Psychiatric Diagnosis Revisited: Towards a System of Staging and Profiling Combining Nomothetic and Idiographic Parameters of Momentary Mental States

Johanna T. W. Wigman*, Jim van Os, Evert Thiery, Catherine Derom, Dina Collip, Nele Jacobs, Marieke Wichers

*Corresponding author for this work

    Research output: Contribution to journalArticleAcademicpeer-review

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    Abstract

    Background: Mental disorders may be reducible to sets of symptoms, connected through systems of causal relations. A clinical staging model predicts that in earlier stages of illness, symptom expression is both non-specific and diffuse. With illness progression, more specific syndromes emerge. This paper addressed the hypothesis that connection strength and connection variability between mental states differ in the hypothesized direction across different stages of psychopathology.

    Methods: In a general population sample of female siblings (mostly twins), the Experience Sampling Method was used to collect repeated measures of three momentary mental states (positive affect, negative affect and paranoia). Staging was operationalized across four levels of increasing severity of psychopathology, based on the total score of the Symptom Check List. Multilevel random regression was used to calculate inter-and intra-mental state connection strength and connection variability over time by modelling each momentary mental state at t as a function of the three momentary states at t-1, and by examining moderation by SCL-severity.

    Results: Mental states impacted dynamically on each other over time, in interaction with SCL-severity groups. Thus, SCL-90 severity groups were characterized by progressively greater inter-and intra-mental state connection strength, and greater inter-and intra-mental state connection variability.

    Conclusion: Diagnosis in psychiatry can be described as stages of growing dynamic causal impact of mental states over time. This system achieves a mode of psychiatric diagnosis that combines nomothetic (group-based classification across stages) and idiographic (individual-specific psychopathological profiles) components of psychopathology at the level of momentary mental states impacting on each other over time.

    Original languageEnglish
    Article numbere59559
    Number of pages8
    JournalPLoS ONE
    Volume8
    Issue number3
    DOIs
    Publication statusPublished - 28-Mar-2013

    Keywords

    • ATTENUATED PSYCHOSIS SYNDROME
    • DAILY-LIFE STRESS
    • PERSECUTORY DELUSIONS
    • EMOTIONAL REACTIVITY
    • BERKSONS BIAS
    • DISORDERS
    • DEPRESSION
    • RISK
    • PSYCHOPATHOLOGY
    • SYMPTOMS

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