Longitudinal Dynamics of Anxiety and Depression in Adolescents With a History of Childhood Maltreatment: A Cross-Lagged Panel Network Analysis

Abstract

Adolescents with childhood maltreatment often develop co-occurring anxiety and depression, yet the temporal interplay of individual symptoms remains unclear. This study aimed to map how specific symptoms influence one another over time in this high-risk group. Nine hundred ninety-nine adolescents completed standardised anxiety and depression measures at baseline, 6 months, and 12 months. We applied cross-lagged panel network models to identify core (central) symptoms and connectors (bridge symptoms) across three waves. Across all three assessment waves, interpersonal problems and social anxiety emerged as the most consistent bridge symptoms linking anxiety and depression clusters. In the initial phase, somatic complaints and physical symptoms served as the dominant connectors, whereas in later waves somatic complaints remained key and social anxiety took on an increasingly central bridging role. Centrality analyses further identified social anxiety, physical symptoms, and harm avoidance as the primary drivers of network cohesion, exerting the strongest overall influence on symptom dynamics. These findings highlight the evolving interplay between anxiety and depressive symptoms in adolescents with childhood maltreatment histories. Targeting these central and bridge symptoms-particularly social anxiety and interpersonal difficulties-early may disrupt maladaptive symptom cascades. Our findings inform the design of symptom-specific prevention and treatment strategies for adolescents exposed to childhood maltreatment.