Towards precision in the diagnostic profiling of patients: leveraging symptom dynamics as a clinical characterisation dimension in the assessment of major depressive disorder

BACKGROUND

International guidelines present overall symptom severity as the key dimension for clinical characterisation of major depressive disorder (MDD). However, differences may reside within severity levels related to how symptoms interact in an individual patient, called symptom dynamics.

AIMS

To investigate these individual differences by estimating the proportion of patients that display differences in their symptom dynamics while sharing the same overall symptom severity.

METHOD

Participants with MDD (n = 73; mean age 34.6 years, s.d. = 13.1; 56.2% female) rated their baseline symptom severity using the Inventory for Depressive Symptomatology Self-Report (IDS-SR). Momentary indicators for depressive symptoms were then collected through ecological momentary assessments five times per day for 28 days; 8395 observations were conducted (average per person: 115; s.d. = 16.8). Each participant's symptom dynamics were estimated using person-specific dynamic network models. Individual differences in these symptom relationship patterns in groups of participants sharing the same symptom severity levels were estimated using individual network invariance tests. Subsequently, the overall proportion of participants that displayed differential symptom dynamics while sharing the same symptom severity was calculated. A supplementary simulation study was conducted to investigate the accuracy of our methodology against false-positive results.

RESULTS

Differential symptom dynamics were identified across 63.0% (95% bootstrapped CI 41.0-82.1) of participants within the same severity group. The average false detection of individual differences was 2.2%.

CONCLUSIONS

The majority of participants within the same depressive symptom severity group displayed differential symptom dynamics. Examining symptom dynamics provides information about person-specific psychopathological expression beyond severity levels by revealing how symptoms aggravate each other over time. These results suggest that symptom dynamics may be a promising new dimension for clinical characterisation, warranting replication in independent samples. To inform personalised treatment planning, a next step concerns linking different symptom relationship patterns to treatment response and clinical course, including patterns related to spontaneous recovery and forms of disorder progression.

Testing similarity in longitudinal networks: The Individual Network Invariance Test

The comparison of idiographic network structures to determine the presence of heterogeneity is a challenging endeavor in many applied settings. Previously, researchers eyeballed idiographic networks, computed correlations, and used techniques that make use of the multilevel structure of the data (e.g., group iterative multiple model estimation and multilevel vector autoregressive) to investigate individual differences. However, these methods do not allow for testing the (in)equality of idiographic network structures directly. In this article, we propose the Individual Network Invariance Test (INIT), which we implemented in the R package INIT. INIT extends common model comparison practices in structural equation modeling to idiographic network structures to test for (in)equality between idiographic networks. In a simulation study, we evaluated the performance of INIT on both saturated and pruned idiographic network structures by inspecting the rejection rate of the χ² difference test and model selection criteria, such as the Akaike information criterion (AIC) and Bayesian information criterion (BIC). Results show INIT performs adequately when t = 100 per individual. When applying INIT on saturated networks, the AIC performed best as a model selection criterion, while the BIC showed better results when applying INIT on pruned networks. In an empirical example, we highlight the possibilities of this new technique, illustrating how INIT provides researchers with a means of testing for (in)equality between idiographic network structures and within idiographic network structures over time. To conclude, recommendations for empirical researchers are provided. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Recognize the Value of the Sum Score, Psychometrics' Greatest Accomplishment

The sum score on a psychological test is, and should continue to be, a tool central in psychometric practice. This position runs counter to several psychometricians' belief that the sum score represents a pre-scientific conception that must be abandoned from psychometrics in favor of latent variables. First, we reiterate that the sum score stochastically orders the latent variable in a wide variety of much-used item response models. In fact, item response theory provides a mathematically based justification for the ordinal use of the sum score. Second, because discussions about the sum score often involve its reliability and estimation methods as well, we show that, based on very general assumptions, classical test theory provides a family of lower bounds several of which are close to the true reliability under reasonable conditions. Finally, we argue that eventually sum scores derive their value from the degree to which they enable predicting practically relevant events and behaviors. None of our discussion is meant to discredit modern measurement models; they have their own merits unattainable for classical test theory, but the latter model provides impressive contributions to psychometrics based on very few assumptions that seem to have become obscured in the past few decades. Their generality and practical usefulness add to the accomplishments of more recent approaches.

Revealing the psychopathological pathway linking trauma to post-traumatic stress disorder: longitudinal network approach

The present study investigated the psychopathological processes of post-traumatic stress disorder (PTSD) following the network approach to psychopathology. The directed acyclic graph model was employed to analyse a large longitudinal data-set of Chinese children and adolescents exposed to a destructive earthquake. It was found that intrusion symptoms were first activated by trauma exposure, and subsequently activated other PTSD symptoms. The data are consistent with the idea that symptoms may form a self-sustaining dynamic network by interacting with each other to promote or maintain the chronicity of PTSD. The findings advance the current understanding about the psychopathological processes of PTSD, and inform further research and clinical practices on post-traumatic psychopathology.

Comparing network structures on three aspects: A permutation test

Network approaches to psychometric constructs, in which constructs are modeled in terms of interactions between their constituent factors, have rapidly gained popularity in psychology. Applications of such network approaches to various psychological constructs have recently moved from a descriptive stance, in which the goal is to estimate the network structure that pertains to a construct, to a more comparative stance, in which the goal is to compare network structures across populations. However, the statistical tools to do so are lacking. In this article, we present the network comparison test (NCT), which uses resampling-based permutation testing to compare network structures from two independent, cross-sectional data sets on invariance of (a) network structure, (b) edge (connection) strength, and (c) global strength. Performance of NCT is evaluated in simulations that show NCT to perform well in various circumstances for all three tests: The Type I error rate is close to the nominal significance level, and power proves sufficiently high if sample size and difference between networks are substantial. We illustrate NCT by comparing depression symptom networks of males and females. Possible extensions of NCT are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Relating stability of individual dynamical networks to change in psychopathology

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.

Towards a general modeling framework of resource competition in cognitive development

The current paper presents an integrated formal model of typical and atypical development based on the mechanisms of mutualism and resource competition. The mutualistic network model is extended with the dynamics of competition for limited resources, such as time and environmental factors. The proposed model generates patterns that resemble established phenomena in cognitive development: the positive manifold, developmental phases, developmental delays and lack of early indicators in atypical development, developmental regression, and "quasi-autism" caused by extreme environmental deprivation. The presented modeling framework fits a general movement towards formal theory construction in psychology. The model is easy to replicate and develop further, and we offer several avenues for future work.

Formalizing theories of child development: Introduction to the special section

Here we introduce a Special Section of Child Development entitled "Formalizing Theories of Child Development." This Special Section features five papers that use mathematical models to advance our understanding of central questions in the study of child development. This landmark collection is timely: it signifies growing awareness that rigorous empirical bricks are not enough; we need solid theory to build the house. By stating theory in mathematical terms, formal models make concepts, assumptions, and reasoning more explicit than verbal theory does. This increases falsifiability, promotes cumulative science, and enables integration with mathematical theory in allied disciplines. The Special Section contributions cover a range of topics: the developmental origins of counting, interactions between mathematics and language development, visual exploration and word learning in infancy, referent identification by toddlers, and the emergence of typical and atypical development. All are written in an accessible manner and for a broad audience.

Reporting standards for psychological network analyses in cross-sectional data

Statistical network models describing multivariate dependency structures in psychological data have gained increasing popularity. Such comparably novel statistical techniques require specific guidelines to make them accessible to the research community. So far, researchers have provided tutorials guiding the estimation of networks and their accuracy. However, there is currently little guidance in determining what parts of the analyses and results should be documented in a scientific report. A lack of such reporting standards may foster researcher degrees of freedom and could provide fertile ground for questionable reporting practices. Here, we introduce reporting standards for network analyses in cross-sectional data, along with a tutorial and two examples. The presented guidelines are aimed at researchers as well as the broader scientific community, such as reviewers and journal editors evaluating scientific work. We conclude by discussing how the network literature specifically can benefit from such guidelines for reporting and transparency. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Towards an encompassing theory of network models: Reply to Brusco, Steinley, Hoffman, Davis-Stober, and Wasserman (2019)

Network models like the Ising model are increasingly used in psychological research. In a recent article published in this journal, Brusco et al. (2019) provide a critical assessment of the conditions that underlie the Ising model and the eLasso method that is commonly used to estimate it. In this commentary, we show that their main criticisms are unfounded. First, where Brusco et al. (2019) suggest that Ising models have little to do with classical network models such as random graphs, we show that they can be fruitfully connected. Second, if one makes this connection it is immediately evident that Brusco et al.'s (2019) second criticism-that the Ising model requires complete population homogeneity and does not allow for individual differences in network structure-is incorrect. In particular, we establish that if every individual has their own topology, and these individual differences instantiate a random graph model, the Ising model will hold in the population. Hence, population homogeneity is sufficient for the Ising model, but it is not necessary, as Brusco et al. (2019) suggest. Third, we address Brusco et al.'s (2019) criticism regarding the sparsity assumption that is made in common uses of the Ising model. We show that this criticism is misdirected, as it targets a particular estimation algorithm for the Ising model rather than the model itself. We also describe various established and validated approaches for estimating the Ising model for networks that violate the sparsity assumption. Finally, we outline important avenues for future research. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Heterogeneity in Individual Network Analysis: Reality or Illusion?

The use of idiographic research techniques has gained popularity within psychological research and network analysis in particular. Idiographic research has been proposed as a promising avenue for future research, with differences between idiographic results highlighting evidence for radical heterogeneity. However, in the quest to address the individual in psychology, some classic statistical problems, such as those arising from sampling variation and power limitations, should not be overlooked. This article aims to determine to what extent current tools to compare idiographic networks are suited to disentangle true from illusory heterogeneity in the presence of sampling error. To this end, we investigate the performance of tools to inspect heterogeneity (visual inspection, comparison of centrality measures, investigating standard deviations of random effects, and GIMME) through simulations. Results show that power limitations hamper the validity of conclusions regarding heterogeneity and that the power required to assess heterogeneity adequately is often not realized in current research practice. Of the tools investigated, inspecting standard deviations of random effects and GIMME proved the most suited. However, all tools evaluated leave the door wide open to misinterpret all observed variability in terms of individual differences. Hence, the current paper calls for caution in the use and interpretation of new time-series techniques when it comes to heterogeneity.

Interpretational issues with the bifactor model: a commentary on 'Defining the p-Factor: An Empirical Test of Five Leading Theories' by Southward, Cheavens, and Coccaro

Southward, Cheavens, and Coccaro (2022, Psychological Medicine) conducted an ambitious investigation aimed at determining the nature of the general p factor of psychopathology by considering the correlation between the p factor and five candidate constructs. Generally, in this area of research, the bifactor model is preferred to the second order common factor model. In this commentary, we identify several interpretational issues concerning the bifactor model, which are based on a realistic psychometric view of latent variables. These issues may hamper the study of the nature of p factor model using the bifactor model.

Comparing theories with the Ising model of explanatory coherence

Theories are among the most important tools of science. Lewin (1943) already noted "There is nothing as practical as a good theory." Although psychologists discussed problems of theory in their discipline for a long time, weak theories are still widespread in most subfields. One possible reason for this is that psychologists lack the tools to systematically assess the quality of their theories. Thagard (1989) developed a computational model for formal theory evaluation based on the concept of explanatory coherence. However, there are possible improvements to Thagard's (1989) model and it is not available in software that psychologists typically use. Therefore, we developed a new implementation of explanatory coherence based on the Ising model. We demonstrate the capabilities of this new Ising model of Explanatory Coherence (IMEC) on several examples from psychology and other sciences. In addition, we implemented it in the R-package IMEC to assist scientists in evaluating the quality of their theories in practice. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

How compliance with behavioural measures during the initial phase of a pandemic develops over time: A longitudinal COVID-19 study

In this longitudinal research, we adopt a complexity approach to examine the temporal dynamics of variables related to compliance with behavioural measures during the COVID-19 pandemic. Dutch participants (N = 2399) completed surveys with COVID-19-related variables five times over a period of 10 weeks (23 April-30 June 2020). With these data, we estimated within-person COVID-19 attitude networks containing a broad set of psychological variables and their relations. These networks display variables' predictive effects over time between measurements and contemporaneous effects during measurements. Results show (1) bidirectional effects between multiple variables relevant for compliance, forming potential feedback loops, and (2) a positive reinforcing structure between compliance, support for behavioural measures, involvement in the pandemic and vaccination intention. These results can explain why levels of these variables decreased throughout the course of the study. The reinforcing structure points towards potentially amplifying effects of interventions on these variables and might inform processes of polarization. We conclude that adopting a complexity approach might contribute to understanding protective behaviour in the initial phase of pandemics by combining different theoretical models and modelling bidirectional effects between variables. Future research could build upon this research by studying causality with interventions and including additional variables in the networks.

Longitudinal development of language and fine motor skills is correlated, but not coupled, in a childhood atypical cohort

LAY ABSTRACT

More and more members of the autistic community and the research field are moving away from the idea that there will be a single biological or cognitive explanation for autistic characteristics. However, little is known about the complex dynamic processes that could explain why early difficulties in the language and motor domain often go hand-in-hand. We here study how language and motor skills develop simultaneously in the British Autism Study of Infant Siblings cohort of infants, and compare the way they are linked between children with and without developmental delays. Our results suggest that improvements in one domain go hand-in-hand with improvements in the other in both groups and show no compelling evidence for group differences in how motor skills relate to language and vice versa. We did observe a larger diversity in motor and language skills at 6 months, and because we found the motor and language development to be tightly linked, this suggests that even very small early impairments can result in larger developmental delays in later childhood. Greater variability at baseline, combined with very strong correlations between the slopes, suggests that dynamic processes may amplify small differences between individuals at 6months to result into large individual differences in autism symptomatology at 36 months.

Modeling psychopathology: From data models to formal theories

Over the past decade, there has been a surge of empirical research investigating mental disorders as complex systems. In this article, we investigate how to best make use of this growing body of empirical research and move the field toward its fundamental aims of explaining, predicting, and controlling psychopathology. We first review the contemporary philosophy of science literature on scientific theories and argue that fully achieving the aims of explanation, prediction, and control requires that we construct formal theories of mental disorders: theories expressed in the language of mathematics or a computational programming language. We then investigate three routes by which one can use empirical findings (i.e., data models) to construct formal theories: (a) using data models themselves as formal theories, (b) using data models to infer formal theories, and (c) comparing empirical data models to theory-implied data models in order to evaluate and refine an existing formal theory. We argue that the third approach is the most promising path forward. We conclude by introducing the abductive formal theory construction (AFTC) framework, informed by both our review of philosophy of science and our methodological investigation. We argue that this approach provides a clear and promising way forward for using empirical research to inform the generation, development, and testing of formal theories both in the domain of psychopathology and in the broader field of psychological science. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Modeling psychopathology: From data models to formal theories

Over the past decade, there has been a surge of empirical research investigating mental disorders as complex systems. In this article, we investigate how to best make use of this growing body of empirical research and move the field toward its fundamental aims of explaining, predicting, and controlling psychopathology. We first review the contemporary philosophy of science literature on scientific theories and argue that fully achieving the aims of explanation, prediction, and control requires that we construct formal theories of mental disorders: theories expressed in the language of mathematics or a computational programming language. We then investigate three routes by which one can use empirical findings (i.e., data models) to construct formal theories: (a) using data models themselves as formal theories, (b) using data models to infer formal theories, and (c) comparing empirical data models to theory-implied data models in order to evaluate and refine an existing formal theory. We argue that the third approach is the most promising path forward. We conclude by introducing the abductive formal theory construction (AFTC) framework, informed by both our review of philosophy of science and our methodological investigation. We argue that this approach provides a clear and promising way forward for using empirical research to inform the generation, development, and testing of formal theories both in the domain of psychopathology and in the broader field of psychological science. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Tailored interventions into broad attitude networks towards the COVID-19 pandemic

This study examines how broad attitude networks are affected by tailored interventions aimed at variables selected based on their connectiveness with other variables. We first computed a broad attitude network based on a large-scale cross-sectional COVID-19 survey (N = 6,093). Over a period of approximately 10 weeks, participants were invited five times to complete this survey, with the third and fifth wave including interventions aimed at manipulating specific variables in the broad COVID-19 attitude network. Results suggest that targeted interventions that yield relatively strong effects on variables central to a broad attitude network have downstream effects on connected variables, which can be partially explained by the variables the interventions were aimed at. We conclude that broad attitude network structures can reveal important relations between variables that can help to design new interventions.

A causal theory of error scores

In modern test theory, response variables are a function of a common latent variable that represents the measured attribute, and error variables that are unique to the response variables. While considerable thought goes into the interpretation of latent variables in these models (e.g., validity research), the interpretation of error variables is typically left implicit (e.g., describing error variables as residuals). Yet, many psychometric assumptions are essentially assumptions about error and thus being able to reason about psychometric models requires the ability to reason about errors. We propose a causal theory of error as a framework that enables researchers to reason about errors in terms of the data-generating mechanism. In this framework, the error variable reflects myriad causes that are specific to an item and, together with the latent variable, determine the scores on that item. We distinguish two types of item-specific causes: characteristic variables that differ between people (e.g., familiarity with words used in the item), and circumstance variables that vary over occasions in which the item is administered (e.g., a distracting noise). We show that different assumptions about these unique causes (a) imply different psychometric models; (b) have different implications for the chance experiment that makes these models probabilistic models; and (c) have different consequences for item bias, local homogeneity, and reliability coefficient α and the test-retest correlation. The ability to reason about the causes that produce error variance puts researchers in a better position to motivate modeling choices. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Values in Psychometrics

When it originated in the late 19th century, psychometrics was a field with both a scientific and a social mission: Psychometrics provided new methods for research into individual differences and at the same time considered these methods a means of creating a new social order. In contrast, contemporary psychometrics-because of its highly technical nature and its limited involvement in substantive psychological research-has created the impression of being a value-free discipline. In this article, we develop a contrasting characterization of contemporary psychometrics as a value-laden discipline. We expose four such values: that individual differences are quantitative (rather than qualitative), that measurement should be objective in a specific sense, that test items should be fair, and that the utility of a model is more important than its truth. Our goal is not to criticize psychometrics for supporting these values but rather to bring them into the open and to show that they are not inevitable and are in need of systematic evaluation.

Quantifying agent impacts on contact sequences in social interactions

Human social behavior plays a crucial role in how pathogens like SARS-CoV-2 or fake news spread in a population. Social interactions determine the contact network among individuals, while spreading, requiring individual-to-individual transmission, takes place on top of the network. Studying the topological aspects of a contact network, therefore, not only has the potential of leading to valuable insights into how the behavior of individuals impacts spreading phenomena, but it may also open up possibilities for devising effective behavioral interventions. Because of the temporal nature of interactions—since the topology of the network, containing who is in contact with whom, when, for how long, and in which precise sequence, varies (rapidly) in time—analyzing them requires developing network methods and metrics that respect temporal variability, in contrast to those developed for static (i.e., time-invariant) networks. Here, by means of event mapping, we propose a method to quantify how quickly agents mingle by transforming temporal network data of agent contacts. We define a novel measure called contact sequence centrality, which quantifies the impact of an individual on the contact sequences, reflecting the individual’s behavioral potential for spreading. Comparing contact sequence centrality across agents allows for ranking the impact of agents and identifying potential ‘behavioral super-spreaders’. The method is applied to social interaction data collected at an art fair in Amsterdam. We relate the measure to the existing network metrics, both temporal and static, and find that (mostly at longer time scales) traditional metrics lose their resemblance to contact sequence centrality. Our work highlights the importance of accounting for the sequential nature of contacts when analyzing social interactions.

Possible Futures for Network Psychometrics

This commentary reflects on the articles included in the Psychometrika Special Issue on Network Psychometrics in Action. The contributions to the special issue are related to several possible future paths for research in this area. These include the development of models to analyze and represent interventions, improvement in exploratory and inferential techniques in network psychometrics, the articulation of psychometric theories in addition to psychometric models, and extensions of network modeling to novel data sources. Finally, network psychometrics is part of a larger movement in psychology that revolves around the analysis of human beings as complex systems, and it is timely that psychometricians start extending their rich modeling tradition to improve and extend the analysis of systems in psychology.

Overlapping timescales obscure early warning signals of the second COVID-19 wave

Early warning indicators based on critical slowing down have been suggested as a model-independent and low-cost tool to anticipate the (re)emergence of infectious diseases. We studied whether such indicators could reliably have anticipated the second COVID-19 wave in European countries. Contrary to theoretical predictions, we found that characteristic early warning indicators generally decreased rather than increased prior to the second wave. A model explains this unexpected finding as a result of transient dynamics and the multiple timescales of relaxation during a non-stationary epidemic. Particularly, if an epidemic that seems initially contained after a first wave does not fully settle to its new quasi-equilibrium prior to changing circumstances or conditions that force a second wave, then indicators will show a decreasing rather than an increasing trend as a result of the persistent transient trajectory of the first wave. Our simulations show that this lack of timescale separation was to be expected during the second European epidemic wave of COVID-19. Overall, our results emphasize that the theory of critical slowing down applies only when the external forcing of the system across a critical point is slow relative to the internal system dynamics.

Autistic Symptoms and Social Functioning in Psychosis: A Network Approach

Psychotic and autistic symptoms are related to social functioning in individuals with psychotic disorders (PD). The present study used a network approach to (1) evaluate the interactions between autistic symptoms, psychotic symptoms, and social functioning, and (2) investigate whether relations are similar in individuals with and without PD. We estimated an undirected network model in a sample of 504 PD, 572 familial risk for psychosis (FR), and 337 typical comparisons (TC), with a mean age of 34.9 years. Symptoms were assessed with the Autism Spectrum Quotient (AQ; 5 nodes) and the Community Assessment of Psychic Experiences (CAPE; 9 nodes). Social functioning was measured with the Social Functioning Scale (SFS; 7 nodes). We identified statistically significant differences between the FR and PD samples in global strength (P < .001) and network structure (P < .001). Our results show autistic symptoms (social interaction nodes) are negatively and more closely related to social functioning (withdrawal, interpersonal behavior) than psychotic symptoms. More and stronger connections between nodes were observed for the PD network than for FR and TC networks, while the latter 2 were similar in density (P = .11) and network structure (P = .19). The most central items in strength for PD were bizarre experiences, social skills, and paranoia. In conclusion, specific autistic symptoms are negatively associated with social functioning across the psychosis spectrum, but in the PD network symptoms may reinforce each other more easily. These findings emphasize the need for increased clinical awareness of comorbid autistic symptoms in psychotic individuals.

More than the sum of its parts: Merging network psychometrics and network neuroscience with application in autism

Network approaches that investigate the interaction between symptoms and behaviours have opened new ways of understanding psychological phenomena in health and disorder in recent years. In parallel, network approaches that characterise the interaction between brain regions have become the dominant approach in neuroimaging research. In this paper, we introduce a methodology for combining network psychometrics and network neuroscience. This approach utilises the information from the psychometric network to obtain neural correlates that are associated with each node in the psychometric network (network-based regression). Moreover, we combine the behavioural variables and their neural correlates in a joint network to characterise their interactions. We illustrate the approach by highlighting the interaction between the triad of autistic traits and their resting-state functional connectivity associations. To this end, we utilise data from 172 male autistic participants (10–21 years) from the autism brain data exchange (ABIDE, ABIDE-II) that completed resting-state fMRI and were assessed using the autism diagnostic interview (ADI-R). Our results indicate that the network-based regression approach can uncover both unique and shared neural correlates of behavioural measures. For instance, our example analysis indicates that the overlap between communication and social difficulties is not reflected in the overlap between their functional brain correlates.

The article introduces a method to combine common practices in network psychometrics and network neuroimaging. Namely, we use the unique variance in behavioural measures as regressors to identify unique neural correlates. This enables the description of brain-level and behavioural-level data into a joint network while keeping the dimensionality of the results manageable and interpretable. We illustrate this approach by showing the network of autistic traits and their correlates in resting-state functional connectivity.

Psychopathological networks: Theory, methods and practice

In recent years, network approaches to psychopathology have sparked much debate and have had a significant impact on how mental disorders are perceived in the field of clinical psychology. However, there are many important challenges in moving from theory to empirical research and clinical practice and vice versa. Therefore, in this article, we bring together different points of view on psychological networks by methodologists and clinicians to give a critical overview on these challenges, and to present an agenda for addressing these challenges. In contrast to previous reviews, we especially focus on methodological issues related to temporal networks. This includes topics such as selecting and assessing the quality of the nodes in the network, distinguishing between- and within-person effects in networks, relating items that are measured at different time scales, and dealing with changes in network structures. These issues are not only important for researchers using network models on empirical data, but also for clinicians, who are increasingly likely to encounter (person-specific) networks in the consulting room.

Intervening on psychopathology networks: Evaluating intervention targets through simulations

Identifying the different influences of symptoms in dynamic psychopathology models may hold promise for increasing treatment efficacy in clinical applications. Dynamic psychopathology models study the behavioral patterns of symptom networks, where symptoms mutually enforce each other. Interventions could be tailored to specific symptoms that are most effective at lowering symptom activity or that hinder the further development of psychopathology. Simulating interventions in psychopathology network models fits in a novel tradition where symptom-specific perturbations are used as in silico interventions. Here, we present the NodeIdentifyR algorithm (NIRA) to identify the projected most efficient, symptom-specific intervention target in a network model (i.e., the Ising model). We implemented NIRA in a freely available R package. The technique studies the projected effects of symptom-specific interventions by simulating data while symptom parameters (i.e., thresholds) are systematically altered. The projected effect of these interventions is defined in terms of the expected change in overall symptom activity across simulations. With this algorithm, it is possible to study (1) whether symptoms differ in their projected influence on the behavior of the symptom network and, if so, (2) which symptom has the largest projected effect in lowering or increasing overall symptom activation. As an illustration, we apply the algorithm to an empirical dataset containing Post-Traumatic Stress Disorder symptom assessments of participants who experienced the Wenchuan earthquake in 2008. The most important limitations of the method are discussed, as well as recommendations for future research, such as shifting towards modeling individual processes to validate these types of simulation-based intervention methods.

Advancing urban mental health research: from complexity science to actionable targets for intervention

Urbanisation and common mental disorders (CMDs; ie, depressive, anxiety, and substance use disorders) are increasing worldwide. In this Review, we discuss how urbanicity and risk of CMDs relate to each other and call for a complexity science approach to advance understanding of this interrelationship. We did an ecological analysis using data on urbanicity and CMD burden in 191 countries. We found a positive, non-linear relationship with a higher CMD prevalence in more urbanised countries, particularly for anxiety disorders. We also did a review of meta-analytic studies on the association between urban factors and CMD risk. We identified factors relating to the ambient, physical, and social urban environment and showed differences per diagnosis of CMDs. We argue that factors in the urban environment are likely to operate as a complex system and interact with each other and with individual city inhabitants (including their psychological and neurobiological characteristics) to shape mental health in an urban context. These interactions operate on various timescales and show feedback loop mechanisms, rendering system behaviour characterised by non-linearity that is hard to predict over time. We present a conceptual framework for future urban mental health research that uses a complexity science approach. We conclude by discussing how complexity science methodology (eg, network analyses, system-dynamic modelling, and agent-based modelling) could enable identification of actionable targets for treatment and policy, aimed at decreasing CMD burdens in an urban context.

The exploratory value of cross-sectional partial correlation networks: Predicting relationships between change trajectories in borderline personality disorder

Objective

Within the network approach to psychopathology, cross-sectional partial correlation networks have frequently been used to estimate relationships between symptoms. The resulting relationships have been used to generate hypotheses about causal links between symptoms. In order to justify such exploratory use of partial correlation networks, one needs to assume that the between-subjects relationships in the network approximate systematic within-subjects relationships, which are in turn the results of some within-subjects causal mechanism. If this assumption holds, relationships in the network should be mirrored by relationships between symptom changes; if links in networks approximate systematic within-subject relationships, change in a symptom should relate to change in connected symptoms.

Method

To investigate this implication, we combined longitudinal data on the Borderline Personality Disorder Severity Index from four samples of borderline personality disorder patients (N = 683). We related parameters from baseline partial correlation networks of symptoms to relationships between change trajectories of these symptoms.

Results

Across multiple levels of analysis, our results showed that parameters from baseline partial correlation networks are strongly predictive of relationships between change trajectories.

Conclusions

By confirming its implication, our results support the idea that cross-sectional partial correlation networks hold a relevant amount of information about systematic within-subjects relationships and thereby have exploratory value to generate hypotheses about the causal dynamics between symptoms.

Connecting brain and behavior in clinical neuroscience: A network approach

In recent years, there has been an increase in applications of network science in many different fields. In clinical neuroscience and psychopathology, the developments and applications of network science have occurred mostly simultaneously, but without much collaboration between the two fields. The promise of integrating these network applications lies in a united framework to tackle one of the fundamental questions of our time: how to understand the link between brain and behavior. In the current overview, we bridge this gap by introducing conventions in both fields, highlighting similarities, and creating a common language that enables the exploitation of synergies. We provide research examples in autism research, as it accurately represents research lines in both network neuroscience and psychological networks. We integrate brain and behavior not only semantically, but also practically, by showcasing three methodological avenues that allow to combine networks of brain and behavioral data. As such, the current paper offers a stepping stone to further develop multi-modal networks and to integrate brain and behavior.

Smart Distance Lab's art fair, experimental data on social distancing during the COVID-19 pandemic

In the absence of a vaccine, social distancing behaviour is pivotal to mitigate COVID-19 virus spread. In this large-scale behavioural experiment, we gathered data during Smart Distance Lab: The Art Fair (n = 839) between August 28 and 30, 2020 in Amsterdam, the Netherlands. We varied walking directions (bidirectional, unidirectional, and no directions) and supplementary interventions (face mask and buzzer to alert visitors of 1.5 metres distance). We captured visitors’ movements using cameras, registered their contacts (defined as within 1.5 metres) using wearable sensors, and assessed their attitudes toward COVID-19 as well as their experience during the event using questionnaires. We also registered environmental measures (e.g., humidity). In this paper, we describe this unprecedented, multi-modal experimental data set on social distancing, including psychological, behavioural, and environmental measures. The data set is available on figshare and in a MySQL database. It can be used to gain insight into (attitudes toward) behavioural interventions promoting social distancing, to calibrate pedestrian models, and to inform new studies on behavioural interventions.

Measurement(s)	Proximity • Movement • Attitudes and beliefs relating to COVID-19 • Indoor environment measures
Technology Type(s)	Ultra-wideband technology • Camera Device • questionnaire • environment sensor
Factor Type(s)	Walking direction • Wearing of face masks • Proximity buzzer
Sample Characteristic - Organism	Homo sapiens
Sample Characteristic - Environment	public exhibition
Sample Characteristic - Location	Kingdom of the Netherlands

Machine-accessible metadata file describing the reported data: 10.6084/m9.figshare.14312180

Network outcome analysis identifies difficulty initiating sleep as a primary target for prevention of depression: a 6-year prospective study

Study Objectives

Major depressive disorder (MDD) is the leading cause of disability worldwide. Its high recurrence rate calls for prevention of first-onset MDD. Although meta-analysis suggested insomnia as the strongest modifiable risk factor, previous studies insufficiently addressed that insomnia might also occur as a residual symptom of unassessed prior depression, or as a comorbid complaint secondary to other depression risks.

Methods

In total, 768 participants from the Netherlands Study of Depression and Anxiety who were free from current and lifetime MDD were followed-up for four repeated assessments, spanning 6 years in total. We performed separate Cox proportional hazard analyses to evaluate whether baseline insomnia severity, short-sleep duration, and individual insomnia complaints prospectively predicted first-onset MDD during follow-up. The novel method of network outcome analysis (NOA) allowed us to sort out whether there is any direct predictive value of individual insomnia complaints among several other complaints that are associated with insomnia.

Results

Over 6-year follow-up, 141 (18.4%) were diagnosed with first-onset MDD. Insomnia severity but not sleep duration predicted first-onset MDD (HR = 1.11, 95% CI: 1.07–1.15), and this was driven solely by the insomnia complaint difficulty initiating sleep (DIS) (HR = 1.10, 95% CI: 1.04–1.16). NOA likewise identified DIS only to directly predict first-onset MDD, independent of four other associated depression complaints.

Conclusions

We showed prospectively that DIS is a risk factor for first-onset MDD. Among the different other insomnia symptoms, the specific treatment of DIS might be the most sensible target to combat the global burden of depression through prevention.

The Mental Health Ecosystem: Extending Symptom Networks With Risk and Protective Factors

Inspired by modeling approaches from the ecosystems literature, in this paper, we expand the network approach to psychopathology with risk and protective factors to arrive at an integrated analysis of resilience. We take a complexity approach to investigate the multifactorial nature of resilience and present a system in which a network of interacting psychiatric symptoms is targeted by risk and protective factors. These risk and protective factors influence symptom development patterns and thereby increase or decrease the probability that the symptom network is pulled toward a healthy or disorder state. In this way, risk and protective factors influence the resilience of the network. We take a step forward in formalizing the proposed system by implementing it in a statistical model and translating different influences from risk and protective factors to specific targets on the node and edge parameters of the symptom network. To analyze the behavior of the system under different targets, we present two novel network resilience metrics: Expected Symptom Activity (ESA, which indicates how many symptoms are active or inactive) and Symptom Activity Stability (SAS, which indicates how stable the symptom activity patterns are). These metrics follow standard practices in the resilience literature, combined with ideas from ecology and physics, and characterize resilience in terms of the stability of the system's healthy state. By discussing the advantages and limitations of our proposed system and metrics, we provide concrete suggestions for the further development of a comprehensive modeling approach to study the complex relationship between risk and protective factors and resilience.

Moderated Network Models

Pairwise network models such as the Gaussian Graphical Model (GGM) are a powerful and intuitive way to analyze dependencies in multivariate data. A key assumption of the GGM is that each pairwise interaction is independent of the values of all other variables. However, in psychological research, this is often implausible. In this article, we extend the GGM by allowing each pairwise interaction between two variables to be moderated by (a subset of) all other variables in the model, and thereby introduce a Moderated Network Model (MNM). We show how to construct MNMs and propose an ℓ1-regularized nodewise regression approach to estimate them. We provide performance results in a simulation study and show that MNMs outperform the split-sample based methods Network Comparison Test (NCT) and Fused Graphical Lasso (FGL) in detecting moderation effects. Finally, we provide a fully reproducible tutorial on how to estimate MNMs with the R-package mgm and discuss possible issues with model misspecification.

Perspectives on Psychometrics Interviews with 20 Past Psychometric Society Presidents

In this article, we present the findings of an oral history project on the past, present, and future of psychometrics, as obtained through structured interviews with twenty past Psychometric Society presidents. Perspectives on how psychometrics should be practiced vary strongly. Some presidents are psychology-oriented, whereas others have a more mathematical or statistical approach. The originally strong relationship between psychometrics and psychology has weakened, and contemporary psychometrics has become a diverse and multifaceted discipline. The presidents are confident psychometrics will continue to be relevant but believe psychometrics needs to become better at selling its strong points to relevant research areas. We recommend for psychometrics to cherish its plurality and make its goals and priorities explicit.

Latent Variable Models and Networks: Statistical Equivalence and Testability

Networks are gaining popularity as an alternative to latent variable models for representing psychological constructs. Whereas latent variable approaches introduce unobserved common causes to explain the relations among observed variables, network approaches posit direct causal relations between observed variables. While these approaches lead to radically different understandings of the psychological constructs of interest, recent articles have established mathematical equivalences that hold between network models and latent variable models. We argue that the fact that for any model from one class there is an equivalent model from the other class does not mean that both models are equally plausible accounts of the data-generating mechanism. In many cases the constraints that are meaningful in one framework translate to constraints in the equivalent model that lack a clear interpretation in the other framework. Finally, we discuss three diverging predictions for the relation between zero-order correlations and partial correlations implied by sparse network models and unidimensional factor models. We propose a test procedure that compares the likelihoods of these models in light of these diverging implications. We use an empirical example to illustrate our argument.

Extended network analysis: from psychopathology to chronic illness

BACKGROUND

Understanding complex associations between psychopathology and chronic illness is instrumental in facilitating both research and treatment progress. The current study is the first and only network-based study to provide such an encompassing view of unique associations between a multitude of mental and physical health-related domains.

METHODS

The current analyses were based on the Singapore Mental Health Study, a cross-sectional study of adult Singapore residents. The study sample consisted of 6616 respondents, of which 49.8% were male and 50.2% female. A network structure was constructed to examine associations between psychopathology, alcohol use, gambling, major chronic conditions, and functioning.

RESULTS

The network structure identified what we have labeled a Cartesian graph: a network visibly split into a psychopathological domain and a physical health domain. The borders between these domains were fuzzy and bridged by various cross-domain associations, with functioning items playing an important role in bridging chronic conditions to psychopathology.

CONCLUSIONS

Current results deliver a comprehensive overview of the complex relation between psychopathology, functioning, and chronic illness, highlighting potential pathways to comorbidity.

The network structure of schema modes

A fundamental question in psychotherapy is whether interventions should target client problems (i.e., problem-focused approaches) or client strengths (i.e., strength-focused approaches). In this study, we first propose to address this question from a network perspective on schema modes (i.e., healthy or dysfunctional patterns of co-occurring emotions, cognitions, and behaviours). From this perspective, schema modes mutually influence each other (e.g., healthy modes reduce dysfunctional modes). Recent evidence suggests that changes in modes that are strongly associated to other modes (i.e., central modes) could be associated with greater treatment effects. We therefore suggest research should investigate the relative centrality of healthy and dysfunctional modes. To make an exploratory start, we investigated the cross-sectional network structure of schema modes in a clinical (comprising individuals diagnosed with paranoid, narcissistic, histrionic, and Cluster C personality disorders) and non-clinical sample. Results showed that, in both samples, the Healthy Adult was significantly less central than several dysfunctional modes (e.g., Undisciplined Child and Abandoned and Abused Child). Although our study cannot draw causal conclusions, this finding could suggest that weakening dysfunctional modes (compared to strengthening the Healthy Adult) might be more effective in decreasing other dysfunctional modes. Our study further indicates that several schema modes are negatively associated, which could suggest that decreasing one might increase another. Finally, the Healthy Adult was among the modes that most strongly discriminated between clinical and non-clinical individuals. Longitudinal and experimental research into the network structure of schema modes is required to further clarify the relative influence of schema modes.

Obsessive-Compulsive Symptoms and Other Symptoms of the At-risk Mental State for Psychosis: A Network Perspective

BACKGROUND

The high prevalence of obsessive-compulsive symptoms (OCS) among subjects at Ultra-High Risk (UHR) for psychosis is well documented. However, the network structure spanning the relations between OCS and symptoms of the at risk mental state for psychosis as assessed with the Comprehensive Assessment of At Risk Mental States (CAARMS) has not yet been investigated. This article aimed to use a network approach to investigate the associations between OCS and CAARMS symptoms in a large sample of individuals with different levels of risk for psychosis.

METHOD

Three hundred and forty-one UHR and 66 healthy participants were included, who participated in the EU-GEI study. Data analysis consisted of constructing a network of CAARMS symptoms, investigating central items in the network, and identifying the shortest pathways between OCS and positive symptoms.

RESULTS

Strong associations between OCS and anxiety, social isolation and blunted affect were identified. Depression was the most central symptom in terms of the number of connections, and anxiety was a key item in bridging OCS to other symptoms. Shortest paths between OCS and positive symptoms revealed that unusual thought content and perceptual abnormalities were connected mainly via anxiety, while disorganized speech was connected via blunted affect and cognitive change.

CONCLUSIONS

Findings provide valuable insight into the central role of depression and the potential connective component of anxiety between OCS and other symptoms of the network. Interventions specifically aimed to reduce affective symptoms might be crucial for the development and prospective course of symptom co-occurrence.

Theory Construction Methodology: A Practical Framework for Building Theories in Psychology

This article aims to improve theory formation in psychology by developing a practical methodology for constructing explanatory theories: theory construction methodology (TCM). TCM is a sequence of five steps. First, the theorist identifies a domain of empirical phenomena that becomes the target of explanation. Second, the theorist constructs a prototheory, a set of theoretical principles that putatively explain these phenomena. Third, the prototheory is used to construct a formal model, a set of model equations that encode explanatory principles. Fourth, the theorist investigates the explanatory adequacy of the model by formalizing its empirical phenomena and assessing whether it indeed reproduces these phenomena. Fifth, the theorist studies the overall adequacy of the theory by evaluating whether the identified phenomena are indeed reproduced faithfully and whether the explanatory principles are sufficiently parsimonious and substantively plausible. We explain TCM with an example taken from research on intelligence (the mutualism model of intelligence), in which key elements of the method have been successfully implemented. We discuss the place of TCM in the larger scheme of scientific research and propose an outline for a university curriculum that can systematically educate psychologists in the process of theory formation.

Highways to happiness for autistic adults? Perceived causal relations among clinicians

The network approach to psychological phenomena advances our understanding of the interrelations between autism and well-being. We use the Perceived Causal Relations methodology in order to (i) identify perceived causal pathways in the well-being system, (ii) validate networks based on self-report data, and (iii) quantify and integrate clinical expertise in autism research. Trained clinicians served as raters (N = 29) completing 374 cause-effects ratings of 34 variables on well-being and symptomatology. A subgroup (N = 16) of raters chose intervention targets in the resulting network which we found to match the respective centrality of nodes. Clinicians' perception of causal relations was similar to the interrelatedness found in self-reported client data (N = 323). We present a useful tool for translating clinical expertise into quantitative information enabling future research to integrate this in scientific studies.

Personality, Resilience, and Psychopathology: A Model for the Interaction between Slow and Fast Network Processes in the Context of Mental Health

Network theories have been put forward for psychopathology (in which mental disorders originate from causal relations between symptoms) and for personality (in which personality factors originate from coupled equilibria of cognitions, affect states, behaviours, and environments). Here, we connect these theoretical strands in an overarching personality–resilience–psychopathology model. In this model, factors in personality networks control the shape of the dynamical landscape in which symptom networks evolve; for example, the neuroticism item ‘I often feel blue’ measures a general tendency to experience negative affect, which is hypothesized to influence the threshold parameter of the symptom ‘depressed mood’ in the psychopathology network. Conversely, events at the level of the fast–evolving psychopathology network (e.g. a depressive episode) can influence the slow–evolving personality variables (e.g. by increasing feelings of worthlessness). We apply the theory to neuroticism and major depressive disorder. Through simulations, we show that the model can accommodate important phenomena, such as the strong relation between neuroticism and depression and individual differences in the change of neuroticism levels and development of depression over time. The results of the simulation are implemented in an online, interactive simulation tool. Implications for research into the relationship between personality and psychopathology are discussed. © 2020 The Authors. European Journal of Personality published by John Wiley & Sons Ltd on behalf of European Association of Personality Psychology

Toward incorporating genetic risk scores into symptom networks of psychosis

BACKGROUND

Psychosis spectrum disorder is a heterogeneous, multifactorial clinical phenotype, known to have a high heritability, only a minor portion of which can be explained by molecular measures of genetic variation. This study proposes that the identification of genetic variation underlying psychotic disorder may have suffered due to issues in the psychometric conceptualization of the phenotype. Here we aim to open a new line of research into the genetics of mental disorders by explicitly incorporating genes into symptom networks. Specifically, we investigate whether links between a polygenic risk score (PRS) for schizophrenia and measures of psychosis proneness can be identified in a network model.

METHODS

We analyzed data from n = 2180 subjects (controls, patients diagnosed with a non-affective psychotic disorder, and the first-degree relatives of the patients). A network structure was computed to examine associations between the 42 symptoms of the Community Assessment of Psychic Experiences (CAPE) and the PRS for schizophrenia.

RESULTS

The resulting network shows that the PRS is directly connected to the spectrum of positive and depressive symptoms, with the items conspiracy and no future being more often located on predictive pathways from PRS to other symptoms.

CONCLUSIONS

To our knowledge, the current exploratory study provides a first application of the network framework to the field of behavior genetics research. This allows for a novel outlook on the investigation of the relations between genome-wide association study-based PRSs and symptoms of mental disorders, by focusing on the dependencies among variables.

Toward an Integrative Psychometric Model of Emotions

Emotions are part and parcel of the human condition, but their nature is debated. Three broad classes of theories about the nature of emotions can be distinguished: affect-program theories, constructionist theories, and appraisal theories. Integrating these broad classes of theories into a unifying theory is challenging. An integrative psychometric model of emotions can inform such a theory because psychometric models are intertwined with theoretical perspectives about constructs. To identify an integrative psychometric model, we delineate properties of emotions stated by emotion theories and investigate whether psychometric models account for these properties. Specifically, an integrative psychometric model of emotions should allow (a) identifying distinct emotions (central in affect-program theories), (b) between- and within-person variations of emotions (central in constructionist theories), and (c) causal relationships between emotion components (central in appraisal theories). Evidence suggests that the popular reflective and formative latent variable models-in which emotions are conceptualized as unobservable causes or consequences of emotion components-cannot account for all properties. Conversely, a psychometric network model-in which emotions are conceptualized as systems of causally interacting emotion components-accounts for all properties. The psychometric network model thus constitutes an integrative psychometric model of emotions, facilitating progress toward a unifying theory.

The network approach to psychopathology: a review of the literature 2008-2018 and an agenda for future research

The network approach to psychopathology posits that mental disorders can be conceptualized and studied as causal systems of mutually reinforcing symptoms. This approach, first posited in 2008, has grown substantially over the past decade and is now a full-fledged area of psychiatric research. In this article, we provide an overview and critical analysis of 363 articles produced in the first decade of this research program, with a focus on key theoretical, methodological, and empirical contributions. In addition, we turn our attention to the next decade of the network approach and propose critical avenues for future research in each of these domains. We argue that this program of research will be best served by working toward two overarching aims: (a) the identification of robust empirical phenomena and (b) the development of formal theories that can explain those phenomena. We recommend specific steps forward within this broad framework and argue that these steps are necessary if the network approach is to develop into a progressive program of research capable of producing a cumulative body of knowledge about how specific mental disorders operate as causal systems.

A cross-sectional and longitudinal network analysis approach to understanding connections among social anxiety components in youth

As proposed in a prominent developmental model, social anxiety has different manifestations: social fear, shy temperament, anxious cognitions, and avoidance of social situations. Drawing from this model, we used the network approach to psychopathology to gain a detailed understanding of specific social anxiety components and their associations. The current article investigated (a) how social anxiety components are interconnected within a network, and (b) the consistency of the network over time, in a community sample of children and adolescents. Data from 3 waves of a longitudinal study were used. At Time 1 (T1) the total sample comprised 331 participants (M_age = 13.34 years); at Time 3 (T3) there were 236 participants (M_age = 17.48 years). Social anxiety components were assessed with self-report questionnaires. Networks of 15 nodes (i.e., components) were estimated. Network analysis of T1 components revealed 4 communities: cognitive, social-emotional, avoidance of performance, and avoidance of interaction situations. There were no direct connections between the cognitive and behavioral communities; social-emotional nodes appeared to act as bridge components between the 2 communities. A similar pattern of component associations and communities was found in the T2 and T3 networks, and the longitudinal network incorporating node change trajectories. Networks were estimated on group-level observational data and conclusions about cause-effect relationships are tentative. Although the sample size decreased across the 3 waves, the reliability of parameter estimates were minimally affected. Findings attest to the potential value of applying the network approach to investigate the pattern of associations among social anxiety components in youth. (PsycINFO Database Record (c) 2019 APA, all rights reserved).