Sex-specific temporal symptom networks in gaming disorder - depression comorbidity: longitudinal validation of the...

Although gaming disorder (GD) and depression commonly co-occur, no prior study has examined their symptom-level temporal dynamics through a theoretical lens. This longitudinal study employed cross-lagged panel network analysis (CLPN) to examine 3,203 Chinese college students (73.90% male, 26.10% female) across two time points (6-month interval) to validate the sex-specific temporal mechanisms of the I-PACE (Interaction of Person-Affect-Cognition-Execution) model. Bidirectional predictive relationships emerged between GD and depression symptoms, with depression showing stronger predictive stability (89.71% vs 77.27% positive connections). Key bridge symptoms included Psychomotor Agitation (Bridge EI1 = 0.690), Time concealment (BridgeEI1 = 0.499) and Game Anxiety (BridgeEI1 = 0.448). Sex-specific network comparisons revealed largely divergent network structures and non-overlapping centrality profiles (edge correlation: r = 0.15, 49% of edges differing in directionality). In males, psychomotor agitation (Bridge EI = 0.826) and time concealment (Bridge EI = 0.595) emerged as descriptively prominent bridge nodes, whereas in females, social withdrawal served as the primary bridge node (Bridge EI = 0.356). The findings provide empirical validation for sex-specific modifications to the I-PACE model, suggesting sex-specific tailored intervention approaches targeting bridge symptoms may enhance therapeutic efficacy for GD-depression comorbidity.