Marieke A Helmich1, Marieke Wichers1, Merlijn Olthof2, Guido Strunk3, Benjamin Aas4, Wolfgang Aichhorn4, Günter Schiepek4, Evelien Snippe5. 1. University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen. 2. Behavioural Science Institute, Radboud University. 3. Centre for Complexity Sciences and Entrepreneurship Education, Technical University Dortmund. 4. Institute for Synergetics and Psychotherapy Research, University Hospital for Psychiatry, Psychotherapy and Psychosomatics, Paracelsus Medical University. 5. University Medical Center Groningen.
Abstract
OBJECTIVE: We examined individual overall trajectories of change and the occurrence of sudden gains in daily self-rated problem severity and the relation of these patterns to treatment response. METHOD: Mood disorder patients (N = 329, mean age = 44, 55% women) completed daily self-ratings about the severity of their complaints as a standard part of treatment, using the Therapy Process Questionnaire (TPQ). Per individual, the best-fitting defined (linear, log-linear, 1-step) trajectory was tested for significance: for change over time, and for specificity of the best-fitting trajectory. Two-hundred and three cases had ICD-10 Symptom Rating (ISR) depression scores posttreatment: a score ≤1 identified 114 treatment responders. Relation to response was examined for sudden gains and type of change trajectory. RESULTS: 138 cases (42%) had a significant decrease in problem severity, of which 54 cases (16%) had a defined trajectory: 50 cases with one-step improvement, and 4 with a linear improvement in daily problem severity. Sudden gains occurred in 28% of the total sample, and within 58% of improvement patterns. Specifically, sudden gains occurred in 68% of significant 1-step trajectories and 25% of the linear cases. Sudden gains and nonspecific change trajectories were significantly more frequent for treatment responders. CONCLUSIONS: At the day-level, patterns of improvement are nonlinear for most patients. Sudden gains occur within various forms of overall change and are associated with treatment response. Clinically relevant improvements in depression occur both gradually and abruptly, and this finding allows for the possibility that the remission process functions according to dynamical systems principles. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
OBJECTIVE: We examined individual overall trajectories of change and the occurrence of sudden gains in daily self-rated problem severity and the relation of these patterns to treatment response. METHOD:Mood disorderpatients (N = 329, mean age = 44, 55% women) completed daily self-ratings about the severity of their complaints as a standard part of treatment, using the Therapy Process Questionnaire (TPQ). Per individual, the best-fitting defined (linear, log-linear, 1-step) trajectory was tested for significance: for change over time, and for specificity of the best-fitting trajectory. Two-hundred and three cases had ICD-10 Symptom Rating (ISR) depression scores posttreatment: a score ≤1 identified 114 treatment responders. Relation to response was examined for sudden gains and type of change trajectory. RESULTS: 138 cases (42%) had a significant decrease in problem severity, of which 54 cases (16%) had a defined trajectory: 50 cases with one-step improvement, and 4 with a linear improvement in daily problem severity. Sudden gains occurred in 28% of the total sample, and within 58% of improvement patterns. Specifically, sudden gains occurred in 68% of significant 1-step trajectories and 25% of the linear cases. Sudden gains and nonspecific change trajectories were significantly more frequent for treatment responders. CONCLUSIONS: At the day-level, patterns of improvement are nonlinear for most patients. Sudden gains occur within various forms of overall change and are associated with treatment response. Clinically relevant improvements in depression occur both gradually and abruptly, and this finding allows for the possibility that the remission process functions according to dynamical systems principles. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
Authors: Günter Schiepek; Helmut Schöller; Giulio de Felice; Sune Vork Steffensen; Marie Skaalum Bloch; Clemens Fartacek; Wolfgang Aichhorn; Kathrin Viol Journal: Front Psychol Date: 2020-08-26
Authors: Kathrin Viol; Helmut Schöller; Andreas Kaiser; Clemens Fartacek; Wolfgang Aichhorn; Günter Schiepek Journal: PLoS One Date: 2022-03-11 Impact factor: 3.240