Background: Early adolescents (ages 11–15), mainly Chinese middle-school students, face academic tracking pressure for the high-school entrance exam and multiple stressors, with depressive symptoms detected in up to 21.9% of this group. Because this stage is a “critical window” for depression intervention and the Ministry of Education requires “stratified and classified interventions”, systematically identifying the patterns and dynamic transition patterns of adolescent depressive symptoms is of considerable practical and theoretical importance. This study aimed to identify the latent profiles and transitions of depressive symptoms among middle-school students and to examine how different types of stress, life satisfaction, and gender predict these transitions. Methods: Using cluster sampling, we recruited 434 middle-school students from Shandong Province, China. The Center for Epidemiological Studies Depression Scale (CES-D), the Middle School Student Stressors Scale, and the Satisfaction with Life Scale (SWLS) were used to assess depressive symptoms, seven types of stress, and life satisfaction, respectively. Two follow-up surveys were conducted one year apart. Latent Profile Analysis (LPA) and Random-Intercept Latent Transition Analysis (RI-LTA) identified the latent depressive-symptom profiles and their transitions, and multinomial logistic regression tested the predictive effects of the stressors, life satisfaction, and gender on these transitions. Results: We identified three depressive-symptom profiles among middle-school students: “no depressive symptoms” (n = 317 at T1; 327 at T2), “low depressive symptoms” (n = 95 at T1; 87 at T2), and “moderate depressive symptoms” (n = 23 at both time points). RI-LTA revealed four transition patterns: “asymptomatic stability” (n = 241), “symptom stability” (n = 32), “symptom remission” (n = 82), and “symptom emergence and development” (n = 79); “asymptomatic stability” was the most common and stable. Multiple stressors increased the odds of both “symptom emergence and development” (OR = 1.90–2.57; p < 0.01, p < 0.001) and “symptom stability” (OR = 1.56–1.66; p < 0.05, p < 0.01). Life satisfaction predicted transitions in opposite directions: it lowered the risk of “symptom emergence and development” (OR = 0.70; p < 0.05) but raised the likelihood of remaining in “symptom stability” (OR = 1.62; p < 0.05). Girls were more likely than boys to move into “symptom emergence and development” (OR = 4.24; p < 0.001). Conclusion: Three depressive-symptom profiles and four transition trajectories were delineated in Chinese middle school students. Stress, life satisfaction, and gender each predict distinct trajectory movement, offering preliminary empirical guidance for tiered and targeted interventions.
Wei et al. (Thu,) studied this question.