Problems Attract Problems: A Network Perspective on Mental Disorders
Title
Problems Attract Problems: A Network Perspective on Mental Disorders
Author
Cramer, AngéLique O. J.
Borsboom, Denny
Research Area
Psychopathology
Topic
Mental Illness Diagnosis and Treatment
Abstract
What is the nature of mental disorders such as major depression and panic disorder? Are mental disorders analogous to tumors, in that they exist as separate entities somewhere in people's minds? Do mental disorders cause symptoms such as insomnia and fatigue? Until very recently, it was exactly this sort of thinking that (implicitly) permeated many, if not all, research paradigms in clinical psychology and psychiatry. However, in recent years, a novel approach has been advocated (i.e., the network perspective), in which mental disorders are not conceived of as entities that have a separate existence from their respective symptoms. Instead, mental disorders are hypothesized to be networks of symptoms that directly influence one another. So, for example, from a network perspective, insomnia and fatigue are not caused by the same underlying disorder (i.e., major depression) but causally influence one another (i.e., insomnia → fatigue). A disorder, then, develops because of such direct relations between symptoms in which positive feedback mechanisms (i.e., vicious circles) are present: for example, insomnia → fatigue → feelings of guilt → insomnia. These feedback mechanisms may propel the aggravation of one's condition and make a person end up in, for example, a full‐fledged depressive episode. In this contribution, we elaborate on network perspectives on the nature of mental disorders as well as their implications for our outlook on diagnosis and comorbidity.