Sifting for the Central Cycles: Daily Assessments of Patient Causal Perceptions to Create Clinically Useful and Reliable Symptom Networks

The network approach to psychopathology is promising, but progress has been hampered by finding methods to create valid and reliable symptom networks for individual patients. One method is to use patient perceptions of causal relations, which risks missing relations due to recall limits. This study evaluated the reliability and validity of four networks created using brief daily assessments of perceived causal relations. Five patients at a university therapy clinic completed one week of pre-training with daily assessments of causal relations between common psychiatric problems. After this, items were individualized and assessed for three weeks. Resulting networks for five patients were all stable and evaluated as clinically useful by both patients themselves and their therapists. Even with individualization the networks tended to include the same nodes (worrying, physical inactivity and fatigue were in all five), and worrying was central to all but one of the networks. The sample is not representative of psychiatry patients in general, and future studies should investigate the method in a larger sample of more severe clinical cases.