Unveiling the hidden connections: network analysis of depressive symptoms, internet addiction, and attachment in Chinese children and adolescents

Abstract Background Children and adolescents diagnosed with major depressive disorder (MDD) often grapple with significant non-suicidal self-injury (NSSI), linked to interpersonal challenges, insecure attachment, and internet addiction. This study explores these relationships in children and adolescents using network analysis, drawing data from seven hospitals in China. Results The study included 162 youths with depressive disorder and 102 healthy controls from seven hospitals. The MDD + NSSI group exhibited severe internet addiction, heightened depressive symptoms, and insecure attachment. Network analysis identified central symptoms (compulsive use) and key bridge symptoms (tolerance symptoms) in the networks related to depressive symptoms, internet addiction, and attachments. These findings suggest potential targets for intervention among children and adolescents at risk for or suffering from depression. Conclusions This study sheds light on the intricate relationship between NSSI, attachment issues, and internet addiction in Chinese adolescents with MDD. The network analysis pinpointed central and key bridge symptoms, offering valuable insights for targeted interventions in children and adolescents at risk for or experiencing depression and associated challenges.