncontrollable worry", "Excessive worry", and "Trouble relaxing" as central symptoms in both groups. "Irritability" emerged as the key bridge symptom in the maltreatment group, whereas it was "Nervousness" in non-maltreatment group. The maltreatment group exhibited stronger network connections and significantly different network structure compared to the non-maltreatment group. "Suicidal ideation" had higher expected influence and three stronger edges in the maltreatment group.
Both overlapping and distinct central and bridge symptoms were identified across the two groups, with "Suicidal ideation" requiring particular attention in the maltreatment group. These findings highlight the importance of interventions that address shared symptom patterns across adolescents, while incorporating tailored components for those with maltreatment experiences.
虐待是抑郁和焦虑症状公认的风险因素。然而，有或没有虐待史的青少年中，这些心理健康问题之间在症状层面的关联仍未得到充分探索。本研究采用网络分析来比较这两组青少年的抑郁和焦虑症状网络。
这项横断面研究纳入了6618名中国青少年。使用儿童创伤问卷简表评估虐待情况，同时分别使用9项患者健康问卷和7项广泛性焦虑障碍量表来测量抑郁和焦虑症状。对有和没有虐待经历的青少年分别进行网络分析，并使用网络比较测试进行比较。
纳入的青少年（平均年龄[标准差]：14.5[1.6]岁；52.2%为男孩）中，63.8%报告曾遭受虐待。受虐待的青少年比未受虐待的同龄人有更严重的抑郁和焦虑症状。网络分析确定“无法控制的担忧”、“过度担忧”和“难以放松”是两组的核心症状。“易怒”在受虐待组中成为关键的桥梁症状，而在未受虐待组中是“紧张”。与未受虐待组相比，受虐待组表现出更强的网络连接和显著不同的网络结构。“自杀意念”在受虐待组中有更高的预期影响和三条更强的边。
两组都发现了重叠和不同的核心及桥梁症状，“自杀意念”在受虐待组中需要特别关注。这些发现凸显了针对青少年共同症状模式进行干预的重要性，同时为有虐待经历的青少年纳入量身定制的部分。
