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. 2025 Jun 16;20(6):e0326239.
doi: 10.1371/journal.pone.0326239. eCollection 2025.

Propensity to childhood anxiety and depression due to exposure to adversity: A multidimensional construct

Angélica C G Santos  1 , Ariane Silva  2 , Matheus Libório  1 , Cristiane Neri Nobre  2 , Hasheem Mannan  3 , Marcos Flávio S V D'Angelo  1
Affiliations

Propensity to childhood anxiety and depression due to exposure to adversity: A multidimensional construct

Angélica C G Santos et al. PLoS One. .

Abstract

Children and adolescents are increasingly susceptible to issues related to anxiety and depression symptoms. The literature does not present a consensus on the composition of indicators that make predictions, prognostic algorithms, or management strategies in mental health promotion and prevention. Most studies primarily focus on the consequences observed in adulthood. This study develops a multidimensional representation of the propensity of children and adolescents to have difficulties in the field of anxiety and depression. The Ordered Weighted Averaging (OWA) operator was used to create a composite indicator, and three quality tests validated the results. For this, it uses information about different dimensions associated with adversity in childhood and adolescence from 54 countries sourced from UNICEF's Multiple Indicator Cluster Surveys to compare the values of proposed dimensions across continents. The generated composite indicator reveals that, on average, countries in Africa show a higher propensity for children and adolescents to present difficulties in the anxiety and depression fields. In the opposite position, the Americas have the lowest average propensity for these mental health conditions. The validation of the results through quality tests reinforces confidence in the direction indicated by the findings, enhancing the decision-making process when dealing with multidimensional phenomena.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Methodological framework.
The results provide a composite indicator encompassing the three dimensions in a single measure, indicating its validity as a representation of the multidimensional phenomenon under study.
Fig 2
Fig 2. Results map of countries in Africa.
Republished from [53] under a CC BY license, with permission from Minas Giannekas, original copyright Copyright © 2025 MapChart.
Fig 3
Fig 3. Results maps for Latin American and Caribbean countries.
Republished from [53] under a CC BY license, with permission from Minas Giannekas, original copyright Copyright © 2025 MapChart.
Fig 4
Fig 4. Results map for countries in Asia.
Republished from [53] under a CC BY license, with permission from Minas Giannekas, original copyright Copyright © 2025 MapChart.
Fig 5
Fig 5. Results map European countries.
Republished from [53] under a CC BY license, with permission from Minas Giannekas, original copyright Copyright © 2025 MapChart.
Fig 6
Fig 6. Results maps for Oceania countries.
Republished from [53] under a CC BY license, with permission from Minas Giannekas, original copyright Copyright © 2025 MapChart.
Fig 7
Fig 7. Proportion of dimensions in the composite indicator by continent.
Fig 8
Fig 8. Correlation results of the dimensions and the OWA CI with the external variable.
The results indicate that the higher indicator, the greater the difficulty faced by children and adolescents in the field of anxiety and depression. This result corroborates the results found in the literature that relate adverse childhood experiences with anxiety and depression [13,43,54].
Fig 9
Fig 9. Discriminating power.
Fig 10
Fig 10. Atypical measurements.
See this image and copyright information in PMC

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