Dynamic interactions between depressive and somatic symptoms following a positive psychology intervention: Evidence from a cross-lagged panel network analysis.
Abstract
Aims
To investigate the dynamic relationships between depressive and somatic symptoms among perinatal women and to explore the potential influence of a positive psychology intervention on symptom network evolution using a cross-lagged panel network (CLPN) approach.
Methods
This exploratory secondary analysis used data from a community-based randomized controlled trial. A total of 687 women received a positive psychology intervention and 735 received usual care, with assessments at baseline (T1), 1 month postpartum (T2), and 3 months postpartum (T3). Depressive-related and somatic symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS) and Somatic Symptom Scale-8 (SSS-8), respectively. CLPN models were estimated separately by group.
Results
Depression-related symptoms, including anhedonia, reduced enjoyment, self-blame, difficulty coping, sadness, and crying, remained prevalent, while anxiety and panic were also frequently observed as anxiety-related manifestations within the EPDS. Fatigue or low energy was the most frequent somatic symptom. Network patterns differed between groups across T1-T2 and T2-T3. In the control group, anxiety, panic, and difficulty coping showed cross-lagged associations with dizziness during T1-T2, while anxiety and panic and panic and sadness showed bidirectional associations during T2-T3. The intervention group showed fewer network connections and cross-domain associations, with anxiety linked to gastrointestinal discomfort, back pain, headache, and dizziness during T1-T2, and back pain occupying a prominent predictive and bridging position during T2-T3.
Conclusions
Depression-related and somatic symptoms showed distinct temporal network patterns across the perinatal period. These exploratory findings provide a basis for further validation of symptom network patterns and their relevance to perinatal psychological interventions.