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The Mereology of Depression—Networks of Depressive Symptoms during the Course of Psychotherapy

Author

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  • Inken Höller

    (Department of Clinical Psychology, University of Duisburg-Essen, 45141 Essen, Germany
    These authors contributed equally to this work.)

  • Dajana Schreiber

    (Department of Clinical Psychology, University of Duisburg-Essen, 45141 Essen, Germany
    These authors contributed equally to this work.)

  • Fionneke Bos

    (Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University of Groningen, 9700RB Groningen, The Netherlands
    Psychiatric Hospital Mental Health Services Drenthe, Outpatient Clinics, 9401LA Assen, The Netherlands)

  • Thomas Forkmann

    (Department of Clinical Psychology, University of Duisburg-Essen, 45141 Essen, Germany)

  • Tobias Teismann

    (Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, 44787 Bochum, Germany)

  • Jürgen Margraf

    (Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, 44787 Bochum, Germany)

Abstract

(1) Background: Research has shown that it is important to examine depressive symptoms in the light of the mereology (the ratio between one symptom and the whole disorder). The goal of this study was to examine changes in the symptom interrelations of patients undergoing cognitive behavioral therapy treatment (CBT) via network analyses. (2) Method: Outpatients with depressive symptoms ( N = 401) were assessed with the Beck Depression Inventory three times (pretreatment, after 12 sessions, and post-treatment) during CBT. Gaussian graphical models were used to estimate the relationships among symptoms. (3) Results: The severity of depressive symptoms significantly decreased over the course of therapy, but connectivity in the networks significantly increased. Communities of symptoms changed during treatment. The most central and predictable symptom was worthlessness at baseline and after 12 sessions, and loss of energy and self-dislike at post-treatment. (4) Conclusion: The results indicate that the severity of depressive symptoms decreased during cognitive behavior therapy, while network connectivity increased. Furthermore, the associations among symptoms and their centrality changed during the course of therapy. Future studies may investigate individual differences and their impact on the planning of psychotherapeutic treatment.

Suggested Citation

  • Inken Höller & Dajana Schreiber & Fionneke Bos & Thomas Forkmann & Tobias Teismann & Jürgen Margraf, 2022. "The Mereology of Depression—Networks of Depressive Symptoms during the Course of Psychotherapy," IJERPH, MDPI, vol. 19(12), pages 1-13, June.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:12:p:7131-:d:835889
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    References listed on IDEAS

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    1. Epskamp, Sacha & Cramer, Angélique O.J. & Waldorp, Lourens J. & Schmittmann, Verena D. & Borsboom, Denny, 2012. "qgraph: Network Visualizations of Relationships in Psychometric Data," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 48(i04).
    2. Angélique O J Cramer & Claudia D van Borkulo & Erik J Giltay & Han L J van der Maas & Kenneth S Kendler & Marten Scheffer & Denny Borsboom, 2016. "Major Depression as a Complex Dynamic System," PLOS ONE, Public Library of Science, vol. 11(12), pages 1-20, December.
    3. Hudson F Golino & Sacha Epskamp, 2017. "Exploratory graph analysis: A new approach for estimating the number of dimensions in psychological research," PLOS ONE, Public Library of Science, vol. 12(6), pages 1-26, June.
    4. Berend Terluin & Michiel R de Boer & Henrica C W de Vet, 2016. "Differences in Connection Strength between Mental Symptoms Might Be Explained by Differences in Variance: Reanalysis of Network Data Did Not Confirm Staging," PLOS ONE, Public Library of Science, vol. 11(11), pages 1-12, November.
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