中国青少年抑郁的核心症状及性别、抑郁程度间的比较：基于网络分析方法

基于精神障碍网络理论，采用中文版流动调查中心抑郁量表对3634名青少年进行调查，使用网络分析方法考察了我国青少年抑郁的核心症状，比较不同性别和抑郁程度青少年的抑郁症状特征网络。结果发现：（1）我国青少年抑郁的核心症状为压抑情绪、失败感、悲伤和乏力；（2）不同性别青少年的抑郁症状网络结构、网络连接强度和核心症状不存在显著差异；（3）不同抑郁程度青少年的抑郁症状网络结构、网络连接强度、核心症状存在显著差异。

Core symptoms of depression in Chinese adolescents and comparison between different gender and levels of depression: A network analysis approach

Abstract: Recently, the network theory of mental disorder (NTMD) and the corresponding method of network analysis have been used in the field of depression to illustrate the structure of depression, the core symptoms of depression, and the network changes over time or under intervention conditions. Previous research has provided a host of evidence and specific suggestions for the treatment of depression. Yet, this theory and method have not been used and explored among Chinese people with depression, especially in Chinese adolescents.It has been argued that adolescents are the high-risk group of depression, however, not many studies focus on adolescents’ depression from the perspective of network theory until recently. Notably, existing studies have demonstrated cultural differences in the core symptoms of depression among adolescents. For example, loneliness has been identified as one of the core depressive symptoms in American adolescents, while it has not been found in Indian adolescents. Similarly, fear of failure has been found in Indian adolescents but not in American adolescents. Therefore，it is meaningful to explore the core symptoms of Chinese adolescents under Chinese culture, which may further facilitate better treatment of Chinese adolescents’ depression. Besides, a large amount of literature has reached the consistent conclusion that the female gets a higher depression score than the male, but recent research has found something different. It has point outed that the network global strength is invariant across genders despite network structure varying with genders. But that study has not considered core symptoms. Hence, we planned to explore gender differences in core symptoms, network structure, and global strength of depression among Chinese adolescents to provide more evidence about it.Additionally, among groups with different levels of depression, the mid-depression group namely, those with depression proneness might be ignored by some traditional researchers who only select high-risk depression or major depression adolescents to study and treat. Actually, the mid-depression group is more likely to step into a high-risk depression group, comparing with the non-depression group. Furthermore, according to NTMD, there are differences between the networks of these groups. To address these gaps, the current study examined core symptoms, network structure, and global strength in all three groups.Guided by NTMD, this study used data collected from Chinese adolescents from grade 7 to grade 12 (N=3634, Mage=14.4 years, 50.6% girls) to test the network structure, network global strength, and core symptoms of depression, by using network analysis method and network comparison. The CES-D scale was used to measure depressive symptoms of adolescents.The result showed that the core symptoms of Chinese adolescents were feeling of failure, depressed mood, sadness, and fatigue. And these core symptoms, network structure, and global strength were invariant across genders, but various in three groups. Specifically, the non-depression group’s core symptoms were depressed mood, lack of happiness, incapacity to enjoy life. Besides the three ones listed above, the mid-depression group’s core symptoms include feeling inferior to others. Moreover, the centrality of these core symptoms in the mid-depression group was overall higher than that of the non-depression group. The high-risk depression group’s core symptoms were also a bit different from the others, including a feeling of failure, sadness, incapacity to enjoy life. The network comparison test showed that in the network structure, the mid-depression group was different from the non-depression group but similar to the high-risk group and that in the global strength, the mid-depression group was higher than the non-depression group but lower than the high-risk group.Results in this study give some suggestions for intervention or treatment towards depression. First, as indicated in the study, core symptoms in Chinese adolescents possessed their own cultural meanings. Thus, intervention or treatment towards depression should not only focus on the core symptoms but also consider the cultural meanings behind symptoms. Second, treatment or intervention should concentrate on different core symptoms according to their depression levels, especially, the attention should be paid to the mid-depression group, because they may meet the condition (changed network structure, increased centrality of core symptoms and increased global strength) to develop high-risk depression.One highlight of this study is that it not only explores the core depressive symptoms of Chinese adolescents but also divides adolescents into different levels of depression groups, beyond existing practice that only selects the high-risk group. Furthermore, it throws light on adolescents with depression proneness and adolescents with high-risk depression from the perspective of network theory.