The Central Role of Emotional Abuse In Children’s Risk Networks: A Three-Wave Cross-Lagged Panel Network Analysis In Rural China

Background and Purpose: Although emotional abuse is increasingly recognized as a prevalent form of child maltreatment, its role in driving subsequent internalizing symptoms relative to other risk factors remains poorly understood, particularly in non-Western rural populations. Understanding which risk factors serve as upstream drivers of child mental health cascades is critical for social work practitioners seeking to prioritize intervention targets. This study used cross-lagged panel network (CLPN) analysis to examine the temporal dynamics among internalizing symptoms and socio-ecological risk factors in rural Chinese children, aiming to identify the most influential nodes driving risk propagation across time.

Methods: Participants were 564 children (52.5% female; Grades 4 at baseline) from four elementary schools in agricultural and pastoral regions of Inner Mongolia, China, assessed across three waves. Networks were estimated across 14 symptom-level and risk-factor nodes: five depressive symptoms, four anxiety symptoms, peer victimization, cyber victimization, emotional abuse, emotional neglect, and harsh parenting. Cross-lagged panel network models were estimated for two consecutive transitions (Wave 1→2, Wave 2→3), controlling for sex, ethnicity, and school. Out-strength centrality was used to identify the most influential nodes and stable pathways.

Results: Across both transitions, emotional abuse consistently exhibited the highest out-strength centrality, predicting subsequent increases in seven to nine mental health symptoms and co-occurring adversities. A reciprocal escalation cycle between emotional abuse and sudden fear emerged in the second transition. Seven edges replicated across both transitions, with pathways predominantly flowing from risk factors to symptoms rather than the reverse. Emotional abuse emerged as the primary upstream hub in the network, exerting broad cross-lagged influence on both internalizing symptoms and other adversities.

Conclusions and Implications: These findings identify caregiver emotional abuse as the central driver of internalizing symptom cascades in rural children. For social work practice, this highlights the importance of screening for emotional abuse, not just physical abuse or neglect, as a priority target in child welfare assessments. School social workers in rural settings should incorporate emotional abuse screening into routine mental health evaluations. Family-based interventions targeting emotional maltreatment in underserved rural communities may yield broad downstream benefits for children’s mental health by disrupting the identified risk propagation pathways. These results advance culturally informed, prevention-oriented social work practice with rural children.