Category: Comorbidity - Anxiety and Other
Idiographic assessment provides the opportunity to explore variables and functional relations that have been selected to maximize their relevance for an individual (Haynes, Mumma, & Pinson, 2009). The present study developed an individualized questionnaire (IndQ) for an individual with obsessive-compulsive and anxiety symptoms, collected ecological momentary assessment (EMA) data utilizing the IndQ, and subsequently conducted a network analysis of the participant’s symptoms. The participant in this study was an adult diagnosed with Obsessive-Compulsive Disorder, Generalized Anxiety Disorder, and Social Anxiety Disorder. An IndQ was developed based upon standardized measures (i.e., Obsessive Compulsive Inventory, Obsessive Beliefs Questionnaire, Penn State Worry Questionnaire, etc.), semi-structured interviews (e.g., Anxiety Disorder Interview Schedule-5), and transcribed assessment sessions. Final items for the IndQ were selected based upon the participant’s rating of relevance and included cognitions, beliefs, obsessions, compulsions, and emotions. The participant completed the IndQ three times a day (i.e., in the morning, afternoon, and evening) for a total of 100 completed observations. The IndQ was sent electronically and could be completed via smartphone or computer. All items were detrended prior to analyses. A concurrent, bivariate network, composed of a matrix of bivariate, concurrent relations was created to display the relations between the participant’s obsessive-compulsive and anxiety symptoms. Centrality indices (i.e., degree, betweenness, and closeness) were examined. Degree indicates the number of connections a symptom has to other symptoms within a network. Betweenness indices summarize the degree to which a symptom lies on the shortest indirect path between two or more other symptoms (Opsahl, Agneessens, & Skvoretz, 2010), whereas closeness is computed as the sum of the length of the shortest paths between a symptom and all symptoms in a network. Items with the highest betweenness included “I was anxious or nervous” (3.72) and “I repeatedly or excessively washed or cleaned during food preparation” (1.49). “I talked or spent positive time with my wife” (1.41), “I was anxious or nervous” (1.37), and “I found it difficult to touch an object when I knew it had been touched by others” (1.19) had the highest level of closeness. “I talked or spent positive time with my wife” (1.40), “I was anxious or nervous” (1.26), and “I worried about something bad happening to the house” (1.19) had the highest degree. The resulting network displays a network of the participant’s obsessive-compulsive and anxiety symptoms. These results can be utilized to develop a tailored treatment plan targeting specific symptoms and relations within the network.