A network analysis of early adversity and depressive symptoms in children and adolescents

Using network analysis, we sought to investigate how diverse forms of early adversity (eg, emotional abuse, physical abuse, general trauma) were associated with depressive symptom clusters in children and adolescents in a psychiatric sample. A total of 464 psychiatry outpatients ages 7 to 19 years (14.2 ± 2.3 years, 278 girls) who met the diagnostic criteria for any mood, anxiety, or other psychiatric disorders (eg, ADHD, ODD, conduct disorder) were included. Depressive symptoms and experiences of early adversity were measured with the Children’s Depression Rating Scale-Revised (CDRS-R) and Early Trauma Inventory (ETI), respectively. A gaussian graphical model (GGM) with regularization techniques and a spin glass community-detection algorithm were used to investigate the specific relationship between early adversity and depressive symptoms. Centrality indices (ie, strength, betweenness, and closeness centrality) were also calculated to identify the core symptoms within the early adversity-depression network. GGM revealed that each type of early adversity showed distinct patterns of connections with 3 clusters of depressive symptoms: depressive mood, somatic symptoms, and functional impairment. Only emotional abuse showed direct associations with all symptom clusters and had the strongest partial correlation with “depressed feelings” (r = 0.1) in the depressive mood–related symptom cluster. Physical abuse showed specific connections primarily linked to functional impairments and somatic symptoms, especially with “irritability” (r = 0.08) in the somatic symptom cluster. General trauma was linked to depressive mood and somatic symptoms, particularly displaying association with “suicidal ideation” (r = 0.06) in the depressive mood–related symptom cluster. In addition, “depressed feelings” was identified as the most central symptom that was highly connected with other symptoms within the network (centrality coefficients = 1.00). These findings indicate that patterns of depressive symptoms in childhood and adolescence may differ depending on the types of early adversity, highlighting the importance of considering different intervention targets for different types of adversity.