Longitudinal Cross-Lagged Associations Between Depression, Anxiety, and Somatic Symptoms in Adolescents With Bullying Victimization: Multi-Level Evidence From Variable and Symptom Analyses

Bullying victimization is associated with depressive, anxiety, and somatic symptoms in adolescence, but most longitudinal studies have examined these symptoms at the domain level and in general adolescent samples. Little is known about how these symptoms unfold over time among bullying-victimized adolescents, or which specific symptoms drive cross-domain propagation. This study examined longitudinal associations among depressive, anxiety, and somatic symptoms from domain- and symptom-level perspectives, with a non-victimized comparison group. This three-wave longitudinal study included 1,108 adolescents who completed annual assessments, including 549 bullying-victimized and 559 non-victimized adolescents. Cross-lagged panel models examined domain-level associations, and cross-lagged panel network analyses identified symptom-level pathways and central symptoms. At the domain level, bullying-victimized adolescents showed an early depression-related pathway: from T1 to T2, depressive symptoms predicted later anxiety and somatic symptoms. From T2 to T3, anxiety symptoms became more prominent predictors of later depressive and somatic symptoms, and somatic symptoms also predicted later depressive symptoms. In contrast, the non-victimized group showed a different pattern, with early somatic symptoms predicting later emotional symptoms and later anxiety symptoms predicting subsequent depressive and somatic symptoms. At the symptom level, bullying-victimized adolescents initially showed motivational deficits, loneliness, and reduced self-confidence as key driving symptoms, whereas confusion, unhappiness, and reduced self-confidence became more prominent drivers later. Bullying-victimized adolescents showed a distinct temporal organization of depressive, anxiety, and somatic symptoms, shifting from an early depression-related pattern to later anxiety-related dysregulation with emerging somatic involvement.