Developing and evaluating cognitive behavioral case formulations and network analyses within complex, comorbid cases: Implications for treatment

Network analysis, a relatively new method of operationalizing psychological disorders as interacting causal systems, differs from the more popular cognitive behavioral case formulation, a method of hypothesizing various aspects (e.g., triggering variables, maintaining variables, causal mechanisms) of an individual’s psychopathology. Although both of these intraindividual frameworks may provide the investigator with valuable information relevant to individualized treatment planning, no previous research has examined if the utilization of both methodologies provides incremental clinical utility above and beyond either method alone. The present study developed a network analysis and case formulation of an individual’s symptomology associated with generalized anxiety disorder with comorbid features consistent with obsessive-compulsive personality disorder (e.g., perfectionism and high standards) using three-times daily ecological momentary assessment via an idiographic questionnaire of variables highly relevant to that individual. Results of the various time series analyses are identified with relation to informed treatment planning decisions. Methodological and clinical implications are discussed.