Intraindividual network analysis of obsessive-compulsive and depressive symptoms: Using network analysis for targeted intervention
David, Sarah Jo
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A network analysis (NA) approach to psychopathology posits that symptoms are mutually interacting components of a system (Borsboom & Cramer, 2013). Obsessive-compulsive disorder (OCD) is characterized by recurrent obsessions or compulsions that cause clinically significant distress or impairment. Major depressive disorder (MDD) is the most common concurrent and lifetime comorbid diagnosis with OCD. Although the results of aggregate-level networks are useful in understanding comorbid OCD and MDD as it presents generally across a clinical sample at a given point in time, previous cross-sectional NA studies do not address the issue of how symptoms in comorbid OCD and MDD (a) interact across time, (b) interact at an intraindividual-level, or (c) how network analysis can be used to select treatment targets in a comorbid OCD and MDD sample. The present study examined how symptoms of OCD and MDD interact across time within intraindividual dynamic networks in four adult participants. Three-times-a-day ecological momentary assessment (EMA) data was collected for each participant utilizing an Individualized Questionnaire (IndQ) that included self-rated idiographic and nomothetic obsessive-compulsive and depressive symptoms. Each participant’s results were used (a) to evaluate the incremental and combined assessment utility of different types of intraindividual network analyses, (b) to evaluate the potential utility of idiographic versus nomothetic networks for treatment planning, and (c) to create and implement a targeted, brief intervention for each participant. Analyses indicated that different types of idiographic intraindividual networks (i.e., concurrent bivariate, lead-lag bivariate, and lead-lag partial) provided incremental assessment utility. Preliminary support was also found for the treatment utility of using EMA and intraindividual dynamic network analyses to design a targeted intervention in comorbid OCD and MDD cases.