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.