Bridging the gap between complexity science and clinical practice by formalizing idiographic theories: A computational model of functional analysis
Open accessAbstract
BACKGROUND: The past decades of research have seen an increase in statistical tools to explore the complex dynamics of mental health from patient data, yet the application of these tools in clinical practice remains uncommon. This is surprising, given that clinical reasoning, e.g., case conceptualizations, largely coincides with the dynamical system approach. We argue that the gap between statistical tools and clinical practice can partly be explained by the fact that current estimation techniques disregard theoretical and practical considerations relevant to psychotherapy. To address this issue, we propose that case conceptualizations should be formalized. We illustrate this approach by introducing a computational model of functional analysis, a framework commonly used by practitioners to formulate case conceptualizations and design patient-tailored treatment. METHODS: We outline the general approach of formalizing idiographic theories, drawing on the example of a functional analysis for a patient suffering from panic disorder. We specified the system using a series of differential equations and simulated different scenarios; first, we simulated data without intervening in the system to examine the effects of avoidant coping on the development of panic symptomatic. Second, we formalized two interventions commonly used in cognitive behavioral therapy (CBT; exposure and cognitive reappraisal) and subsequently simulated their effects on the system. RESULTS: The first simulation showed that the specified system could recover several aspects of the phenomenon (panic disorder), however, also showed some incongruency with the nature of panic attacks (e.g., rapid decreases were not observed). The second simulation study illustrated differential effects of CBT interventions for this patient. All tested interventions could decrease panic levels in the system. CONCLUSIONS: Formalizing idiographic theories is promising in bridging the gap between complexity science and clinical practice and can help foster more rigorous scientific practices in psychotherapy, through enhancing theory development. More precise case conceptualizations could potentially improve intervention planning and treatment outcomes. We discuss applications in psychotherapy and future directions, amongst others barriers for systematic theory evaluation and extending the framework to incorporate interactions between individual systems, relevant for modeling social learning processes. With this report, we hope to stimulate future efforts in formalizing clinical frameworks.
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Burger et al. (2020) proposed that case conceptualization could be formalized through computational modeling, which they demonstrated through a functional analysis of exposure and cognitive reappraisal for panic disorder.
“Burger et al. (2020) proposed that case conceptualization could be formalized through computational modeling, which they demonstrated through a functional analysis of exposure and cognitive reappraisal for panic disorder.”
From Measuring the active elements of cognitive-behavioral therapies (2023) · cites this paper as Burger et al., 2020
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Self-citation
- Authors
- Burger, J., van der Veen, D. C., Robinaugh, D. J., Quax, R., Riese, H., Schoevers, R. A., & Epskamp, S.
- Affiliations
- University Medical Center Groningen (NL)
- Harvard University (US)
- University of Amsterdam (NL)
- Corresponding author
- Burger, Julian
- Venue
- BMC Medicine
- Published
- 2020-04-08
- Volume
- 18
- Issue
- 1
- Pages
- 99-99
- ISSN
- 1741-7015 (ISSN-L)
- PMC
- PMC7333286
- OpenAlex
- W3015085531
- Cited by
- 99
- References
- 68
- Citations by year
- 2026: 10 · 2025: 10 · 2024: 13 · 2023: 14 · 2022: 14 · 2021: 22 · 2020: 16
- FWCI
- 15.95
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UvA-DARE (University of Amsterdam) (acceptedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by)
- OSF Preprints (OSF Preprints) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- NWO (406.18.542)
- National Institute of Mental Health Career Development Award (1K23MH113805-01A1)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- functional analysis, case formulation, computational modeling, differential equations, panic disorder, avoidance coping, cognitive behavioral therapy, exposure therapy, cognitive reappraisal, theory evaluation
- MeSH terms
- Computer Simulation, Humans, Mental Health, Psychotherapy
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