The reciprocal relationship between depression, social anxiety and aggression in Chinese adolescents: The moderating effects of family functioning

Background: Depression, social anxiety, and aggression often co-occur in adolescents. Several theoretical models have been proposed to explain the temporal relationships of these symptoms, with relevant empirical evidence mixed. The role of environmental factors should be taken into consideration.Objectives: To examine the temporal relationship between depression, social anxiety, and aggression in adoles-cents, and to extend previous work by exploring the moderating effects of family functioning.Method: A total of 1947 Chinese adolescents completed the survey questionnaires at two time points: family functioning at baseline, and depression, social anxiety, and aggression at baseline and 6-month follow-up. Data was analyzed using a cross-lagged model.Results: Bidirectional positive association was found between depression and aggression. However, although social anxiety predicted subsequent depression and aggression, the opposite relationship was not found. More-over, favorable family functioning alleviated depression and moderated the prediction of social anxiety to depression.Conclusions: Findings suggested that clinicians should pay attention to the underlying depressive symptoms of adolescents with aggressive behaviors, and to the level of aggression of adolescents with depression. In-terventions on social anxiety may prevent the transformation of social anxiety to depression and aggression. Adaptive family functioning may act as a protective factor for the comorbid depression in adolescents with social anxiety, which can be targeted by relevant interventions.