A two-year study of 971 Chinese teens found that lower social trust in 2020 was associated with more depressive symptoms in 2022. More arguments with parents, greater academic pressure and lower satisfaction with teachers were also linked to higher symptom scores.
The findings describe statistical associations, not proof that low trust or stressful relationships cause depression. The researchers also cautioned that their prediction model is not ready for clinical screening.
Social trust was the strongest of 13 measured factors
The study followed adolescents aged 10 to 15 using data from the China Family Panel Studies. Social trust included confidence in family members, neighbors, strangers, local officials and doctors.
Among the 13 factors examined, social trust ranked first on the main measure of predictive importance. In a regression model, each one-point increase in social trust was associated with a 0.060-point lower score on the 2022 symptom measure.
The other four highest-ranked factors were popularity with peers, arguments with parents, satisfaction with teachers and age. Peer popularity ranked second on the main importance measure but tenth on a second measure. It was not significantly associated with symptoms in the regression model.
Family, school and academic pressure also mattered
Academic pressure showed one of the clearest links with later symptoms. Each step up on the study’s five-point stress scale was associated with 0.36 more points on the CES-D8 symptom score.
Each additional argument with parents during the previous month was associated with 0.09 more points. By contrast, each point higher in teacher satisfaction was associated with 0.13 fewer points.
Girls scored 0.8 points higher than boys, while each additional year of age was associated with about 0.18 more points. Talking with parents more often and liking school were not significantly linked to symptoms after the other factors were included.
None of the four internet-related measures—online shopping, gaming, short-video viewing or online classes—was significant in the regression model. These behaviors were recorded as yes-or-no items, however, rather than by the amount of time spent online.
What the findings cannot show
The study used the eight-item CES-D8, which ranges from 0 to 24. The researchers treated a score of 9 or higher as indicating elevated depression risk; this is not the same as a clinical diagnosis.
The study did not adjust for depressive symptoms at the start of the study. As a result, it cannot establish whether low trust, family conflict or other factors came before symptoms or partly followed them.
Only 971 of the 3,360 adolescents in the 2020 starting pool had complete data from both waves. The sample may therefore not represent Chinese teens as a whole. Family income, psychiatric history and genetics were not measured, and several factors were assessed with single questions.
All 13 factors together explained about 6% of the variation in 2022 symptom scores. A prediction chart based on age, sex, parent arguments, academic pressure, teacher satisfaction and social trust had only modest ability to distinguish teens with and without elevated symptoms. It was tested in the same dataset rather than in a separate group, and the researchers said it should not currently be used for clinical screening or resource decisions.
Why supportive relationships remain relevant
The results fit with broader evidence that school and family relationships can be connected with adolescent mental health, while still leaving the direction of those relationships uncertain. An earlier analysis of 1,772 teens followed from 2016 to 2020 found a correlation between family conflict and depressive symptoms. A 2025 meta-analysis of 27 long-term studies involving 57,074 adolescents found that school connectedness predicted fewer later depressive symptoms, while depressive symptoms also predicted weaker school connection later.
For families and schools, the practical message is not to label a teen based on a single survey result. It is to pay attention to sustained changes in mood, interest, sleep or social behavior, and to make it easier for young people to discuss pressure and conflict without blame.
Low mood, loss of interest, poor sleep or withdrawal lasting two weeks or more is worth raising with a pediatrician, school counselor or mental-health professional.
AI tools were used to assist with the preparation of this article.
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