Divergent pathways to depression: a network analysis of adverse childhood experiences in migrant and non-migrant youth

Background: The interplay among Adverse Childhood Experiences (ACEs), rural-to-urban migration, and depression is a critical public health concern, particularly in rapidly urbanizing societies like China. While traditional variable-level studies confirm a general association, they often obscure the granular psychological pathways through which individual traumatic experiences manifest as specific depressive symptoms. Rural-to-urban migration represents a complex environmental transition that may fundamentally reshape these pathways due to unique stressors like social exclusion and identity fragmentation. This study employs a network analysis approach to compare the symptom-level architecture of ACEs and depressive symptoms in migrant and non-migrant university students, identifying key "bridging symptoms" to inform targeted interventions. Methods: = 10,509, age = 18.56 ± 1.52) groups based on their reported residential status during childhood. A symptom network analysis was performed. Results: 12% of children had experienced rural-to-urban migration during childhood, and 53% of adolescents reported exposure to ACEs. In the rural-to-urban group, sexual abuse emerged as the key bridging symptom linking ACEs to depressive symptoms, whereas in the non-rural-to-urban group, household substance abuse was the primary bridging symptom connecting ACEs and depressive symptoms. Moreover, the Network Comparison Test revealed significant differences between sexual abuse and household substance abuse across groups. In addition, sleep problems were identified as a notable depressive symptom within the rural-to-urban group. Conclusion: This study highlights distinct symptom-level pathways linking ACEs to depressive symptoms in rural-to-urban versus non-rural-to-urban adolescents, emphasizing the pivotal role of sexual abuse among migrants and household substance abuse among non-migrants. Public mental health initiatives targeting adolescents in transitional settings could specifically address the unique risk factors highlighted by these key bridging symptoms.