Developmental trajectories of depressive symptoms in left-behind children: A longitudinal cohort study of the early adolescents.

This longitudinal study aimed to identify developmental trajectories of depressive symptoms among left-behind children during early adolescence (ages 9-14) in China and to examine baseline predictors differentiating stable-low from escalating symptom pathways. Data were drawn from the Psychological Health Guard for Children and Adolescents Project of China, including 72,887 left-behind children from Nanchong, Sichuan, a region characterized by high labor out-migration, whose parents had migrated and left them behind. They were assessed three times over 18 months using the Center for Epidemiological Studies-Depression Scale. Latent class growth analysis identified six distinct trajectories. Results indicated that while the majority (70.4%) maintained consistently low symptom levels (low-stable class), a critical subgroup (2.2%) exhibited a sharp increase from low initial levels (low-escalating class). Logistic regression comparing these two classes revealed that at baseline (T1), being female (vs. male, OR = 0.51), lower family satisfaction (e.g., very dissatisfied vs. very satisfied, OR = 2.74), shorter weekday and weekend sleep duration (e.g., 7-10 hr protective vs. <5 hr, ORs ≈ 0.41-0.57), lack of regular physical exercise (any frequency protective vs. never, ORs ≈ 0.61-0.67), and higher smartphone use (notably weekend >4 hr vs. never, OR = 1.98) significantly predicted higher odds of membership in the low-escalating class. Findings highlight substantial resilience within this population but also identify key individual, familial, and behavioral risk factors associated with symptom escalation, informing targeted interventions for this vulnerable group. (PsycInfo Database Record (c) 2025 APA, all rights reserved).