The Reciprocal Effects Among Cumulative Risk, Depression, and Psychache in Adolescents: A Developmental Cascade Model

Objectives: Early adolescence is a key period of ecological and physiological change, during which exposure to accumulating risks from various environmental systems can negatively impact mental health. This study aimed to investigate the potential longitudinal relationships among cumulative risk, depression, and psychache in adolescents. Methods: A three-wave longitudinal study spanning one year was conducted with 675 (47.5% girls; Mean age = 14.13, standard deviation [SD] = 0.45) middle school students. The Random Intercept Cross-Lagged Panel Model (RI-CLPM) was used to explore the dynamic reciprocal relationships among these variables. Results: At the within-individual level, cumulative risk, depression, and psychache showed relative stability over time (β ranges from 0.21 to 0.52, p < 0.01). Prior cumulative risk significantly and positively predicted later depression and psychache (β ranges from 0.21 to 0.52, p < 0.01). Prior depression significantly and positively predicted later cumulative risk and psychache (β ranges from 0.15 to 0.17, p < 0.01). Prior psychache significantly and positively predicted later depression (β ranges from 0.25 to 0.26, p < 0.001). Conclusion: A cascading effect of mutual influences existed among cumulative risk, depression, and psychache in early adolescents. These findings highlight the usefulness of screening for both cumulative risk and psychache to identify at-risk individuals. Additionally, including psychache assessment in early intervention strategies could enhance their effectiveness.