Longitudinal transitions of somatic-emotional distress in Chinese adolescents: A random-intercept latent transition analysis of the longitudinal protective effects of resilience.

Pediatric internalizing problems, suicidality, and functional gastrointestinal disorders (FGIDs) frequently co-occur, but their longitudinal dynamics and the protective role of resilience remain under-investigated. In this two-wave, 12-month prospective study included 9035 Chinese children and adolescents aged 10-17 years, we used self-report measures (the Rome IV Diagnostic Questionnaire for Functional Gastrointestinal Disorders, Patient Health Questionnaire-9, General Anxiety Disorder-7, Suicide Behaviors Questionnaire-Revised, and Resilience Scale for Children and Adolescents) to assess these factors. We applied latent profile analysis to identify discrete symptom profiles and random-intercept latent transition analysis (RI-LTA) to examine transition patterns. Three-step multinomial logistic regression was used to evaluate the predictive effects of baseline resilience on profile transitions. Four discrete profiles emerged: Somatic-Emotional Healthy (~60%), Mild (~20%), Moderate (~12%), and Severe Somatic-Emotional Distress (~6%). RI-LTA revealed substantial stability, particularly for the Healthy (81% retention) and Severe (56% retention) profiles. Higher baseline resilience significantly buffered against transitions to more severe profiles for initially healthy adolescents (odds ratios ranging from 0.50 to 0.77, all p < 0.001). Specific dimensions (emotion regulation, family support, and interpersonal assistance) reduced the risk of distress onset and extreme deterioration. However, baseline resilience did not predict spontaneous recovery from mild or severe distress (all p > 0.05). Somatic-emotional distress exhibits distinct severity profiles with strong persistence at extremes. Resilience buffers against symptom onset and escalation but shows limited efficacy in reversing established symptoms. Universal interventions prioritizing emotion regulation and social support networks are urgently needed to disrupt the trajectory of pediatric somatic-emotional distress.