Psychiatric Diagnosis Revisited: Towards a System of Staging and Profiling Combining Nomothetic and Idiographic Parameters of Momentary Mental States
Figure 1
Visual representation of dynamics between mental states with increasing levels of psychopathological severity.
Depicted is a hypothesized circuit between 6 mental states across different stages of severity. The connections represent the impact of one mental state at time point t-1 on another mental state at time-point t. The impact of a mental state on itself from t-1 to t is the intra-mental state connection. In the earliest stage, inter and intra-mental state connections are uniformly weak (top; dotted lines). In the next stage, inter- and intra-mental state connections not only get stronger (middle; solid lines), but there are also more differences between persons with regard to which connections get stronger (person on the left strongest connections on the right side of the circuit, person on the right strongest connections on the left side of the circuit), i.e. there is more profiling. In the most severe stage of psychopathology, mental state connections are growing even stronger (bottom; bold/dotted lines) and more variable across persons. The increased variability in connection strength can be quantified by the random effect from the multilevel random regression model. Thus, staging is represented in this figure by increasing severity of psychopathology, reflected by more powerful connections between mental states impacting on each other, and profiling is represented by the gradual differentiation of syndromes (indicated by different colours) with increasing levels of psychopathological severity. Based on: Epskamp, S., Cramer, A. O. J., Waldorp, L. J., Schmittmann, V. D. & Borsboom, D. (2012). Qgraph: Network visualizations of relationships in psychometric data. Journal of Statistical Software, 48, 1–18.