TY - JOUR
T1 - Anticipating Transitions in Mental Health in At-Risk Youths
T2 - A 6-Month Daily Diary Study Into Early-Warning Signals
AU - Schreuder, Marieke J.
AU - Hartman, Catharina A.
AU - Groen, Robin N.
AU - Smit, Arnout C.
AU - Wichers, Marieke
AU - Wigman, Johanna T.W.
N1 - Publisher Copyright:
© The Author(s) 2022.
PY - 2023/11
Y1 - 2023/11
N2 - If psychopathology behaves like a complex dynamic system, sudden onset or worsening of symptoms may be preceded by early-warning signals (EWSs). EWSs could thus reflect personalized warning signals for impending psychopathology. We empirically investigated this hypothesis in at-risk youths (N = 122, mean age = 23.6 ± 0.7 years, 57% males) from the clinical cohort of Tracking Adolescents’ Individual Lives Survey (TRAILS-CC), who provided daily emotion assessments for 6 months. We analyzed whether EWSs (rising autocorrelations and standard deviations in emotions) preceded transitions toward psychopathology. Across indicators and a range of analytical options, EWSs had low sensitivity (M = 26%, SD = 11%) and moderate specificity (M = 75%, SD = 14%). Thus, in the present sample, the proposed generic nature and clinical utility of EWSs could not be substantiated. Given this finding, we call for a more nuanced view on the application of complex-dynamic-systems principles to psychopathology and lay out key questions to be addressed in the future.
AB - If psychopathology behaves like a complex dynamic system, sudden onset or worsening of symptoms may be preceded by early-warning signals (EWSs). EWSs could thus reflect personalized warning signals for impending psychopathology. We empirically investigated this hypothesis in at-risk youths (N = 122, mean age = 23.6 ± 0.7 years, 57% males) from the clinical cohort of Tracking Adolescents’ Individual Lives Survey (TRAILS-CC), who provided daily emotion assessments for 6 months. We analyzed whether EWSs (rising autocorrelations and standard deviations in emotions) preceded transitions toward psychopathology. Across indicators and a range of analytical options, EWSs had low sensitivity (M = 26%, SD = 11%) and moderate specificity (M = 75%, SD = 14%). Thus, in the present sample, the proposed generic nature and clinical utility of EWSs could not be substantiated. Given this finding, we call for a more nuanced view on the application of complex-dynamic-systems principles to psychopathology and lay out key questions to be addressed in the future.
KW - at-risk mental state
KW - diary studies
KW - early-warning signals
KW - personalized psychiatry
KW - psychopathology
KW - transitions in mental health
UR - http://www.scopus.com/inward/record.url?scp=85143218841&partnerID=8YFLogxK
U2 - 10.1177/21677026221103138
DO - 10.1177/21677026221103138
M3 - Article
AN - SCOPUS:85143218841
SN - 2167-7026
VL - 11
SP - 1026
EP - 1043
JO - Clinical Psychological Science
JF - Clinical Psychological Science
IS - 6
ER -