Does depression affect the association between prosocial behavior and anxiety? A cross-sectional study of students in China

Xiyan Zhang, Tao Lv, Gerard Leavey, Na Zhu, Xin Li, Yan Li, Yanhua Chen

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Abstract

Background: A growing number of studies have suggested that adolescents’
prosocial behavior can protect against depression and anxiety. It is known that
anxiety and depression are often comorbid. However, it remains unclear if when
depression is present, prosocial behavior remains protective against anxiety,
and if when anxiety is present, prosocial behavior remains protective against
depression. The purpose of this study was to determine the association of anxiety
and depressive with prosocial behavior.

Methods: A large representative sample of middle-school students was recruited
for a cross-sectional study and completed standardized instruments (the Children’s Depression Inventory (CDI), Screen for Child Anxiety Related Emotional Disorders–Child version (SCARED-C), and Strengths and Difficulties Questionnaire (SDQ)).  We used structural equation modeling (SEM) to examine the protective effect of prosocial behavior against anxiety when depression was present.

Results: A survey of 3,510 students was conducted, and the final analysis included 3,169 students, comprising 1,616 boys (51.0%) and 1,553 girls (49.0%), with a mean age of 13.09  years (SD  =  1.31, range 11–16).The prevalence rates of anxiety and depression in early adolescents were 31.6 and 16.7%, respectively. More than two-thirds of depressed adolescents had comorbid anxiety, while more
than one-third of anxious adolescents had comorbid depression. Regression
models showed that compared with depressed adolescents, adolescents without
depressive symptoms exhibited a significant negative correlation between
prosocial behaviors and anxiety and depression (β  = −0.01, p  > 0.01, β  = −0.06,
p  > 0.01; β  = −0.11, p  < 0.01, and β  = −0.17, p  < 0.01). There was no difference in the relationship between prosocial behavior and depression between anxious and non-anxious adolescents (p  > 0.05).

Conclusion: Anxiety and depression are common in adolescence and are often
comorbid disorders. However, the comorbidity is not symmetrical. Specifically,
the protective effect of prosocial behavior against anxiety is weaker in depressed
adolescents. Findings are discussed in light of related research and theory, and
insights for intervention programs and future research are presented.
Original languageEnglish
Article number1274253
Pages (from-to)1-9
Number of pages9
JournalFrontiers in public health
Volume11
Early online date10 Oct 2023
DOIs
Publication statusPublished (in print/issue) - 2023

Bibliographical note

Funding Information:
The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by Excellent Youth Medical Talents Training Program of Pudong Health Bureau of Shanghai (PWRq2021-09), Science and Technology Development Fund Of Shanghai Pudong New Area (PKJ2017-Y67) and the Medical Discipline Construction Project of Pudong Health Committee of Shanghai Medical Discipline Construction Project of Pudong Health (PWYgy2021-02).

Publisher Copyright:
Copyright © 2023 Zhang, Lv, Leavey, Zhu, Li, Li and Chen.

Copyright © 2023 Zhang, Lv, Leavey, Zhu, Li, Li and Chen.

Keywords

  • prosocial behavior
  • anxiety
  • depression
  • adolescent
  • emotion
  • Anxiety/epidemiology
  • Cross-Sectional Studies
  • Humans
  • Male
  • Altruism
  • Depression/epidemiology
  • Students
  • Adolescent
  • Female

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