Cultural variation in temporal associations among somatic complaints, anxiety, and depressive symptoms in adolescence

Different domains of internalizing symptoms (somatic, anxiety, depressive) often occur concurrently, suggesting that they may share common etiology. In longitudinal analyses of internalizing among youth, anxiety is often found to precede depression. However, relatively few studies have also assessed...

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Bibliographic Details
Published in:Journal of psychosomatic research 2019-09, Vol.124, p.109763-109763, Article 109763
Main Authors: Kim, Jacqueline H.J., Tsai, William, Kodish, Tamar, Trung, Lam T., Lau, Anna S., Weiss, Bahr
Format: Article
Language:English
Subjects:
Adolescent
Adolescents
Anxiety
Anxiety - complications
Anxiety - psychology
Asian
Asian Americans
Complaints
Cultural differences
Culture
Depression - complications
Depression - psychology
Depressive
Developmental stages
Etiology
Female
Humans
Intercultural sensitivity
Internalization
Internalizing
Internalizing disorders
Male
Medically Unexplained Symptoms
Mental depression
Path analysis
Psychological distress
Self Report
Somatic
Somatic symptoms
Teenagers
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Summary:Different domains of internalizing symptoms (somatic, anxiety, depressive) often occur concurrently, suggesting that they may share common etiology. In longitudinal analyses of internalizing among youth, anxiety is often found to precede depression. However, relatively few studies have also assessed how somatic problems, the third symptom domain, are involved in longitudinal patterns of internalizing. In addition, temporal relations among internalizing symptom domains may vary by cultural group as somatic symptoms are posited to be a more culturally-normative way of communicating or experiencing distress in non-Western, interdependent cultures. Thus, the present study examined longitudinal relations among these three internalizing symptom domains in three ethnocultural adolescent samples. 304 European American, 420 Vietnamese American, and 717 Vietnamese adolescents' self-reported internalizing symptoms (somatic, anxiety, depressive) were assessed at three time points, spaced three months apart, using multigroup cross-lagged path analysis. Anxiety symptoms consistently predicted increases in depressive symptoms in European American adolescents. In contrast, for Vietnamese and Vietnamese American adolescents, the most consistent relation was with somatic complaints predicting increases in anxiety. Anxiety and depressive symptoms bidirectionally predicted each other among the Vietnamese and Vietnamese American adolescents. Cultural group differences were evident in the temporal course of internalizing symptoms. The pattern of results have implications for culturally relevant intervention targets, during a developmental period of risk for internalizing disorders. •Earlier anxiety symptoms precede increased depressive symptoms across cultural groups•Somatic complaints precede increased anxiety and depressive symptoms among Vietnamese and Vietnamese American adolescents•Variations in symptom associations may relate to differing cultural norms for affect regulation or emotion expression•Early identification of somatic symptoms may aid prevention efforts with youth from interdependent cultures
ISSN:0022-3999
1879-1360
DOI:10.1016/j.jpsychores.2019.109763