Network analysis links adolescent depression with childhood, peer, and family risk environment factors

Interoception as a key node in the multidimensional psychological structural model of depression: a structural equation model analysis of integrating environmental, cognitive and behavioral-emotional factors

BACKGROUND

The psychological structural model of major depressive disorder (MDD) is complex and multifaceted, consisting of the environment factors (EF), cognitive function (CF), and behavioral-emotional manifestations (BEM). Currently, the diagnosis and treatment of MDD is difficult to improve the disease state as a whole through an intervention point. Constructing the psychological structural model of MDD and finding the critical node of the psychological structural model are meaningful for the diagnosis and treatment of MDD.

METHODS

308 MDD patients (MDDs) participated in this research. They completed assessments of 34 psychological factors, including EF, CF, BEM and interoception function (IF). Pearson correlation was used to investigate the relationship between IF and each factor in the depressive multidimensional psychological structural model (EF, CF and BEM) which was constructed by structural equation modeling (SEM). Critical nodes were identified by the goodness of fit of the model. The depressive multidimensional psychological structural model (EF, CF and BEM) was created through SEM. IF was added to the depressive multidimensional psychological structural model to further verify the pathways and effects of interoception in the network.

RESULTS

IF was significantly correlated with all psychological factors. In the depressive multidimensional psychological structural model, EF (βdirect = 0.163, p = 0.033) and BEM (βdirect = 0.230, p = 0.003) can directly influence MDD. When adding IF to the model, interoception predicted all the factors in the model. The poorer EF led to the lower IF (βdirect = - 0.346, p < 0.001). Interoception dysfunction increased the risk of the CF (βdirect = -0.525, p = 0.002) and BEM (βdirect = - 0.250, p = 0.031) of the patients. EF had the largest total effect on MDD (βdirect = 0.365, βindirect = 0.150, βtotal = 0.515), IF (βdirect = - 0.309, βindirect = - 0.126, βtotal = - 0.434) are second only to EF.

CONCLUSIONS

IF is a part of the psychological structural model of MDD that predicts EF, CF, and BEM. It could be a potential intervention point to improve the depressive state as a whole.

Network analysis of adverse childhood experiences and problematic internet use among Chinese adolescents

BACKGROUND

The association between adverse childhood experiences (ACEs) and problematic internet use (PIU) in adolescents has received increasing attention. However, item-level associations between ACEs and PIU remained underexplored. This study utilized network analysis to explore these complex interactions and enhance understanding of the linking pathways.

METHODS

From November to December 2021, 6685 Chinese adolescents aged 11-20 self-reported their internet use through the Young Diagnostic Questionnaire (YDQ). ACEs were assessed via the Childhood Trauma Questionnaire-Short Form and the Adverse Childhood Experiences-International Questionnaire. An ACE-PIU network was constructed based on the Ising model, with centrality and bridge centrality indices calculated. Network stability and accuracy were assessed using a case-dropping bootstrap procedure. The Network Comparison Test was applied to examine gender and age differences.

RESULTS

Among participants, 52.2 % were boys and the mean age was 14.5 years. Network analysis identified PIU2 ("need for increased online time"), PIU5 ("staying online longer than intended"), and PIU6 ("risking significant relationships/opportunities due to internet use") as central nodes in the ACE-PIU network model. Additionally, ACE6 ("household mental illness") and ACE2 ("emotional abuse") within the ACE cluster, along with PIU8 ("using the internet to escape problems") and PIU7 ("lying about internet use") within the PIU cluster, emerged as bridge nodes linking the ACE and PIU clusters. No significant differences in network structures or global strengths were observed across gender or age groups.

CONCLUSION

The identification of central and bridge nodes within the ACE-PIU network provides insights regarding the potential pathways linking ACEs to PIU among Chinese adolescents.

Parent-Adolescent Discrepancies in Perceiving Parental Psychological Control and Autonomy Support Predict Adolescents' Psychological Adjustment: Does Adolescent Gender Make a Difference?

Few studies simultaneously examined how parent-adolescent discrepancies in reporting psychological control and autonomy support predicted adolescents' adjustment and the moderation by adolescent gender remains unknown. This longitudinal study addressed these gaps using a Chinese sample of 310 adolescents (158 girls; Mage = 13.34, SD = 0.36) and their parents. Adolescents reported depression and resilience and dyads reported parenting. The latent difference scores analysis showed higher psychological control and lower autonomy support perceived by adolescents than parents and larger parent-boy discrepancies in psychological control. Psychological control discrepancies predicted higher adolescents' depression and autonomy support discrepancies predicted lower boys' depression. The results suggest that parent-adolescent discrepant perceptions of different parenting behaviors predict adolescents' adjustment via different processes, which vary for boys and girls.

Depressive symptoms, cognitive functions and daily activities: An extended network analysis in monozygotic and dizygotic twins

BACKGROUND

The network theory posits that depression emerges as the result of individual symptoms triggering each other. Risk factors for depression can impact these between-symptoms interactions through extended networks. The study aimed to model the extended network of depressive symptoms and known depression risk factors - objective cognitive function, intellectual, physical, and social daily activities, and then, compare the observed networks between monozygotic (MZ) and dizygotic (DZ) co-twins.

METHODS

Twin pairs, 722 MZ and 2200 DZ, aged 40-79, were selected from the Dansh Twin Registry for having complete measures of depressive symptoms (e.g., sadness), cognitive functions (e.g., verbal memory), physical (e.g., brisk walk), intellectual (e.g., reading newspapers) and social activities (e.g., phone calls). Gaussian graphical models were used to estimate and compare the networks first between co-twins and then, between MZ to DZ twin pairs separately.

RESULTS

Specific intellectual, physical and social activities were central in the extended networks of depressive symptoms and, with the exception of processing speed, more central than cognition. The extended networks' structure was more homogeneous between MZ co-twins relative to DZ co-twins. Cognitive nodes were more central in MZ than DZ co-twins.

LIMITATIONS

Cross-sectional design, participants were middle-aged or older, mostly affective (non-somatic) depressive symptoms.

CONCLUSIONS

In depression networks, core connecting elements were intellectual, physical and social activities. The interaction between cognition and daily activities seems critical for triggering depressive symptoms. Thus, clinical interventions aimed at preventing depression and associated cognitive deficits should focus on maintenance and/or engagement in stimulating daily activities.

Associations between trauma exposure and irritability within the family unit: a network approach

BACKGROUND

Pediatric irritability is a pervasive psychiatric symptom, yet its etiology remains elusive. While trauma exposure may contribute to the development of irritability, empirical research is limited. This study examined the prevalence of irritability among trauma-exposed children, identified factors that differentiate trauma-exposed children with and without irritability, and employed a network analysis to uncover associations between irritability and trauma exposure in the family unit.

METHODS

Sample included 676 children (56.3% male, mean age = 9.67 ± 3.7 years) and their parents referred by the Connecticut Department of Children and Families to Fathers for Change - a psychotherapy intervention designed to reduce intimate partner violence (IPV) and child maltreatment. Child's trauma exposure, post-traumatic stress disorder (PTSD) symptoms, and irritability were assessed pre-intervention using self- and caregiver-report. Parents self-reported their childhood and adulthood trauma exposures, PTSD symptoms, irritability, psychopathology, and IPV.

RESULTS

Across caregiver- and child-reports, 16%-17% of children exhibited irritability. Irritable children experienced greater trauma exposure, interpersonal violence, emotional abuse, and PTSD severity. They had caregivers, particularly mothers, with greater trauma histories, IPV, and psychopathology. Network analysis revealed 10 nodes directly correlated to child's irritability including child's PTSD severity, parental IPV (specifically psychological violence), and parental psychopathology.

CONCLUSIONS

Results provide initial empirical evidence that pediatric irritability is linked to trauma exposure, suggesting trauma histories be considered in the diagnosis and treatment of irritability. Interventions addressing caregiver trauma, IPV, and psychopathology may ameliorate pediatric irritability. Future studies could benefit from adopting network approaches with longitudinal or time series data to elucidate causality and points of intervention.

Age of onset of major depressive episode and association with lifetime psychiatric disorders, health-related quality of life and impact of gender: A cross sectional and retrospective cohort study

OBJECTIVE

To assess the long-term impact of the age of onset (AOO) of the first major depressive episode (MDE) according to 3 age groups and considering gender.

METHODS

Data were extracted from NESARC III, a representative U.S.

SAMPLE

We included 8053 participants with an MDE history in a cross-sectional and retrospective cohort study. We defined 3 AOO groups: childhood-onset (< 13 yo), adolescence-onset (13-18 yo), and adult-onset (> 18 yo). We compared sociodemographic characteristics, lifetime psychiatric disorders per DSM-5 criteria, and health-related quality of life (HRQOL) in each group and performed gender-stratified analyses.

RESULTS

Prevalence of childhood-onset MDE was 10.03 %, adolescence-onset was 14.12 %, and adult-onset was 75.85 %. Suicide attempts (AOR = 3.61; 95 % CI 2.90-4.50), anxiety disorders (AOR = 1.92; 95 % CI 1.62-2.27), and personality disorders (AOR = 3.08; 95 % CI 2.56-3.71) were more frequent in the childhood-onset than in the adult-onset one. Adolescence-onset group showed similar results. Physical Disability scale (p < 0.001) and Mental Disability scale (p < 0.001) were significantly lower in the childhood-onset group. Results were more nuanced in the adolescence-onset group. Women in childhood-onset and adolescence-onset groups had poorer outcomes than the adult-onset group. Differences were less pronounced in men.

LIMITATIONS

Recall and classification biases inherent to survey design.

CONCLUSION

Individuals, particularly women, who experienced their first MDE during childhood or adolescence exhibit higher lifetime psychiatric disorder prevalence and poorer HRQOL than those with adult-onset MDE. These findings highlight the importance of preventive measures, early diagnosis, and treatment of youth depression.

Pathway from childhood trauma to nonsuicidal self-injury in adolescents with major depressive disorder: the chain-mediated role of psychological resilience and depressive severity

This study aimed to explore the pathway from childhood trauma to nonsuicidal self-injury (NSSI) in adolescents with major depressive disorder (MDD) and to examine the chain-mediating role of psychological resilience and depressive symptoms in this pathway. A total of 391 adolescents with MDD were recruited in the present study. The Chinese version of the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Chinese version of the Symptoms Check List-90 (SCL-90), the Chinese version of the Conner-Davidson Resilience Scale (CD-RISC), and the Ottawa Self-Injury Inventory Chinese Revised Edition (OSIC) were used to evaluate childhood trauma, depressive symptoms, psychological resilience and NSSI, respectively. Our results showed that 60.87% of adolescents with MDD had NSSI in the past month. Childhood trauma frequency was negatively correlated with psychological resilience but positively correlated with depressive symptoms and NSSI severity in adolescents with MDD. The stepwise logistic regression analysis identified that age, childhood trauma and depressive symptoms could independently predict the occurrence of NSSI, and the three-step hierarchical regression showed that childhood trauma, psychological resilience and depressive symptoms were all significantly associated with NSSI frequency in adolescents with MDD. Furthermore, the chain-mediation analysis revealed that psychological resilience and depression serially mediated the relationship between childhood trauma and NSSI in adolescents with MDD. Interventions targeted at improving resilience and depression may mitigate the impact of childhood trauma severity on NSSI risk in adolescents with MDD.

The effects of childhood trauma on nonsuicidal self-injury and depressive severity among adolescents with major depressive disorder: The different mediating roles of positive and negative coping styles

OBJECTIVE

We aimed to examine whether positive and negative coping styles mediated the influences of childhood trauma on NSSI or depressive severity in adolescents with major depressive disorder (MDD).

METHODS

The Children's Depression Inventory (CDI), the Ottawa Self-Injury Inventory Chinese Revised Edition (OSIC), the short-form Childhood Trauma Questionnaire (CTQ-SF), and the Simplified Coping Style Questionnaire (SCSQ) were evaluated in 313 adolescents with MDD.

RESULTS

MDD adolescents with NSSI had higher CTQ-SF total score, emotional and sexual abuse subscale scores, but lower CDI total and subscale scores compared to the patients without NSSI. The multiple linear regression analysis revealed that emotional abuse (β = 0.075, 95 % CI: 0.042-0.107) and ineffectiveness (β = -0.084, 95 % CI: -0.160 ∼ -0.009) were significantly associated with the frequency of NSSI in adolescents with MDD, but emotional abuse (β = 0.884, 95 % CI: 0.570-1.197), sexual abuse (β = 0.825, 95 % CI: 0.527-1.124) and negative coping style (β = 0.370, 95 % CI: 0.036-0.704) were independently associated with the depressive severity in these adolescents. Furthermore, the mediation analysis demonstrated that positive coping style partially mediates the effect of childhood trauma on NSSI (Indirect effect = 0.002, 95 % bootCI: 0.001-0.004), while the negative coping style partially mediates the relationship between childhood trauma and depressive severity (Indirect effect = 0.024, 95 % bootCI: 0.005-0.051) in adolescents with MDD.

LIMITATIONS

A cross-sectional design, the retrospective self-reported data, the small sample size.

CONCLUSION

Our findings suggest that coping styles may serve as mediators on the path from childhood trauma to NSSI or depressive severity in MDD adolescents.

Self-concept mediates the relationships between childhood traumatic experiences and adolescent depression in both clinical and community samples

BACKGROUND

Childhood trauma is a pivotal risk factor for adolescent depression. While the association between childhood trauma and depression is well-established, the mediating role of self-concept has not been acknowledged. Specifically, limited attention has been paid to how childhood maltreatment impacts adolescent depression through physical and social self-concept, both in clinical and community samples. This study aims to investigate how distinct and cumulative childhood trauma affects adolescent depression, as well as the potential mediating role of self-concept in their relationships.

METHODS

We recruited 227 depressed adolescents (dataset 1, 45 males, age = 15.34 ± 1.96) and 574 community adolescents (dataset 2, 107 males, age = 16.79 ± 0.65). Each participant was assessed on five subtypes of childhood trauma severity, cumulative trauma index, physical and social self-concept, and depression. Mediation models were tested separately in the clinical and community samples.

RESULTS

Clinically depressed adolescents experienced a higher level of trauma severity, a greater number of trauma subtypes, and had lower levels of physical and social self-concept compared to community adolescents. Analyses on childhood trauma severity and cumulative trauma index jointly indicated that physical and social self-concept played mediation roles in the relationships between childhood trauma experiences and depression. Moreover, the mediating effects of self-concept were stronger in depressed adolescents when compared to community samples.

CONCLUSIONS

Our findings suggest that physical and social self-concept play mediating roles in the pathway linking childhood trauma and adolescent depression, particularly in clinically depressed individuals.

The Relationship of Rejection Sensitivity to Depressive Symptoms in Adolescence: The Indirect Effect of Perceived Social Acceptance by Peers

Rejection sensitivity (RS), the tendency to expect, perceive and overreact to rejection from others, has been linked to children's and adolescents' increased vulnerability to depressive symptoms, negatively affecting their perceptions of the quality of their relationship with their peers. The aim of this study is to examine (a) the indirect effect of perceived peer social acceptance in the relationship between RS and depressive symptoms in a sample of Greek adolescents, (b) the differential effect of the different components of rejection sensitivity (angry and anxious RS) on the model, and (c) possible gender differences. The sample of the study consists of 295 adolescents (139 boys, 156 girls, Mage = 14.20, SD = 1.60) residing in the greater Heraklion Prefecture area. Data collection was carried out using self-report questionnaires that measured demographic characteristics, self-perceptions about their peer relationships (self-perception profile for adolescents/SPPA), susceptibility to rejection (children's rejection sensitivity questionnaire/CRSQ), and depressive symptoms (children's depression inventory/CDI). Results showed that (a) RS was positively related to depressive symptoms and negatively related to adolescents' perceptions of their relationships, (b) relationship perceptions were negatively related to depressive symptoms, and gender differences were also found, (c) perceived social acceptance by peers was found to have an indirect effect in the relationship between RS and depressive symptoms, with girls showing a greater effect, and (d) differences were observed in the mediating model between the components of RS, with the mediating effect of perceptions being higher in the model with anxious RS, which appears to confirm previous theoretical postulations. The results of this study highlight the importance of adolescents' perceptions of their peer relationships in the occurrence of depressive symptoms during this developmental period, especially in youths with anxious rejection sensitivity.

Bifidobacterium: a probiotic for the prevention and treatment of depression

Depression is a common psychological disease, which has become one of the main factors affecting human health. It has a serious impact on individuals, families, and society. With the prevalence of COVID-19, the incidence of depression has further increased worldwide. It has been confirmed that probiotics play a role in preventing and treating depression. Especially, Bifidobacterium is the most widely used probiotic and has positive effects on the treatment of depression. The mechanisms underlying its antidepressant effects might include anti-inflammation and regulation of tryptophan metabolism, 5-hydroxytryptamine synthesis, and the hypothalamus-pituitary-adrenal axis. In this mini-review, the relationship between Bifidobacterium and depression was summarized. It is hoped that Bifidobacterium-related preparations would play a positive role in the prevention and treatment of depression in the future.