DescriptionA crucial question in psychiatry is whether a specific person, at a specific moment in time, is vulnerable for impending mental health problems. Answering this question may substantially advance our ability to implement targeted early interventions, which could eventually prevent the onset or worsening of mental health problems. In this thesis, I therefore examined whether mental health problems in youth can be foreseen based on personalized warning signals. To this end, me and my team set up the TRAILS TRANS-ID study, in which 134 young adults at increased risk for mental disorders registered their mood daily for a period of six consecutive months. The resulting data are unique in their richness – covering 183 measurements per person – and allow for monitoring the ebb and flow of mental health problems with individuals. One of the main findings of my thesis is that sudden increases in mental health problems reported by youth are only seldomly preceded by warning signals. These signals were based on generic indicators of instability – which characterize complex dynamic systems. Hence, personalized warning signals inspired by complex dynamic systems theory did not prove clinically useful. This means that, currently, it remains impossible to monitor vulnerability to mental health problems in a personalized way. To better understand this finding, it is important further investigate whether and to what extent mental health can be conceptualized and measured as a complex dynamic system. Further, it is paramount to investigate alternative methods for personalized prediction. This could eventually improve the timely detection of youth in need of help.
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