Abstract
Network theory, as a theoretical and methodological framework, is energizing many research fields, among which clinical psychology and psychiatry. Fundamental to the network theory of psychopathology is the role of specific symptoms and their interactions. Current statistical tools, however, fail to fully capture this constitutional property. We propose community detection tools as a means to evaluate the complex network structure of psychopathology, free from its original boundaries of distinct disorders. Unique to this approach is that symptoms can belong to multiple communities. Using a large community sample and spanning a broad range of symptoms (Symptom Checklist-90-Revised), we identified 18 communities of interconnected symptoms. The differential role of symptoms within and between communities offers a framework to study the clinical concepts of comorbidity, heterogeneity and hallmark symptoms. Symptoms with many and strong connections within a community, defined as stabilizing symptoms, could be thought of as the core of a community, whereas symptoms that belong to multiple communities, defined as communicating symptoms, facilitate the communication between problem areas. We propose that defining symptoms on their stabilizing and/or communicating role within and across communities accelerates our understanding of these clinical phenomena, central to research and treatment of psychopathology.
Highlights
Ever since the nineteenth century, definitions of mental disorders were formulated and documented in classification schemes to facilitate communication about, treatment of and research on psychopathology (e.g.1,2)
The network approach thereby concentrates on the evaluation of symptom-to-symptom interactions, both within as well as between disorders, with the network structure of all psychopathological symptoms representing the landscape of psychopathology[10]
A potential bridge symptom between major depression (MD) and generalized anxiety disorder (GAD) is “sleep problems” (e.g.9,15); that is, developing sleep problems may be the bridge that is crossed when someone, who already suffers from MD, develops GAD, or vice versa
Summary
Ever since the nineteenth century, definitions of mental disorders were formulated and documented in classification schemes to facilitate communication about, treatment of and research on psychopathology (e.g.1,2). One community detection algorithm that is applicable to psychopathology is the Clique Percolation Method (CPM), as it allows nodes to belong to more than one community (18 applied to, for example, the human interactome, e.g.19 social media, e.g.20 and scientific publications, e.g.21). As such, this approach provides a natural representation of the theoretical stance of the network approach on the fuzzy borders between disorders[9]. The identification of these local problem areas provides novel insights into the interdependency of symptoms on the local (community) structure over and above the interdependencies in the global structure of the psychopathology network
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