Network intervention analysis of anxiety-related outcomes and processes of acceptance and commitment therapy (ACT) for anxious cancer survivors

Fishbein, Joel N.; Haslbeck, Jonas M B; Arch, Joanna J.

doi:10.1016/j.brat.2023.104266

Cited by 8 publications

(5 citation statements)

References 47 publications

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“…This provided a stability estimate reflecting the proportion of runs in which an edge weight was nonzero. We followed the approach of Fishbein et al (2023) and focus our reporting and interpretation only on the edges between the treatment node and symptom nodes that yielded a stability estimate of .60 or greater (see Supplemental Material, for all results, including those with lower stability estimates). This approach was selected to avoid overinterpretation of results that were highly dependent on sample composition; however, it should be noted that there is no empirical research investigating optimal cut points for determining which network edges are interpreted.…”

Section: Discussionmentioning

confidence: 99%

Session-level effects of cognitive processing therapy and prolonged exposure on individual symptoms of posttraumatic stress disorder among U.S. veterans.

Moshier,

Mahoney,

Bovin

et al. 2024

Journal of Consulting and Clinical Psychology

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To compare the course of change in individual posttraumatic stress disorder (PTSD) symptoms during prolonged exposure therapy (PE) and cognitive processing therapy (CPT). Method: We analyzed data from a previously published randomized clinical trial comparing PE and CPT among male and female U.S. military veterans with PTSD (Schnurr et al., 2022). Using data from a self-rated PTSD symptom measure administered before each therapy session, we evaluated individual symptom change from pretreatment to final therapy session (N = 802). Then, using network intervention analysis, we modeled session-by-session PTSD symptom networks that included treatment allocation (CPT vs. PE) as a node in the networks, allowing us to compare individual symptom change following each session in each treatment. Results: Relative to CPT, PE was associated with greater reduction in 10 PTSD symptoms from first to final session of therapy. Numerous treatment-specific effects on individual symptoms emerged during the treatment period; these session-level effects occurred only in symptoms relatively specific to the diagnosis of PTSD (e.g., avoidance, hypervigilance). PE was associated with greater reduction in avoidance following the introduction and early weeks of imaginal exposure. The treatments yielded comparable effects on trauma-related blame and negative beliefs from pretreatment to final therapy session. However, there were differences in session-level change in these symptoms that may reflect differential timing of interventions that reduce distorted cognitions within each treatment. Conclusions: Findings may facilitate the shared decision-making process for patients choosing between CPT and PE. Session-level results provide direction for future research on the specific intervention components of CPT and PE.What is the public health significance of this article? In this study, we investigated the pattern of change in the individual symptoms of posttraumatic stress disorder (PTSD) occurring during two of the most strongly recommended psychotherapies for PTSD, cognitive processing therapy and prolonged exposure. The results help contribute to hypotheses about how these treatments work and provide information about which specific symptoms of PTSD are most responsive to these therapies.

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Section: Discussionmentioning

confidence: 99%

Session-level effects of cognitive processing therapy and prolonged exposure on individual symptoms of posttraumatic stress disorder among U.S. veterans.

Moshier,

Mahoney,

Bovin

et al. 2024

Journal of Consulting and Clinical Psychology

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“…The answers to these questions are still unknown but the first results seem promising [63,64]. Although targeting psychological symptoms and behaviors is inherently distinct from targeting genes or computer networks, recent studies [63][64][65][66][67][68] have started to reveal contrasting effects not only among different treatment modalities [65][66][67][68], but also throughout the course of treatment [63,64]. These early results suggest that achieving a remarkable level of precision in psychological treatments may be attainable.…”

Section: Discussionmentioning

confidence: 99%

Centrality measures in psychological networks: A simulation study on identifying effective treatment targets

Castro,

Gysi,

Ferreira

et al. 2024

PLoS ONE

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The network theory of psychopathology suggests that symptoms in a disorder form a network and that identifying central symptoms within this network might be important for an effective and personalized treatment. However, recent evidence has been inconclusive. We analyzed contemporaneous idiographic networks of depression and anxiety symptoms. Two approaches were compared: a cascade-based attack where symptoms were deactivated in decreasing centrality order, and a normal attack where symptoms were deactivated based on original centrality estimates. Results showed that centrality measures significantly affected the attack’s magnitude, particularly the number of components and average path length in both normal and cascade attacks. Degree centrality consistently had the highest impact on the network properties. This study emphasizes the importance of considering centrality measures when identifying treatment targets in psychological networks. Further research is needed to better understand the causal relationships and predictive capabilities of centrality measures in personalized treatments for mental disorders.

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“…Lastly, limita�ons are related to the causal aspects in the network analysis. As stated by Fishbein et al (2023), contemporaneous changes in a NIA approach do not imply causality of mechanisms. A direct effect is hence not synonymous with a causal effect.…”

Section: Strengths Limitations and Further Researchmentioning

confidence: 98%

“…In recent �mes, a network analysis strategy for studying interven�on and treatment effects was proposed: Network Interven�on Analysis (NIA; (Blanken et al, 2019) Applying NIA to examine direct and indirect effects of an interven�on is an approach with mul�ple strengths. First, the approach is exploratory and does not rely on specifying a priori theore�cal mechanisms which are typically assessed in other common approaches, such as media�on analysis (Fishbein et al, 2023). Thus, mul�ple mechanis�c processes and outcomes can be examined in a single model, without the need to specify hypothe�cal pathways before analysis.…”

Section: The Network Intervention Analysismentioning

confidence: 99%

“…A direct effect is hence not synonymous with a causal effect. The lack of knowledge about the temporal sequence of direct and indirect effects makes causal inference challenging, but NIA enables core drives of change to be explored (Fishbein et al, 2023). Even though randomiza�on and the observed associa�on could indicate a causal pathway, there may be measurement error as well as other poten�al confounders and mechanis�c pathways impac�ng the observed associa�ons.…”

Section: Strengths Limitations and Further Researchmentioning

confidence: 99%

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Mechanisms of Change in a Digital Five Ways to Wellbeing Intervention: A Network Intervention Analysis of a Randomized Controlled Trial

Prydz,

Bjørndal,

Czajkowski

et al. 2024

Preprint

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While digital positive psychology interventions demonstrate effectiveness in promoting wellbeing and reducing illbeing in the general population, their mechanisms of change are relatively underexplored. The wellbeing promotive digital intervention, Five Ways to Wellbeing for All (5waysA), has been shown effective (effect sizes from .20 to .49) in a large (N= 963) randomized controlled trial (Prydz et al., 2024). In the present study, Network Intervention Analysis (NIA) was applied to identify associations and putative mechanisms linking the 5waysA intervention to a set of wellbeing outcomes. Following the 10-week intervention period, the NIA revealed that only positive emotions on an aggregate level were conditionally dependent on the treatment allocation variable. These findings suggest that the effectiveness of the 5waysA intervention primarily reflects the direct enhancement of positive emotions. Our findings provide insights of potential importance for advancing the theoretical framework of the Five Ways to Wellbeing and other mental health and wellbeing promoting interventions.

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Network intervention analysis of anxiety-related outcomes and processes of acceptance and commitment therapy (ACT) for anxious cancer survivors

Cited by 8 publications

References 47 publications

Session-level effects of cognitive processing therapy and prolonged exposure on individual symptoms of posttraumatic stress disorder among U.S. veterans.

Session-level effects of cognitive processing therapy and prolonged exposure on individual symptoms of posttraumatic stress disorder among U.S. veterans.

Centrality measures in psychological networks: A simulation study on identifying effective treatment targets

Mechanisms of Change in a Digital Five Ways to Wellbeing Intervention: A Network Intervention Analysis of a Randomized Controlled Trial

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