Network analysis of depression and anxiety symptom relationships in a psychiatric sample

Abstract

Researchers have studied psychological disorders extensively from a common cause perspective, in which symptoms are treated as independent indicators of an underlying disease. In contrast, the causal systems perspective seeks to understand the importance of individual symptoms and symptom-to-symptom relations. In the current study, we used network analysis to examine the relationships between and among depression and anxiety symptoms from the causal systems perspective. We utilized data from a large psychiatric sample at admission and discharge from a partial hospital program (N = 1029, mean treatment duration = 8 days). We investigated features of the depression/anxiety network including topology, network centrality, stability of the network at admission and discharge as well as change in the network over the course of treatment. Results revealed that individual symptoms of depression and anxiety were more related to other symptoms within each disorder than to symptoms between disorders. Sad mood and worry were among the most central symptoms in the network. The network structure was stable both at admission and between admission and discharge, although the overall strength of symptom relationships increased as symptom severity decreased over the course of treatment. Examining depression and anxiety symptoms as dynamic systems may provide novel insights into the maintenance of these mental health problems.

False alarm? A comprehensive reanalysis of “Evidence that psychopathology symptom networks have limited replicability” by Forbes, Wright, Markon, and Krueger (2017).

“…Also, these values do not resemble correlations typically found for these kinds of symptoms (e.g. see Beard et al, 2016).…”

Co-occurring internalizing and externalizing psychopathology in childhood and adolescence: a network approach

“…Although an abundance of network studies has been published recently, the majority have focussed their enquiry on the structure of single disorders [14,15], or a narrow range of comorbid disorders [16]. To our knowledge, only two studies have used network methods to model broader psychiatric comorbidity; Boschloo and colleagues [17] examined the network structure of 120 symptoms from 12 supposedly distinct DSM-IV disorders in the second wave of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC, N = 34,653).…”

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

“…The network approach to psychopathology has received increasing attention and recognition in the last years, and has been used to study a plethora of mental disorders, including depressive disorders (Fried, Epskamp, Nesse, Tuerlinckx, & Borsboom, 2016), generalized anxiety disorder (Beard et al, 2016), post-traumatic stress disorder (PTSD) (McNally et al, 2015), eating disorders (Forbush, Siew, & Vitevitch, 2016), and psychosis (Isvoranu, Borsboom, van Os, & Guloksuz, 2016) (see for a review of the empirical literature and important concepts). The core idea is that problems (often symptoms) cluster in specific constellations (syndromes) because they are associated in causal webs and vicious circles (Borsboom & Cramer, 2013).…”