Comparison of depressive and anxiety symptom networks in maltreated and non-maltreated adolescents

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.