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Critical Fluctuations as an Early-Warning Signal for Sudden Gains and Losses in Patients Receiving Psychotherapy for Mood Disorders
Open accessAbstract
Whereas sudden gains and losses (large shifts in symptom severity) in patients receiving psychotherapy appear abrupt and hence may seem unexpected, hypotheses from complex-systems theory suggest that sudden gains and losses are actually preceded by certain early-warning signals (EWSs). We tested whether EWSs in patients’ daily self-ratings of the psychotherapeutic process predicted future sudden gains and losses. Data were collected from 328 patients receiving psychotherapy for mood disorders who completed daily self-ratings about their therapeutic process using the Therapy Process Questionnaire (TPQ). Sudden gains and losses were classified from the Problem Intensity scale of the TPQ. The other items of the TPQ were used to compute the EWSs. EWSs predicted an increased probability for sudden gains and losses in a 4-day predictive window. These results show that EWSs can be used for real-time prediction of sudden gains and losses in clinical practice.
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“However, EMA data has also been successfully used to predict the development of symptoms within treatments [e.g., (42)].”
From Personalised depression forecasting using mobile sensor data and ecological momentary assessment (2022) · cites this paper as [42]
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Metadata
- Authors
- Olthof, M., Hasselman, F., Strunk, G., van Rooij, M., Aas, B., Helmich, M. A., Schiepek, G., & Lichtwarck-Aschoff, A.
- Affiliations
- Radboud University Nijmegen (NL)
- TU Dortmund University (DE)
- Behavioural Science Institute, Radboud University
- LMU Klinikum (DE)
- University Medical Center Groningen (NL)
- Paracelsus Medical University (AT)
- Corresponding author
- Olthof, Merlijn
- Venue
- Clinical Psychological Science
- Publisher
- SAGE Publications
- Published
- 2019-09-24
- Volume
- 8
- Issue
- 1
- Pages
- 25-35
- ISSN
- 2167-7026 (ISSN-L)
- 2167-7034
- OpenAlex
- W2976346093
- Cited by
- 146
- References
- 53
- Citations by year
- 2026: 11 · 2025: 12 · 2024: 20 · 2023: 30 · 2022: 32 · 2021: 23 · 2020: 16 · 2019: 2
- FWCI
- 21.34
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Clinical Psychological Science (publishedVersion, cc-by-nc)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, cc-by-nc)
- Open access LMU (Ludwid Maxmilian's Universitat Munchen) (submittedVersion, cc-by-nc)
- Radboud Repository (Radboud University) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion, other-oa)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by-nc)
- Funders
- h2020 european research council (ERC-CoG-2015; No 681466)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Physical Sciences › Environmental Science › Global and Planetary Change › Ecosystem dynamics and resilience
- Keywords
- early warning indicators, critical fluctuations, psychotherapy outcome prediction, mood disorders, therapeutic process, complexity theory
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