Dynamic networks of psychological symptoms, impairment, substance use, and social support: The evolution of psychopathology among emerging adults
Open accessAbstract
Background: Subthreshold/attenuated syndromes are established precursors of full-threshold mood and psychotic disorders. Less is known about the individual symptoms that may precede the development of subthreshold syndromes and associated social/functional outcomes among emerging adults. Methods: We modeled two dynamic Bayesian networks (DBN) to investigate associations among self-rated phenomenology and personal/lifestyle factors (role impairment, low social support, and alcohol and substance use) across the 19Up and 25Up waves of the Brisbane Longitudinal Twin Study. We examined whether symptoms and personal/lifestyle factors at 19Up were associated with (a) themselves or different items at 25Up, and (b) onset of a depression-like, hypo-manic-like, or psychotic-like subthreshold syndrome (STS) at 25Up. Results: The first DBN identified 11 items that when endorsed at 19Up were more likely to be reendorsed at 25Up (e.g., hypersomnia, impaired concentration, impaired sleep quality) and seven items that when endorsed at 19Up were associated with different items being endorsed at 25Up (e.g., earlier fatigue and later role impairment; earlier anergia and later somatic pain). In the second DBN, no arcs met our a priori threshold for inclusion. In an exploratory model with no threshold, >20 items at 19Up were associated with progression to an STS at 25Up (with lower statistical confidence); the top five arcs were: feeling threatened by others and a later psychotic-like STS; increased activity and a later hypo-manic-like STS; and anergia, impaired sleep quality, and/or hypersomnia and a later depression-like STS. Conclusions: These probabilistic models identify symptoms and personal/lifestyle factors that might prove useful targets for indicated preventative strategies.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Earliest expressions of psychopathology have high rates of co-occurrence, change from one clinical picture to another, and only gradually differentiate into more distinct mental disorders.
“These earliest expressions of psychopathology have high rates of co-occurrence, change from one clinical picture to another, and only gradually differentiate into more distinct mental disorders [67, 69, 70].”
From Efficacy of a transdiagnostic Internet prevention approach in adolescents (EMPATIA study): study protocol of a randomized controlled trial (2024) · cites this paper as [69]
The Introduction (page unavailable) says early symptoms can precede subthreshold syndromes and later mental disorders. The Discussion > Primary findings (page unavailable) reports that some symptoms predicted different symptoms 5–6 years later, supporting change across symptom patterns. It does not establish high rates of co-occurrence or show that early presentations gradually differentiate into distinct disorders. (LLM, conf=0.84)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005) · Archives of General Psychiatry · doi:10.1001/archpsyc.62.6.593 · Cited by 20,391 · see citing works
Causality: Models, Reasoning, and Inference
Pearl, J. (2009) · doi:10.1017/cbo9780511803161 · Cited by 11,653 · see citing works
A network theory of mental disorders
Borsboom, D. (2017) · World Psychiatry · doi:10.1002/wps.20375 · Cited by 3,482 · see citing works
Group, W. A. W. (2002) · Addiction · doi:10.1046/j.1360-0443.2002.00185.x · Cited by 1,982 · see citing works
Learning Bayesian Networks with the bnlearn R Package
Scutari, M. (2010) · Journal of Statistical Software · doi:10.18637/jss.v035.i03 · Cited by 1,978 · see citing works
Developing the World Health Organization Disability Assessment Schedule 2.0
Üstün, T. B., Chatterji, S., Kostanjsek, N., Rehm, J., Kennedy, C., Epping-Jordan, J., Saxena, S., von Korff, M., & Pull, C. (2010) · Bulletin of the World Health Organization · doi:10.2471/blt.09.067231 · Cited by 1,851 · see citing works
Mood disorders in children and adolescents: an epidemiologic perspective
Kessler, R. C., Avenevoli, S., & Ries Merikangas, K. (2001) · Biological Psychiatry · doi:10.1016/s0006-3223(01)01129-5 · Cited by 1,181 · see citing works
Lewinsohn, P. M., Klein, D. N., & Seeley, J. R. (1995) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199504000-00012 · Cited by 778 · see citing works
An Individualized Risk Calculator for Research in Prodromal Psychosis
Cannon, T. D., Yu, C., Addington, J., Bearden, C. E., Cadenhead, K. S., Cornblatt, B. A., Heinssen, R., Jeffries, C. D., Mathalon, D. H., McGlashan, T. H., et al. (2016) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2016.15070890 · Cited by 574 · see citing works
Konings, M., Bak, M., Hanssen, M., van Os, J., & Krabbendam, L. (2006) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2005.00741.x · Cited by 523 · see citing works
Preventive psychiatry: a blueprint for improving the mental health of young people
Fusar‐Poli, P., Correll, C. U., Arango, C., Berk, M., Patel, V., & Ioannidis, J. P. A. (2021) · World Psychiatry · doi:10.1002/wps.20869 · Cited by 497 · cited 1× · see citing works
“Improving our understanding of progression from earlier to later stages of mental illness among emerging adults is an area of major clinical, public health, and economic interest [11, 12].”
BackgroundBeyond the “at risk mental state” concept: transitioning to transdiagnostic psychiatry
McGorry, P. D., Hartmann, J. A., Spooner, R., & Nelson, B. (2018) · World Psychiatry · doi:10.1002/wps.20514 · Cited by 488 · see citing works
Dominguez, M.-D.-G., Wichers, M., Lieb, R., Wïttchen, H., & van Os, J. (2009) · Schizophrenia Bulletin · doi:10.1093/schbul/sbp022 · Cited by 465 · see citing works
Co-morbid obsessive–compulsive disorder and depression: A bayesian network approach
McNally, R. J., Mair, P., Mugno, B. L., & Riemann, B. C. (2017) · Psychological Medicine · doi:10.1017/s0033291716003287 · Cited by 308 · see citing works
Shankman, S. A., Lewinsohn, P. M., Klein, D. N., Small, J. W., Seeley, J. R., & Altman, S. E. (2009) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2009.02117.x · Cited by 300 · see citing works
Transdiagnostic clinical staging in youth mental health: a first international consensus statement
Shah, J. L., Scott, J., McGorry, P. D., Cross, S. P. M., Keshavan, M. S., Nelson, B., Wood, S. J., Marwaha, S., Yung, A. R., Scott, E. M., et al. (2020) · World Psychiatry · doi:10.1002/wps.20745 · Cited by 291 · see citing works
Self-citationMcNally, R. J., Heeren, A., & Robinaugh, D. J. (2017) · European Journal of Psychotraumatology · doi:10.1080/20008198.2017.1341276 · Cited by 277 · see citing works
Crouse, J. J., Carpenter, J. S., Song, Y. J. C., Hockey, S. J., Naismith, S. L., Grunstein, R. R., Scott, E. M., Merikangas, K. R., Scott, J. L., & Hickie, I. B. (2021) · The Lancet Psychiatry · doi:10.1016/s2215-0366(21)00034-1 · Cited by 266 · see citing works
Self-citationHafeman, D. M., Merranko, J., Axelson, D., Goldstein, B. I., Goldstein, T., Monk, K., Hickey, M. B., Sakolsky, D., Diler, R., Iyengar, S., et al. (2016) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2015.15040414 · Cited by 212 · see citing works
Development of a simple screening tool for common mental disorders in general practice
Hickie, I. B., Davenport, T. A., Hadži-Pavlović, D., Koschera, A., Naismith, S. L., Scott, E. M., & Wilhelm, K. A. (2001) · The Medical Journal of Australia · doi:10.5694/j.1326-5377.2001.tb143784.x · Cited by 207 · see citing works
Self-citationThe Structure of The Extended Psychosis Phenotype in Early Adolescence--A Cross-sample Replication
Wigman, J. T. W., Vollebergh, W., Raaijmakers, Q. A. W., Iedema, J., van Dorsselaer, S., Ormel, J., Verhulst, F. C., & van Os, J. (2009) · Schizophrenia Bulletin · doi:10.1093/schbul/sbp154 · Cited by 200 · see citing works
Iorfino, F., Scott, E. M., Carpenter, J. S., Cross, S. P., Hermens, D. F., Killedar, M., Nichles, A., Zmicerevska, N., White, D., Guastella, A. J., et al. (2019) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2019.2360 · Cited by 188 · see citing works
Self-citationSymptoms of DSM-III-R Major Depression in Adolescence: Evidence from an Epidemiological Survey
ROBERTS, R. E., Lewinsohn, P. M., & Seeley, J. R. (1995) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199512000-00011 · Cited by 178 · see citing works
Carrión, R. E., Cornblatt, B. A., Burton, C. Z., Tso, I. F., Auther, A. M., Adelsheim, S., Calkins, R., Carter, C. S., Niendam, T., Sale, T. G., et al. (2016) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2016.15121565 · Cited by 170 · cited 2× · see citing works
“First, feeling threatened by others at 19Up was associated with progression to a psychotic-like subthreshold syndrome, consistent with reports from the USA [7, 40] and China [41] showing that higher levels of suspiciousness predict conversion from a clinical high risk state to a full-threshold psychotic disorder; it i…”
ResultInfluentialScott, J., Kallestad, H., Vedaa, O., Sivertsen, B., & Etain, B. (2021) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2021.101429 · Cited by 162 · see citing works
Self-citationMoffa, G., Catone, G., Kuipers, J., Kuipers, E., Freeman, D. H., Marwaha, S., Lennox, B., Broome, M. R., & Bebbington, P. (2017) · Schizophrenia Bulletin · doi:10.1093/schbul/sbx013 · Cited by 151 · see citing works
Dynamic Bayesian networks as prognostic models for clinical patient management
van Gerven, M. A. J., Taal, B. G., & Lucas, P. (2008) · Journal of Biomedical Informatics · doi:10.1016/j.jbi.2008.01.006 · Cited by 115 · see citing works
Circadian depression: A mood disorder phenotype
Carpenter, J. S., Crouse, J. J., Scott, E. M., Naismith, S. L., Wilson, C., Scott, J., Merikangas, K. R., & Hickie, I. B. (2021) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2021.02.045 · Cited by 114 · see citing works
Self-citationTijssen, M. J. A., van Os, J., Wïttchen, H., Lieb, R., Beesdo‐Baum, K., Mengelers, R., & Wichers, M. (2010) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.109.065763 · Cited by 98 · see citing works
Dynamic Bayesian network modeling of fMRI: A comparison of group-analysis methods
Li, J., Wang, Z. J., Palmer, S. J., & McKeown, M. J. (2008) · NeuroImage · doi:10.1016/j.neuroimage.2008.01.068 · Cited by 89 · see citing works
Hansell, N. K., Wright, M. J., Medland, S. E., Davenport, T. A., Wray, N. R., Martin, N. G., & Hickie, I. B. (2011) · Psychological Medicine · doi:10.1017/s0033291711002431 · Cited by 87 · see citing works
Self-citationLongitudinal Prediction of the Infant Gut Microbiome with Dynamic Bayesian Networks
McGeachie, M. J., Sordillo, J. E., Gibson, T. E., Weinstock, G. M., Liu, Y., Gold, D. R., Weiss, S. T., & Litonjua, A. A. (2016) · Scientific Reports · doi:10.1038/srep20359 · Cited by 83 · see citing works
Zhang, T., Xu, L., Tang, Y., Li, H., Tang, X., Cui, H., Wei, Y., Wang, Y., Hu, Q., Liu, X., et al. (2019) · Psychological Medicine · doi:10.1017/s0033291718002738 · Cited by 82 · see citing works
Characterizing Dynamic Changes in the Human Blood Transcriptional Network
Zhu, J., Chen, Y., Leonardson, A. S., Wang, K., Lamb, J. R., Emilsson, V., & Schadt, E. E. (2010) · PLoS Computational Biology · doi:10.1371/journal.pcbi.1000671 · Cited by 57 · see citing works
Amore, M., Murri, M. B., Calcagno, P., Rocca, P., Rossi, A., Aguglia, E., Bellomo, A., Blasi, G., Carpiniello, B., Cuomo, A., et al. (2020) · European Psychiatry · doi:10.1192/j.eurpsy.2020.45 · Cited by 51 · see citing works
Kuipers, J., Moffa, G., Kuipers, E., Freeman, D., & Bebbington, P. (2018) · Psychological Medicine · doi:10.1017/s0033291718000879 · Cited by 50 · see citing works
Perceived support and adjustment to stress in a general population sample of female twins
Kessler, R. C., Kendler, K. S., Heath, A. C., Neale, M. C., & Eaves, L. J. (1994) · Psychological Medicine · doi:10.1017/s0033291700027306 · Cited by 43 · see citing works
Couvy‐Duchesne, B., O’Callaghan, V. S., Parker, R., Mills, N. T., Kirk, K. M., Scott, J. L., Vinkhuyzen, A. A. E., Hermens, D. F., Lind, P. A., Davenport, T. A., et al. (2018) · BMJ Open · doi:10.1136/bmjopen-2017-018959 · Cited by 32 · see citing works
Self-citationTwenty-Five and Up (25Up) Study: A New Wave of the Brisbane Longitudinal Twin Study
Mitchell, B. L., Campos, A. I., Rentería, M. E., Parker, R., Sullivan, L., McAloney, K., Couvy‐Duchesne, B., Medland, S. E., Gillespie, N. A., Scott, J. L., et al. (2019) · Twin Research and Human Genetics · doi:10.1017/thg.2019.27 · Cited by 29 · see citing works
Self-citationScott, J. L., Martin, N. G., Parker, R., Couvy‐Duchesne, B., Medland, S. E., & Hickie, I. B. (2020) · Early Intervention in Psychiatry · doi:10.1111/eip.12942 · Cited by 24 · see citing works
Self-citationScott, J. L., Crouse, J. J., Ho, N., Carpenter, J. S., Martin, N. G., Medland, S. E., Parker, R., Byrne, E. M., Couvy‐Duchesne, B., Mitchell, B. L., et al. (2021) · Bipolar Disorders · doi:10.1111/bdi.13067 · Cited by 24 · see citing works
Self-citationScott, J., Crouse, J. J., Ho, N., Iorfino, F., Martin, N., Parker, R., McGrath, J., Gillespie, N. A., Medland, S., & Hickie, I. B. (2021) · PLOS ONE · doi:10.1371/journal.pone.0252550 · Cited by 15 · see citing works
Self-citationA novel, complex systems approach to modelling risk of psychological distress in young adolescents
Beaudequin, D. A., Schwenn, P., McLoughlin, L. T., Parker, M. J., Boyes, A., Simcock, G. P., Lagopoulos, J., & Hermens, D. F. (2021) · Scientific Reports · doi:10.1038/s41598-021-88932-y · Cited by 8 · see citing works
Self-citationCrouse, J. J., Ho, N., Scott, J. L., Martin, N. G., Couvy‐Duchesne, B., Hermens, D. F., Parker, R., Gillespie, N. A., Medland, S. E., & Hickie, I. B. (2021) · Translational Psychiatry · doi:10.1038/s41398-021-01390-y · Cited by 3 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Ren, Q., Yang, T.-X., Wang, Y., Lui, S., & Chan, R. (2025) · Schizophrenia bulletin · doi:10.1093/schbul/sbae172 · Cited by 7 · see citing works
Sampogna, G., Caraci, F., Carmassi, C., Dell’Osso, B. M., Ferrari, S., Martinotti, G., Sani, G., Serafini, G., Signorelli, M. S., & Fiorillo, A. (2023) · Expert Opinion on Pharmacotherapy · doi:10.1080/14656566.2023.2237410 · Cited by 6 · see citing works
Catapano, P., Cipolla, S., Rosa, C. D., Milano, S., Vozza, D., Guadagno, D., Perris, F., Sampogna, G., & Fiorillo, A. (2024) · Medicina · doi:10.3390/medicina60060926 · Cited by 4 · see citing works
“A complex relationship has been proposed between the radicalization process and the presence of mental disorders in perpetrators [15–17], which can be useful to study in order to identify possible protective and risk factors [5].”
BackgroundHäfeli, X. A., Hirsig, A., & Schmidt, S. J. (2024) · BMJ Open · doi:10.1136/bmjopen-2024-084821 · Cited by 5 · see citing works
“68 Thus, the challenge is to get a detailed understanding of how subclinical symptoms emerge, stabilise or fade over time and eventually develop into full-threshold disorders.”
Tonini, E., Crouse, J. J., Shin, M., Carpenter, J. S., Lloyd, A. R., Hindmarsh, G., McKenna, S., Nichles, A., Zmicerevska, N., Scott, J. L., et al. (2025) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2025.112141 · Cited by 3 · see citing works
Self-citationHirsig, A., Häfeli, X. A., & Schmidt, S. J. (2024) · Trials · doi:10.1186/s13063-024-08241-3 · Cited by 2 · see citing works
“These earliest expressions of psychopathology have high rates of co-occurrence, change from one clinical picture to another, and only gradually differentiate into more distinct mental disorders [67, 69, 70].”
BackgroundActivation differentiates illness trajectories among youth seeking mental health care
Tonini, E., Crouse, J. J., Shin, M., Scott, J. L., Carpenter, J. S., Nichles, A., Zmicerevska, N., Iorfino, F., Capon, W., Wood, S. J., et al. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.03.084 · Cited by 1 · see citing works
Self-citationImpact of the Post Pandemic on College Student’ Lifestyles
Huamán-Romaní, Y.-L., Garrido-Arismendis, J.-J., Nugent, M. A. L. M., Silva, G. J. S., Alburqueque, I. L. V., & Lipa, R. C. (2023) · HUMAN REVIEW International Humanities Review / Revista Internacional de Humanidades · doi:10.37467/revhuman.v21.5044
“…times the internet was a practice of a sedentary lifestyle, there was even a seizure to online shopping and thanks to the intervention it was possible to avoid chronic diseases and indebtedness because this psychotic disorder is related to the lifestyle of university students (Crouse et al., 2022).”
Impact of the Post Pandemic on College Student’ Lifestyles
Huamán-Romaní, Y.-L., Garrido-Arismendis, J.-J., Nugent, M. A. L. M., Silva, G. J. S., Alburqueque, I. L. V., & Lipa, R. C. (2023) · HUMAN REVIEW International Humanities Review / Revista Internacional de Humanidades · doi:10.37819/revhuman.v21i1.1715
Li, K. Q., Liu, Y., Zhou, P., Xie, X., Xu, S., Yang, C., Zhang, J., Huang, L., Wang, J., & Ji, M. (2026) · Current Psychology · doi:10.1007/s12144-025-08792-x
“It is important to note that subthreshold mental symptoms, especially in conditions like depression and anxiety, have dynamic characteristics (Crouse et al., 2022 ), and may evolve (Marian et al., 2023).”
Falade, J., Oluwasuyi, S., Mosaku, K. S., & Eegunranti, B. A. (2026) · Research Square · doi:10.21203/rs.3.rs-10233519/v1
Crouse, J. J., Shin, M., Hockey, S. J., Jeon, E., Bradshaw, N., Nichles, A., Zmicerevska, N., Chong, M. K., You, H., Wray, N. R., et al. (2026) · BMJ Open · doi:10.1136/bmjopen-2025-114817 · Cited by 2 · see citing works
“27 There is suggestive (but non-conclusive) evidence of a critical role for circadian disturbances, 23 28 at least for a subgroup of people with mood disorders.”
Self-citationCarpenter, J. S., Crouse, J. J., Varidel, M., Tonini, E., Shin, M., Zmicerevska, N., Nichles, A., Hermens, D. F., Merikangas, K. R., Scott, E. M., et al. (2026) · Bipolar Disorders · doi:10.1111/bdi.70183
Self-citation
- Authors
- Crouse, J. J., Ho, N., Scott, J., Parker, R., Park, S. H., Couvy-Duchesne, B., Mitchell, B. L., Byrne, E. M., Hermens, D. F., Medland, S. E., Martin, N. G., Gillespie, N. A., & Hickie, I. B.
- Affiliations
- The University of Sydney (AU)
- Université Paris Cité (FR)
- QIMR Berghofer Medical Research Institute (AU)
- University of the Sunshine Coast (AU)
- Virginia Commonwealth University (US)
- Corresponding author
- Crouse, Jacob J.
- ORCID
- Venue
- European Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2022
- Volume
- 65
- Issue
- 1
- Pages
- e32-e32
- ISSN
- 0924-9338 (ISSN-L)
- 1778-3585
- PMC
- PMC9280922
- OpenAlex
- W4282556020
- Cited by
- 14
- References
- 44
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 4 · 2023: 3
- FWCI
- 2.30
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- European Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- NORA - Norwegian Open Research Archives (submittedVersion, cc-by)
- Funders
- National Institutes of Health
- National Health and Medical Research Council
- National Institute on Drug Abuse (R00DA023549)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- emerging adults, dynamic Bayesian networks, symptom progression, role impairment, social support, alcohol and drug use, psychotic-like symptoms, anergia, fatigue, preventive interventions
- MeSH terms
- Adult, Bayes Theorem, Mental Disorders, Humans, Risk Factors, Social Support, Twin Studies as Topic, Substance-Related Disorders, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
