Simulating symptom-specific interventions linking depression and anxiety among civil aviation college students: a network analysis differentiated by perceived parental relationships

Depression and anxiety frequently co-occur among civil aviation college students, and parental relationships have been shown to play an important role in the development of this comorbidity. However, the symptom-level mechanisms underlying depression–anxiety comorbidity remain unclear among them. Examining this comorbidity from a network perspective, while accounting for perceived parental relationships, may help predict key bridge symptoms and simulate interventions for these bridge symptoms. A total of 1,033 participants completed the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 scale that assessed depressive and anxiety symptoms. Then, based on their self-reported perceptions of parental relationships, 503 students were classified into a group with a harmonious parental relationship and 530 into a group with a disharmonious parental relationship. Symptom network analysis, Bayesian-based directed acyclic graph analysis, and the symptom-specific intervention simulation analysis were conducted. Findings indicated that although there was no significant difference in the overall network structure, the symptom associations differed markedly between the two groups. In the harmonious group, “guilt”, “motor disturbances”, “uncontrollable worrying”, and “feeling afraid” linked the depression–anxiety comorbidity (p < .05), whereas in the disharmonious group, the depression-anxiety comorbidity was associated with “motor disturbances” and “irritability” (p < .05). In addition, “fatigue” may be the most effective alleviating intervention target for both groups. Besides, “depressed or sad mood” and “motor disturbances” could be considered separately for preventive care when dealing with those with harmonious and disharmonious parental relationships, respectively. The findings suggest potential implications for parental relationship-specific strategies to alleviate the linkage between depression and anxiety symptoms among civil aviation college students.