Depicting the associations between different forms of psychopathology in trauma-exposed adolescents


Psychiatric comorbidity in traumatized youth is prevalent, but such associations between two disorders may be confounded with other comorbid conditions. Few studies have examined the unique relationships among multiple disorders. Which disorders maximally explain the relationships between others and whether such disorders differ by sex remain largely unknown. Using a construct-level network approach, this study characterized the independent associations among nine prevalent emotional and behavioral disorders/problems evaluated by the PTSD Checklist for DSM-5, the Revised Children’s Anxiety and Depression Scale, and the Youth Self-Report in a sample of 1181 disaster-exposed adolescents (53.9% girls; a mean age of 14.3 \(\pm \) 0.8 years). The associations were strong among the seven internalizing problems and between the two externalizing ones, but weaker between these two spectra of psychopathology. Major depressive disorder (MDD) was most strongly connected with others, maximally accounting for the associations, especially those between the two spectra. Overall and individual association strength and the connecting role of MDD were generally equivalent across sex. These findings highlight the necessity of MDD in linking comorbid forms of psychopathology in traumatized youth, and suggest MDD as a potential intervention priority in this population.

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This study was funded by the External Cooperation Program of Chinese Academy of Sciences (153111KYSB20160036), the National Natural Science Foundation of China (31271099, 31471004), and the Key Project of Research Base of Humanities and Social Sciences of Ministry of Education (16JJD190006).

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Correspondence to Li Wang.

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This study has been approved by the Institutional Review Board of the Institute of Psychology, Chinese Academy of Sciences and has been performed in accordance with the 1964 Declaration of Helsinki and its later amendments.

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Cao, X., Wang, L., Cao, C. et al. Depicting the associations between different forms of psychopathology in trauma-exposed adolescents. Eur Child Adolesc Psychiatry 29, 827–837 (2020).

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  • Comorbidity
  • Trauma
  • Sex
  • Adolescence