Personalized feedback on symptom dynamics of psychopathology: A proof-of-principle study
Open accessAbstract
BACKGROUND AND OBJECTIVES: In the proposed symptom network approach to psychopathology, psychiatric disorders are assumed to result from the (causal) interplay between symptoms. By implementing this approach we explored whether individual feedback on symptom dynamics complements current categorical classification and treatment. The aim of this proof-of-principle case-study was to explore the feasibility, acceptability and usability of this transdiagnostic approach. METHODS: A female patient, aged 67, suffering from treatment resistant anxious and depressive symptoms was treated in our tertiary outpatient clinic for old age psychiatry. She participated in ecological momentary assessments (EMA), which involved intensive repeated measurements of mood and context-related items during two weeks. Visualizations of the interplay between the items were provided by network graphs and were discussed with the patient. RESULTS: Network graphs were discussed with the patient. For example, it was hypothesized and discussed with the patient that feeling relaxed increased physical activity, causing physical discomfort in the following hours. Physical discomfort caused stress as its symptoms resembled her feared somatic anxiety symptoms. This increased the patient's insight that stress, expressed as somatic symptoms, played a central role in her panic disorder. This started a dialogue on how to cope with stress caused by somatic (anxiety) symptoms and provided a rationale for the patient to start an interoceptive exposure intervention she had repeatedly refused before. LIMITATIONS: The observed symptom dynamics may not be generalizable to any other random two weeks. CONCLUSIONS: Personalized diagnosis of psychopathology incorporating complex symptom dynamics is feasible and a promising addition to current categorical diagnostic systems and could guide intervention selection. This merits further exploration.
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Initial case studies have shown that person-specific networks were feasible, well-received by patients, and provided clinically relevant information.
“Several initial case studies, which collected data through ESM and created PSNs for individual patients, have shown that PSNs were feasible, well-received by patients, and provided clinically relevant information [24–27].”
From Using person-specific networks in psychotherapy: challenges, limitations, and how we could use them anyway (2020) · cites this paper as [27]
Proof-of-principle studies applying person-specific networks have made different choices in creating them.
“This is illustrated by the fact that proof-of-principle studies applying PSNs have made different choices in creating PSNs [24–27].”
From Using person-specific networks in psychotherapy: challenges, limitations, and how we could use them anyway (2020) · cites this paper as [27]
In Kroeze and colleagues' case study, discussion about a PSN led to the formulation of causal hypotheses and motivated the patient to try a new treatment direction she had previously doubted.
“In their case study, Kroeze and colleagues provided an example of a stimulating discussion about a PSN [27].”
From Using person-specific networks in psychotherapy: challenges, limitations, and how we could use them anyway (2020) · cites this paper as [27]
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Cites
Diagnostic and Statistical Manual of Mental Disorders
(2012) · Springer eBooks · doi:10.1007/springerreference_121117 · Cited by 20,769 · see citing works
Russell, J. A. (1980) · Journal of Personality and Social Psychology · doi:10.1037/h0077714 · Cited by 16,334 · cited 2× · see citing works
“When affective states are rated in a valence-arousal two-dimensional space or grid (Russell, 1980; Russell, Weiss, & Mendelsohn, 1989) four quadrants are created: stress, excitement, depression and relaxation.”
BackgroundNetwork analysis: An integrative approach to the structure of psychopathology
Borsboom, D., & Cramer, A. O. J. (2013) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-050212-185608 · Cited by 4,359 · see citing works
Self-citationNode centrality in weighted networks: Generalizing degree and shortest paths
Opsahl, T., Agneessens, F., & Skvoretz, J. V. (2010) · Social Networks · doi:10.1016/j.socnet.2010.03.006 · Cited by 3,734 · see citing works
Fiske, A., Wetherell, J. L., & Gatz, M. (2009) · Annual Review of Clinical Psychology · doi:10.1146/annurev.clinpsy.032408.153621 · Cited by 2,353 · see citing works
Affect Grid: A single-item scale of pleasure and arousal.
Russell, J. A., Weiss, A., & Mendelsohn, G. A. (1989) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.57.3.493 · Cited by 1,951 · see citing works
Mental disorders as networks of problems: a review of recent insights
Fried, E. I., van Borkulo, C. D., Cramer, A. O. J., Boschloo, L., Schoevers, R. A., & Borsboom, D. (2016) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-016-1319-z · Cited by 1,067 · see citing works
Self-citationState of the aRt personality research: A tutorial on network analysis of personality data in R
Costantini, G., Epskamp, S., Borsboom, D., Perugini, M., Mõttus, R., Waldorp, L., & Cramer, A. O. J. (2014) · Journal of Research in Personality · doi:10.1016/j.jrp.2014.07.003 · Cited by 1,004 · see citing works
Self-citationExperience sampling research in psychopathology: opening the black box of daily life
Myin-Germeys, I., Oorschot, M., Collip, D., Lataster, J., Delespaul, P., & van Os, J. (2009) · Psychological Medicine · doi:10.1017/s0033291708004947 · Cited by 817 · see citing works
Widiger, T. A., & Samuel, D. B. (2005) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.114.4.494 · Cited by 752 · see citing works
Anxiety disorders in older adults: a comprehensive review
Wolitzky-Taylor, K. B., Castriotta, N., Lenze, E. J., Stanley, M. A., & Craske, M. G. (2010) · Depression and Anxiety · doi:10.1002/da.20653 · Cited by 726 · see citing works
Mini-Mental State Examination (MMSE)
Gauthier, S. G. (2001) · CRC Press eBooks · doi:10.3109/9780203213896-22 · Cited by 659 · see citing works
Phenomenology of depression in older compared with younger adults: Meta-analysis
Hegeman, J. M., Kok, R., van der Mast, R. C., & Giltay, E. J. (2012) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.111.095950 · Cited by 365 · see citing works
Kramer, I., Simons, C. J. P., Hartmann, J. A., Menne-Lothmann, C., Viechtbauer, W., Peeters, F., Schruers, K., van Bemmel, A. L., Myin-Germeys, I., Delespaul, P., et al. (2014) · World Psychiatry · doi:10.1002/wps.20090 · Cited by 306 · see citing works
Gould, R. L., Coulson, M. C., & Howard, R. J. (2012) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2011.03824.x · Cited by 267 · see citing works
Gould, R. L., Coulson, M., & Howard, R. J. (2012) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2012.04166.x · Cited by 201 · see citing works
Ecological momentary assessment in aging research: A critical review
Cain, A. E., Depp, C. A., & Jeste, D. V. (2009) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2009.01.014 · Cited by 164 · see citing works
van Os, J., Delespaul, P., Wigman, J. T. W., Myin‐Germeys, I., & Wichers, M. (2013) · World Psychiatry · doi:10.1002/wps.20046 · Cited by 126 · see citing works
Wigman, J. T. W., van Os, J., Thiery, E. W., Derom, C. A., Collip, D., Jacobs, N., & Wichers, M. (2013) · PLoS ONE · doi:10.1371/journal.pone.0059559 · Cited by 98 · see citing works
Antidepressants in elderly: Metaregression of double-blind, randomized clinical trials
Calati, R., Signorelli, M. S., Balestri, M., Marsano, A., Ronchi, D. D., Aguglia, E., & Serretti, A. (2012) · Journal of Affective Disorders · doi:10.1016/j.jad.2012.11.053 · Cited by 91 · see citing works
Diagnostic heterogeneity in psychiatry: towards an empirical solution
Wardenaar, K. J., & de Jonge, P. (2013) · BMC Medicine · doi:10.1186/1741-7015-11-201 · Cited by 81 · see citing works
Mini-Mental State Examination (MMSE)
Shahid, A., Wilkinson, K., Marcu, S., & Shapiro, C. M. (2011) · Springer eBooks · doi:10.1007/978-1-4419-9893-4_51 · Cited by 58 · see citing works
Psychiatry beyond labels: introducingcontextual precision diagnosisacross stages of psychopathology
van Os, J., Delespaul, P., Wigman, J. T. W., Myin‐Germeys, I., & Wichers, M. (2013) · Psychological Medicine · doi:10.1017/s0033291713000937 · Cited by 24 · see citing works
Bennik, E. C. (2015) · University of Groningen research database (University of Groningen / Centre for Information Technology) · Cited by 12 · see citing works
Geriatric Psychiatry: What’s in a Name, and Five Concerns about DSM-5
Rapoport, M. J. (2014) · Canadian Geriatrics Journal · doi:10.5770/cgj.17.117 · Cited by 3 · see citing works
(2014) · Institutional Repository University of Antioquia (University of Antioquia) · doi:10.1371/journal.pone
Flagged first, then by citations
Research works printed but not linked: 2
- Epskamp S., Cramer A. O. J., Waldorp L. J., Schmittermann V. D., & Borsboom D (2012). Qgraph; network visualizations of relationships in psychometric data. Journal of Statistical Software, 48, 1- 18.
- Sytema S., & Van der Krieke L (2013). Routine outcome monitoring: A tool to improve the quality of mental health care? In Thornicroft G, Ruggeri M & Goldberg D (Eds.), Improving mental health care: The global challenge (1st ed, pp. 246- 263). Chichester: John Wiley & Sons.
Cited by
Sorted by citations
Epskamp, S., van Borkulo, C. D., van der Veen, D. C., Servaas, M. N., Isvoranu, A.-M., Riese, H., & Cramer, A. O. J. (2018) · Clinical Psychological Science · doi:10.1177/2167702617744325 · Cited by 448 · see citing works
Self-citationvan Roekel, E., Keijsers, L., & Chung, J. M. (2019) · Journal of Research on Adolescence · doi:10.1111/jora.12471 · Cited by 191 · see citing works
Lutz, W., Rubel, J. A., Schwartz, B., Schilling, V., & Deisenhofer, A.-K. (2019) · Behaviour Research and Therapy · doi:10.1016/j.brat.2019.103438 · Cited by 196 · see citing works
Bastiaansen, J. A., Kunkels, Y. K., Blaauw, F., Boker, S. M., Ceulemans, E., Chen, M., Chow, S.-M., de Jonge, P., Emerencia, A. C., Epskamp, S., et al. (2019) · doi:10.31234/osf.io/c8vp7 · Cited by 158 · see citing works
Self-citationInvestigating the feasibility of idiographic network models.
Mansueto, A. C., Wiers, R. W., van Weert, J. C. M., Schouten, B. C., & Epskamp, S. (2023) · Psychological Methods · doi:10.1037/met0000466 · Cited by 147 · see citing works
Bos, F. M., Snippe, E., Bruggeman, R., Wichers, M., & van der Krieke, L. (2019) · Psychiatric Services · doi:10.1176/appi.ps.201900050 · Cited by 120 · see citing works
A network perspective on suicidal behavior: understanding suicidality as a complex system
de Beurs, D., Bockting, C., Kerkhof, A., Scheepers, F., O’Connor, R., Penninx, B., & van de Leemput, I. (2021) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12676 · Cited by 119 · see citing works
A Clinician’s Primer for Idiographic Research: Considerations and Recommendations
Piccirillo, M. L., Beck, E. D., & Rodebaugh, T. L. (2019) · Behavior Therapy · doi:10.1016/j.beth.2019.02.002 · Cited by 90 · see citing works
von Klipstein, L., Riese, H., van der Veen, D. C., Servaas, M. N., & Schoevers, R. A. (2020) · BMC Medicine · doi:10.1186/s12916-020-01818-0 · Cited by 63 · see citing works
Self-citationRath, D., de Beurs, D., Hallensleben, N., Spangenberg, L., Glaesmer, H., & Forkmann, T. (2019) · Internet Interventions · doi:10.1016/j.invent.2019.100292 · Cited by 66 · see citing works
Single-subject research in psychiatry: facts and fictions
Zuidersma, M., Riese, H., Snippe, E., Booij, S. H., Wichers, M., & Bos, E. H. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.539777 · Cited by 54 · see citing works
Self-citationNap-van der Vlist, M. M., Houtveen, J., Dalmeijer, G. W., Grootenhuis, M. A., van der Ent, C. K., van Grotel, M., Swart, J. F., van Montfrans, J. M., van de Putte, E. M., & Nijhof, S. L. (2021) · Internet Interventions · doi:10.1016/j.invent.2021.100395 · Cited by 31 · see citing works
Network analysis of persistent somatic symptoms in two clinical patient samples
Senger, K., Heider, J., Kleinstäuber, M., Sehlbrede, M., Witthöft, M., & Schröder, A. (2022) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000999 · Cited by 14 · see citing works
Schellekens, M. P. J., Bootsma, T. I., Van Woezik, R. A. M., & Van der Lee, M. L. (2021) · Journal for Person-Oriented Research · doi:10.17505/jpor.2021.23447 · Cited by 9 · see citing works
- Authors
- Kroeze, R., van der Veen, D. C., Servaas, M. N., Bastiaansen, J. A., Voshaar, R. C. O. V., Borsboom, D., Ruhe, H. G., Schoevers, R. A., & Riese, H.
- Affiliations
- University Medical Center Groningen (NL)
- University of Amsterdam (NL)
- ORCID
- Venue
- Journal for Person-Oriented Research
- Publisher
- Journal for Person-Oriented Research
- Published
- 2017-11-03
- Volume
- 3
- Issue
- 1
- Pages
- 1-11
- ISSN
- 2002-0244 (ISSN-L)
- PMC
- PMC7842618
- OpenAlex
- W2766008849
- Cited by
- 93
- References
- 26
- Citations by year
- 2026: 3 · 2025: 9 · 2024: 9 · 2023: 5 · 2022: 4 · 2021: 21 · 2020: 12 · 2019: 13 · 2018: 9 · 2017: 6 · 2016: 2
- FWCI
- 14.39
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by
- Locations
- Journal for Person-Oriented Research (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- UvA-DARE (University of Amsterdam) (publishedVersion, other-oa)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
- 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 › Personality Disorders and Psychopathology
- Keywords
- personalized diagnosis, symptom dynamics, transdiagnostic psychiatry, ecological momentary assessment, network graphs, personalized feedback, interoceptive exposure, panic disorder, somatic anxiety, stress, physical activity, older adults, treatment-resistant depression, anxiety
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