Monthly dynamic associations between cost-of-living pressure and depressive and anxiety symptoms: a longitudinal study based on cross-lagged network analysis.

BACKGROUND: Cost-of-living pressure is an important social determinant of public mental health, but its short-term associations with specific depressive and anxiety symptoms remain unclear. METHODS: We analyzed 12 monthly waves from the Changing Cost of Living Study. A pooled lag-1 cross-lagged panel network was estimated to examine group-level temporal predictive associations among five economic-pressure indicators, eight PHQ-8 depressive symptoms, and seven GAD-7 anxiety symptoms. The analysis included 4,085 complete lag-1 observations from 471 participants, adjusting for country, age, gender, subjective socioeconomic status, and wave. Robustness checks used a conservative lambda.1se network, deletion sensitivity analyses for overlapping symptom items, and bootstrap stability assessment. RESULTS: Economic-pressure nodes showed high autoregressive stability, particularly housing risk, employment risk, food insecurity, poverty/deprivation risk, and difficulty managing finances. Within-symptom paths were stronger than cross-domain paths. Stable bidirectional associations emerged between anhedonia and depressed mood, uncontrollable worry and excessive worry, and psychomotor problems and restlessness. Some economic pressure-to-symptom paths were detected in the lambda.min model, but these small paths were not retained in the more conservative lambda.1se model. CONCLUSIONS: At the group level, monthly temporal predictive patterns under cost-of-living pressure were characterized mainly by persistence within economic pressures and reciprocal associations within depressive and anxiety symptoms. Cross-domain economic pressure-symptom associations were weak and should not be interpreted as causal effects or as evidence of a uniform individual-level process.