A Network Approach to Studying the Associations Between Posttraumatic Stress Disorder Symptoms and Dissociative Experiences.

In recent years, there has been a growing recognition of a dissociative subtype of posttraumatic stress disorder (D-PTSD), characterized by experiences of depersonalization (DP) and derealization (DR), among individuals with PTSD. Little is known, however, about how experiences of DP and/or DR are associated with the experience of other PTSD symptoms. The central aim of the present paper was to explore the associations among DP, DR, and other PTSD symptoms by means of a network analysis of cross-sectional data for 557 participants whose overall self-reported PTSD symptom severity warranted a probable PTSD diagnosis. Three notable findings emerged: (a) a strong association between DP and DR, (b) the identification of DP as the most central symptom in the network, and (c) the discovery that clusters of symptoms in the network were roughly consistent with DSM-5 PTSD criteria. We discuss these findings in light of some considerations, including the nature of our sample and the limits of interpreting cross-sectional network models.

Are Retrospective Assessments Means of People's Experiences?: Accounting for Interpersonal and Intrapersonal Variability when Comparing Retrospective Assessment Data to Ecological Momentary Assessment Data.

Retrospective Assessment (RA) scores are often found to be higher than the mean of Ecological Momentary Assessment (EMA) scores about a concurrent period. This difference is generally interpreted as bias towards salient experiences in RA. During RA participants are often asked to summarize their experiences in unspecific terms, leaving room for personal interpretation. As a result, participants may use various strategies to summarize their experiences. In this study, we reanalyzed an existing dataset (N = 92) using a repeated N = 1 approach. We assessed for each participant whether it was likely that their RA score was an approximation of the mean of their experiences as captured by their EMA scores. We found considerable interpersonal differences in the difference between EMA scores and RA scores, as well as some extreme cases. Furthermore, for a considerable part of the sample (n = 46 for positive affect, n = 56 for negative affect), we did not reject the null hypothesis that their RA score represented the mean of their experiences as captured by their EMA scores. We conclude that in its current unspecific form RA may facilitate bias, although not for everyone. Future studies may determine whether differences between RA and EMA are mitigated using more specific forms of RA, while acknowledging interindividual differences.

A Review of Explicit and Implicit Assumptions When Providing Personalized Feedback Based on Self-Report EMA Data.

Ecological Momentary Assessment (EMA) in which participants report on their moment-to-moment experiences in their natural environment, is a hot topic. An emerging field in clinical psychology based on either EMA, or what we term Ecological Retrospective Assessment (ERA) as it requires retrospectivity, is the field of personalized feedback. In this field, EMA/ERA-data-driven summaries are presented to participants with the goal of promoting their insight in their experiences. Underlying this procedure are some fundamental assumptions about (i) the relation between true moment-to-moment experiences and retrospective evaluations of those experiences, (ii) the translation of these experiences and evaluations to different types of data, (iii) the comparison of these different types of data, and (iv) the impact of a summary of moment-to-moment experiences on retrospective evaluations of those experiences. We argue that these assumptions deserve further exploration, in order to create a strong evidence-based foundation for the personalized feedback procedure.

Deconstructing and Reconstructing Resilience: A Dynamic Network Approach.

Resilience is still often viewed as a unitary personality construct that, as a kind of antinosological entity, protects individuals against stress-related mental problems. However, increasing evidence indicates that maintaining mental health in the face of adversity results from complex and dynamic processes of adaptation to stressors that involve the activation of several separable protective factors. Such resilience factors can reside at biological, psychological, and social levels and may include stable predispositions (such as genotype or personality traits) and malleable properties, skills, capacities, or external circumstances (such as gene-expression patterns, emotion-regulation abilities, appraisal styles, or social support). We abandon the notion of resilience as an entity here. Starting from a conceptualization of psychiatric disorders as dynamic networks of interacting symptoms that may be driven by stressors into stable maladaptive states of disease, we deconstruct the maintenance of mental health during stressor exposure into time-variant dampening influences of resilience factors onto these symptom networks. Resilience factors are separate additional network nodes that weaken symptom-symptom interconnections or symptom autoconnections, thereby preventing maladaptive system transitions. We argue that these hybrid symptom-and-resilience-factor networks provide a promising new way of unraveling the complex dynamics of mental health.