Example citation

An exploratory analysis of symptom networks in OCD found that negative appraisals of intrusive thoughts were the most central symptoms [@olatunji2019]

Key takeaways

  • OCD sample (n = 150), other primary diagnoses (n = 114), unselected nonclinical sample (n = 310).
  • OCI-R and Obsessional Beliefs Questoinnaire-44
  • Negative appraisals of intrusive thoughts were the most central symptoms: “Having intrusive thoughts means I’m out of control” and “Having nasty thoughts means I am a terrible person”. Hoarding symptoms in the OCI-R peripheral to the network.
  • Do central symptoms predict OCD severity and other clinical variables better than non-central symptoms? They used the top two central compared to the least central symptoms, to predict YBOCS/BDI/STAI values. Very poor prediction of YBOCS (R^2 = 0.03)

Why select other samples than OCD? Because cognitive biases like Intolerance of uncertainty are dimensional constructs present in all individuals to some extent. Including nonclinical participants may aid in constructing the network for OCD.

Network edges, where symptoms (Network nodes) influence each other, can work both via activation (pathological network) and also via deactivation (healthy network). So it might be a good clue as to which symptoms to prioritize in treatment.

The OBQ-44 has three main factors:

  • Responsibility/Threat estimation
  • Perfectionism/certainty
  • Importance/control of thoughts

Methods

Only one item reflecting each construct, otherwise highly correlated items will inflate centrality estimates. See picture below for the ones selected from OCI-R.