Day-to-Day Variation in Perceived Causal Networks: A Feasibility Study in Two Psychiatric Settings

Purpose The network approach conceptualizes psychopathology as a system of causally interacting problems of living. Longitudinal Perceived Causal Networks (L-PECAN) is a self-report method designed to capture day-to-day variability in patients’ perceived causal relations between problems. We examined the feasibility of an L-PECAN procedure in two clinical settings and explored within-person variability in perceived causal network structures. Methods Patients in two psychiatric clinics first completed an L-PECAN training week using a generic item list. Personalized items, including contextual factors, were then formulated and used subsequently for a minimum of three weeks. Feasibility was evaluated via recruitment rates and adherence. Within-person variability was examined using saturation and drift analyses. Results Eight patients completed the protocol. Median daily completion times ranged from one to eight minutes. Participants largely perceived their personalized problems as being caused by their other problems. Some causal relations were perceived consistently across days, but overall network structures showed substantial day-to-day variability. Conclusions An L-PECAN procedure incorporating a training week and personalized nodes appeared feasible in the university clinic, whereas uptake and adherence indicated greater implementation challenges in specialist psychiatric care. The method provides a structured way to examine day-to-day variability in perceived causal problem networks. Further research is needed to establish feasibility across clinical populations and to evaluate validity and clinical utility.