Transdiagnostic symptom networks in adolescent psychopathology: A longitudinal panel network analysis

Understanding symptom patterns of emerging psychopathology is essential for early detection and intervention. Network analysis offers a promising approach by conceptualizing emerging psychopathology as dynamic interactions between symptoms over time. This study aims to explore the structure of a transdiagnostic symptom network in adolescents.

A one-year prospective study was conducted with a general population sample of 1186 Swiss adolescents with no current or past mental disorders (data collection: February 2021-March 2024; age 11-17 years (M = 14.19, SD = 1.90); 56.5% female). Participants completed online self-report questionnaires on 29 symptoms across seven mental disorders at five time points. Panel Graphical Vector Autoregression (Panel GVAR) models were used to estimate contemporaneous and temporal symptom networks. Centrality measures, including node expected influence (EI), bridge expected influence (BEI), bridge betweenness (BB), in-strength, and out-strength, were computed to characterize the network.

In the contemporaneous network, anxiety, depressive, and eating disorder symptoms, particularly excessive worry (EI = 1.08), body dissatisfaction (EI = 1.03), and low self-esteem (EI = 1.01), exhibited the highest EI. Irritability (BEI = 0.80/BB = 0.58) and low self-esteem (BEI = 0.57/BB = 0.50) acted as important bridge symptoms within the network. In the temporal network, uncontrollable worry (β = 0.71) predicted anxiety and depressive symptoms. Body dissatisfaction (β = 1.09) and weight concerns (β = 1.04) predicted symptoms across various disorder domains, including anxiety, depressive, psychotic, bipolar, and obsessive-compulsive symptoms. Depressive symptoms were primarily influenced by other symptoms.

Worry, body dissatisfaction and weight concerns play a pivotal role in emerging psychopathology by linking multiple disorder domains and shaping symptom dynamics over time. These findings may enhance early detection by identifying high-risk adolescents and may inform prevention strategies, such as interventions targeting excessive worry and negative body image, to reduce symptom escalation and improve long-term mental health outcomes.