Subthreshold depression among university students is a well-established risk factor for developing major depression. Therefore, identifying factors that contribute to its progression is critical for prevention. Although avoidance is a risk factor for depression, the specific patterns of avoidance associated with deterioration remain unclear. Avoidance behavior exhibited by individuals with depressive symptoms has four patterns: behavioral-social, behavioral-nonsocial, cognitive-social, and cognitive-nonsocial avoidance. This longitudinal study aimed to explore changes in these avoidance patterns among university students whose subthreshold depression either worsened to depression or remained stable.

This study included 626 students who completed a questionnaire at Times 1 and 2 (with a six-month interval). Two-way repeated measures ANOVAs and logistic regression analyses were conducted to examine the relationship between avoidance patterns and progression to depression.

Both ANOVAs and logistic regression analyses indicated that behavioral-nonsocial avoidance was significantly associated with the progression from subthreshold depression to depression at the six-month follow-up.

This is the first study to demonstrate that among all the avoidance patterns, avoidance occurring in nonsocial situations is associated with a worsening status from subthreshold depression to depression. These findings provide important insights for preventing the progression of subthreshold depression to major depression among university students.