The dynamics of psychological attributes and symptomatic comorbidity of depression in children and adolescents

• Published in: Social Psychiatry and Psychiatric Epidemiology Vol. 59; no. 2; pp. 341 - 351
• Main Authors: Sánchez Hernández, Milagros Ocalin, Holgado-Tello, Francisco Pablo, Carrasco, Miguel Á.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-02-2024; Springer Nature B.V
• Subjects: Adolescent; Aggression - psychology; Anxiety; Anxiety - epidemiology; Anxiety - psychology; Child; Children; Comorbidity; Depression - diagnosis; Depression - epidemiology; Depression - psychology; Epidemiology; Graph theory; Humans; Medicine; Medicine & Public Health; Mental depression; Network analysis; Position measurement; Psychiatry; Psychopathology; Psychopathologies; Children; Adolescents; Comorbidity; Network analysis
• ISSN: 0933-7954; 1433-9285
• DOI: 10.1007/s00127-023-02532-x

Purpose
This investigation aimed to explore attribute dynamics and symptomatic comorbidity of depression with internalizing, externalizing, and other personal–contextual problems in children and adolescents from a network analysis.
Methods
We tested an attribute network of regularized partial correlations, standard and alternative centrality measures, and comorbidity bridge symptoms according to centrality bridge measures.
Results
Regularized partial correlation network and a centrality measures graph shown the prominent position of social problems and anxiety–depression. Minimum spanning tree (MST) found a hierarchical dynamics between attributes where mixed anxiety–depression was identified as the core and the other attributes were hierarchically connected to it by being positioned in six branches that are differentiated according to their theoretical contents. The most central connections are established with the attributes of their own community or theoretical groups, and 37 bridge symptoms were identified in all networks.
Conclusions
A significant role of mixed anxiety depression as an activator and intermediary of psychopathologies was supported as a central attribute of internalizing problems. Aggressive behavior as part of the broad externalizing dimension was one of the constructs that most intensively activate the network, and social problems were also distinguished as a relevant factor not only in terms of connections and central attributes but also in terms of bridge symptoms and comorbidity. This framework extends to the study of symptomatic “comorbidity.”