Symptomatic Pathways of Comorbid Depression, Anxiety, and Stress Among Adolescents Exposed to Childhood Trauma-Insights from the Network Approach

Childhood trauma can have a long-lasting influence on individuals and contribute to mental disorders, including depression and anxiety. Depression, anxiety, and stress are highly comorbid among adolescents with the trauma experience. Yet, the evolution of comorbidity remains unclear. To fill this gap, the current study aimed to explore the symptomatic and changing patterns of depression, anxiety, and stress among adolescents exposed to childhood trauma.

A total of 1548 college students (females = 782 (50.98%), Mean_age = 19.59, SD_age = 1.14) in China completed the Childhood Trauma Questionnaire (CTQ) and the Depression, Anxiety, and Stress Scales (DASS-21), and 942 students (Females = 516 (54.78%), Mean_age = 19.57, SD_age = 1.16) met the selection standard based on the cut-off scores of the CTQ. The symptomatic network and directed acyclic graph (DAG) network approaches were used.

The results revealed that males reported experiencing significantly more physical abuse, physical neglect, emotional neglect, and sexual abuse compared to females. However, females scored significantly higher than males on "Worried" (DASS9), "Agitated" (DASS11), "Panic" (DASS15), and "Scared" (DASS20). No significant difference between genders was observed in the network structure and global strength. Meanwhile, among all participants, "Down-hearted" and "Agitated" appeared to be the most interconnected symptoms, the bridge symptoms in the symptom network, as well as the most vital symptoms in the directed acyclic graph network. Apart from that, "Panic" also served as the most prominent symptom in the directed acyclic graph network.

The results suggested that intervention targeted at assisting adolescents in developing more adaptive coping strategies with stress and regulating emotion could benefit the alleviation of comorbid depression, anxiety, and stress.