Association of stressful life events with depressive symptoms among adolescents: A network analysis.

Background: Stressful life events (SLEs) have been identified as predictors of adolescent depressive symptoms. However, the item-level association is underexplored. Using network analysis, this study aimed to examine the complex associations between various types of SLEs and adolescent depressive symptoms, and to explore gender and age differences in these associations.

Method: This cross-sectional study used data from 6514 middle school students aged 11-20 in Guangzhou, China. Adolescents self-reported SLEs and depressive symptoms with the Adolescent Self-rating Life Events Checklist and the 9-item Patient Health Questionnaire (PHQ-9). A Gaussian graphical model was used to construct the network of SLEs and depressive symptoms. Central and bridge nodes were identified, and network stability was evaluated. Differences by gender and age groups were examined using Network Comparison Test.

Results: Among participants, the mean age was 14.5 (SD: 1.6) years and 52.0 % were boys. The overall network was highly stable and identified being scolded by parents (SLE14), heavy academic burden (SLE2), and fatigue/loss of energy (PHQ5) as central nodes. Unwilling to attend school (SLE23), guilt/worthlessness (PHQ6), marked changes in daily life (SLE22), and failure in examinations (SLE1) emerged as key bridge nodes linking SLEs and depressive symptoms. The network structures and global strengths were comparable between boys and girls and across early, middle, and late adolescence.

Conclusions: The identification of central and bridge nodes in the network of SLEs and depressive symptoms highlights the importance of addressing specific stressors to mitigate adolescent depressive symptoms. Future longitudinal studies are needed to confirm the temporal dynamics.