Network analysis of comorbid depression and anxiety and their associations with response style among adolescents with subthreshold depression

Anxiety and depression are common among adolescents in China, and evidence shows that subthreshold depression has a strong relationship with depression. This study uses network analysis to investigate comorbid anxiety and depression and their associations with response styles among Chinese adolescents with subthreshold depression. 371 Participants completed measures of assessing the anxious and depressvie symptoms, and the response styles. Bridge symptoms were calculated to identify, respectively, anxiety and depression networks' main symptoms. A flow network of response styles was used as we investigated specific relationships among anxiety, depression, and response style. Network analysis revealed physiological and affective symptoms, where affect may be positive or depressed, were central. The most noticeable bridge symptoms were physical and somatic. Depressed affect and physical symptoms were positively correlated with rumination, while harm avoidance had a weak positive correlation with distraction. Timely interventions targeting both sets of symptoms are needed for the alleviation and prevention of depressive symptoms and anxiety. Depressed affect and harm avoidance have links to rumination and distraction, which increases comprehension of how response styles are related to depression as well as anxiety.