Longitudinal Relationships Between Depressive Symptoms and Generalized Anxiety Symptoms in Adolescents: A Cross-Lagged Network Analysis

The comorbidity of depression and generalized anxiety have raised questions about the existing classification system. Based on the perspective of network analysis, the developmental relationship between psychological symptoms can be explored more clearly. The current study aimed to explore the longitudinal network association of depressive symptoms and generalized anxiety symptoms in non-clinical adolescents. The sample contained 1,947 Chinese adolescents (Mage = 13.93, SD = 1.71; 48.5% girls). Their depression (PHQ-9) and generalized anxiety (GAD-7) symptoms were assessed at baseline (T1) and 6-month follow-up (T2). Data was analyzed using a cross-lagged network analysis. Depressive symptoms and generalized anxiety symptoms were closely related and did not appear to be distinct categories in adolescence. More generalized anxiety symptoms predicted depressive symptoms rather than vice versa. After controlling for gender, and age, "Difficulty relaxing" presented the highest out-expected influence (out-EI) in the network, while "trouble concentrating", and "suicidal ideation" showed the lowest in expected influence (in-EI). Findings suggested that interventions for generalized anxiety symptoms may help reduce depressive symptoms among Chinese adolescents. Specifically, alleviating "difficulty relaxing" may improve overall mental health.