Cross-lagged Models Research Articles

Age at separation, residential mobility, and depressive symptoms among twins in late adolescence and young adulthood: a FinnTwin12 cohort study

BackgroundSeparating with close siblings and leaving the parental home at an early age represents a major life event for an adolescent (reflected by age at separation in a twin pair) and may predispose them to poor mental health. This study aims to examine the association of age at separation and residential mobility on depressive symptoms in late adolescence and young adulthood and to explore possible underlying genetic effects.MethodsResidential mobility consisted of the number and total distance of moves before age 17. Based on 3071 twins from the FinnTwin12 cohort, we used linear regression to assess the association of age at separation and residential mobility with General Behavior Inventory (GBI) scores at age 17 and in young adulthood. A higher GBI score indicated more depressive symptoms occurred. Then, the mixed model for repeated measures (MMRM) was used to visualize the scores’ trajectory and test the associations, controlling for "baseline" state. Twin analyses with a bivariate cross-lagged path model were performed between the difference in GBI scores, between cotwins, and separation status for the potential genetic influence.ResultsCompared to twins separated before age 17, twins who separated later had significantly lower GBI scores at age 17 and in young adulthood. In MMRM, separation at a later age and a higher number of moves were associated with a higher GBI score in young adulthood. A small genetic effect was detected wherein GBI within-pair differences at age 17 were associated with separation status before age 22 (coefficient: 0.01).ConclusionThe study provides valid evidence about the influence of siblings and family on depressive symptoms in later adolescence and young adulthood while finding some evidence for a reverse direction effect. This suggests more caution in the interpretation of results. A strong association between residential mobility and depressive symptoms was affirmed, although further detailed research is needed.

Symphony of Success: Leader-Practitioner Reciprocity during Evidence-Based Practice Implementation

This study aimed to explore the reciprocal relationships between implementation leadership and practitioner implementation citizenship behavior during the implementation of evidence-based practices (EBPs). Data were collected at two timepoints with a time lag of six months during a national implementation of evidence-based treatment for post-traumatic stress disorder in Norwegian mental health clinics. Data from 72 leaders and 346 practitioners were analyzed with a two-wave cross-lagged panel model, accounting for the nested structure and adjusting for demographic variables. Significant positive autoregressive effects for both implementation leadership and implementation citizenship behavior indicated some stability in ratings across time. Significant cross-lagged effects in both directions indicated that practitioners who experienced greater implementation leadership from their leaders demonstrated greater implementation citizenship behavior six months later, and vice versa. Findings hence supported both the social exchange hypothesis and the followership hypothesis, suggesting reciprocal associations between the constructs. The findings underscore the mutually influential relationship between leaders’ behavior and practitioners’ engagement in citizenship behavior during EBP implementation. The study emphasizes the importance of interventions focusing on leadership behaviors that encourage practitioner engagement and mutually beneficial behavior patterns, highlighting the reciprocal and vital roles that both leaders and practitioners play in successful EBP implementation.

Longitudinal Associations Between Negative Body Image, Self-Disgust, and Nonsuicidal Self-Injury Among Chinese Adolescents: Disentangling Between- and Within-Person Effects.

Nonsuicidal self-injury (NSSI) and negative body image are both highly prevalent among adolescents, and there are theoretically proposed reciprocal associations between them. However, previous research has not differentiated between stable personal traits and time-varying state levels when examining these associations, and the underlying mechanisms remain unclear. To address these gaps, this study investigated the longitudinal associations between negative body image, self-disgust, and NSSI among Chinese adolescents, disentangling the between- and within-person effects by employing random intercept cross-lagged panel models (RI-CLPMs). A total of 515 Chinese adolescents (50.7% boys; baseline Mage = 12.34 years, SD = 0.47) participated in a four-wave longitudinal study with 6-month intervals. The results indicated that, at the between-person level, higher levels of self-disgust were associated with more NSSI and more concerns about general appearance, facial appearance, shortness, and fatness, but were not associated with concerns about thinness. At the within-person level, general appearance concern and NSSI positively predicted each other over time through self-disgust. Concerns about facial appearance, shortness, and fatness all positively predicted self-disgust, which in turn positively predicted NSSI over time, but not vice versa. These findings highlight the stable and trait-like associations between self-disgust, NSSI, and most negative body image dimensions. Self-disgust is worth considering as a target for intervention, as it plays a mediating role in the long-term associations between negative body image and NSSI.

Body fat and muscularity dissatisfaction are not prospectively associated with psychological wellbeing among sexual minority men: A case for separating within- and between-person variation in examinations of body image phenomena and their outcomes

Extensive cross-sectional research reports that body fat and muscularity dissatisfaction contribute to negative psychological outcomes among sexual minority men; however, longitudinal models are necessary for accurately quantifying the strength and direction of these relationships. We investigated the bidirectional longitudinal relationships of body fat and muscularity dissatisfaction with psychological quality of life among 2953 sexual minority men using random intercept cross-lagged panel models. Consistent with existing literature, we found that higher average muscularity and body fat dissatisfaction were associated with higher average psychological quality of life impairment between-persons. Unexpectedly, these constructs were not significantly associated within-persons/longitudinally. These findings conflict existing literature’s conclusions that muscularity and body fat dissatisfaction consistently contribute to poorer psychological wellbeing in this population. A significant between-person relationship in the absence of within-person relationships suggests that intermediary constructs (e.g., body ideal internalization) may account for the between-person effects of muscularity and body fat dissatisfaction on psychological wellbeing. Future research can accurately estimate these effects and identify reliable intervention targets by ensuring that within- and between-person relationships are examined separately, rather than being conflated.

Does grit predict thriving or is it the other way around? A latent cross-lagged panel model on the triarchic model of grit and the 5Cs of positive youth development.

Grit, defined as passion and perseverance to achieve long-term goals, has been associated with adolescents' optimal academic and psychological functioning. However, the role of grit in adolescents' positive youth development (PYD)-characterized by the 5Cs known as competence, confidence, connection, character, and caring-remains unknown. Using latent cross-lagged panel modeling, this study examined the longitudinal relations between the triarchic model of grit (TMG) dimensions (i.e., perseverance of effort, consistency of interest, and adaptability to situations), and the 5Cs of PYD while controlling for specific socio-demographic covariates (gender, age, SES, and school type). Data were obtained from 1620 Filipino adolescents (Mage = 17.15; SDage = 1.00) in November 2021 and May 2022. Results show that grit dimensions predicted subsequent PYD dimensions, but not vice versa. Specifically, while perseverance and adaptability were linked to higher levels of competence, confidence, and character, consistency was associated with lower levels of competence and confidence six months later. Results highlight the importance of grit's dimensions in facilitating PYD characteristics among adolescents, especially efficacy-related Cs (competence and confidence). Theoretical and practical implications in promoting adolescent thriving and well-being are discussed.

Exploring the Relationship Among Financial Hardship, Anxiety, and Depression in Patients With Cancer: A Longitudinal Study.

Financial hardship (FH) is a complex issue in cancer care, affecting material conditions, well-being, and coping behaviors. This study aimed to longitudinally examine FH, anxiety, depressive symptoms, and their associations while incorporating social determinants of health and health care cost covariates in a sample of patients diagnosed with cancer. This prospective, longitudinal cohort study analyzed data from 2,305 participants from the Northwestern University Improving the Management of Symptoms during and following Cancer Treatment trial. Outcomes assessed at baseline and at 3, 6, 9, and 12 months postbaseline included depressive symptoms, anxiety, and FH. Analysis involved random intercept cross-lagged panel models to explore between- and within-person effects, incorporating factors such as age, sex, insurance status, neighborhood area deprivation, health care charges, out-of-pocket costs, and health literacy. The cohort had a mean age of 60.7 (standard deviation [SD] = 12.7) years and was mostly female (64.9%) and White (86.2%). Correlations were found between FH and depressive symptoms (r = 0.310) and anxiety (r = 0.289). A predictive relationship was observed between FH and depressive symptoms, with baseline and 6-month depressive symptom levels predicting later FH (baseline β = .079, P = .070; 6-month β = .072, P = .081) and 9-month FH significantly predicting 12-month depressive symptoms (β = .083, P = .025), even after accounting for health care charges and out-of-pocket costs. Baseline and 9-month anxiety showed a predictive relationship with subsequent FH (baseline β = .097, P = .023; 9-month β = .071, P = .068). FH emerged as a prominent issue, with nearly half of participants experiencing some level of FH. Depressive symptoms and anxiety were related to FH. These findings underscore the need for a comprehensive approach in cancer care that concurrently addresses anxiety, depressive symptoms, and FH, recognizing their interconnected impact.

Coach-athlete attachment and athlete burnout: testing longitudinal mediation via cognitive reappraisal and expressive suppression

ABSTRACT Athlete burnout is a psychological syndrome that leads to emotional and physical exhaustion, a reduced sense of achievement, and sport devaluation among athletes. Drawing on attachment theory and the emotion regulation model of attachment, this study aimed to explore the potential mechanism of the relationship between coach-athlete attachment and athlete burnout. We employed a two-wave longitudinal design method to track 352 adult athletes in China, from which 258 completed the entire data collection (Mage = 22.2; SD = 3.2 years; 68.2% male). Results of the cross-lagged panel model for a half-longitudinal design showed that secure attachment was negatively linked to athlete burnout through cognitive reappraisal and expressive suppression, and avoidant attachment was positively linked to athlete burnout through expressive suppression. Our study applies attachment theory to the literature on athlete burnout and emphasises the importance of emotion regulation. The findings encourage coaches and sports-related therapists to develop appropriate interventions targeting attachment style and cognitive reappraisal training to reduce the risk of athlete burnout.

The association between posttraumatic stress disorder symptom severity and distress tolerance in traumatic stress treatment.

Distress tolerance, or the perceived ability to tolerate negative emotional states, is often associated with posttraumatic stress disorder (PTSD) such that higher distress tolerance is generally associated with less severe PTSD symptom levels. As distress tolerance is often considered a risk and maintenance factor in distress disorders, examining the association between changes in distress tolerance and changes in PTSD symptoms may have clinical relevance. The present study examined the associations between PTSD symptom severity and distress tolerance across three assessment points over 12 weeks among 212 patients receiving outpatient psychotherapy services. Using random-intercept cross-lagged panel modeling (RI-CLPM), concurrent and prospective associations between PTSD and distress tolerance were examined. PTSD symptoms at Time 1 and Time 2 significantly predicted distress tolerance at Time 2, β = -.296, and Time 3, β = -.395, respectively. Distress tolerance did not predict subsequent PTSD symptom severity. Exploratory analyses examined distress tolerance and four PTSD symptom clusters over time. Patterns of results differed across clusters, though it was consistent that only PTSD symptom clusters predicted subsequent distress tolerance and not vice versa. The results support the interrelationship of changes in psychopathology and emotional distress tolerance and indicate that distress tolerance may be an important factor in symptom remission during PTSD treatment.

Longitudinal Dynamic Relationships Between Videogame Use and Symptoms of Gaming Disorder and Depression Among Chinese Children and Adolescents.

Although previous studies have shown a close relationship between gaming disorder and depressive symptoms, few have measured normal videogame use, symptoms of gaming disorder, and depressive symptoms concurrently. The longitudinal dynamics between these variables remain unclear. This study used two demographic cohorts to examine the longitudinal relationship between gaming and depressive symptoms: children (n = 1513, 46.9% girls, Mage ± SD = 9.63 ± 0.58 years) and adolescents (n = 1757, 48.5% girls, Mage ± SD = 12.55 ± 0.70 years). Random intercept cross-lagged panel models (RI-CLPMs) were employed to distinguish between within- and between-person levels of gaming and depressive symptoms. The RI-CLPM results showed a stable link between symptoms of gaming disorder and depression at the between-person level for both children and adolescents. At the within-person level, among children, depressive symptoms positively predicted subsequent gaming disorder symptoms, but gaming disorder symptoms were not a significant predictor of depressive symptoms at this level. Among adolescents, there was no significant cross-lagged effect between symptoms of gaming disorder and depression at the within-person level. Additionally, there was no significant cross-lagged effect between normal videogame use and depressive symptoms in either cohort. These results highlight the different effects of normal videogame use and gaming disorder symptoms associated with depressive symptoms. The different effects on children and adolescents underscore the importance of considering the different developmental stages in the study of gaming and mental health outcomes.

Supply and demand effects between tobacco retailer density and smoking prevalence

ObjectivePlaces with more tobacco retailers have higher smoking prevalence levels, but whether this is because retailers locate where people who smoke live or whether tobacco availability prompts tobacco use is...

Early-Childhood Tablet Use and Outbursts of Anger

Tablet use continues to increase in preschool-aged children. The use of mobile devices has been linked to child emotional dysregulation. However, few studies have been able to show a clear direction of association between child tablet use and the development of self-regulation skills. In addition, few studies have modeled within-person associations over time. To estimate how child tablet use contributes to expressions of anger and frustration across the ages of 3.5 to 5.5 years at the within-person level. The study team also examined the extent to which associations are bidirectional to clarify the direction of the correlations. This prospective, community-based convenience sample of 315 parents of preschool-aged children from Nova Scotia, Canada, was studied repeatedly at the ages of 3.5 (2020), 4.5 (2021), and 5.5 years (2022) during the COVID-19 pandemic. All analyses were conducted between October 5, 2023, and December 15, 2023. Parent-reported tablet use at the ages of 3.5, 4.5, and 5.5 years. Parents reported child expressions of anger/frustration at the ages of 3.5, 4.5, and 5.5 years using the Children's Behavior Questionnaire. The sample was equally distributed across child sex (171 were identified by parents as being born boys [54%] and 144 as girls [46%]). Most reported being Canadian (287 [91.0%]) and married (258 [82.0%]). A random-intercept cross-lagged panel model revealed that a 1-SD increase in tablet use at 3.5 years (corresponding to 1.22 hours per day) was associated with a 22% SD scale increase in anger/frustration at age 4.5 years (standardized coefficient = 0.22; 95% CI, 0.01-0.44). A 1 SD scale increase in anger and frustration at 4.5 years was associated with a 22% SD (corresponding to 0.28 hours per day) increase in tablet use at 5.5 years (standardized coefficient = 0.22; 95% CI, 0.01-0.43). In this study, child tablet use at age 3.5 years was associated with more expressions of anger and frustration by the age of 4.5 years. Child proneness to anger/frustration at age 4.5 years was then associated with more use of tablets by age 5.5 years. These results suggest that early-childhood tablet use may contribute to a cycle that is deleterious for emotional regulation.

Social Support and Non-Suicidal Self-Injury in Adolescents: The Differential Influences of Family, Friends, and Teachers.

Non-suicidal self-injury (NSSI) is common among adolescents and is associated with a range of detrimental consequences. Family, teachers, and friends are essential sources of social support for adolescents. Increased social support from these sources may reduce NSSI behaviors among adolescents. However, it is uncertain if each source of social support retains its significance when their influences are evaluated simultaneously, and how each source influences the others to impact NSSI behaviors. To address this gap, this research investigated the direct and indirect effects of each source of social support on adolescent NSSI using cross-lagged panel model (CLPM), as well as whether these relationships varied by sex. A total of 3098 Chinese adolescents with a range of 10 to 15 years old (Mage = 13.27, SD = 0.73, 42.4% girls) completed assessments on three waves across approximately two years. The results indicated that teacher support compared to family and friend support showed the strongest association with NSSI behaviors and mediated the relationship between family support and NSSI. These findings highlight teacher support as a hub in the role of social support on NSSI and emphasize the importance of the connections between teacher and family support.

Trajectories of sleep problems and the longitudinal associations with mental health difficulties among Chinese adolescents

ObjectiveGrowing research highlights the negative impact of sleep problems on adolescent mental health. However, the developmental trajectory of sleep problems during adolescence and their relationship with mental health difficulties, including both internalizing and externalizing symptoms, remain unclear. Additionally, the direction of the effects between sleep problems and mental health difficulties is not well established. This study aims to identify the developmental trajectories of sleep problems and examine their association with mental health difficulties in both internalizing and externalizing domains. MethodThe study involved 1,281 Chinese middle school students (645 males, mean age at initial assessment = 12.73, SD = 0.68). Data were collected at four time points (T1, T2, T3, T4) over approximately 6-month intervals, spanning from the first semester of seventh grade to the second semester of 8th grade. ResultsLatent growth modeling revealed an overall increasing trend in sleep problems. Parallel latent growth modeling indicated that trajectories of sleep problems were positively related to the developmental trends of mental health difficulties, as shown by intercept-intercept and slope-slope associations. The cross-lagged panel model demonstrated significant bidirectional associations between sleep problems and internalizing symptoms. In contrast, we observed unidirectional associations between sleep problems and externalizing symptoms. Hence, sleep problems were a significant predictor of subsequent externalizing symptoms, with no significant reverse effect observed. ConclusionThese findings suggest that future research should explore whether interventions targeting sleep problems can reduce the incidence of both internalizing and externalizing symptoms. Additionally, interventions aimed at internalizing symptoms may potentially improve adolescent sleep, while those targeting externalizing symptoms may not have the same effect.

Parent- and Adolescent-Driven Effects in Emotion-Related Communication and Longitudinal Relationships with Depressive Symptoms in Adolescents.

Communication on emotions is an important aspect of parent-adolescent communication, yet its process and effects remain less examined in families of adolescents. This study examined the bidirectional association between parental responses to adolescents' emotions and adolescents' emotional communication behaviors, and further examined their longitudinal predictive effects on adolescent depressive symptoms. The potential moderating role of adolescent gender was also examined. A total of 503 adolescents (Mage = 13.45, SD = 0.50; 44.73% females) participated in this study, with 438 adolescents completing the three-wave longitudinal survey. Adolescents' emotional communication behaviors, parental responses to emotions, and depressive symptoms were reported. The bidirectional relationship was examined using cross-lagged panel models, while the parent- and adolescent-driven effects of emotional communication on adolescent depressive symptoms and the moderation effect of adolescent gender were examined using multi-group structural equation modeling. The findings revealed gender-specific patterns in parent-adolescent communication on emotions. Significant parent- and adolescent-driven effects of positive communication behaviors on adolescent depressive symptoms were found. However, only negative communication behaviors initiated by parents predicted adolescent depressive symptoms, with this effect mediated by adolescents' negative communication behaviors. This study deepened the understanding of characteristics and effects of parent-child emotional communication during adolescence, which has implications for interventions aiming at improving parent-adolescent relationship and adolescents' mental health.

Increases in sense of purpose predict future positive changes in personality traits.

This longitudinal study examined the reciprocal relationship between the Big Five personality traits and sense of purpose over a 13-year period using a nationally representative sample of American adults (N = 11,010). The random intercept cross-lagged panel model revealed unidirectional effects: increases in sense of purpose predicted subsequent increases in openness, agreeableness, conscientiousness, and extraversion, as well as decreases in neuroticism. Conversely, changes in personality traits did not predict future changes in sense of purpose. One potential mechanism underlying this effect might involve the link between sense of purpose and optimal self-regulatory processes and outcomes, such as successful planning, goal-directed behaviour, and self-control, which promote gradual positive changes in personality traits. Another plausible mechanism may be the association between purpose and improved subjective well-being and reduced psychological distress, which have been found to predict positive changes in personality traits. These findings challenge previous research that has interpreted cross-sectional associations as evidence that personality traits are predictive of purpose, rather than the other way around. The findings that intentionally cultivating a strong sense of purpose may facilitate positive personality change in adulthood.

Longitudinal Relations among Self-Compassion, Self-Esteem, and Depressive Symptoms in College Students: Disentangling the Within-Person Process from Stable Between-Person Differences.

Although previous studies have shown that self-compassion is associated with self-esteem and depressive symptoms, little is known about the intra-individual processes and the temporal dynamics of these variables. This study used a longitudinal design to explore the association between self-compassion, self-esteem and depressive symptoms among 5785 college students (aged 17-22 years; Mage = 18.63, SD = 0.88; 48.2% females). The participants were assessed six times in a six-month interval over three years. The random intercept cross-lagged panel models (RI-CLPMs) were used to disentangle within-person processes from stable between-person differences. Results of RI-CLPMs indicated that at the within-person level, self-compassion can positively predict subsequent self-esteem and negatively predict subsequent depressive symptoms, and vice versa. Self-esteem played a longitudinal mediating role in the prediction from self-compassion to depressive symptoms at the within-person level. These results indicate that cultivating self-compassion in college students is crucial as it can bolster their self-esteem and alleviate depressive symptoms.

A family systems investigation on couple emotional intimacy, parent-child relationships, and child social skills in middle childhood.

This study investigated familial attachment-based processes in middle childhood, using 788 families (50.6% boys; 84.4% White), assessed six times from 4.5 years old to Grade 6. An adapted Random Intercept Cross-Lagged Panel Model revealed between-family associations among couple emotional intimacy, relationships with both parents, and child social skills (β = .18-.66). Within-family increases in child assertion and self-control prospectively predicted relationships with parents (βs = .13), and parent-child relationships predicted various child social skills (βs = .13-.17). Couple emotional intimacy predicted child cooperation, assertion, and responsibility (βs = .12-.24) and father-child relationships in Grade 6 (βs = .20-22) at the within-family level. Findings underscore a systemic consideration of attachment-based processes in the family.

Reductions in PTSD severity precede reductions in pain intensity among veterans receiving intensive treatment.

Chronic pain often co-occurs with posttraumatic stress disorder (PTSD). The mutual maintenance hypothesis proposes that there may be shared underlying mechanisms of symptoms of pain exacerbating PTSD, and vice versa. The association between PTSD and pain intensity remains understudied. To elucidate the relationship, the present study examined the temporality of changes in PTSD severity and pain intensity in veterans undergoing intensive PTSD treatment. Data from 332 veterans undergoing intensive 2-week cognitive processing therapy- (CPT-) based treatment (ITP) with adjunctive components (i.e., mindfulness, art therapy). Random intercepts cross-lagged panel models (RI-CLPMs) were used to examine within-subjects relationships between pain intensity and PTSD severity over the course of the program. Veterans experienced large PTSD severity reductions (Essg = 1.20; p < .001) and small pain severity reductions (Essg = 0.21; p < .001) over the course of treatment, despite pain not being a treatment target. RI-CLPMs revealed that PTSD severity significantly predicted subsequent pain severity. Results indicate the absence of a bidirectional relationship in that changes in pain intensity did not predict later PTSD severity improvement during the ITP. Time trends for both PTSD severity and pain intensity were generally consistent with respect to baseline demographic characteristics. Our findings support the mutual maintenance regarding the association between PTSD and pain intensity. Future research should investigate temporal associations in other evidence-based PTSD treatments and formats and evaluate the long-term impacts of PTSD treatment on pain intensity. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Unraveling the dynamics of loneliness and cognition in late life: a cross-lagged panel model.

Loneliness and cognitive decline are pressing concerns among older adults, yet little research has explored cognition as a predictor of loneliness. This study investigates the dynamic relationship between loneliness and cognitive function in older adults using the random intercept cross-lagged panel model (RI-CLPM). Data were drawn from Waves 9-14 of the Health and Retirement Study (HRS), encompassing 8,473 individuals aged 65 years and older. Loneliness was assessed using the UCLA Loneliness Scale, and cognitive function was measured using immediate and delayed word recall and serial 7s from the HRS RAND file. Age, gender, education, marital status, self-health report, and depression were included as covariates. Using Mplus, we computed RI-CLPMs. The first three models were conducted on loneliness and cognitive functions. Then unconditional RI-CLPMs with no exogenous predictors were computed. Three conditional model results showed that age, gender, marital status, self-health report, and depression were significantly associated with loneliness in the first wave, but only age and self-health report were significantly associated with immediate and delayed word recall at the first wave, not with serial 7s. For carry-over effects, loneliness showed significant positive associations across consecutive waves, but cognitive functions showed significant positive associations just in the last two waves. Some spill-over effects were found between loneliness and cognitive functions. For within-person effects, although initially non-significant, a negative association between loneliness and immediate and delayed word recall emerged in later waves (11-12 and 13-14). The conditional models indicated that older age, not being married, male gender, low self-reported health, and high depression levels were positively associated with loneliness. However, only older age and lower self-reported health were positively linked to cognitive functions. This study underscores the link between loneliness and cognitive function decline in older adults, emphasizing the need to address loneliness to potentially reduce cognitive decline. Insights into demographic predictors of loneliness and cognitive function could inform targeted interventions for promoting successful aging.

Reciprocal longitudinal associations between positive body image and wellbeing among early-adult women

This longitudinal study examined the prospective associations between body appreciation and wellbeing (i.e., self-esteem, depression, and emotional wellbeing) as well as body image flexibility and wellbeing among 490 women between 18–35 years of age (M = 28.63; SD = 4.27) residing in the United States. Women were contacted in three waves, each two months apart, and completed measures relating to each construct online. As a prerequisite of longitudinal analyses, this study found evidence of configural, metric, scalar, and strict invariance over time for each relevant measure. Cross-lagged panel modeling evidenced bidirectional associations between body appreciation and self-esteem between all waves and unidirectional associations between body appreciation and subsequent depression (negative) and body appreciation and subsequent emotional wellbeing (positive). Results showed bidirectional associations between body image flexibility, self-esteem, depression, and emotional wellbeing, although these bidirectional associations never occurred during the same interval between waves. This study evidences that higher body appreciation and body image flexibility are prospectively associated with increases in self-esteem, emotional wellbeing and decreases in depression, and also shows scenarios where the inverse associations also hold true. We also describe how this study complements existing cross-sectional research and the need to examine associations among more diverse participant groups.