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Exploring the underlying structure of mental disorders: cross-diagnostic differences and similarities from a network perspective using both a top-down and a bottom-up approach

Published online by Cambridge University Press:  25 March 2015

J. T. W. Wigman
Affiliation:
Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
J. van Os
Affiliation:
Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands Department of Psychosis Studies, King's College London, King's Health Partners, Institute of Psychiatry, De Crespigny Park, London, UK
D. Borsboom
Affiliation:
Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
K. J. Wardenaar
Affiliation:
Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
S. Epskamp
Affiliation:
Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
A. Klippel
Affiliation:
Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
W. Viechtbauer
Affiliation:
Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
I. Myin-Germeys
Affiliation:
Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
M. Wichers
Affiliation:
Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
MERGE
Affiliation:
Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
Corresponding
E-mail address:

Abstract

Background

It has been suggested that the structure of psychopathology is best described as a complex network of components that interact in dynamic ways. The goal of the present paper was to examine the concept of psychopathology from a network perspective, combining complementary top-down and bottom-up approaches using momentary assessment techniques.

Method

A pooled Experience Sampling Method (ESM) dataset of three groups (individuals with a diagnosis of depression, psychotic disorder or no diagnosis) was used (pooled N = 599). The top-down approach explored the network structure of mental states across different diagnostic categories. For this purpose, networks of five momentary mental states (‘cheerful’, ‘content’, ‘down’, ‘insecure’ and ‘suspicious’) were compared between the three groups. The complementary bottom-up approach used principal component analysis to explore whether empirically derived network structures yield meaningful higher order clusters.

Results

Individuals with a clinical diagnosis had more strongly connected moment-to-moment network structures, especially the depressed group. This group also showed more interconnections specifically between positive and negative mental states than the psychotic group. In the bottom-up approach, all possible connections between mental states were clustered into seven main components that together captured the main characteristics of the network dynamics.

Conclusions

Our combination of (i) comparing network structure of mental states across three diagnostically different groups and (ii) searching for trans-diagnostic network components across all pooled individuals showed that these two approaches yield different, complementary perspectives in the field of psychopathology. The network paradigm therefore may be useful to map transdiagnostic processes.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2015 

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References

Angst, J, Gamma, A, Benazzi, F, Ajdacic, V, Eich, D, Rössler, W (2003). Toward a re-definition of subthreshold bipolarity: epidemiology and proposed criteria for bipolar-II, minor bipolar disorders and hypomania. Journal of Affective Disorders 73, 133146.CrossRefGoogle Scholar
Bak, M, Delespaul, P, Krabbendam, L, Huistra, K, Walraven, W, Van Os, J (2009). Capturing coping with symptoms in people with a diagnosis of schizophrenia: introducing the MACS-24. International Journal of Methods in Psychiatric Research 18, 412.CrossRefGoogle ScholarPubMed
Borsboom, D, Cramer, AOJ (2013). Network analysis: an integrative approach to the structure of psychopathology. Annual Review of Clinical Psychology 9, 91121.CrossRefGoogle ScholarPubMed
Borsboom, D, Cramer, AOJ, Schmittmann, VD , Epskamp, S, Waldorp, LJ (2011). The small world of psychopathology. PLoS ONE 6(11): e27407.CrossRefGoogle ScholarPubMed
Breetvelt, EJ, Boks, MPM, Numans, ME, Selten, JP, Sommer, IEC, Grobbee, DE, Kahn, RS, Geerlings, MI (2010). Schizophrenia risk factors constitute general risk factors for psychiatric symptoms in the population. Schizophrenia Research 120, 184190.CrossRefGoogle ScholarPubMed
Bringmann, LF, Vissers, N, Wichers, M, Geschwind, N, Kuppens, P, Peeters, F, Borsboom, D, Tuerlinckx, F (2013). A network approach to psychopathology: new insights into clinical longitudinal data. PLoS ONE. Published online: 04 04 2013 . doi:10.1371/journal.pone.0060188.CrossRefGoogle ScholarPubMed
Buckholtz, JW, Meyer-Lindenberg, A (2012). Psychopathology and the human connectome: toward a transdiagnostic model of risk for mental illness. Neuron 74, 9901004.CrossRefGoogle Scholar
Bystritsky, A, Nierenberg, A, Feusner, J, Rabinovich, M (2012). Computational non-linear dynamical psychiatry: a new methodological paradigm for diagnosis and course of illness. Journal of Psychiatric Research 46, 428435.CrossRefGoogle ScholarPubMed
Carter, RM, Wittchen, HU, Pfister, H, Kessler, RC (2001). One-year prevalence of subthreshold and threshold DSM-IV generalized anxiety disorder in a nationally representative sample. Depression and Anxiety 13, 7888.CrossRefGoogle Scholar
Collip, D, Nicolson, N, Lardinois, M, Lataster, T, van Os, J, Myin-Germeys, I (2011). Daily cortisol, stress reactivity and psychotic experiences in individuals at above average genetic risk for psychosis. Psychological Medicine 41, 23052315.CrossRefGoogle ScholarPubMed
Epskamp, S, Cramer, AOJ, Waldorp, LJ, Schmittmann, VD, Borsboom, D (2011). Qgraph: network representations of relationships in data. R package version 0.4, 10.Google Scholar
Frances, AJ, Widiger, T (2012). Psychiatric diagnosis: lessons from the DSM-IV past and cautions for the DSM-5 future. Annual Review of Clinical Psychology 8, 109130.CrossRefGoogle ScholarPubMed
Geschwind, N, Peeters, F, Drukker, M, van Os, J, Wichers, M (2011). Mindfulness training increases momentary positive emotions and reward experience in adults vulnerable to depression: a randomized controlled trial. Journal of Consulting and Clinical Psychology 79, 618628.CrossRefGoogle ScholarPubMed
Haslam, N, Holland, E, Kuppens, P (2011). Categories versus dimensions in personality and psychopathology: a quantitative review of taxometric research. Psychological Medicine 42, 903920.CrossRefGoogle ScholarPubMed
Hill, SK, Reilly, JL, Harris, MSH, Rosen, C, Marvin, RW, Deleon, O, Sweeny, JA (2009). A comparison of neuropsychological dysfunction in first-episode psychosis patients with unipolar depression, bipolar disorder, and schizophrenia. Schizophrenia Research 113, 167175.CrossRefGoogle Scholar
Hyman, SE (2010). The diagnosis of mental disorders: the problem of reification. Annual Review of Clinical Psychology 6, 155179.CrossRefGoogle Scholar
Kendell, R, Jablensky, A (2003). Distinguishing between the validity and utility of psychiatric diagnoses. American Journal of Psychiatry 160, 412.CrossRefGoogle ScholarPubMed
Kendler, KS, Gardner, CO (1998). Boundaries of major depression: an evaluation of DSM-IV criteria. American Journal of Psychiatry 155, 172177.Google ScholarPubMed
Kendler, KS, Zachar, P, Craver, C (2011). What kinds of things are psychiatric disorders? Psychological Medicine 41, 11431150.CrossRefGoogle ScholarPubMed
Kessler, RC, Berglund, P, Demler, O, Jin, R, Merikangas, KR, Walters, EE (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry 62, 593602.CrossRefGoogle ScholarPubMed
Kessler, RC, McLaughlin, KA, Green, JG, Gruber, MJ, Sampson, NA, Zaslavsky, AM, Aguilar-Gaxiola, S, Alhamzawi, AO, Alonso, J, Angermeyer, M (2010) Childhood adversities and adult psychopathology in the WHO World Mental Health Surveys. British Journal of Psychiatry 197, 378385.CrossRefGoogle ScholarPubMed
Kessler, RC, Price, RH, Wortman, CB (1985). Social factors in psychopathology: stress, social support, and coping processes. Annual Review of Psychology 36, 531572.CrossRefGoogle ScholarPubMed
Kessler, RC, Wang, PS (2008). The descriptive epidemiology of commonly occurring mental disorders in the United States. Annual Review of Public Health 29, 115129.CrossRefGoogle ScholarPubMed
Krueger, RF, Piasecki, TM (2002). Toward a dimensional and psychometrically-informed approach to conceptualizing psychopathology. Behaviour Research and Therapy 40, 485499.CrossRefGoogle Scholar
Kupfer, DJF, First, MB, Regier, DA (2002) A Research Agenda for DSM-V. American Psychiatric Association: Arlington, Virginia.Google Scholar
Lataster, J, Myin-Germeys, I, Wichers, M, Delespaul, PA, van Os, J, Bak, M (2011). Psychotic exacerbation and emotional dampening in the daily life of patients with schizophrenia switched to aripiprazole therapy: a collection of standardized case reports. Therapeutic Advances in Psychopharmacology 1, 145151.CrossRefGoogle ScholarPubMed
Lataster, T, Valmaggia, L, Lardinois, M, van Os, J, Myin-Germeys, I (2013). Increased stress reactivity: a mechanism specifically associated with the positive symptoms of psychotic disorder. Psychological Medicine 43, 13891400.CrossRefGoogle ScholarPubMed
Myin-Germeys, I, Oorschot, M, Collip, D, Lataster, J, Delespaul, P, van Os, J (2009). Experience sampling research in psychopathology: opening the black box of daily life. Psychological Medicine 39, 15331547.CrossRefGoogle Scholar
Myin-Germeys, I, van Os, J, Schwartz, JE, Stone, AA, Delespaul, PA (2001). Emotional reactivity to daily life stress in psychosis. Archives of General Psychiatry 58, 11371144.CrossRefGoogle ScholarPubMed
O'Connor, BP (2000). SPSS and SAS programs for determining the number of components using parallel analysis and Velicer's MAP test. Behavior Research Methods 32, 396402.Google ScholarPubMed
Opsahl, T, Agneessens, F, Skvoretz, J (2010). Node centrality in weighted networks: generalizing degree and shortest paths. Social Networks 32, 245251.CrossRefGoogle Scholar
Rosenfield, S, Mouzon, D (2013). Gender and mental health. In: Handbook of the Sociology of Mental Health, 2nd edn (ed. Aneshensel, C. S. et al. ), ch. 14 (Handbooks of Sociology and Social Research). Springer Science+Business Media: Dordrecht.Google Scholar
Thewissen, V, Bentall, RP, Lecomte, T, van Os, J, Myin-Germeys, I (2008). Fluctuations in self-esteem and paranoia in the context of daily life. Journal of Abnormal Psychology 117, 143153.CrossRefGoogle Scholar
Van de Leemput, IA, Wichers, M, Cramer, AOJ, Borsboom, D, Tuerlinckx, F, Kuppens, P, van Nes, EH, Viechtbauer, W, Giltay, EJ, Aggen, SH, Derom, C, Jacobs, N, Kendler, SK, van der Maas, HLJ, Neale, MC, Peeters, F, Theiry, E, Zachaer, P, Scheffer, M (2013). Critical slowing down as early warning for the onset and termination of depression. Proceedings of the National Academy of Sciences USA 111, 8792.CrossRefGoogle Scholar
Van Os, J, Linscott, R, Myin-Germeys, I, Delespaul, Ph, Krabbendam, L (2009). A systematic review and meta-analysis of the psychosis continuum: evidence for a psychosis proneness-persistence-impairment model of psychotic disorder. Psychological Medicine 39, 179195.CrossRefGoogle ScholarPubMed
Weiser, M, van Os, J, Davidson, M (2005). Time for a shift in focus in schizophrenia: from narrow phenotypes to broad endophenotypes. British Journal of Psychiatry 187, 203205.CrossRefGoogle ScholarPubMed
Wichers, M (2014). The dynamic nature of depression: a new micro-level perspective of mental disorder that meets current challenges. Psychological Medicine 44, 13491360.CrossRefGoogle ScholarPubMed
Wichers, M, Lothmann, C, Simons, CJP, Nicolson, NA, Peeters, F (2011). The dynamic interplay between negative and positive emotions in daily life predicts response to treatment in depression: a momentary assessment study. British Journal of Clinical Psychology 51, 206222.CrossRefGoogle ScholarPubMed
Widiger, TA (2005). A dimensional model of psychopathology. Psychopathology 38, 211214.CrossRefGoogle ScholarPubMed
Widiger, TA, Samuel, DB (2005). Diagnostic categories or dimensions? A question for the Diagnostic and Statistical Manual of Mental Disorders. Journal of Abnormal Psychology 114, 494.Google ScholarPubMed
Wigman, JTW, Collip, D, Wichers, M, Delespaul, Ph, Derom, C, Thiery, E, Vollebergh, WAM, Lataster, T, Jacobs, N, Myin-Germeys, I, van Os, J (2013a). Altered Transfer of Momentary Mental States (ATOMS) as the basic unit of psychosis liability in interaction with environment and emotions. PLoS One 8, e54653.CrossRefGoogle Scholar
Wigman, JTW, van Os, J, Thiery, E, Derom, C, Collip, D, Jacobs, N, Wichers, M (2013b). Psychiatric diagnosis revisited: towards a system of staging and profiling combining nomothetic and idiographic parameters of momentary mental states. PLoS ONE 8, e59559.CrossRefGoogle Scholar

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