Network destabilization and transition in depression: New methods for studying the dynamics of therapeutic change

Abstract

The science of dynamic systems is the study of pattern formation and system change. Dynamic systems theory can provide a useful framework for understanding the chronicity of depression and its treatment. We propose a working model of therapeutic change with potential to organize findings from psychopathology and treatment research, suggest new ways to study change, facilitate comparisons across studies, and stimulate treatment innovation. We describe a treatment for depression that we developed to apply principles from dynamic systems theory and then present a program of research to examine the utility of this application. Recent methodological and technological developments are also discussed to further advance the search for mechanisms of therapeutic change.

Replicability and generalizability of PTSD networks: A cross-cultural multisite study of PTSD symptoms in four trauma patient samples

“…In other words, a mental disorder like depression does not arise from one central brain dysfunction that gives rise to all symptoms, but from problems that form dynamic systems that can be hard to escape. Clinical network theory has been explained in detail in several recent publications (Borsboom, 2017;Cramer, Waldorp, van der Maas, & Borsboom, 2010;Hayes, Yasinski, Ben Barnes, & Bockting, 2015;McNally, 2016), and we will refrain from reiterating it here in more detail.…”

A Prospective Study on How Symptoms in a Network Predict the Onset of Depression

“…However, a limitation is that MDD symptoms were assessed at a single time point and, therefore, the temporal relationship between symptoms is unknown. Time series analyses of longitudinal data from the experience sampling method could help to unravel the dynamics of symptom networks over time [9], which might also be a promising approach for examining therapeutic changes [for an interesting review on this topic, see [10]].…”

Symptom-Specific Effects of Psychotherapy versus Combined Therapy in the Treatment of Mild to Moderate Depression: A Network Approach

“…Network models are highly promising in this approach as they can be expanded with other psychiatric or physical symptoms (e.g., anxiety, nausea) to provide insight into secondary or side effects of a treatment independent of its effects on depressive symptoms. Furthermore, dynamic networks of depressive symptoms during various treatment stages could reveal that changes in specific symptoms are preceded by changes in other symptoms, which may inform on pathways underlying indirect responses of symptoms to a treatment [10].…”