Voorbij diagnostische labels:

Een dynamische netwerk benadering van psychopathologie.

Marieke Wichers, Adjunct-hoogleraar

Interdisciplinary Center Psychopathology and Emotion regulation

University Medical Centre Groningen

Naam spreker Prof. Dr. M. C. Wichers

Belangenverstrengeling (potentieel) Geen / Zie hieronder

Voor bijeenkomst mogelijk relevante

relaties met bedrijven -

Sponsoring of onderzoeksgeld

Honorarium of andere (financiële)

vergoeding

Aandeelhouder

Andere relatie, namelijk …

ERC consolidator grant 2015

350 euro vergoeding voor

het geven van deze lezing. Dit

bedrag wordt weer voor ander

onderzoek ingezet.

Disclosure belangen spreker

Wat zijn eigenlijk psychiatrische stoornissen??

Patient 1

Patient 2

DSM structuur

What kind of things are mental disorders?

Frequent prospective measurements

Childhood trauma Stress-sensitivity Depressive

symptoms

Kramer, I et. Al. Schizophr Bull. 2014 Mar;40(2):278-86

Follow-up psychotic symptoms

moment-to-moment interplay between negative affect and

paranoia

Exp1 Exp2 Exp3 Exp4 Exp5

ESM: experiences producing cascades of effects

Low connectivity in the network High connectivity in the network

Wichers, Wigman, Myin-Germeys, Emotion Review, 2015

Cascades and networks

Healthy controls (n=207)

Insecure

Suspicious

1

2

4

3

5

Cheerful

Satisfied

Down

Satisfied

1

2

4

3

5

Cheerful

Insecure

Down Suspicious

Depression (n=129)

Looking through the microscope: real data

Wigman JTW. (…) Wichers M., Psychol Med 2015

Satisfied

1

2

4

3

5

Cheerful

Insecure

Down Suspicious

Depression (n=129)

1

2

4

3

5

Cheerful

Satisfied

Insecure

Down Suspicious

Psychosis (n=263)

Looking through the microscope: real data

Wigman JTW. (…) Wichers M., Psychol Med 2015

Netwerken: andere visie op psychopathologie

Weinig mechanistisch inzicht Statische benadering Geen oplossing voor individuele

verschillen

Traditional approach: Network approach:

Geeft mechanistisch inzicht Neemt dynamiek mee Persoons-specifieke modellen Meer info dan alleen symptomen

Impact van stress

Traditioneel model

Netwerk model

Cramer AOJ. BorsBoom D. (…) Kendler KS 2012. Psychol Medicine

And what about genes?

Wichers, Psychological Medicine 2014

Transdiagnostic approach

Cramer AOJ. (..) Borsboom 2010. Behavioral and Brain Sciences 33, 137-150 Borsboom D. & Cramer AOJ. Annu Rev Clin Psychol. 2013;9:91-121.

Personalized network structures

Towards translation of science to clinical practice

Automatic feedback of project “How nuts are the Dutch”, Peter de Jonge UMCG

Concentration

Cheerfulness

Mental unrest

Self-esteem Worry

My own factor

Stress

Activity

PA low aroual

NA low arousal

PA high arousal

NA high arousal

Stress

Activity

PA low arousal

NA low arousal

PA high arousal

NA high arousal

Personal models

People with same depression score on QIDS and matched on age and seks (in total n=50; HowNutsareDutch data)

Non-anhedonic: PA most strongly influences other network nodes Anhedonic: NA most strongly influences other network nodes

19

2,5

2,0

1,5

1,0

S C L - 9 0 - R

depression scale

0 5 10 15 20 25 30 35

w e e k

Dose reduction week 7-14

Single-case experiment

2,0

1,5

1,0

S C L - 9 0 - R

depression scale

0 5 10 15 20 25 30 35

w e e k

Start of experiment Close to transition

PA= positive affect; SU= suspicious; MU= mental unrest NA= negative affect; WO = worry

Application to eating disorders?

Symptoom dynamiek? Transdiagnostische verbanden? Mechanismen?

stressor

Lage eigenwaarde

somber Sociaal terugtrekken

piekeren

Positief affect

binge moment