The Network Structure of Symptoms of the Diagnostic and Statistical Manual of Mental Disorders

Lynn Boschloo, Claudia D van Borkulo, Mijke Rhemtulla, Katherine M Keyes, Denny Borsboom, Robert A Schoevers

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Although current classification systems have greatly contributed to the reliability of psychiatric diagnoses, they ignore the unique role of individual symptoms and, consequently, potentially important information is lost. The network approach, in contrast, assumes that psychopathology results from the causal interplay between psychiatric symptoms and focuses specifically on these symptoms and their complex associations. By using a sophisticated network analysis technique, this study constructed an empirically based network structure of 120 psychiatric symptoms of twelve major DSM-IV diagnoses using cross-sectional data of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC, second wave; N = 34,653). The resulting network demonstrated that symptoms within the same diagnosis showed differential associations and indicated that the strategy of summing symptoms, as in current classification systems, leads to loss of information. In addition, some symptoms showed strong connections with symptoms of other diagnoses, and these specific symptom pairs, which both concerned overlapping and non-overlapping symptoms, may help to explain the comorbidity across diagnoses. Taken together, our findings indicated that psychopathology is very complex and can be more adequately captured by sophisticated network models than current classification systems. The network approach is, therefore, promising in improving our understanding of psychopathology and moving our field forward.

Original languageEnglish
Pages (from-to)e0137621
JournalPLoS ONE
Volume10
Issue number9
DOIs
Publication statusPublished - 2015

Fingerprint

behavior disorders
Psychopathology
Diagnostic and Statistical Manual of Mental Disorders
Psychiatry
national surveys
Mental Disorders
epidemiological studies
Comorbidity
Differential Diagnosis
alcohols
Alcohols
Electric network analysis
methodology

Keywords

  • Affective Symptoms
  • Comorbidity
  • Cross-Sectional Studies
  • Diagnostic and Statistical Manual of Mental Disorders
  • Humans
  • Mental Disorders/classification
  • Psychopathology

Cite this

Boschloo, L., van Borkulo, C. D., Rhemtulla, M., Keyes, K. M., Borsboom, D., & Schoevers, R. A. (2015). The Network Structure of Symptoms of the Diagnostic and Statistical Manual of Mental Disorders. PLoS ONE, 10(9), e0137621. https://doi.org/10.1371/journal.pone.0137621
Boschloo, Lynn ; van Borkulo, Claudia D ; Rhemtulla, Mijke ; Keyes, Katherine M ; Borsboom, Denny ; Schoevers, Robert A. / The Network Structure of Symptoms of the Diagnostic and Statistical Manual of Mental Disorders. In: PLoS ONE. 2015 ; Vol. 10, No. 9. pp. e0137621.
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Boschloo, L, van Borkulo, CD, Rhemtulla, M, Keyes, KM, Borsboom, D & Schoevers, RA 2015, 'The Network Structure of Symptoms of the Diagnostic and Statistical Manual of Mental Disorders' PLoS ONE, vol. 10, no. 9, pp. e0137621. https://doi.org/10.1371/journal.pone.0137621

The Network Structure of Symptoms of the Diagnostic and Statistical Manual of Mental Disorders. / Boschloo, Lynn; van Borkulo, Claudia D; Rhemtulla, Mijke; Keyes, Katherine M; Borsboom, Denny; Schoevers, Robert A.

In: PLoS ONE, Vol. 10, No. 9, 2015, p. e0137621.

Research output: Contribution to JournalArticleAcademicpeer-review

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