Implementing precision methods in personalizing psychological therapies: Barriers and possible ways forward

Deisenhofer, Anne-Katharina; Barkham, Michael; Beierl, Esther T.; Schwartz, Brian; Aafjes-van Doorn, Katie; Beevers, Christopher G.; Berwian, Isabel M.; Blackwell, Simon E.; Bockting, Claudi L.; Brakemeier, Eva-Lotta; Brown, Gary; Buckman, Joshua E.J.; Castonguay, Louis G.; Cusack, Claire E.; Dalgleish, Tim; de Jong, Kim; Delgadillo, Jaime; DeRubeis, Robert J.; Driessen, Ellen; Ehrenreich-May, Jill; Fisher, Aaron J.; Fried, Eiko I.; Fritz, Jessica; Furukawa, Toshi A.; Gillan, Claire M.; Gómez Penedo, Juan Martín; Hitchcock, Peter F.; Hofmann, Stefan G.; Hollon, Steven D.; Jacobson, Nicholas C.; Karlin, Daniel R.; Lee, Chi Tak; Levinson, Cheri A.; Lorenzo-Luaces, Lorenzo; McDanal, Riley; Moggia, Danilo; Ng, Mei Yi; Norris, Lesley A.; Patel, Vikram; Piccirillo, Marilyn L.; Pilling, Stephen; Rubel, Julian A.; Salazar-de-Pablo, Gonzalo; Saunders, Rob; Schleider, Jessica L.; Schnurr, Paula P.; Schueller, Stephen M.; Siegle, Greg J.; Uher, Rudolf; Watkins, Ed; Webb, Christian A.; Wiltsey Stirman, Shannon; Wynants, Laure; Youn, Soo Jeong; Zilcha-Mano, Sigal; Lutz, Wolfgang; Cohen, Zachary D.

doi:10.1016/j.brat.2023.104443

Cited by 8 publications

(4 citation statements)

References 109 publications

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“…Identifying if people align with an overcontrolled, undercontrolled, resilient, or combined impulsivity-perfectionism profile can help determine most suitable treatment options and tailor assessments to target the personality-level mechanisms that maintain disordered eating ( 72 , 73 ). However, our research underscores that caution should be taken when generalizing from subtype to individual clinical presentations, and points towards the utility of idiographic approaches to integrating personality and psychopathology ( 74 ). In clinical practice, this suggests the importance of routinely assessing personality traits for both treatment matching and outcome assessment.…”

Section: Discussionmentioning

confidence: 81%

Reading tea leaves or tracking true constructs? An assessment of personality-based latent profiles in eating disorders

Soodla,

Soidla,

Akkermann

2024

Front. Psychiatry

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BackgroundEating disorder (ED) subtyping studies have often extracted an undercontrolled, an overcontrolled and a resilient profile based on trait impulsivity and perfectionism. However, the extent to which methodological choices impact the coherence and distinctness of resulting subtypes remains unclear.ObjectiveIn this paper, we aimed to assess the robustness of these findings by extracting personality-based subtypes on a sample of ED patients (N = 221) under different analytic conditions.MethodsWe ran four latent profile analyses (LPA), varying the extent to which we constrained variances and covariances during model parametrization. We then performed a comparative analysis also including state ED symptom measures as indicators. Finally, we used cross-method validation via k-means clustering to further assess the robustness of our profiles.ResultsOur results demonstrated a four-profile model based on variances in impulsivity and perfectionism to fit the data well. Across model solutions, the profiles with the most and least state and trait disturbances were replicated most stably, while more nuanced variations in trait variables resulted in less consistent profiles. Inclusion of ED symptoms as indicator variables increased subtype differentiation and similarity across profiles. Validation cluster analyses aligned most with more restrictive LPA models.ConclusionThese results suggest that ED subtypes track true constructs, since subtypes emerged method-independently. We found analytic methods to constrain the theoretical and practical conclusions that can be drawn. This underscores the importance of objective-driven analytic design and highlights its relevance in applying research findings in clinical practice.

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Section: Discussionmentioning

confidence: 81%

Reading tea leaves or tracking true constructs? An assessment of personality-based latent profiles in eating disorders

Soodla,

Soidla,

Akkermann

2024

Front. Psychiatry

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“…Finally, repeated measures data could enable researchers to conduct an N-of-1 study on a single parent to gain insight into unique, intraindividual processes (Kazdin, 2016;Schork, 2015). Apart from applied behavior analysis research, however, person-level methods are still relatively rarely integrated into program efficacy research, including randomized clinical trials (though see Deisenhofer et al, 2024 for a discussion of person-level methods in the treatment of psychopathology, and see Fisher et al, 2019 for an empirical example of using data from individuals to inform personalized treatment).…”

Section: Methods Advances To Embrace Heterogeneity In Translational R...mentioning

confidence: 99%

“…Precision medicine is sometimes narrowly focused on applications of genetic testing to guide treatment decisions; however, it can refer more broadly to evidence-based treatment recommendations based on individual features (DeRubeis, 2019). Personalized recommendations can include treatment selection, dosage, delivery mode, and timing, and can be informed by characteristics at multiple levels of analysis including an individual's biological, psychological, and contextual characteristics and circumstances (e.g., Collins & Varmus, 2015;Deisenhofer et al, 2024;Ng & Weisz, 2016;Wright & Woods, 2020;Zilcha-Mano, 2021).…”

Section: Developmental Psychopathology and Precision Mental Healthmentioning

confidence: 99%

The next generation of developmental psychopathology research: Including broader perspectives and becoming more precise

Valentino,

Edler

2024

Dev Psychopathol

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The current Special Issue marks a major milestone in the history of developmental psychopathology; as the final issue edited by Cicchetti, we have an opportunity to reflect on the remarkable progress of the discipline across the last four decades, as well as challenges and future directions for the field. With contemporary issues in mind, including rising rates of psychopathology, health disparities, and international conflict, as well as rapid growth and accessibility of digital and mobile technologies, the discipline of developmental psychopathology is poised to advance multidisciplinary, developmentally- and contextually- informed research, and to make substantial progress in supporting the healthy development of individuals around the world. We highlight key future directions and challenges for the next generation of developmental psychopathology research including further investigation of culture at multiple levels of analysis, incorporation of macro-level influences into developmental psychopathology research, methods advances to address heterogeneity in translational research, precision mental health, and the extension of developmental psychopathology research across the lifespan.

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“…Sin embargo, a pesar de estas dificultades, hay avances promisorios en la temática: las líneas de investigación vinculadas al desarrollo de sistemas de monitoreo con feedback representan un primer paso para brindar información clínicamente relevante a los terapeutas tigaciones y proyectos. Para una revisión detallada de los desafíos y posibles a nivel mundial sobre esta temática, recomendamos leer (Deisenhofer et al, 2024). ¿Cuáles son los Facilitadores Para Llevar a Cabo Investigación Sobre Personalización en Psicoterapia en la Región?…”

Section: Conclusiónunclassified

Personalización en Psicoterapia: Estado Actual y Desafíos para su Implementación en Latinoamérica

Tamara Manubens,

Buongiorno,

Gómez Penedo

2024

rdp

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La pregunta acerca de qué tratamiento psicoterapéutico es el más efectivo para cada paciente no es novedosa en la investigación en psicoterapia. Sin embargo, en la última década, el interés de responder esta pregunta ha virado hacia la denominada personalización de tratamientos o precisión en salud mental. Estos abordajes tienen por objetivo identificar las estrategias más adecuadas para cada paciente a partir de algunas de sus características trans-diagnósticas. El objetivo del presente artículo es describir la situación actual de la investigación sobre personalización de tratamientos psicoterapéuticos en la región latinoamericana. Se presentarán las principales líneas de investigación que suelen vincularse a sistemas de monitoreo y feedback. Además, se mencionarán proyectos innovadores y prometedores en la región que buscan desarrollar algoritmos de machine learning para predecir respuestas a los tratamientos. Estas líneas de investigación han podido realizarse a pesar de los obstáculos estructurales que suelen marcar la investigación en Latinoamérica: principalmente la falta de financiamiento, lo que repercute en la posibilidad de implementar los desarrollos realizados en la región. Sin embargo, los avances sobre esta temática se han visto facilitados por financiamiento de organizaciones internacionales que buscan incentivar el desarrollo científico. Por último, se presentarán propuestas para desarrollar la temática en la región, teniendo en cuenta los obstáculos y facilitadores mencionados, y con un foco particular en el potencial de implementación de estos modelos en la práctica clínica.

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Implementing precision methods in personalizing psychological therapies: Barriers and possible ways forward

Cited by 8 publications

References 109 publications

Reading tea leaves or tracking true constructs? An assessment of personality-based latent profiles in eating disorders

Reading tea leaves or tracking true constructs? An assessment of personality-based latent profiles in eating disorders

The next generation of developmental psychopathology research: Including broader perspectives and becoming more precise

Personalización en Psicoterapia: Estado Actual y Desafíos para su Implementación en Latinoamérica

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