Examining Relationships between Psychological Flexibility and Comorbidity of Depression and Anxiety: A Network Analysis in a Non-Clinical Community Sample

Background: Although depression and anxiety often co-occur, the relationship between their symptoms has not been explored in non-clinical populations. Moreover, the relationship between these affective symptoms and psychological flexibility (PF) requires further investigation to improve intervention sensitivity. This study used a network approach to examine the comorbidities of depression and anxiety, and their relationship with PF. Methods: The study sample included 1,059 Korean community participants. Two separate networks were established using items that assess depression, anxiety, and PF. Bridge strength centrality was calculated to identify the components that acted as bridges between different clusters in the network. Results: The results indicated that the major symptoms related to depression and anxiety symptom clusters were depressed mood, restlessness, and irritability. Additionally, the PF value process was positively associated with combined symptom clusters. Conclusions: These findings provide a nuanced understanding of how symptoms and protective processes interact with and influence each other. Clinical implications and future research directions have been discussed.