Adolescent anxiety and depression: perspectives of network analysis and longitudinal network analysis

Background Anxiety and depression often co-occur, exhibiting high comorbidity, with their trends evolving over time. However, the specific pathways through which comorbid symptoms of anxiety and depression evolve and interact remain unclear. To investigate these questions, this study employed Network Analysis (NA) and Longitudinal Network Analysis (LNA) to explore the central symptoms of anxiety and depression, as well as the temporal evolution of these central symptoms. Methods The study focused on 606 high school students who were not in their final year in Shandong of China, with assessments conducted from March to September 2022. The bootnet package in R was used for establishing NA and LNA models, as well as for conducting accuracy analysis and node stability analysis. Results The results of the NA indicated that adolescent highly susceptible to anxiety and depression. And uncontrollable worry was a common central symptom, while irritability emerged as a central bridging symptom across all three NAs. The LNA results revealed that suicidal ideation and worthlessness were key central symptoms in the LNA. Furthermore, worthlessness played a pivotal role in the developmental pathway of "suicidal ideation -> worthlessness -> anxiety and uncontrollable worry." A reduction in suicidal ideation was associated with decreased severity in other symptoms. Conclusions The findings suggest that adolescent anxiety and depression are in a state of vulnerability, and that irritability, worthlessness, and suicidal ideation are potential targets for interventions to address adolescent anxiety and depression.