Residential Collegefalse
Status已發表Published
Inter-relationships of depressive and anxiety symptoms with suicidality among adolescents: A network perspective
Hong Cai1,2; Ines H.I. Chow1,2; Si-Man Lei3; Grace K.I. Lok4; Zhaohui Su5; Teris Cheung6; Anastasia Peshkovskaya7,8; Yi-Lang Tang9,10; Todd Jackson11; Gabor S. Ungvari12,13; Ling Zhang14; Yu-Tao Xiang1,2
2023-03-01
Source PublicationJOURNAL OF AFFECTIVE DISORDERS
ISSN0165-0327
Volume324Pages:480-488
Abstract

Background: Persons with suicidality including suicidal ideation (SI), suicide plans (SP) and/or suicide attempts (SA) are at higher risk for future suicide than those without suicidality. To reduce the risk of future suicide, it is important to understand symptoms of emotional distress that have the strongest links with SI, SP and SA. This network analysis examined item-level relations of depressive and anxiety symptoms with suicidality among adolescents during the COVID-19 pandemic. Methods: Adolescents between 12 and 20 years of age were assessed with the Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7), and individual binary reponse (no/yes) items assessing SI, SP, and SA during the pandemic. The structure of depressive symptoms, anxiety symptoms and suicidality was characterized using “Expected Influence” and “Bridge Expected Influence” as centrality indices in the symptom network. Network stability was tested using a case-dropping bootstrap procedure. Node-specific predictive betweenness was computed to examine short paths of anhedonia, other depressive symptoms and anxiety symptoms with suicidality. A Network Comparison Test (NCT) was conducted to examine whether network characteristics differed based on gender. Results: Prevalence rates of depressive symptoms, anxiety symptoms, and suicidality were 44.60 % (95% confidence interval (CI) = 41.53–47.67 %), 31.12 % (95%CI = 28.26–33.98 %), and 16.95 % (95%CI = 14.63–19.26 %), respectively, in the study sample. The network analysis identified GAD3 (“Worry too much”) as the most central symptom, followed by GAD6 (“Irritability”) and PHQ6 (“Guilt”) in the sample. Additionally, PHQ6 (“Guilt”), GAD6 (“Irritability”), and PHQ2 (“Sad mood”) were bridge nodes linking depressive and anxiety symptoms with suicidality. A flow network indicated that the connection between S (“Suicidality”) and PHQ6 (“Guilt”) reflected the strongest connection, followed by connections of S (“Suicidality”) with GAD2 (“Uncontrollable worrying”), and S (“Suicidality”) with PHQ2 (“Sad mood”). Finally, PHQ2 (“Sad mood”) was the main bridge node linking anhedonia with other depressive and anxiety symptoms and suicidality in the sample. Conclusions: Findings highlight the potential importance of reducing specific depressive and anxiety symptoms as possible means of reducing suicidality among adolescents during the pandemic. Central symptoms and key bridge symptoms identified in this study should be targeted in suicide prevention for at-risk adolescents.

KeywordAdolescents Anxiety Depression Network Analysis Suicidality
MOST Discipline Catalogue10.1016/j.jad.2022.12.093
DOI10.1016/j.jad.2022.12.093
URLView the original
Indexed BySCIE ; SSCI
Language英語English
WOS Research AreaNeurosciences & Neurology ; Psychiatry
WOS SubjectClinical Neurology ; Psychiatry
WOS IDWOS:000923444500001
PublisherELSEVIER, RADARWEG 29, 1043 NX AMSTERDAM, NETHERLANDS
Scopus ID2-s2.0-85145830905
Fulltext Access
Citation statistics
Document TypeJournal article
CollectionDEPARTMENT OF PUBLIC HEALTH AND MEDICINAL ADMINISTRATION
Faculty of Education
Faculty of Health Sciences
Faculty of Social Sciences
DEPARTMENT OF PSYCHOLOGY
INSTITUTE OF COLLABORATIVE INNOVATION
Institute of Translational Medicine
Corresponding AuthorLing Zhang; Yu-Tao Xiang
Affiliation1.Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
2.Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
3.Faculty of Education, University of Macau, Macao SAR, China
4.Kiang Wu Nursing College of Macau, Macao SAR, China
5.School of Public Health, Southeast University, Nanjing, China
6.School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China
7.Neuroscience Center, Tomsk State University, Tomsk, Russia
8.Mental Health Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russia
9.Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
10.Atlanta Veterans Affairs Medical Center, Decatur, GA, USA
11.Department of Psychology, Faculty of Social Sciences, University of Macau, Macao, SAR, China
12.University of Notre Dame Australia, Fremantle, Australia
13.Division of Psychiatry, School of Medicine, University of Western Australia / Graylands Hospital, Perth, Australia
14.The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
First Author AffilicationFaculty of Health Sciences;  University of Macau
Corresponding Author AffilicationFaculty of Health Sciences;  University of Macau
Recommended Citation
GB/T 7714
Hong Cai,Ines H.I. Chow,Si-Man Lei,et al. Inter-relationships of depressive and anxiety symptoms with suicidality among adolescents: A network perspective[J]. JOURNAL OF AFFECTIVE DISORDERS, 2023, 324, 480-488.
APA Hong Cai., Ines H.I. Chow., Si-Man Lei., Grace K.I. Lok., Zhaohui Su., Teris Cheung., Anastasia Peshkovskaya., Yi-Lang Tang., Todd Jackson., Gabor S. Ungvari., Ling Zhang., & Yu-Tao Xiang (2023). Inter-relationships of depressive and anxiety symptoms with suicidality among adolescents: A network perspective. JOURNAL OF AFFECTIVE DISORDERS, 324, 480-488.
MLA Hong Cai,et al."Inter-relationships of depressive and anxiety symptoms with suicidality among adolescents: A network perspective".JOURNAL OF AFFECTIVE DISORDERS 324(2023):480-488.
Files in This Item:
There are no files associated with this item.
Related Services
Recommend this item
Bookmark
Usage statistics
Export to Endnote
Google Scholar
Similar articles in Google Scholar
[Hong Cai]'s Articles
[Ines H.I. Chow]'s Articles
[Si-Man Lei]'s Articles
Baidu academic
Similar articles in Baidu academic
[Hong Cai]'s Articles
[Ines H.I. Chow]'s Articles
[Si-Man Lei]'s Articles
Bing Scholar
Similar articles in Bing Scholar
[Hong Cai]'s Articles
[Ines H.I. Chow]'s Articles
[Si-Man Lei]'s Articles
Terms of Use
No data!
Social Bookmark/Share
All comments (0)
No comment.
 

Items in the repository are protected by copyright, with all rights reserved, unless otherwise indicated.