Background <p>Childhood trauma exhibits complex associations with adolescent mental health, however the interplay between specific trauma subtypes and psychological symptoms remains underexplored. This study employs network analysis to map symptom-trauma interactions, identify potential intervention targets, and explore gender differences in these interactions among adolescents with major depressive disorder (MDD).</p> Methods <p>A total of 723 adolescents diagnosed with MDD were recruited from a psychiatric clinic in China. Psychological symptoms (SCL-90) and childhood trauma exposure (CTQ) were assessed. Regularized partial correlation networks (<i>EBICglasso</i>) were utilized to model interactions among 15 nodes (10 symptoms and 5 trauma types), compute centrality metrics, and test gender differences.</p> Results <p>The results revealed that Interpersonal sensitivity (IPS) emerged as the most central node, demonstrating the highest expected influence (EI) (1.67), and formed the strongest edge with emotional abuse (weight = 0.41). A tightly coupled community linked emotional abuse/neglect, IPS, and depression. Moreover, IPS functioned as a bridge symptom, connecting trauma clusters to psychological symptoms (bridge strength = 0.98). Node invariance testing revealed significant gender differences in IPS, however, within their respective gender-specific networks, IPS demonstrated the highest strength and EI values in both males and females. Essentially, no obvious significant gender differences were observed in the network.</p> Conclusions <p>This pioneering network study of trauma-symptom associations in Chinese adolescents with MDD identifies IPS as a transdiagnostic factor through which childhood trauma is associated with mental health risks. The structural equivalence across genders suggests universal intervention targets during adolescence. Clinically, enhancing interpersonal skills in emotionally traumatized youth may disrupt pathogenic pathways to depression and other psychology symptoms.</p>