The transdiagnostic network of childhood trauma, anxiety, and depression in college students: centrality of emotional neglect and the bridging function of emotional abuse.

BACKGROUND

College students are highly susceptible to anxiety and depression, for which childhood trauma (CT) is a major risk factor. However, the fine-grained pathways linking specific CT subtypes to these disorders remain unclear, limiting targeted intervention. This study aimed to use network analysis to investigate the associations between CT subtypes and symptoms of anxiety, depression, and their comorbidities among college students.

METHODS

A cross-sectional online survey was conducted among 2,864 students from nine Chinese universities. Participants completed the Childhood Trauma Questionnaire-Short Form (CTQ-SF), Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9). Three regularized partial correlation networks (CT-anxiety, CT-depression, and CT-comorbidity) were constructed using the R package. Expected influence (EI) and bridge expected influence (BEI) indices were used to identify central and bridge nodes. Network stability was assessed via case-dropping bootstrapping.

RESULTS

Emotional neglect consistently emerged as the most central node across all three networks. In the CT-anxiety network, emotional abuse and "afraid something will happen" were key bridging nodes. In the CT-depression network, emotional abuse and "thoughts of death" possessed the greatest degree of bridge centrality. Critically, in the CT-comorbidity network, this same pairing again exhibited the strongest bridge centrality, demonstrating its stable role as a transdiagnostic bridge linking CT to both anxiety and depression, even within comorbid presentations.

CONCLUSIONS

Emotional neglect, emotional abuse, and the key symptoms "afraid something will happen" and "thoughts of death" emerge as the central and bridge nodes linking CT to anxiety, depression, and their comorbidity. These nodes represent precise targets for early intervention to reduce the mental health burden among college students.

TRIAL REGISTRATION: Not applicable.