Exploring the role of repetitive negative thinking in the transdiagnostic context of depression and anxiety in children

Abstract Background The prevalence of depressive and anxiety symptoms in children is increasing, often presenting as co-occurring symptoms, yet screening for such co-occurrence remains inadequate. This study investigates repetitive negative thinking (RNT) as a transdiagnostic factor in the co-occurr...

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Main Authors: Kuiliang Li, Lei Ren, Xiao Li, Chang Liu, Xuejiao Tan, Ming Ji, Xi Luo
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Psychology
Subjects:
Online Access:https://doi.org/10.1186/s40359-025-03169-y
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author Kuiliang Li
Lei Ren
Xiao Li
Chang Liu
Xuejiao Tan
Ming Ji
Xi Luo
author_facet Kuiliang Li
Lei Ren
Xiao Li
Chang Liu
Xuejiao Tan
Ming Ji
Xi Luo
author_sort Kuiliang Li
collection DOAJ
description Abstract Background The prevalence of depressive and anxiety symptoms in children is increasing, often presenting as co-occurring symptoms, yet screening for such co-occurrence remains inadequate. This study investigates repetitive negative thinking (RNT) as a transdiagnostic factor in the co-occurrence of depression and anxiety symptoms in children, aiming to develop novel early screening strategies. Methods Two cross-sectional surveys collected demographic information and self-reported measures of depression, anxiety, and RNT from primary school students in China. Structural equation modeling and network analysis were used to examine relationships among variables. Additionally, four machine learning algorithms (random forest, support vector machine, decision tree, and extreme gradient boosting) were applied to predict the co-occurrence of depression and anxiety symptoms. Results RNT and its factors were significantly positively correlated with depressive and anxiety symptoms (r = 0.56–0.68, p < 0.001) and mediated 12.94% of their bidirectional relationship (95% CI, 10.60%-15.27%). Network analysis revealed that RNT’s core features exhibited the highest bridge betweenness and bridge expected influence, indicating a critical mediating role in the co-occurrence of symptoms. The random forest model showed optimal predictive performance (AUC = 0.90, recall = 0.95), supporting its applicability for early screening. Conclusion RNT, particularly its core features, may play an important transdiagnostic role in the co-occurrence of depression and anxiety symptoms in children. This study provides an effective method for early screening in resource-limited settings, particularly in educational settings. Future research should validate the utility of RNT-targeted interventions, such as mindfulness-based therapies.
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spelling doaj-art-99dc4bd0e0474b6a85498abf58ebf9cf2025-08-20T03:42:09ZengBMCBMC Psychology2050-72832025-08-0113111310.1186/s40359-025-03169-yExploring the role of repetitive negative thinking in the transdiagnostic context of depression and anxiety in childrenKuiliang Li0Lei Ren1Xiao Li2Chang Liu3Xuejiao Tan4Ming Ji5Xi Luo6School of Psychology, Shaanxi Normal UniversityMilitary Psychology Section, Logistics University of PAPXuanhan Experimental Primary School.Brain and Mental Health, QIMR Berghofer Medical Research InstituteDepartment of Medical English, College of Basic Medicine, Army Medical UniversitySchool of Psychology, Shaanxi Normal UniversityDepartment of Medical English, College of Basic Medicine, Army Medical UniversityAbstract Background The prevalence of depressive and anxiety symptoms in children is increasing, often presenting as co-occurring symptoms, yet screening for such co-occurrence remains inadequate. This study investigates repetitive negative thinking (RNT) as a transdiagnostic factor in the co-occurrence of depression and anxiety symptoms in children, aiming to develop novel early screening strategies. Methods Two cross-sectional surveys collected demographic information and self-reported measures of depression, anxiety, and RNT from primary school students in China. Structural equation modeling and network analysis were used to examine relationships among variables. Additionally, four machine learning algorithms (random forest, support vector machine, decision tree, and extreme gradient boosting) were applied to predict the co-occurrence of depression and anxiety symptoms. Results RNT and its factors were significantly positively correlated with depressive and anxiety symptoms (r = 0.56–0.68, p < 0.001) and mediated 12.94% of their bidirectional relationship (95% CI, 10.60%-15.27%). Network analysis revealed that RNT’s core features exhibited the highest bridge betweenness and bridge expected influence, indicating a critical mediating role in the co-occurrence of symptoms. The random forest model showed optimal predictive performance (AUC = 0.90, recall = 0.95), supporting its applicability for early screening. Conclusion RNT, particularly its core features, may play an important transdiagnostic role in the co-occurrence of depression and anxiety symptoms in children. This study provides an effective method for early screening in resource-limited settings, particularly in educational settings. Future research should validate the utility of RNT-targeted interventions, such as mindfulness-based therapies.https://doi.org/10.1186/s40359-025-03169-yRepetitive negative thinkingDepressionAnxietyTransdiagnosticNetwork analysisMachine learning
spellingShingle Kuiliang Li
Lei Ren
Xiao Li
Chang Liu
Xuejiao Tan
Ming Ji
Xi Luo
Exploring the role of repetitive negative thinking in the transdiagnostic context of depression and anxiety in children
BMC Psychology
Repetitive negative thinking
Depression
Anxiety
Transdiagnostic
Network analysis
Machine learning
title Exploring the role of repetitive negative thinking in the transdiagnostic context of depression and anxiety in children
title_full Exploring the role of repetitive negative thinking in the transdiagnostic context of depression and anxiety in children
title_fullStr Exploring the role of repetitive negative thinking in the transdiagnostic context of depression and anxiety in children
title_full_unstemmed Exploring the role of repetitive negative thinking in the transdiagnostic context of depression and anxiety in children
title_short Exploring the role of repetitive negative thinking in the transdiagnostic context of depression and anxiety in children
title_sort exploring the role of repetitive negative thinking in the transdiagnostic context of depression and anxiety in children
topic Repetitive negative thinking
Depression
Anxiety
Transdiagnostic
Network analysis
Machine learning
url https://doi.org/10.1186/s40359-025-03169-y
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