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The complexity of associations between borderline personality features, depression symptoms, anxiety symptoms, and suicidal behavior in adolescents: a study based on network analysis
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DOI：10.1186/s12888-026-08498-9.png)
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Abstract
En 中文
Suicidal behavior is a major public mental health concern during adolescence and is closely linked to borderline personality features and internalizing symptoms. Symptom network analysis may help clarify the complex interrelations among borderline personality features, depressive and anxiety symptoms, and suicide-related behaviors by identifying central and bridge nodes. This cross-sectional survey was conducted between September and October 2023 in three secondary schools in Nanning, Guangxi, China. Students aged 12–18 years completed the Borderline Personality Features Scale for Children, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Suicidal Behaviors Questionnaire-Revised. A sparse Gaussian graphical model was estimated using Spearman correlations with EBICglasso; centrality and bridge centrality were computed. Network accuracy was evaluated via bootstrapping, and sex-stratified network differences were tested using NetworkComparisonTest. A total of 5,572 adolescents were included (age 12–18, 53.9% male). The integrated network of suicidal behaviors, depressive and anxiety symptoms, and borderline personality features was highly interconnected: of the 276 possible edges, 177 (64.0%) were retained as non-zero in the regularized network. The most central symptoms were irritability, uncontrollable worry, excessive worry, and sad mood. The key bridge nodes were suicidal ideation and past-year suicidal ideation frequency. Network stability was excellent. Adolescent suicidal behaviors, BPF, depressive and anxiety symptoms form a densely connected symptom system. Irritability and worry-related symptoms appear as central hubs, while suicidal ideation and past-year suicidal ideation frequency emerge as key bridge nodes. These findings highlight potential candidate targets for early identification and precision-oriented prevention, while causal inferences require longitudinal validation.
Keywords:
Network analysis
Suicidal behavior
Borderline personality features
Depression
Anxiety
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