Category: Obsessive Compulsive and Related Disorders
A network analysis approach to psychopathology (Borsboom & Cramer, 2013) conceptualizes symptoms as a mutually interacting system. The present study examined indegree and outdegree estimates of an intraindividual network (IIN) of bivariate lead-lag relations in a participant with checking compulsions to tailor treatment for the participant. Indegree estimates the number of edges arriving at a node, i.e., how much information a symptom receives directly from other symptoms in the network. Outdegree estimates the number of edges departing from a node, i.e., how much information a symptom sends directly to other symptoms. The participant was an adult women diagnosed with Obsessive-Compulsive, Generalized Anxiety, and Social Anxiety Disorders who presented with checking compulsions and obsessions related to feared catastrophes happening to her home (e.g., fire, flood, burglary). An individualized questionnaire was completed three times a day (morning, afternoon, and evening) for 100 completed observations prior to cognitive-behavioral treatment. To construct the IIN, all items were detrended. Each symptom at time t was lagged on all other symptoms, including itself, at time t - 1. Bivariate correlations were then utilized to create a lead-lag bivariate IIN of the participant’s symptoms. Symptoms with the highest outdegree were “I checked the front and back door, faucets or pipes, garage door, or stove or appliances” (3.45), “I made a mental check list to make sure things were safe or turned off” (3.16), and “had persistent doubts about whether I really did it and stopped or paused because I did not believe what I was seeing” (1.49). Thus, these checking compulsions and doubting were specifically targeted for treatment. Symptoms with the highest indegree were “I talked or spent positive time with my wife” (2.33), “I checked the front and back door, faucets or pipes, garage door, or stove or appliances” (2.12), “I made a mental check list to make sure things were safe or turned off” (1.82), and “I was anxious speaking with someone” (1.30). These items, with high indegree in the IIN, may be ideal to monitor as idiographic indicators of change. This study contributes to the current literature by providing an example of tailoring cognitive-behavioral treatment based upon individualized ecological momentary assessment and an examination of indegree and outdegree in a lead-lag bivariate intraindividual network. Future studies may examine changes in IINs at various points throughout treatment and post-treatment.