Monthly dynamic associations between cost-of-living pressure and depressive and anxiety symptoms: a longitudinal...

Cost-of-living pressure is an important social determinant of public mental health, but its short-term associations with specific depressive and anxiety symptoms remain unclear.

We analyzed 12 monthly waves from the Changing Cost of Living Study. A pooled lag-1 cross-lagged panel network was estimated to examine group-level temporal predictive associations among five economic-pressure indicators, eight PHQ-8 depressive symptoms, and seven GAD-7 anxiety symptoms. The analysis included 4,085 complete lag-1 observations from 471 participants, adjusting for country, age, gender, subjective socioeconomic status, and wave. Robustness checks used a conservative lambda.1se network, deletion sensitivity analyses for overlapping symptom items, and bootstrap stability assessment.

Economic-pressure nodes showed high autoregressive stability, particularly housing risk, employment risk, food insecurity, poverty/deprivation risk, and difficulty managing finances. Within-symptom paths were stronger than cross-domain paths. Stable bidirectional associations emerged between anhedonia and depressed mood, uncontrollable worry and excessive worry, and psychomotor problems and restlessness. Some economic pressure-to-symptom paths were detected in the lambda.min model, but these small paths were not retained in the more conservative lambda.1se model.

At the group level, monthly temporal predictive patterns under cost-of-living pressure were characterized mainly by persistence within economic pressures and reciprocal associations within depressive and anxiety symptoms. Cross-domain economic pressure-symptom associations were weak and should not be interpreted as causal effects or as evidence of a uniform individual-level process.