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ORIGINAL RESEARCH article
Front. Psychiatry
Sec. Mood Disorders
Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1543651
A Network Analysis of Alexithymia, Empathy, and Suicidal Ideation in Chinese Adolescents with Major Depressive Disorders
Provisionally accepted
Yudong Shi 1,2*
Qing Zhang 1,2
Song Wang 1,2
Ling Zhang 1
Zhiwei Liu 3 Jiawei Wang 4
LUO XIANGFEN 5
Wen Xiangwang 6
Huanzhong Liu 1- 1 Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- 2 Anhui Psychiatric Center, Anhui Medical University, Hefei,Anhui Province, China
- 3 Department of Psychiatry, Fuyang Third People’s Hospital, Fuyang, Anhui Province, China
- 4 Bozhou People's Hospital, Bozhou, Anhui, China
- 5 Second Affiliated Hospital, Bengbu Medical University, Bengbu, Anhui Province, China
- 6 Department of Psychiatry, Ma’anshan Fourth people’s Hospital, Ma’anshan, China
Background: Suicidal ideation is prevalent in major depressive disorder (MDD) and is closely related to empathy and alexithymia. While traditional approaches (e.g., regression models) focus on linear associations, network analysis provides unique advantages by mapping dynamic symptom interactions and identifying pivotal nodes that may drive suicidal risk. This study investigates these relationships through a network lens to reveal actionable intervention targets.The study included 329 adolescents with MDD (ages 12-18). The Alexithymia Scale (TAS-20), Interpersonal Reactivity Index (IRI), and the Positive and Negative Suicide Ideation scale (PNSI) were used to assess alexithymia, empathy, and suicidal ideation levels, respectively.Network analysis was conducted to model the relationships between symptoms and calculate centrality and stability indices.Results: Network analysis revealed strong stability with Emotional Identification Difficulty (DIF) and Personal Distress (PD) identified as the most influential core symptoms, exhibiting the strongest bridging roles between emotional dysfunction and suicidal ideation. DIF showed particularly robust connections to both PD and suicidal ideation, while comparative subgroup analyses indicated no significant differences in network patterns between first-episode and recurrent MDD patients, suggesting consistent symptom dynamics across illness stages.: By revealing DIF and PD as central therapeutic targets, this study demonstrates how network analysis can uncover intervention opportunities missed by traditional approaches. Clinically, targeting these nodes through emotion recognition training and distress tolerance interventions may disrupt the pathway to suicidality in adolescents with MDD.
Keywords: Major Depressive Disorder, alexithymia, adolescents, Empathy, Network analysis, suicide ideation
Received: 11 Dec 2024; Accepted: 28 Mar 2025.
Copyright: © 2025 Shi, Zhang, Wang, Zhang, Liu, Wang, XIANGFEN, Xiangwang and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yudong Shi, Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
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