We introduce two complementary measures for the identification of critical instabilities and fluctuations in natural time series: the degree of fluctuations F and the distribution parameter D. Both are valid measures even of short and coarse-grained data sets, as demonstrated by artificial data from the logistic map (Feigenbaum-Scenario). A comparison is made with the application of the positive Lyapunov exponent to time series and another recently developed complexity measure-the Permutation Entropy. The results justify the application of the measures within computer-based real-time monitoring systems of human change processes. Results from process-outcome research in psychotherapy and functional neuroimaging of psychotherapy processes are provided as examples for the practical and scientific applications of the proposed measures.

Objective: The feasibility of a high-frequency real-time monitoring approach to psychotherapy is outlined and tested for patients' compliance to evaluate its integration to everyday practice. Criteria concern the ecological momentary assessment, the assessment of therapy-related cognitions and emotions, equidistant time sampling, real-time nonlinear time series analysis, continuous participative process control by client and therapist, and the application of idiographic (person-specific) surveys.Methods: The process-outcome monitoring is technically realized by an internet-based device for data collection and data analysis, the Synergetic Navigation System. Its feasibility is documented by a compliance study on 151 clients treated in an inpatient and a day-treatment clinic.Results: We found high compliance rates (mean: 78.3%, median: 89.4%) amongst the respondents, independent of the severity of symptoms or the degree of impairment. Compared to other diagnoses, the compliance rate was lower in the group diagnosed with personality disorders.Conclusion: The results support the feasibility of high-frequency monitoring in routine psychotherapy settings. Daily collection of psychological surveys allows for the assessment of highly resolved, equidistant time series data which gives insight into the nonlinear qualities of therapeutic change processes (e.g., pattern transitions, critical instabilities).

Objective: While destabilization periods characterized by high variability and turbulence in a patient's psychological state might seem obstructive for psychotherapy, a complex systems approach to psychopathology predicts that these periods are actually beneficial as they indicate possibilities for reorganization within the patient. The present study tested the hypothesis that destabilization is related to better treatment outcome. Method: 328 patients who received psychotherapy for mood disorders completed daily self-ratings about their psychotherapeutic process. A continuous measure of destabilization was defined as the relative strength of the highest peak in dynamic complexity, a measure for variability and turbulence, in the self-ratings of individual patients. Results: Destabilization was found to be related to better treatment outcome. When improvers and non-improvers were analyzed separately, destabilization was found to be related to better treatment outcome in improvers but not in nonimprovers. Conclusions: Destabilization in daily self-ratings of the psychotherapeutic process is associated with better treatment outcome. The identification of destabilization periods in process-monitoring data is clinically relevant. During destabilization, patients are believed to be increasingly sensitive to the effects of therapy. Clinicians could tailor their interventions to these sensitive periods.

No abstract

The results suggest that a group experience of regular monitored mountain hiking, organized as an add-on therapy to usual care, is associated with an improvement of hopelessness, depression, and suicide ideation in patients suffering from high-level suicide risk.

Summary: This contribution is based on the evidence that most psychological practitioners are concerned with the facilitation of change processes. They help people to learn, to develop, or to change patterns of cognitions, emotions, and behaviors. Consequently, they need assessment tools that enable them to represent the essential features of the complex systems they are concerned with, i.e., structure of functioning and dynamics. After some introductory remarks on systemic assessment, we focus on two methods of comprehensive data representation: one of them is used in order to represent the structure of functioning of a system, the other to assess its dynamics. The first one is called “idiographic system modeling” and represents the interrelations between the most important variables of a system by graphical means. The other one is based on a continuously produced flow of data about the functioning of a system and on a continuous screening of dynamic features of this time series (critical fluctuations, degree of synchronization, and stability vs. instability). It is called “real-time monitoring.” Perhaps this methodology can help to bridge the gap between research, usually realized in artificial laboratory settings, and the change processes taking place in practice.

This study investigates neuronal activation patterns during the psychotherapeutic process, assuming that change dynamics undergo critical instabilities and discontinuous transitions. An internet-based system was used to collect daily self-assessments during inpatient therapies. A dynamic complexity measure was applied to the resulting time series. Critical phases of the change process were indicated by the maxima of the varying complexity. Repeated functional magnetic resonance imaging (fMRI) measurements were conducted over the course of the therapy. The study was realized with 9 patients suffering from obsessive-compulsive disorder (subtype: washing/contamination fear) and 9 matched healthy controls. For symptom-provocative stimulation individualized pictures from patients’ personal environments were used. The neuronal responses to these disease-specific pictures were compared to the responses during standardized disgust-provoking and neutral pictures. Considerably larger neuronal changes in therapy-relevant brain areas (cingulate cortex/supplementary motor cortex, bilateral dorsolateral prefrontal cortex, bilateral insula, bilateral parietal cortex, cuneus) were observed during critical phases (order transitions), as compared to non-critical phases, and also compared to healthy controls. The data indicate that non-stationary changes play a crucial role in the psychotherapeutic process supporting self-organization and complexity models of therapeutic change.

Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim.