Which symptoms of depression and anxiety are most strongly associated with happiness? A network analysis of Indian and Kenyan adolescents

Abstract Background : Network analyses have been applied to understand the relationships between individual symptoms of depression and anxiety. However, little is known about which symptoms are most strongly associated with “positive” indicators of mental health, such as happiness. Furthermore, few studies have examined symptom networks in participants from low- and middle-income countries. Methods : To address these gaps, we applied network analyses in a sample of Indian adolescents (Study 1; n=1,080) and replicated these analyses in a pre-registered study with Kenyan adolescents (Study 2; n=2,176). Participants from both samples completed the same measures of depressive symptoms, anxiety symptoms, and happiness. Results : Feeling sad and feeling like a failure had the strongest (negative) associations with happiness items. These two symptoms, as well as worrying and feeling nervous, had the strongest associations with other symptoms of depression and anxiety. Symptoms of depression and anxiety formed a single cluster, which was distinct from a cluster of happiness items. Main findings were consistent across the two samples, suggesting a cross-culturally robust pattern. Limitations : We used cross-sectional data, and we administered scales assessing a limited subset of symptoms and happiness items. Conclusions : Our findings support the idea that some symptoms of depression and anxiety are more strongly associated with happiness. These findings contribute to a body of literature emphasizing the advantages of symptom-level analyses. We discuss how efforts to understand associations between individual symptoms and “positive” mental health indicators, like happiness, could have theoretical and practical implications for clinical psychological science.