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Morosan L, de Almeida ER, van der Tuin S, van den Berg D, Booij SH, Wigman JTW. The impact of daily social support on the associations between daily negative events and daily suspiciousness across different clinical stages of psychosis. Schizophr Res 2024; 270:76-84. [PMID: 38870719 DOI: 10.1016/j.schres.2024.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 05/15/2024] [Accepted: 06/08/2024] [Indexed: 06/15/2024]
Affiliation(s)
- L Morosan
- Interdisciplinary Center of Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, Groningen, the Netherlands.
| | - E Raposo de Almeida
- Interdisciplinary Center of Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, Groningen, the Netherlands; Institute & Department of Psychiatry (LIM-23), Hospital das Clinicas, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - S van der Tuin
- Interdisciplinary Center of Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, Groningen, the Netherlands
| | - D van den Berg
- Department of Psychosis Research and Innovation, Parnassia Psychiatric Institute, The Hague, the Netherlands; Department of Clinical Psychology, VU University and Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - S H Booij
- Interdisciplinary Center of Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, Groningen, the Netherlands; Center for Integrative Psychiatry, Lentis, Groningen, the Netherlands
| | - J T W Wigman
- Interdisciplinary Center of Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, Groningen, the Netherlands
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Raposo de Almeida E, van der Tuin S, Muller MK, van den Berg D, Wang YP, Veling W, Booij SH, Wigman JTW. The associations between daily reports of loneliness and psychotic experiences in the early risk stages for psychosis. Early Interv Psychiatry 2024. [PMID: 38661051 DOI: 10.1111/eip.13537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 04/11/2024] [Accepted: 04/15/2024] [Indexed: 04/26/2024]
Abstract
AIM Bi-directional associations between loneliness and psychotic experiences (PEs) have been reported, but the mechanisms underlying these associations are unknown. This study aims to explore associations between daily reports of loneliness and PEs, and test differences in this association across young adult individuals at different levels of risk for psychosis. METHODS We analysed 90-day diary data on loneliness and PEs from N = 96 participants (mean age 24.7, range 18-35, 77% female) divided into 4 subgroups, each indexing increased levels of risk for psychosis according to the clinical staging model: 'psychometric' (n = 25), 'low' (n = 27), 'mild' (n = 24), and 'ultra-high'(n = 20) risk. Multilevel vector autoregressive models examined within-day (contemporaneous) and between-day (temporal) associations between loneliness and PEs for the total sample. Next, these associations were compared across subgroups. RESULTS Loneliness and PEs were significantly associated contemporaneously (partial correlation B = 0.14) but not temporally. Subgroup membership moderated both contemporaneous and temporal associations. The contemporaneous association between loneliness and PEs was stronger in the low-risk subgroup compared to the mild-risk (B = -0.35, p < .01) and ultra-high-risk (B = -0.36, p < .01) subgroups. The temporal association between loneliness on the previous day and PEs on the current day was stronger in mild-risk subgroup compared to the ultra-high-risk subgroup (B = -0.03, p = .03). After adjusting for multiple testing, only the contemporaneous-but not the temporal-associations remained statistically significant. CONCLUSIONS Loneliness is associated with PEs in individuals at risk for psychosis, particularly in those with low to mild symptoms. Our findings tentatively suggest that especially individuals with low expressions of PEs may be more sensitive to social context, but future studies are needed to replicate and further unravel the potentially stage-specific interplay between social context and PEs.
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Affiliation(s)
- Esdras Raposo de Almeida
- Interdisciplinary Center of Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
- Institute & Department of Psychiatry (LIM-23), Hospital das Clinicas, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Sara van der Tuin
- Interdisciplinary Center of Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
| | - Merel K Muller
- Interdisciplinary Center of Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
| | - David van den Berg
- Department of Psychosis Research, Parnassia Psychiatric Institute, The Hague, The Netherlands
- Department of Clinical Psychology, VU University and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Yuan-Pang Wang
- Institute & Department of Psychiatry (LIM-23), Hospital das Clinicas, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Wim Veling
- University Center of Psychiatry, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Sanne H Booij
- Interdisciplinary Center of Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
| | - Johanna T W Wigman
- Interdisciplinary Center of Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
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Steenhuis LA, Harms T, Nauta MH, Bartels-Velthuis AA, Albers CJ, Aleman A, Vos M, Pijnenborg GHM, van den Berg D, Palstra EC, Wigman JTW, Booij SH. The dynamics of social activation and suspiciousness in individuals at ultra-high risk for psychosis. Schizophr Res 2023; 262:67-75. [PMID: 37925753 DOI: 10.1016/j.schres.2023.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 04/25/2023] [Accepted: 10/18/2023] [Indexed: 11/07/2023]
Abstract
INTRODUCTION Social functioning is often impaired during the ultra-high risk (UHR) phase for psychosis, but group-level studies regarding the role of social functioning in transition to psychosis are inconsistent. Exploring the inter-individual differences which underlie the association between social functioning and psychotic symptoms in this phase could yield new insights. OBJECTIVE To examine the idiographic and dynamic association between social activation and suspiciousness in individuals at UHR for psychosis using time-series analysis. METHODS Twenty individuals at UHR for psychosis completed a diary application every evening for 90 days. Two items on social activation (quantity: 'time spent alone' and quality: 'feeling supported') and two items on suspiciousness ('feeling suspicious' and 'feeling disliked') were used. Time series (T = 90) of each individual were analyzed using vector auto regression analysis (VAR), to estimate the lagged (over 1 day) effect of social activation on suspiciousness, and vice versa, as well as their contemporaneous associations. RESULTS Heterogeneous person-specific associations between social activation and suspiciousness were found in terms of strength, direction and temporal aspects. CONCLUSIONS The association between social activation and suspiciousness differs amongst individuals who are at UHR for psychosis. These findings underline the importance of tailoring psychosocial interventions to the individual. Future studies may examine whether using results of single-subject studies in clinical practice to personalize treatment goals leads to better treatment outcomes.
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Affiliation(s)
- Laura A Steenhuis
- University of Groningen, Faculty of Behavioural and Social Sciences, Department of Clinical and Developmental Neuropsychology, Grote Kruisstraat 2/1, 9712 TS Groningen, the Netherlands; GGZ Drenthe, Department of Psychotic Disorders, Dennenweg 9, 9404 LA Assen, the Netherlands.
| | - Tim Harms
- University of Groningen, Faculty of Behavioural and Social Sciences, Department of Clinical and Developmental Neuropsychology, Grote Kruisstraat 2/1, 9712 TS Groningen, the Netherlands
| | - Maaike H Nauta
- University of Groningen, Faculty of Behavioural and Social Sciences, Department of Clinical and Developmental Neuropsychology, Grote Kruisstraat 2/1, 9712 TS Groningen, the Netherlands
| | - Agna A Bartels-Velthuis
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Hanzeplein 1, 9713, GZ, Groningen, the Netherlands
| | - Casper J Albers
- University of Groningen, Faculty of Behavioural and Social Sciences, Department of Psychometrics & Statistics, Grote Kruisstraat 2/1, 9712 TS Groningen, the Netherlands
| | - André Aleman
- University of Groningen, Faculty of Behavioural and Social Sciences, Department of Clinical and Developmental Neuropsychology, Grote Kruisstraat 2/1, 9712 TS Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation, Hanzeplein 1, 9713 GZ Groningen, the Netherlands
| | - Maarten Vos
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Hanzeplein 1, 9713, GZ, Groningen, the Netherlands
| | - Gerdina H M Pijnenborg
- University of Groningen, Faculty of Behavioural and Social Sciences, Department of Clinical and Developmental Neuropsychology, Grote Kruisstraat 2/1, 9712 TS Groningen, the Netherlands; GGZ Drenthe, Department of Psychotic Disorders, Dennenweg 9, 9404 LA Assen, the Netherlands
| | - David van den Berg
- VU University and Amsterdam Public Health Research, Department of Clinical Psychology, van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands; Parnassia Psychiatric Institute, Department of Psychosis Research, Zoutkeetsingel 40, 2512 HN The Hague, the Netherlands
| | - Eline C Palstra
- VU University and Amsterdam Public Health Research, Department of Clinical Psychology, van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands; Parnassia Psychiatric Institute, Department of Psychosis Research, Zoutkeetsingel 40, 2512 HN The Hague, the Netherlands
| | - Johanna T W Wigman
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Hanzeplein 1, 9713, GZ, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Neuroscience, Antonius Deusinglaan 1, 9713 AV, Groningen, the Netherlands
| | - Sanne H Booij
- University of Groningen, University Medical Center Groningen, Department of Neuroscience, Antonius Deusinglaan 1, 9713 AV, Groningen, the Netherlands
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van der Tuin S, Hoekstra RHA, Booij SH, Oldehinkel AJ, Wardenaar KJ, van den Berg D, Borsboom D, Wigman JTW. Relating stability of individual dynamical networks to change in psychopathology. PLoS One 2023; 18:e0293200. [PMID: 37943819 PMCID: PMC10635522 DOI: 10.1371/journal.pone.0293200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 10/07/2023] [Indexed: 11/12/2023] Open
Abstract
One hypothesis flowing from the network theory of psychopathology is that symptom network structure is associated with psychopathology severity and in turn, one may expect that individual network structure changes with the level of psychopathology severity. However, this expectation has rarely been addressed directly. This study aims to examine (1) the stability of individual contemporaneous symptom networks over a one-year period and (2) whether network stability is associated with a change in psychopathology. We used daily diary data of n = 66 individuals, located along the psychosis severity continuum, from two separate 90-day periods, one year apart (t = 180). Based on the newly developed Individual Network Invariance Test (INIT) to assess symptom-network stability, participants were divided into two groups with stable and unstable networks and we tested whether these groups differed in their absolute change in psychopathology severity. The majority of the sample (n = 51, 77.3%) showed a stable network over time while most individuals showed a decrease in psychopathological severity. We found no significant association between a change in psychopathology severity and individual network stability. Our results call for further critical evaluation of the association between networks and psychopathology to optimize the implementation of clinical applications based on current methods.
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Affiliation(s)
- Sara van der Tuin
- University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Centre Psychopathology and Emotion regulation, University of Groningen, Groningen, The Netherlands
| | - Ria H. A. Hoekstra
- Department of Psychological Methods, University of Amsterdam, Amsterdam, The Netherlands
| | - Sanne H. Booij
- University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Centre Psychopathology and Emotion regulation, University of Groningen, Groningen, The Netherlands
- Center for Integrative Psychiatry, Lentis, Groningen, The Netherlands
| | - Albertine J. Oldehinkel
- University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Centre Psychopathology and Emotion regulation, University of Groningen, Groningen, The Netherlands
| | - Klaas J. Wardenaar
- University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Centre Psychopathology and Emotion regulation, University of Groningen, Groningen, The Netherlands
| | - David van den Berg
- Department of Clinical Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands
- Department of Psychosis Research, Parnassia Psychiatric Institute, The Hague, The Netherlands
| | - Denny Borsboom
- Department of Psychological Methods, University of Amsterdam, Amsterdam, The Netherlands
| | - Johanna T. W. Wigman
- University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Centre Psychopathology and Emotion regulation, University of Groningen, Groningen, The Netherlands
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van der Tuin S, Booij SH, Muller MK, van den Berg D, Oldehinkel AJ, Wigman JTW. The added value of daily diary data in 1- and 3-year prediction of psychopathology and psychotic experiences in individuals at risk for psychosis. Psychiatry Res 2023; 329:115546. [PMID: 37864993 DOI: 10.1016/j.psychres.2023.115546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 10/10/2023] [Accepted: 10/15/2023] [Indexed: 10/23/2023]
Abstract
This study aimed to assess whether adding information on psychological experiences derived from a daily diary to baseline cross-sectional data could improve short- (1-year) and long-term (3-years) prediction of psychopathology and positive psychotic experiences (PEs). We used 90-day daily diary data from 96 individuals in early subclinical risk stages for psychosis. Stepwise linear regression models were built for psychopathology and PEs at 1- and 3-years follow-up, adding: (1) baseline questionnaires, (2) the mean and variance of daily psychological experiences, and (3) individual symptom network density. We assessed whether similar results could be achieved with a subset of the data (7-14- and 30-days). The mean and variance of the diary improved model prediction of short- and long-term psychopathology and PEs, compared to prediction based on baseline questionnaires solely. Similar results were achieved with 7-14- and 30-day subsets. Symptom network density did not improve model prediction except for short-term prediction of PEs. Simple metrics, i.e., the mean and variance from 7 to 14 days of daily psychological experiences assessments, can improve short- and long-term prediction of both psychopathology and PEs in individuals in early subclinical stages for psychosis. Diary data could be a valuable addition to clinical risk prediction models for psychopathology development.
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Affiliation(s)
- S van der Tuin
- Dept of Psychiatry, Interdisciplinary Centre Psychopathology and Emotion regulation, University of Groningen, University Medical Center Groningen, Hanzeplein 1 (Entrance 24- Triade), Groningen 9700 RB, the Netherlands.
| | - S H Booij
- Dept of Psychiatry, Interdisciplinary Centre Psychopathology and Emotion regulation, University of Groningen, University Medical Center Groningen, Hanzeplein 1 (Entrance 24- Triade), Groningen 9700 RB, the Netherlands; Center for Integrative Psychiatry, Lentis, Groningen, the Netherlands
| | - M K Muller
- Dept of Psychiatry, Interdisciplinary Centre Psychopathology and Emotion regulation, University of Groningen, University Medical Center Groningen, Hanzeplein 1 (Entrance 24- Triade), Groningen 9700 RB, the Netherlands; Department of Psychiatry, Rijks Universiteit Groningen, University Medical Center Groningen, GGZ Drenthe Mental Health Institution, Assen, the Netherlands
| | - D van den Berg
- Department of Clinical Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands; Department of Psychosis research and Innovation, Parnassia Psychiatric Institute, the Hague, the Netherlands
| | - A J Oldehinkel
- Dept of Psychiatry, Interdisciplinary Centre Psychopathology and Emotion regulation, University of Groningen, University Medical Center Groningen, Hanzeplein 1 (Entrance 24- Triade), Groningen 9700 RB, the Netherlands
| | - J T W Wigman
- Dept of Psychiatry, Interdisciplinary Centre Psychopathology and Emotion regulation, University of Groningen, University Medical Center Groningen, Hanzeplein 1 (Entrance 24- Triade), Groningen 9700 RB, the Netherlands
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van der Tuin S, Booij SH, Oldehinkel AJ, van den Berg D, Wigman JTW, Lång U, Kelleher I. The dynamic relationship between sleep and psychotic experiences across the early stages of the psychosis continuum. Psychol Med 2023; 53:1-9. [PMID: 37218061 PMCID: PMC10755227 DOI: 10.1017/s0033291723001459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 04/26/2023] [Accepted: 05/01/2023] [Indexed: 05/24/2023]
Abstract
BACKGROUND Psychotic disorders develop gradually along a continuum of severity. Understanding factors associated with psychosis development, such as sleep, could aid in identification of individuals at elevated risk. This study aimed to assess (1) the dynamic relationship between psychotic experiences (PEs) and sleep quality and quantity, and (2) whether this relationship differed between different clinical stages along the psychosis continuum. METHODS We used daily diary data (90 days) of individuals (N = 96) at early stages (i.e. before a first diagnosis of psychosis) along the psychosis continuum. Multilevel models were constructed with sleep quality and sleep quantity as predictors of PEs and vice versa. Post-hoc, we constructed a multilevel model with both sleep quality and quantity as predictors of PEs. In addition, we tested whether associations differed between clinical stages. RESULTS Within persons, poorer sleep predicted next day PEs (B = -0.02, p = 0.01), but not vice versa. Between persons, shorter sleep over the 90-day period predicted more PEs (B = -0.04, p = 0.002). Experiencing more PEs over 90-days predicted poorer (B = -0.02, p = 0.02) and shorter (B = -1.06, p = 0.008) sleep. We did not find any significant moderation effects for clinical stage. CONCLUSIONS We found a bidirectional relationship between sleep and PEs with daily fluctuations in sleep predicting next day PEs and general patterns of more PEs predicting poorer and shorter sleep. Our results highlight the importance of assessing sleep as a risk marker in the early clinical stages for psychosis.
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Affiliation(s)
- S. van der Tuin
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Centre Psychopathology and Emotion Regulation, Groningen, the Netherlands
| | - S. H. Booij
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Centre Psychopathology and Emotion Regulation, Groningen, the Netherlands
- Center for Integrative Psychiatry, Lentis, Groningen, the Netherlands
| | - A. J. Oldehinkel
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Centre Psychopathology and Emotion Regulation, Groningen, the Netherlands
| | - D. van den Berg
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Department of Psychosis Research, Parnassia Psychiatric Institute, The Hague, the Netherlands
| | - J. T. W. Wigman
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Centre Psychopathology and Emotion Regulation, Groningen, the Netherlands
| | - U. Lång
- University College Dublin, School of Medicine, Dublin, Ireland
| | - I. Kelleher
- University College Dublin, School of Medicine, Dublin, Ireland
- University of Edinburgh, Centre for Clinical Brain Sciences, Edinburgh, UK
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Bos FM, von Klipstein L, Emerencia AC, Veermans E, Verhage T, Snippe E, Doornbos B, Hadders-Prins G, Wichers M, Riese H. A Web-Based Application for Personalized Ecological Momentary Assessment in Psychiatric Care: User-Centered Development of the PETRA Application. JMIR Ment Health 2022; 9:e36430. [PMID: 35943762 PMCID: PMC9399881 DOI: 10.2196/36430] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 04/11/2022] [Accepted: 05/06/2022] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Smartphone self-monitoring of mood, symptoms, and contextual factors through ecological momentary assessment (EMA) provides insights into the daily lives of people undergoing psychiatric treatment. Therefore, EMA has the potential to improve their care. To integrate EMA into treatment, a clinical tool that helps clients and clinicians create personalized EMA diaries and interpret the gathered data is needed. OBJECTIVE This study aimed to develop a web-based application for personalized EMA in specialized psychiatric care in close collaboration with all stakeholders (ie, clients, clinicians, researchers, and software developers). METHODS The participants were 52 clients with mood, anxiety, and psychotic disorders and 45 clinicians (psychiatrists, psychologists, and psychiatric nurses). We engaged them in interviews, focus groups, and usability sessions to determine the requirements for an EMA web application and repeatedly obtained feedback on iteratively improved high-fidelity EMA web application prototypes. We used human-centered design principles to determine important requirements for the web application and designed high-fidelity prototypes that were continuously re-evaluated and adapted. RESULTS The iterative development process resulted in Personalized Treatment by Real-time Assessment (PETRA), which is a scientifically grounded web application for the integration of personalized EMA in Dutch clinical care. PETRA includes a decision aid to support clients and clinicians with constructing personalized EMA diaries, an EMA diary item repository, an SMS text message-based diary delivery system, and a feedback module for visualizing the gathered EMA data. PETRA is integrated into electronic health record systems to ensure ease of use and sustainable integration in clinical care and adheres to privacy regulations. CONCLUSIONS PETRA was built to fulfill the needs of clients and clinicians for a user-friendly and personalized EMA tool embedded in routine psychiatric care. PETRA is unique in this codevelopment process, its extensive but user-friendly personalization options, its integration into electronic health record systems, its transdiagnostic focus, and its strong scientific foundation in the design of EMA diaries and feedback. The clinical effectiveness of integrating personalized diaries via PETRA into care requires further research. As such, PETRA paves the way for a systematic investigation of the utility of personalized EMA for routine mental health care.
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Affiliation(s)
- Fionneke M Bos
- Rob Giel Research Center, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.,Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Lino von Klipstein
- Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Ando C Emerencia
- Research Support, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, Netherlands
| | - Erwin Veermans
- Rob Giel Research Center, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Tom Verhage
- Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Evelien Snippe
- Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | | | - Grietje Hadders-Prins
- Rob Giel Research Center, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Marieke Wichers
- Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Harriëtte Riese
- Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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Kuranova A, Booij SH, Oldehinkel AJ, Wichers M, Jeronimus B, Wigman JTW. Reflections on psychological resilience: a comparison of three conceptually different operationalizations in predicting mental health. Eur J Psychotraumatol 2021; 12:1956802. [PMID: 34589174 PMCID: PMC8475143 DOI: 10.1080/20008198.2021.1956802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Psychological resilience refers to the ability to maintain mental health or recover quickly after stress. Despite the popularity of resilience research, there is no consensus understanding or operationalization of resilience. OBJECTIVE We plan to compare three indicators of resilience that each involve a different operationalization of the construct: a) General resilience or one's self-reported general ability to overcome adversities; b) Daily resilience as momentarily experienced ability to overcome adversities; and c) Recovery speed evident in the pattern of negative affect recovery after small adversities in daily life. These three indicators are constructed per person to investigate their cross-sectional associations, stability over time, and predictive validity regarding mental health. METHODS Data will be derived from the prospective MIRORR study that comprises 96 individuals at different levels of psychosis risk and contains both single-time assessed questionnaires and 90-days intensive longitudinal data collection at baseline (T0) and three yearly follow-up waves (T1-T3). General resilience is assessed using the Brief Resilience Scale (BRS) at baseline. Daily resilience is measured by averaging daily resilience scores across 90 days. For recovery speed, vector-autoregressive models with consecutive impulse response simulations will be applied to diary data on negative affect and daily stressors to calculate pattern of affect recovery. These indicators will be correlated concurrently (at T0) to assess their overlap and prospectively (between T0 and T1) to estimate their stability. Their predictive potential will be assessed by regression analysis with mental health (SCL-90) as an outcome, resilience indicators as predictors, and stressful life events as a moderator. CONCLUSION The comparison of different conceptualizations of psychological resilience can increase our understanding of its multifaceted nature and, in future, help improve diagnostic, prevention and intervention strategies aimed at increasing psychological resilience.
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Affiliation(s)
- Anna Kuranova
- Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University Center Psychiatry (UCP), University of Groningen, Groningen, The Netherlands
| | - Sanne H Booij
- Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University Center Psychiatry (UCP), University of Groningen, Groningen, The Netherlands.,Department of Research and Education, Friesland Mental Health Care Services, Leeuwarden, The Netherlands.,Center for Integrative Psychiatry, Lentis, Groningen, The Netherlands
| | - Albertine J Oldehinkel
- Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University Center Psychiatry (UCP), University of Groningen, Groningen, The Netherlands
| | - Marieke Wichers
- Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University Center Psychiatry (UCP), University of Groningen, Groningen, The Netherlands
| | - Bertus Jeronimus
- Department of Developmental Psychology, University of Groningen, Groningen, The Netherlands
| | - Johanna T W Wigman
- Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University Center Psychiatry (UCP), University of Groningen, Groningen, The Netherlands.,Department of Research and Education, Friesland Mental Health Care Services, Leeuwarden, The Netherlands
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Reilly T, Mechelli A, McGuire P, Fusar-Poli P, Uhlhaas PJ. E-Clinical High Risk for Psychosis: Viewpoint on Potential of Digital Innovations for Preventive Psychiatry. JMIR Ment Health 2019; 6:e14581. [PMID: 31584006 PMCID: PMC6915798 DOI: 10.2196/14581] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 06/28/2019] [Accepted: 06/28/2019] [Indexed: 12/12/2022] Open
Abstract
E-mental health is an emerging area of research that has the potential to overcome some of the current barriers to progress in working with people at clinical high risk for psychosis (CHR-P). This article provides an overview of how e-mental health could be used in the detection, prediction, and treatment in the CHR-P population. Specifically, we evaluate e-detection, e-prediction, and e-therapeutics for this clinical population. E-mental health holds great promise to improve current management of CHR-P individuals.
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Affiliation(s)
- Thomas Reilly
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Andrea Mechelli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.,Early Psychosis: Interventions and Clinical-Detection Lab, Department of Psychosis Studies, King's College London, London, United Kingdom.,OASIS Service, South London and Maudsley National Health Service Foundation Trust, London, United Kingdom.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.,National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley National Health Service Foundation Trust, London, United Kingdom
| | - Peter J Uhlhaas
- Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, United Kingdom
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McGorry PD, Hartmann JA, Spooner R, Nelson B. Beyond the "at risk mental state" concept: transitioning to transdiagnostic psychiatry. World Psychiatry 2018; 17:133-142. [PMID: 29856558 PMCID: PMC5980504 DOI: 10.1002/wps.20514] [Citation(s) in RCA: 257] [Impact Index Per Article: 42.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The "at risk mental state" for psychosis approach has been a catalytic, highly productive research paradigm over the last 25 years. In this paper we review that paradigm and summarize its key lessons, which include the valence of this phenotype for future psychosis outcomes, but also for comorbid, persistent or incident non-psychotic disorders; and the evidence that onset of psychotic disorder can at least be delayed in ultra high risk (UHR) patients, and that some full-threshold psychotic disorder may emerge from risk states not captured by UHR criteria. The paradigm has also illuminated risk factors and mechanisms involved in psychosis onset. However, findings from this and related paradigms indicate the need to develop new identification and diagnostic strategies. These findings include the high prevalence and impact of mental disorders in young people, the limitations of current diagnostic systems and risk identification approaches, the diffuse and unstable symptom patterns in early stages, and their pluripotent, transdiagnostic trajectories. The approach we have recently adopted has been guided by the clinical staging model and adapts the original "at risk mental state" approach to encompass a broader range of inputs and output target syndromes. This approach is supported by a number of novel modelling and prediction strategies that acknowledge and reflect the dynamic nature of psychopathology, such as dynamical systems theory, network theory, and joint modelling. Importantly, a broader transdiagnostic approach and enhancing specific prediction (profiling or increasing precision) can be achieved concurrently. A holistic strategy can be developed that applies these new prediction approaches, as well as machine learning and iterative probabilistic multimodal models, to a blend of subjective psychological data, physical disturbances (e.g., EEG measures) and biomarkers (e.g., neuroinflammation, neural network abnormalities) acquired through fine-grained sequential or longitudinal assessments. This strategy could ultimately enhance our understanding and ability to predict the onset, early course and evolution of mental ill health, further opening pathways for preventive interventions.
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Affiliation(s)
- Patrick D. McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health, and Centre for Youth Mental HealthUniversity of MelbourneParkvilleAustralia
| | - Jessica A. Hartmann
- Orygen, The National Centre of Excellence in Youth Mental Health, and Centre for Youth Mental HealthUniversity of MelbourneParkvilleAustralia
| | - Rachael Spooner
- Orygen, The National Centre of Excellence in Youth Mental Health, and Centre for Youth Mental HealthUniversity of MelbourneParkvilleAustralia
| | - Barnaby Nelson
- Orygen, The National Centre of Excellence in Youth Mental Health, and Centre for Youth Mental HealthUniversity of MelbourneParkvilleAustralia
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