Early warning signals and critical transitions in psychopathology: challenges and recommendations

Marieke A Helmich; Merlijn Olthof; Albertine J Oldehinkel; Marieke Wichers; Laura F Bringmann; Arnout C Smit

doi:10.1016/j.copsyc.2021.02.008

Early warning signals and critical transitions in psychopathology: challenges and recommendations

Curr Opin Psychol. 2021 Oct:41:51-58. doi: 10.1016/j.copsyc.2021.02.008. Epub 2021 Feb 23.

Authors

Marieke A Helmich¹, Merlijn Olthof², Albertine J Oldehinkel³, Marieke Wichers³, Laura F Bringmann⁴, Arnout C Smit³

Affiliations

¹ University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), P.O. Box 30.001 (CC72), 9700 RB Groningen, The Netherlands. Electronic address: m.a.helmich@umcg.nl.
² Behavioural Science Institute, Radboud University, Montessorilaan 3, 6525 HR Nijmegen, The Netherlands.
³ University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), P.O. Box 30.001 (CC72), 9700 RB Groningen, The Netherlands.
⁴ University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), P.O. Box 30.001 (CC72), 9700 RB Groningen, The Netherlands; University of Groningen, Faculty of Behavioural and Social Sciences, Department of Psychometrics and Statistics, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands.

PMID: 33774486
DOI: 10.1016/j.copsyc.2021.02.008

Abstract

Empirical evidence is mounting that monitoring momentary experiences for the presence of early warning signals (EWS) may allow for personalized predictions of meaningful symptom shifts in psychopathology. Studies aiming to detect EWS require intensive longitudinal measurement designs that center on individuals undergoing change. We recommend that researchers (1) define criteria for relevant symptom shifts a priori to allow specific hypothesis testing, (2) balance the observation period length and high-frequency measurements with participant burden by testing ambitious designs with pilot studies, and (3) choose variables that are meaningful to their patient group and facilitate replication by others. Thoroughly considered designs are necessary to assess the promise of EWS as a clinical tool to detect, prevent, or encourage impending symptom changes in psychopathology.

Keywords: Critical transitions; Early warning signals; Ecological momentary assessment; Psychopathology; Symptom change.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Humans
Mental Disorders* / diagnosis
Mental Disorders* / therapy